Are Female Nurses Treated Differently?

Abstract

In last month’s Point/Counterpoint, 2 male nurse practitioners (NPs) considered ways in which males in our profession are and are not treated differently from females. As we reviewed the column for publication, it was clear that the topic of gender bias in nursing, as among our patients and in society at large, is very much characterized by the observers, including JNP's Editor-in-Chief Dr Marilyn Edmunds (Another Task for NPs: Gender Salary Disparity, J Nurs Pract. 2015;11;A7-8). An enduringly complex social construct, it sometimes seems surprising that gender bias has been part of our thinking for virtually all of our lives and yet there remains so much to be considered, not to mention accomplished, to move us toward our goal of equal treatment based on gender. And so, as a companion to last month’s column, this month 2 female NPs consider some of the ways in which female nurses are and are not treated differently. Nanette AlexanderNanette Alexander, DNP, APRN, ANP-BC, FAANP, has been a nurse practitioner for 20 years. She joined Prime Health Care, PC, a multispecialty regional practice in Glastonbury, CT, 17 years ago. In addition to adult primary care, Dr. Alexander specializes in pulmonary disease, seeing patients and lecturing frequently on pulmonary medicine. She also has expertise in public health policy. Among many leadership roles, Dr. Alexander was co-chair of the political action committee of the American College of Nurse Practitioners and has held numerous positions with the Connecticut Advanced Practice Nurse Society. Nanette Alexander, DNP, APRN, ANP-BC, FAANP, has been a nurse practitioner for 20 years. She joined Prime Health Care, PC, a multispecialty regional practice in Glastonbury, CT, 17 years ago. In addition to adult primary care, Dr. Alexander specializes in pulmonary disease, seeing patients and lecturing frequently on pulmonary medicine. She also has expertise in public health policy. Among many leadership roles, Dr. Alexander was co-chair of the political action committee of the American College of Nurse Practitioners and has held numerous positions with the Connecticut Advanced Practice Nurse Society. Female NPs are treated differently from males. In my practice, I have had the opportunity to work with both male and female nurse colleagues. I have seen the differences in both staff and patients. It starts in nursing school, where patients and/or staff self-select away from male students and nurses, the selection being granted, and the bias, whether unconscious or conscious, starts. My male nursing student colleagues were denied experiences in obstetrics. Interestingly, there was no problem with male residents. As a nurse in the inpatient setting, larger patients were given to male nurses, as they were perceived to have the physical strength to care for the patient. As an NP I have noted instances of scheduling staff having gender bias. A female patient with a rash is scheduled with a female provider, regardless of the schedule, because the staff believes the patient would be more comfortable; staff, not the patient, made the decision. I have heard a physician colleague prefer a male candidate for hire, not over credentials and experience, but because there would be no maternity leave involved. Salary negotiations were also based on providing for his family, which I did not hear when we interviewed female candidates. On the topic of salary, a 25-year analysis published in JAMA (Muench U, Sindelar J, Busch SH, Buerhaus PI. Salary Differences Between Male and Female Registered Nurses in the United States. JAMA. 2015;313(12):1265-67) showed that the gender gap in nurses' pay that favors males has not changed significantly over time. Our society continues to have gender bias. Often the bias is not intentional, but it is all too real. This bias shortchanges both genders as it assumes gender plays a role in patient care. The assumption is that gender makes a better selection than the skill set that the provider can offer. The assumption that income and employment should be a gender consideration is not only unfair, but also illegal. Gender neutrality needs to be a goal. Point/Counterpoint offers thought-provoking topics relevant to nurse practitioners in every issue of JNP. Two authors present thoughtful but opposing viewpoints on current subjects, from scope of practice and regulations to work ethics and care practices. Your opinion on these matters is also important, so go to www.npjournal.org or scan the QR code here to register your vote for either side of each topic. Comments or suggestions for future columns should be sent to Department Editor Donald Gardenier at [email protected] Alison MitchellAlison Mitchell, MSN, RN, ACNP-BC, FAANP, is an acute care NP who provides hospitalist care at Houston Methodist Hospital. She has educated NPs about federal and state policy for over a decade. Ms. Mitchell served as treasurer and director of state affiliates for the American College of Nurse Practitioners and was honored with the 2014 Texas Nurse Practitioner of the Year Award and the AANP Advocate Award for Texas in 2014. Alison Mitchell, MSN, RN, ACNP-BC, FAANP, is an acute care NP who provides hospitalist care at Houston Methodist Hospital. She has educated NPs about federal and state policy for over a decade. Ms. Mitchell served as treasurer and director of state affiliates for the American College of Nurse Practitioners and was honored with the 2014 Texas Nurse Practitioner of the Year Award and the AANP Advocate Award for Texas in 2014. In cases where nurses may be treated differently if male or female, I see no evidence of NPs experiencing gender-biased treatment. From a hospital perspective, NPs must prove themselves with competent clinical decision-making, strong social skills, and active collaboration with other disciplines. Treatment from employers or managers is based directly on the NP’s ability to get the job done, not on gender. I am part of a large NP service organization, and we hire based on qualifications from an accredited NP program, personal interview skills, and clinical prowess. Houston is a melting pot of diversity with people of every race and creed from the all parts of the world. Gender, race, religion, or sexual orientation is not a consideration in this process. Male and female NPs have the same opportunities in the NP service, depending on their personal skill set. All NPs are encouraged to pursue publication, plan conferences, submit abstracts and presentations, precept, and contribute to evidence-based information and practice. The NP service supports new graduates with a personalized orientation and mentorship from within the team. More experienced NPs make themselves accessible to provide support and clinical advice. The NP service has female leadership with a vacancy coming up for a manager. Internal candidates have been encouraged to apply if they believe they have skill sets that complement the director and the needs of the NP service. This is definitely an equal opportunity position to advance into management. Again, male NP versus female NP gender bias is not a part of the hiring process. Physicians will often ask NPs to moonlight for them based on compatibility with their medical practice, observed clinical competency, and communication skills. There is no obvious difference in male versus female NPs being approached to moonlight by various physician providers.