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August 19, 2022
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Career

Getting more men into nursing means a rethink of gender roles, pay and recognition. But we need them urgently

August 17, 2022 by Rayan Calimlim Leave a Comment

Demand for health care is soaring as the population ages, medical treatments become more widely available and more people live with chronic and complex illnesses.

However, there is global shortage of health professionals – and the pandemic has only accentuated the trend. Overwork, burnout and stress are causing nurses to leave in droves.

The World Health Organization estimates we’ll need a further 9 million nurses worldwide by 2030. According to the International Council of Nurses, the figure is closer to 13 million.

Part of the solution is to recruit and retain more men in nursing. This would help address workforce shortages and could, over time, reduce the industry gender pay gap as the existence of men in nursing becomes more normalised.

And as jobs dry up in traditionally male-focused industries – such as mining and manufacturing – work in health care should be an attractive option for men, providing job security, career opportunities and salary.

But attracting men to the profession won’t be without its challenges. It will require a serious society-wide rethink around gender roles, compensation and recognition for the importance of nursing work.

Why are there so few men in nursing?

Caregiving is feminised in society and health care, and the nursing profession has strong female foundations. This has established a trajectory and a culture that has kept the representation of men to around 10% in many high income countries.

This is despite fervent efforts by many in the industry to achieve the equity of gender representation you see in most professions.

The reasons are complex and multifaceted. Men in nursing are often portrayed negatively in media and movies. Stereotypes abound.

And some men in nursing face discrimination from patients and staff, underpinned by false assumptions women are better suited to the role. Many people still underestimate the capacity of men to undertake personal care tasks.

Research also shows low male participation can stem from reticence by career counsellors to recommend nursing as a career.

A recent Australian report shows the dominance of women in the nursing workforce may hinder some men from considering nursing as a career, particularly those for whom masculinity is central to their identity. So we must work to undo the perception nursing is a feminine job – it is not.

Negative perceptions around the prestige of nursing and its perceived status in the community may hinder some men’s interest in nursing as a career.

Good role modelling is important. Many educational institutions and supporters such as Johnson & Johnson are working hard to in present positive images of men in nursing and normalise that men can be great nurses too.

Source: JHU.

Retaining men in the workforce and addressing the ‘glass escalator’

Many regulatory and professional bodies are monitoring the participation of men in nursing. Some organisations offer incentives. For example, The American Association for Men in Nursing offers scholarships, awards and training to attract and retain men in the profession.

It is important to recognise some barriers for men come from within the nursing profession itself.

Some in the nursing workforce perceive that men are on a career “glass escalator”. Unlike a “glass ceiling”, which inhibits career progression, the “glass escalator” allows men to be fast-tracked up the nursing workforce to higher positions in an effort to retain them.

This can cause some to perceive male participation in nursing as a negative, which reduces inclusion.

But this glass escalator phenomenon, which can occur in other industries too, can only be overcome if male participation in the workforce is normalised.

And it is critically important to look at the structural, gender-driven factors that inhibit women embracing leadership roles.

It’s also worth noting women in the health and caregiving sector face a larger gender pay gap than in other economic sectors. A joint report by the International Labour Organization and the World Health Organization found:

Women in the health and care sector face a larger gender pay gap than in other economic sectors, earning on average of 24% less than peers who are men […] Within countries, gender pay gaps tend to be wider in higher pay categories, where men are over-represented. Women are over-represented in the lower pay categories.

Although this differential is not easily explained, it does reflect the value society ascribes to caregiving. If women are over-represented in the lower pay categories (which tend to focus more on personal care tasks) that suggests society ascribes low value to caregiving tasks, and over-representation of women in caregiving helps to further “feminise” caregiving.

It is highly likely these factors conspire to dissuade men and boys from getting started in nursing and undertaking caregiving roles within the profession.

Time for action

We urgently need more men in nursing.

Not only does this make good sense for health care, as it presents opportunities for engagement with men, but also good sense for our society and economic productivity. Investment in education and job creation in the health and social sectors could improve health outcomes, shore up global health security, and boost inclusive economic growth.

