Vox on nursing as the empathy-oriented job of the future
An engaging Vox video from late 2017 argues that men should overcome regressive gender notions and enter nursing, which it calls the “robot-proof” “job of the future.” But the video itself reinforces the gendered angel stereotype that nursing is all about “caring and empathy,” ignoring the advanced scientific skills and critical judgments that modern nursing requires.
November 27, 2017 – Today the popular news site Vox posted the third part of its future-of-work video series “Shift Change,” a look at nursing entitled “The robot-proof job men aren’t taking.” Reporter Liz Scheltens argues that nursing is among the jobs least likely to succumb to automation because it is all about human relationships. Yet nursing remains overwhelmingly female, she notes, so men should wake up and consider the profession, particularly since the aging population has increased demand for nurses. The video shows how gender assumptions in society and the media have kept nursing mostly female, exacerbating shortages and leaving men who have lost their traditionally “male” jobs in fields like manufacturing unwilling to take available nursing jobs. The segment also explains that despite the advent of so-called “robot nurses,” robots are unlikely to replace nurses and others whose jobs involve emotional skills. But the video makers don’t seem to know that “caring and empathy” are only part of nursing. The profession also requires qualities traditionally considered to be “male” ones: scientific expertise, technological aptitude, advocacy skills, and toughness. Robots will have trouble assuming many of those nursing roles, not just displaying empathy. And ignoring those qualities in service of the “nurturing” narrative itself reflects the gendered angel stereotype. People of all genders need to know that nursing requires intellect, strength, and people skills. Nurses don’t just provide comfort; they save lives. Low awareness of that fact is a big reason the profession remains underpowered and understaffed. We thank Vox for the helpful information about men in nursing, but the profession should be portrayed as one that requires scientific expertise and advanced clinical skills.
Caring, empathy, and…?
The piece’s subhead summarizes its message: “Nursing is the job of the future. Why is its workforce still 90 percent female?” The introductory text says that although it may seem that future work will be about technology, the jobs least likely to be displaced by automation involve “building human relationships.” For example, health care jobs like nursing will be in demand and offer good salaries, but they remain “dominated by women,” even though many traditionally male jobs are disappearing, because of an enduring perception that they are “women’s work.” Men in nursing counter that “caring and empathy” are skills that men can and should develop.
The nine-minute video expands on these basic ideas. Scheltens notes that U.S. Bureau of Labor Statistics (BLS) projections show that the jobs expected to grow the most from 2016-2026 include nursing and other health care work. Then she graphs that growth against the annual salaries of the jobs and identifies “a clear winner: nursing.” But nursing remains among the most gender-segregated fields, with about one man for every nine women.
Scheltens explores why nursing will likely resist technological displacement. She notes that “scientists have enlisted the help of robots” that “can lift and move patients, take vital signs, deliver medication, and even make scheduling and assignment decisions,” “but contrary to the doomsday headlines” suggesting the robots will solve the nursing shortage, “there is little chance these machines will replace human nurses any time soon.” The video describes a 2013 University of Oxford study on jobs susceptible to automation in the next two decades. The researchers used a risk scale ranging from 0 (least susceptible) to 100% (most). On the fortunate end of the scale were jobs requiring “creativity” (composers: 1.5%), “expert perception and manipulation” (surgeons: .04%), or “high degrees of social intelligence” (elementary school teachers: .04%). Predications were worse for jobs where those skills are less key (telemarketers: 99%). Nursing was one of the least vulnerable of the 700+ jobs studied, at .9%. Scheltens says that “when you watch nurses in action, it’s easy to see why: the ability to build trust, to connect; it’s what makes nursing immune from automation.” Meanwhile, the background music is soft, gentle – evidently nursing is all about comfort and emotion, not science, thinking, or excitement.
Since that’s totally wrong, it is apparently not easy at all to see what nursing is about! The video makers apparently didn’t get the health knowledge and critical thinking underlying what Scheltens was seeing as nurses interacted with patients and families. In fact, nursing requires all of the skills Scheltens sees at the high end of the scale, not just the emotional / social ones.
The video goes on to say that this human element has long kept men out of nursing. We see an Archie McFee Male Nurse Action Figure (a longtime favorite of ours, despite the unhelpful phrase “male nurse”). Then, Bill Lecher of Cincinnati Children’s Hospital appears on the video in a business suit, observing that jokes about men in nursing always hurt a little, and we see clips of characters showing contempt for men in nursing from the film Meet the Parents and the TV show Friends. The video includes no credential for Lecher, not even as a nurse. In fact, Lecher appears to have a DNP, MBA, and MS, and to be “senior clinical director,” supervising hundreds of staff. But maybe mentioning any of that stuff would seem too traditionally “male.”
