To Men in Nursing: Consider Your Privilege


I want to talk about men in nursing and privilege. I expect it will be a difficult, nuanced dialogue, but it’s an important one, and one particularly relevant to nursing, a profession so entwined with the ideals of egalitarianism, advocacy and feminism.

Before I begin, I want to clarify: I do not want to challenge the presence of men in our profession, their growth in numbers, their competency, or their intentions. I do want to challenge men in our profession to challenge themselves to analyze their privilege, and I want to challenge men in our profession who have already done this work to challenge others to do the same. Specifically, I want to challenge male nursing groups, particularly NYC Men in Nursing and the American Association of Men in Nursing, that provide networking and career opportunities for their mostly male members. Broadly, I want to challenge all male nurses who use their privilege, inadvertently or purposefully, to get higher positions and higher pay.

I identify as an intersectional feminist. Intersectionality is a term used by modern feminists to define the multiple identities that are subject to systems of oppression. An intersectional feminist holds that arguing against sexism is logically and ethically invalid if you do not also rally against racism, classism, homophobia, transphobia, queerphobia, ableism, ageism and religious discrimination in our society. Intersectional feminists work hard to examine their own identities of privilege (I, for example, am white, able-bodied, cisgendered and educated) and how they have benefitted us, and work to dismantle the systems that bolster that privilege. Intersectional feminists “call people in” instead of calling them out.

I often discuss experiences of discrimination in the workplace with other non-male identifying feminists, and through these conversations, I learned I am very lucky to be a nurse. Compared to tech or the restaurant service industry, for example, nursing is a feminist dreamland. Most men I have met in nursing have been respectful and compassionate. Disappointingly, however, only a few have demonstrated a deep understanding of the privilege they enjoy, both in our profession and society at large, due to their gender. Male nurses have great capacity to be intersectional feminists, but because they do not bear the brunt of gender inequality, it takes more work for them to recognize it than it does for women, and because it’s hard to say no to a leg up, it takes more self-sacrifice to shun its benefits.

As an intersectional feminist, I empathize with the position of men as a minority in an industry. They comprise only about 10% of nurses. Male nurses have historically been made fun of for being feminine (I’ve seen the movie Meet the Parents), which I’m sure can be hard for some men. Male-identifying nurses who are gay or queer suffer homophobia in the workplace. Our black male nurses come from identities that have higher rates of imprisonment, police brutality and death by homicide. Men are also more likely to be mistaken for doctors, according to one male classmate of mine, for whom I played my well-worn miniature violin. Seriously, though, I empathize with all of this and readily acknowledge that some identities men have (race, disability, sexuality) put them at higher risk for discrimination than some women. I even empathize with the doctor comment, but mostly just because I am proud to be a nurse. 

But we must remember, a minority population is not always a victimized one. Male nurses are more likely to hold advanced practice positions, and they earn more money than female nurses in comparable positions with comparable accreditation and experience. Men are less likely to be the recipient of sexual harassment from a patient or coworker. Men are less likely to be demeaned and ignored as professionals by MDs and other team members. Men are promoted faster and more often. Ultimately, the privilege men, particularly white men, still have within our profession is difficult to reconcile, and to me, despite my empathy, trumps their minority status.

As a student at NYU, the most active group at my school was Men Entering Nursing. Despite their good intentions, I could not shake my philosophical argument with the group. I keep coming back to one analogy:

Imagine that we had a student interest group for white students. Imagine that the group for white students became the most active group in the school. The group hosted events with all white presenters. The professor leading the group was friendly and available and helped you find jobs and study for tests. The group had a strong affiliation with the citywide white group, which provided excellent career guidance and networking opportunities. Of course, non-white students would be allowed as well, if they wanted to join the group and enjoy its networking and academic benefits. Some non-white students even sat on the e-board, but most avoided joining because they had enough on their plate trying to address non-white issues. To top it all off, one month after the election of Donald Trump, all the white students in the school (even if they weren’t Whites in Nursing members) were asked to gather after the last exam before graduation in their scrubs and take a group photo, and no one questioned it at all.

Even if white people only comprised 10% of the student and professional population, this would be inappropriate. I am a white person, and I would do everything I could to reduce this group’s influence at the university, or I would try to funnel the momentum of the group toward events and dialogue focused on privilege analysis. This is what I suggest men in nursing do in the future. 

This is my perspective, but I am open to others. I am open to being called wrong and being corrected. I am open to dialogue. Please share your ideas.