Perhaps most importantly, robust health care systems should be representative of the populations they serve. The workforce in any industry should be drawn from a range of perspectives, including gender and culture.The Conversation

Patricia Davidson, Vice-Chancellor, University of Wollongong; Caleb Ferguson, Associate Professor, University of Wollongong, and Jason Farley, Professor, Infectious Disease-Trained Epidemiologist and Nurse Practitioner, Johns Hopkins University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Looking to get into aged care nursing? Check out this Transition to Practice Program! 

July 26, 2022 by Rayan Calimlim Leave a Comment

A Federal government program is aiming to address the chronic staffing crisis in aged care by encouraging and supporting recently graduated registered nurses and enrolled nurses to make aged care nursing their career of choice. 

Launched in 2021, the Aged Care Transition to Practice Program (ACTPP) assists new nurses through their first year of clinical practice by offering mentorship, professional development, and specialist clinical education to help increase their skills and capabilities.  

With a growing ageing population, aged care has become one of the fastest growing areas of clinical practice within the Australian healthcare sector. 

Further, the sector is in desperate need of more qualified aged care nurses, as evidenced by the findings of the Royal Commission into Aged Care Quality and Safety.  

Federal Chief Nursing and Midwifery Officer, Adjunct Professor (Practice) Alison McMillan lauded the program as allowing new aged care nurses “opportunities for growth [to] make aged care nursing a career of choice.” 

“Many graduates don’t realise aged care provides nurses with opportunities for rapid development and career advancement compared to other clinical settings,.” Professor McMillan said.  

With mandated minimum staffing in aged care facilities soon set to be legislated by the Federal Government and coming into effect July 2023, programs like the ACTPP will be needed to recruit and retain nursing staff in the sector.  

The program is open to graduated registered nurses and enrolled nurses who have graduated within the last two years and who are currently in their first year of clinical practice.  

For those looking for a career change, registered nurses who have worked in another sector for more than 12 months and are in their first year of clinical practice in aged care are also eligible.  

For more information about the program and eligibility requirements check out the Department of Health and Aged Care website here. 

Moral injury: what happens when exhausted health workers can no longer provide the care they want for their patients

July 4, 2022 by Rayan Calimlim 1 Comment

Healthcare workers already face life-and-death decisions daily. But as multiple winter illnesses add pressure to a system already stretched by COVID, staff now also have to deal with daily abuse, acute staff shortages and unsafe working conditions. At times, they cannot provide the care they would like for their patients.

The impact on health workers is often described as stress and burnout. The consequences of this prolonged pressure can be seen in the number of doctors, nurses and other health professionals leaving their jobs for overseas positions and the private sector, or being lost to their professions completely.

Many of these healthcare workers may well be suffering from a more serious form of psychological distress than burnout: moral injury.

Moral injury refers to the psychological, social and spiritual impact of events on a person who holds strong values (such as caring for patients) and operates in high-stakes situations (hospital emergency care), but has to act in a way inconsistent with those values.

Examples include having to turn patients away despite them being in pain or discomfort; being unable to provide adequate care due to staff shortages; having to care for a dying patient isolated from their loved ones while wearing full protective gear.

Symptoms of moral injury can include strong feelings of guilt and shame (about not being able to uphold healthcare values, for example) as well as high levels of anger and contempt towards the system that prevents proper care.

High levels of self-criticism, loss of trust in people and organisations and a weakening of personal relationships are further symptoms of moral injury.

It can be viewed as a more severe form of burnout. But while burnout can happen in most workplaces, moral injury requires the three core components listed above.

From war to the operating table

The term moral injury arose in military psychology to refer to situations where, for example, soldiers were unable to intervene to save lives in case they risked breaching the rules of engagement. More recently, the term has been adapted to apply to healthcare.

Viewing the experiences of health workers through this lens can help us understand why they may experience a seesawing emotional state and the confusing conflict of simultaneously wanting to be at work while wishing they were anywhere but.

For healthcare workers, understanding the concept of moral injury may help reframe it as something that is happening to them rather than because they don’t have the skills to cope. The latter can sometimes be a mistaken implication of the term burnout.

While healthcare workers are largely at the mercy of the organisations they work for, there are some steps individuals can take to alleviate moral injury. Firstly, simply recognising they may be suffering from this condition can reduce confusion and validate their experiences.

Secondly, reconnecting back to an individual’s values and beliefs can help refocus and re-energise, at least temporarily. Reminding themselves why they got into this job in the first place is a useful place to start.

