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Could shortage-driven migration change nursing's gender gap?

August 23, 2005 -- Today the New Kerala web site posted an interesting unsigned piece about the apparent surge in interest in nursing among the men in the Indian state of Kerala. The story, "Kerala male nurses storm traditional female bastion," suggests that local males are being lured by the "[l]ucrative nursing options" overseas, with 20% of current Indian nursing school graduates going abroad. The piece is very positive about nursing, noting its intellectual components and at times sounding more like a recruitment ad in discussing how interesting and fulfilling the profession is. The piece does not explain exactly what nurses do to save lives and improve outcomes. And it seems oblivious of the larger context of the nursing shortage, and the effect this talent drain is having on health care in India. But the piece does--without seeming to realize it--raise the question of whether the huge pay differentials and transnational migration stemming from the shortage could alter the profession's gender makeup, potentially helping to empower the profession and ease the shortage.

The story asserts that the "trickle of male nurses" in past decades in Kerala "now seems to have become a deluge." It attributes this change to the relatively high-paying jobs available in the U.S., Europe and the Gulf nations. The piece cites the principal of one of the local nurse "training institutes," Chandrakanti Amma, as saying that the number of males entering the profession is now growing by nearly 10% per year. It reports that a recent survey found that 13% of Indian nursing students are now male. Amma notes: "Even boys with high marks in physics, chemistry and biology, even those who secured over 90% marks are giving the first preference to BSc (Bachelor of Science) Nursing." The piece says that female Indian nurses have "always been admired" for their "diligence" and "compassionate nature," but suggests that the "huge amount of physical labour" in hospitals today has contributed to the demand for male nurses, noting that male nurses are often asked to lift patients, help incapacitated ones, and move heavy equipment. The piece reports that the current global shortage of 300,000 nurses is expected to grow to "over 800,000 in the next 15-20 years." It also suggests that although developing nations have greater nursing needs today, demand in the U.S. is "most awesome." It asserts, without citation, that another factor in the demand for male nurses is that "usually most male patients demand a male nurse."

At a couple points, the piece switches into infomercial mode, stating that nursing is "of course more interesting than other fields. [It's] about being bold, courageous, intelligent and also empathetic." Later, we learn that nursing is consistently ranked as one of the most "respected and trusted" professions, that it is a "high-demand" career offering "lots of flexibility," and that nurses "feel rewarded when they are saving lives and helping people."

The piece also includes a bit of history, citing writer Erica Ikon for the idea that the first "nursing school" started in India around 250 B.C., at a time when only men were considered "pure" enough. It also notes that the Indian Army has a "long history" of male nurses, and that 25-30% of Indian military nurses are male.

The piece certainly has interesting material about the growing interest of Indian men in nursing, though it does not seem to see much of the larger context, and some of its statements are not entirely convincing. Perhaps the most intriguing aspects of the story are the extent to which the new interest from men could change nursing's long-term gender composition, possibly helping the profession gain power and reducing the global shortage. Although the challenges and rewards of nursing today may not yet be enough to overcome the preconceptions of men in many developed nations, possibly the compensation differentials are so huge that men in the developing world will be motivated to join the profession. This could potentially have some impact on both their home nations and the nations to which they emigrate. Of course, the piece seems oblivious of the negative impact on Indian health care of 20% of its nursing graduates going overseas, especially when the cash-strapped government has provided many of the resources to train them. Because the piece does not even see this as an issue, it also fails to mention that some of these nurses may at least send remittances back to India, and some may return with enhanced skills.

With regard to male nurses in clinical settings, it is not clear what is the basis for the claim that most male patients demand a male nurse, especially when--as the piece itself notes--less than 10% of nurses are male. There does seem to be some basis for the material about male nurses being expected to do the harder physical labor; the piece fails to note that some find this unfair to male nurses and their patients, whose nurses do not necessarily have time to do everyone else's heavy lifting.

We do appreciate the piece's positive general comments about nursing, especially the ones about intelligence and "life-saving," and its inclusion of statements suggesting that even academically superior male students are entering the field. Of course, it never explains what nurses actually do for patients that calls for this intelligence and skill.

We thank the New Kerala site for this interesting article.

See the article "Kerala male nurses storm traditional female bastion" that appeared in the August 23, 2005 edition of New Kerala.

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