Jillian Primiano, RN, BSN, recently graduated from NYU Rory Meyers College of Nursing, where as a student, she worked with the Hartford Institute of Geriatric Nursing to develop education for geriatric care providers and improve health outcomes for older adults. Before earning her nursing degree, she studied History and Journalism at Boston University with a focus on Cold War anti-war activism, feminism and the Civil Rights Movement. After her first stint in college, she spent three years teaching English, American Studies and International Relations at An Giang University in Vietnam’s Mekong Delta, where she learned about her privilege in ways she could never have imagined.

The Power of Ten!


Sigma Theta Tau has now published the 2nd Edition of the book “The Power of Ten,” a book of essays by nursing leaders that address ten top issues for nurses to rally around for the next few years.  These issues were identified prior to the results of the 2016 election, and now they are issues of increasing importance!  The essays provide ideas and inspiration for actions to strengthen nursing’s focus and activism.  The issues are:

  1. Educational Reform
  2. Academic Progression
  3. Diversity
  4. Interprofessional collaboration
  5. Systems thinking
  6. Voice of Nursing
  7. Global Stewardship
  8. Practice authority
  9. Delivery of care
  10. Professional handoff

This is an important resource for all nurses who are determined to act on the fundamental values of nursing.  The essays are a follow-up to the 2012 “Future of Nursing” report; the issues dovetail with the four recommendations of the report, and sine a light on the actions that nurses can take now to bring a culture of health to the center in shaping the future of nursing and healthcare.  The essays are short and to the point, and there are inspirational quotes from nursing leaders throughout that point the way forward.

Check it out! The book is available in several different formats directly from Sigma Theta Tau or from Amazon.  All proceeds from the book are being donated in equal parts to the American Red Cross nursing programs and the American Nurses Foundation.

The Call for Community, Art, and Artists in the Resistance Movement


This week, members of the Nurse Manifest Team gathered together by the warmth of our computer screens for engaging video conference. We took the time to welcome some new members and talk about the future of the movement. I have to say for me, being with like minded #NurseResisters was so energizing (even though I have been suffering through a bout of the flu this week!) and also very comforting.

It’s important for #NurseResisters to remember we are not alone and to gather those around us during these challenging times: when change seems to be happening at a rapid pace, when social media pages are filled with what resisters might find to be concerning or bad governmental news, when there are 10 things you would like to take action on, but you can’t be on the phone all day….it can become easy to become discouraged, overwhelmed, or burned out. This is where truly being with a like minded community can lift your spirits and buoy your endurance.

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And endurance is what we will need. I know right now it sometimes feel like a sprint…get out there and get things done now, get to this march, make your signs, write your emails and postcards, get on the phone….because the administration has been creating changes at a rapid pace, the media and social media have been bumping up our energy, and we feel drawn to create change now.

The thing is, this is not a sprint and it’s not a solo race…it’s more like a team based marathon or ultra-marathon, and it is going to take teams of like minded community members to both participate in and complete the race.

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Individual Sprint

Versus

Team Marathon

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We need to carry lights, march together through the dark night with our nightingale lamps, and strive toward unity. There is no clear finish line, and no medals for winners, second, and third place. There is a beautiful planet and population of people that need caring for and this endurance test is in part about not giving up that vision of a caring, compassionate, kind, peaceful, unified, and spirit filled world.

I suggest other #NurseResisters start gathering with your communities in real life or as we did last week, in real time via video or phone conferencing. Set aside thoughtful, meaningful time to be together, to discuss future actions, and also to just support one another, to laugh together, to share your stories. Communities can rejuvenate and recharge us, and they are a must for folks who plan to run the long race.

I also did want to share that part of our discussion last week focused on the use of humor, satire, parody, art, and music to support and gather people together. Saturday Night live is becoming a great example of the power of humor, parody, and satire to help us lighten our load, to help us rejuvenate, to connect us across time and space.

 

 

While there are many older political songs we can use (Carol King just re-released One Small Voice with free download!: https://soundcloud.com/user-844282824/one-small-voice), it remains imperative that we also create new art and new music that reflects our current siutation here, now in 2017. Until then, let’s be strong together:

“One small voice speaking out in honesty
Silenced, but not for long
One small voice speaking with the values
we were taught as children
Tell the truth
You can change the world
But you’d better be strong”

(Carole King/ copyright Rockingdale Records).

 

Have you ever considered being on a Board?