Then the video traces the idea that nursing is a woman’s job to the 1850’s, basically blaming it on English nurse Florence Nightingale, who cared for sick soldiers in the Crimean War. Overcoming male physician resistance, it notes, Nightingale imposed strict sanitary and dietary guidelines, and fewer patients died of preventable diseases – a curiously indirect way of saying she saved many lives, as if it was most important not to over-credit her for something like that. Likewise, the video fails to say that she founded modern nursing. Instead, we learn that after the war, “Nightingale-inspired nursing schools” appeared all over the world teaching her methods. Nurses don’t achieve; things just happen. The piece concedes that nursing gave women a chance to develop an identity outside the home despite everything they were being told.
But Nightingale was no feminist. She saw nursing as a natural extension of what it meant to be a woman. According to Nightingale, women had a natural capacity for caring. Men did not. They couldn’t attend Nightingale’s nursing schools, which blocked them from the profession. But the thing is, before Nightingale’s reforms, men had a long history as nurses.
Scheltens notes that monks had cared for the poor and sick in Europe for centuries. And men served as nurses in the U.S. Civil War, including the poet Walt Whitman. A quote from his poem The Wound Dresser describes soothing the wounded, which fits with the piece’s hand-holding vision of nursing. Fifty years later, Scheltens notes, the U.S. Army Nurse Corps was all female.
It seems fair to say that Nightingale’s views were a key factor in the unjust exclusion of men from nursing during this early period, but not to flatly declare that she, who did so much to advance women’s status despite fierce male resistance, was “no feminist.” Her 19th Century vision was certainly not helpful to men who wanted to be nurses, and defining nurturing qualities as inherently female does not help women either in the end. But her work was still of historic importance in helping women find a path out of domestic servitude, dependence, and oppression. It also seems unfair to assign Nightingale all the blame for the social view that nursing is feminine work over the ensuing years. It’s not clear that the profession could have been established to the extent it was had she proposed that men and women work side by side in such difficult conditions. And surely to a significant degree her vision of women’s innate qualities reflected her society’s limited views, then and now, for reasons that go well beyond nursing. Nightingale did not singlehandedly create and sustain the sense that women are the nurturers.
By the time men could legally join the profession in the 1950s, the video continues, “nursing had become synonymous with femininity, a link that was reinforced by advertising, mass media, and popular culture, which in turn affected how we raised our children. They absorbed the idea that men and women were born with certain personality traits, which made them better suited to certain jobs.” We see a children’s book informing us that “boys are doctors” and “girls are nurses.” But we know now, the video says, that these traits are not innate but “largely a product of our environment.” We see a clip of Marci Cottingham, a sociologist at the University of Amsterdam, who notes that boys are socialized to be more stoic and less emotional. So, the video concludes, a job that requires emotional connection, like nursing, is assuming to be beyond men. The Cincinnati nurse Lecher recounts how his daughter’s 5-year-old friends once said he could not be a nurse because he was not her mom. Nurse Garret Chunn says he got a sense as a child that nurses were “nurturing” and that men could not be. And several men in nursing appear in YouTube videos recounting comments they’ve heard from members of the public to the effect that they must be doctors, or asking why they are not; did they fail med school?
Scheltens notes that some other health jobs also have gender imbalances despite high projected demand and higher-than-average salaries, mentioning genetic counselors, physical therapists, and physician’s assistants. Meanwhile, the economy is shedding jobs in fields traditionally associated with men, like manufacturing, and the male employment participation rate has been falling in recent decades, according to BLS data. Scheltens: “Our long-held beliefs about gender are clashing with a new economic reality, one in which emotional intelligence is vital.”
The video describes recent campaigns to attract men to nursing. Cottingham notes that many of these rely on the same gender stereotypes that have kept men out of nursing, emphasizing “stoicism,” “athleticism,” and macho attributes rather than nurturing. She asks whether nursing should change—“or should we expect men to change”? Nurse Guy Beck of Cincinnati Children’s says it takes a while to reconcile manliness and nursing, but now he thinks caring is the most masculine thing. Scheltens concludes: “Caring, empathy, and trust are human strategic advantages over robots. And those skills don’t belong to one gender. They’re like a muscle. The more we build that muscle, the better prepared we’ll be for whatever the future holds.”
