October 31, 2020

Establishing Professional Identity as Men in Nursing

Throughout the years, patients and their families have mistaken non-physician health care professionals (HCPs) for physicians. In this post, I relate my own experience with this misidentification and consider how men in nursing may establish a professional identity without ambiguity.

It’s no secret among HCPs that the majority of the American public exhibits some degree of illiteracy in the areas of health and health care. As our nation’s health care system becomes increasingly complex and increasingly reliant on technological interventions, HCPs are hard-pressed to provide their services to patients in such a way as to enable patients to make informed decisions. In light of this, it’s no wonder that misidentification of HCPs may occur.

Beyond patient health care illiteracy, there is the possibility that HCP misidentification may be the result of latent presuppositions concerning the nature of the health care workforce. Various professions within health care have developed with specific educational, licensing, and certification requirements. For many reasons, the physician workforce has been composed predominantly of men, whereas nurses have been predominantly women. These lopsided workforce distributions have been engineered socially, whether intentionally or not, so that patients and their families have developed expectations governing their interactions with HCPs. Consistent with these expectations, older male physicians are thought to be most competent, and women in health care are assumed to be nurses.

In addition to these gender-related assumptions, there are also assumptions related to HCP behavior and roles. Higher educational attainment, authoritative speech, and methodical activity may be assumed to belong to physicians, it seems. Physician extenders, such as physician’s assistants and nurse practitioners, are often assumed to be physicians because of the nature of their interactions with patients. As an aside, it’s worth noting that these and similar assumptions are likely in play during debates over the scope of practice of advanced practice nurses.

In my experience, many patients look for patterns of behavior in HCPs that exemplify or merit leadership roles. As a nurse, I am frequently mistaken for a physician by patients and their families. Often when I enter a patient’s room, the patient quickly ends a phone call by stating that his/her “doctor” has arrived. In other cases, if I’m asked by another nurse for assistance, the patient and family seem to assume that the nurse requesting help is calling a physician to the patient’s room. Patients have often asked me directly whether or not I’m a physician. Some combination of these and other scenarios takes place several times each week, despite the facts that my ID badge designates me an RN and that the color of my scrubs is identical to every other nurse’s.

In the interest of full disclosure, I know that I’m only one nurse among many and that my professional background is relatively rare among nurses. Also, I haven’t studied this phenomenon systematically. In fact, my conclusions in this area have been arrived at inductively. However, I think I’m not far off the mark in suspecting that the reasons for my misidentification as a physician include my maleness, my apparent age (complete with salt-and-pepper hair), my comfort level with medical terminology and physiology, and my organizational behavior.

Because of the predominance of women in nursing, I believe men in nursing are more likely than women to be misidentified as physicians. Given that, how should men establish their professional identity as nurses?

  1. Cast a vision and develop a mission. Know who you are, why you’re a nurse, and where you’re going in your career. Build your career on this foundation.
  2. Practice with integrity. As a man in nursing, be both competent and confident in your nursing skill set.
  3. Fully embrace your role in health care, knowing that, whether or not you are correctly identified as a nurse, you will provide the highest quality care in your power.
  4. Practice the Golden Rule by treating other HCPs as you would have them treat you. Be genuine in building others up and fostering excellence in others.
  5. Exemplify what some have called organizational citizenship behavior. Be an aggregator of information, an establishor of relationships, a connector of resources, and a developer of innovations.
  6. Be consistent but flexible. Let what is excellent and praiseworthy in your personality show through in your practice. Others will come to rely on you while trusting you to lead. This will induce loyalty to your personal brand.

These are just a few suggestions I’ve tried to implement in my own nursing practice. One might say these aren’t specifically suited to men more than women, and that’s as it should be. However, men in nursing may be poised to implement these suggestions to more noticeable effect, given their relative minority status in the field.

What else would you add to this list?

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