Here at the NurseManifest project, we have tended to emphasize grass roots, “on the street” kinds of activism to bring our deepest nursing values into everyday experience.  But manifesting nursing values needs to happen everywhere, and one of the spheres whereconference-table this is vitally important is in the Board Rooms, large and small.  Lisa Sundean, who is one of our NurseManifest bloggers, is embarking on her dissertation project to explore nurses on Boards, and in the interest of sharing her work wide and far, she has established website and blog – SundeanRN.org!  Her first blog post is now available, explaining why this is vitally important!  I highly recommend that you read her post: What do Boards Have to do with Nursing?  And if you have never considered serving in this capacity, think about it now!  We need to be manifesting nursing everywhere – at the bedside, the chairside, the curbside, and yes, the board side!

Sociopolitical Knowing: Connecting with hearts, minds, guts, and groins


[Edited 8/6/16] At a time when many are celebrating the official nomination of Hillary Rodham Clinton I am also acutely aware that many are not. While there are many valid concerns that have been raised, what troubles me most is to hear the contempt and disbelief that anyone could support Trump. It concerns me because it reflects a de-humanizing and de-valuing of many in the white working class.

We expect that our students and coworkers will be sensitive to the values and personal goals our patients and their families. We expect nurses to be non-judgemental towards patients who are living in poverty, suffering from addictions, or making decisions that do not seem based in upper-middle class norms and values. Can we also expect nurses to develop an understanding of how to be respectful and understand what is important to people with different political views. 

Sociopolitical Knowing is a core strength of professional nursing. Conceptualized by Jill White in 1995, sociopolitical knowing occurs on two levels:

1) the sociopolitical context of the persons (nurse and patient), and 2) the sociopolitical context of nursing as a practice profession, including both society’s understanding of nursing and nursing’s understanding of society and its politics. [emphasis added]

To start the dialogue, I am circling back to the Spiral Dynamics model that was used to organize the sociopolitical context of nursing in the published Results from the Nurse Manifest 2003 Study: Nurses’ Perspectives on Nursing.

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Basics principles of leadership and motivation according to Spiral Dynamics:

  1. identify the specific needs and capacities of individuals and groups, and
  2. calibrate the precise developmental messages that fit each unique situation.

Sociopolitical knowing requires an understanding of how to connect with and motivate people where they are. It means developing an understanding of what messages will be most effective in “pushing someone’s buttons” or eliciting a strong emotional response. The table below highlights the most prevalent value memes in modern society – defined through worldview, core values, and value-based reasons for violence and war. 

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How Trump connects: From sexual innuendos and vulgar speech to stoking conspiracy theories and racist viewpoints, Trump often makes his connection with people’s minds, guts, and testicles. He has effectively tapped into pent-up frustrations and fears, justifying aggression and intolerance to make America “great again” (red and orange) and “safe again” (blue and green). 

How Clinton connects: From It Takes a Village to Hard Choices, Clinton has a long history of speaking to people’s hearts, minds, and ovaries. She has effectively tapped into national pride and hope, focusing on accomplishments that make America “great right now” (red and orange) and safer through unity and tolerance (blue and green). 

Both campaigns employ messaging that is strategically targeted at different audiences. The point of this blog entry was not to start a political debate — this is not the place for that. Rather, I am hoping to start a conversation about understanding how we might apply sociopolitical knowing to strengthen our ability to communicate with others. I hope that through application of sociopolitical knowing we can better connect with different communities about the work of nursing, and issues that impact the patient populations and communities we serve.

Please help build the dialogue around sociopolitical knowing, through comments here, and conversations with your coworkers, family, and friends. 

References for further reading:

Beck, D. E. Human Capacities in the Integral Age: How Value Systems Shape Organizational Productivity, National Prosperity and Global Transformation

Charen, M. What Hillbilly Elegy Reveals About Trump and America: A harrowing portrait of the plight of the white working class. National Review, July 28, 2016.

Harryman, W. Is Hillary Clinton the First Integral Politician? Integral Options Cafe, November 6, 2005.

Jarrín, O. F. Results from the Nurse Manifest 2003 Study: Nurses’ Perspectives on Nursing. Advances in Nursing Science, 29(2), E74-E85.

Pew Research Center. Few Clinton, Trump Supporters Have Close Friends on the Other Side. August 3, 2016.

Schwartzbach, S. M. Drowned: Nurses Under Water. The Nurse Sonja. July 27, 2016.

Vance, J. D. Hillbilly Elegy: A Memoir of a Family and Culture in Crisis. 2016; HarperCollins: New York, NY. 

White, J. Patterns of knowing: review, critique, and update. ANS Adv Nurs Sci. 1995 Jun;17(4):73-86.