Boys don't nurse
August 20, 2009 -- Today the Times of India briefly reported that a court in Madras had upheld the Tamil Nadu government's decision to bar male candidates from a "diploma course in nursing," apparently indefinitely, on the grounds that the course syllabus had been changed to include midwifery, and anyway, government hospitals will have enough "male nurses" till 2045. An applicant denied admission had challenged the new policy on the grounds that it violated the constitutional right to be free of gender discrimination. The jurist responsible for the court decision was Justice K Suguna, who is female. The government's action appears to reflect damaging gender assumptions, including that no one wants men to provide pre- or post-natal care (does that apply to male physicians?), and that male nurses are "needed" only in practice settings that presumably are seen to require their special physical attributes, like jails and orthopedics. Sadly, any action that reduces the presence of men in nursing is likely to weaken and isolate the profession even further, exacerbating the global nursing crisis. The Times of India might have raised some of these issues or at least sought comment from nursing experts, but we thank the paper for its report on this important subject.
The piece was headlined "HC upholds govt's decision not to admit boys to nursing course." It reported that the government had been "allotting" 10% of the available places in the course to male candidates, but decided to make it an "all-girl course" starting in the 2008-09 year after the Indian Nursing Council began using a new syllabus with a mandatory midwifery element. The government reportedly explained why men could not receive this training this way:
As no woman prefers to have the assistance of male nurses during delivery, antenatal, post-natal and labour ward for care, it is not possible to impart the training to male candidates.
The government also noted that "male nurses were required only in a few places like jail, ortho department, mental health hospitals and operation theatres," and that it had enough to fill those limited needs until 2045.
U Ashad Ali, a man who was denied admission in November 2008, challenged the government's decision in court. He argued that "discrimination on sex grounds was violative of the fundamental rights enshrined in the Constitution." He also maintained that (in the report's words) "male nursing assistants were very much needed in various hospitals."
Justice Suguna rejected his claims. In effect, she accepted the government's rationale, stating that the government had supplied documentation to support it, that there would be enough male nurses until 2045, and that "[i]f the service of the male nurse is not in need...the decision of the government in restricting admission to female candidates alone has to be accepted."
The rationales for the decision seem to be that male nurses are only needed in a few areas, seemingly those that require particular physical strength or in which they would be less vulnerable, and that male nurses cannot care for pregnant women or new mothers, presumably because women would be embarrassed or afraid. However, we see no support for these rationales other than untested and asymmetrical assumptions. As for birth-related settings, are male physicians similarly barred? Have men been barred from medical schools because they cannot complete any required OB/GYN training? And while men might have certain advantages in some of the settings in which they are supposedly more needed, we're not aware of support for the idea that women cannot provide nursing that is just as effective in settings like operating rooms and orthopedics. This seems to reflect a separate assumption that women are not strong enough for certain challenging practice areas. Are women barred from those settings? Or from those that involve intimate care for men, which would seem to be most settings?
The basic assumption that underlies all of this seems to be that nursing is inherently female across the board, and men should only be doing it if they are "needed" in a few specific areas that might present special burdens or risks to women. That assumption reflects regressive attitudes--the same kind that long excluded women from the legal profession, incidentally. In fact, barring men from nursing poses a special threat to the profession during the current crisis, because nurses in many nations struggle for the respect and resources they need for their patients and themselves. Increasing the profession's already extreme gender segregation will only weaken it further, since women generally have less power than men. It is easy to imagine the profession receiving even less attention in a variety of areas, from educational funding to adequate staffing to safe work settings, if it is identified even more strongly with "women's work."
The report is brief, but it might have at least identified some of these issues, or sought comment from outside nursing experts, who might have been able to place the government's decision in the context of nursing in India today. Even so, we thank the Times of India for a fair report on this important topic.
For a more in-depth discussion of men, women and gender roles related to nursing, please see Chapter 6 of our book Saving Lives: Why the Media's Portrayal of Nurses Puts Us All at Risk.
See the article "HC upholds govt's decision not to admit boys in nursing course" in the August 20, 2009 issue of The Times of India.