This video does a good job exploring some key stereotypes about men in nursing, including the wannabe physician, and how they have been shaped in particular by the media, a factor that is insufficiently recognized. The video also shows how these views have deprived society of needed nurses and kept men from entering nursing, even when many traditionally “male” jobs have been displaced by automation. The piece focuses closely on the notion that men can’t do nursing because they lack innate empathy, and it may not make enough of the enduring sense that men shouldn’t do nursing because it is associated with femininity, and because of gender fear and insecurity, which is probably a more powerful factor. In any case, the video is also good to some extent in making the point that robots can’t replace nurses, underlining the importance of caring and empathy – suggesting these qualities are not dispensable, even though they have traditionally been associated with women. It is important to recognize, as the video does, that these psychosocial skills are valuable and not something just anyone can do.
Unfortunately, the video relies heavily on the same gendered stereotypes that have harmed the profession, strongly suggesting that nurses are just empathetic handholders. In fact, nursing includes plenty of aspects traditionally associated with men—it requires advanced scientific knowledge, critical thinking, clinical expertise, and the ability to educate and advocate. But no would dream, based on this video, that nursing means working with advanced technology or that hundreds of thousands of nurses have graduate degrees in nursing. In fact, the video doesn’t mention that nurses need to go to college at all, and nowhere does it state the educational credentials of the nurses who appear, even though Lecher has a doctorate. This emotional conception of the profession has been a key underlying cause of the long-term nursing shortage, more so than the aging population, which was not such a big issue 20 years ago when the current shortage began. The video makers seem unaware that nurses have struggled with short-staffing linked not just to a lack of available nurses but to managerial decisions to employ too few skilled nurses and to replace them with cheaper assistive personnel. Those decisions are to a great extent the result of the same assumptions that Vox seems to make, that nursing is nice but does not make the difference between life and death. The sense that “caring and empathy” define the profession has not been helpful in an era of ruthless cost-cutting. The world needs more nurses. Whether it’s willing to pay for them is unclear. But attracting more men to the work would help.
Special Bonus commentary from a man in nursing!
For some insightful further analysis on the Vox piece from a man in nursing, see the commentary that Elton Joe posted on the Vox site’s comment thread. We repost it here with his permission:
Thank you for telling the truth about why there are so few men in nursing–Florence Nightingale founded modern nursing as a female-only field, and for decades, those women who held power in nursing discriminated against men, to the detriment of our entire society. Those days are past us, but the legacy of stereotypes about nursing remain. One of those stereotypes, which this video doesn’t do enough to dispel, is that nursing is a job that only requires caring and empathy to perform. In order to become a registered nurse, one must meet rigorous academic and ethical standards, as well as obtain a college education and license to perform highly scientific, technical work. Nurses are at the bedside with the patient 24 hours a day, and must efficiently perform and prioritize tasks, make life-or-death decisions, be vigilant about subtle changes in the patient’s condition, and communicate in a way that is culturally sensitive and at the appropriate level of understanding with patients, their families, physicians, pharmacists, therapists, technicians, managers, and all other members of the healthcare team. All while making sure everything we do is correctly documented and within our legal scope of practice and code of ethics.
The practice of nursing requires not only sensitivity and smarts, but strength and stamina–both physical and emotional. It takes enormous patience to take care of patients. Nurses do much more than empathize and hold hands. We save lives, too.
But even though nurses play one of the most vital roles in society, nursing as a profession receives much less funding, attention, and respect than medicine. Most people aren’t even aware that nursing is a different discipline than medicine. Most men aren’t told that nursing is even a possibility for them as a career field. High-achieving young people interested in chemistry and biology are pushed towards medicine, biochem engineering, and other fields more commonly seen as scientific, technical, challenging, prestigious, and well-paid. Nursing is rarely presented as a prestigious profession. It is often seen as a very low-class, low-wage job. Combined with the stereotypes of nursing as women’s work, it’s no wonder relatively few men consider nursing as a profession.
This video talks about the stereotypes holding men back from entering nursing, but it doesn’t do enough to dispel those stereotypes and present a modern, realistic view of nursing as a profession.
I’ve realized more and more that the problem is not simply that nurses aren’t respected, but that the public still doesn’t even understand what we do. Patients and their family members often ask me if I’m a student or in training (I guess the implication is that nurses are junior physicians or studying to become physicians someday). They see it as a compliment to say that you could or should go to medical school someday. They still don’t understand that nurses’ command structure is not “under” physicians and we do not work “for” physicians.
I am currently a Trauma/Surgical/Cardiovascular ICU registered nurse in Little Rock, Arkansas. I save people’s lives for a living.