Organisational responses

Organisations and businesses must play a lead role in preventing and treating moral injury. Many of the factors leading to it (lack of resources or staff, a pandemic or peak flu season) are outside the control of individuals.

Most modern businesses will be aware they have a legal responsibility to look after their employees’ mental and physical well-being.

At a high level, organisations can advocate for systemic change and increases in funding and resourcing, where needed. But these higher-level changes take time to achieve. In the meantime, it is important healthcare workers are protected and supported.

Broad steps an organisation can take to prevent or reduce moral injury include removing the burden of difficult ethical decisions from frontline workers and instead adopting evidence-based policies to guide an organisation-wide response. Where possible, rotating staff between high and low-stress environments may help.

Providing funding for workers to access professional psychological supervision is another practical step businesses can consider. At a team level, it can be helpful to have leaders who are visible, validating and can help make sense of the moral conflict. Leaders can also play a role in keeping alive professional values and modelling their own struggles with the situation.

The general public also has a role to play in supporting healthcare workers. Any steps we can take to protect our own health and thereby reduce pressure on the system can have a cumulative effect on the well-being of doctors, nurses and allied health clinicians. The health of our nation rests with those who work in this field and it is in all our interest that their health is protected and prioritised.The Conversation

Dougal Sutherland, Clinical Psychologist, Te Herenga Waka — Victoria University of Wellington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

British nurses and midwives quitting profession in droves 

May 25, 2022 by Rayan Calimlim Leave a Comment

Figures released by the British Nursing and Midwifery Council (NMC) has found a 13% rise in the numbers of nurses and midwives leaving the profession over the past year. 

The latest annual data from the NMC revealed a total of 27,133 nurses and midwives made the decision to exit the profession between April 2021 and March 2022. 

Of the reasons provided for the exodus, the most common were: retirement, “personal circumstances”, too much pressure at work, negative workplace culture and plans to leave the UK entirely. 

Publishing the data, Andrea Sutcliffe, Chief Executive and Registrar at the NMC, warned those who left “shared troubling stories about the pressure they’ve had to bear during the pandemic”. 

In responding to the alarming data, the Royal College of Nursing General Secretary and Chief Executive, Pat Cullen said that the loss “is being felt profoundly by both patients and nurses alike”. 

“When we have tens of thousands of vacant nurse jobs, a sharp rise in leavers should not be overlooked while we welcome new recruits. Ministers should avoid overclaiming today – nursing staff tell us these shortages are biting more than ever. 

“With an imminent government decision on NHS pay and the pay review body reports due this month, these figures are a reminder of the scale of the challenge and why radical action is needed to boost the nursing workforce”. 

The College has called for a sustainable workforce plan to be implemented urgently by the British government to stem the tide of nurses and midwives leaving.  

Innovation and Judith Meppem scholarship applications are open

April 11, 2022 by Madeline Lucre Leave a Comment

The Innovation and Judith Meppem Scholarships applications are now open.

These scholarships are a wonderful opportunity for nurses and midwives in NSW Health to broaden and share their knowledge and expertise, and to put their innovative ideas into practice.

Innovation Scholarships – Applications open 23 March until 25 May 2022

 Scholarships of up to $15,000 are available for innovative projects that will drive improvements in focus areas of the public health system as below;

  • improve the provision of high quality, appropriate, safe, available services when and where needed
  • support care that is coordinated and responsive to individual needs
  • enhance cultures of staff wellbeing to support nursing and midwifery practice and improve service delivery and patient care
  • apply new models of care and approaches, to strengthen nursing and midwifery practice

 Judith Meppem Scholarships  – Applications open 4 April until 4 June 2022

Judith Meppem scholarships offer up to $12,000 to support nurses and midwives to undertake a study tour, to observe and learn about innovative and best practice in their profession.

Scholarship and application information can be found on the nursing and midwifery website 

New Ramsay EA after company-wide campaign

December 2, 2021 by Madeline Lucre Leave a Comment

Member leaders played a vital role in negotiations.

NSWNMA members at Ramsay Health Care have overcome pandemic-related disruptions and obstacles to finalise a new, two-year enterprise agreement.

The NSWNMA started negotiating with Ramsay in April 2021 and staff voted to accept the company’s improved offer in October.

During this six-month period, COVID-19-related lockdowns in NSW forced a shift from face-to-face to Zoom meetings and created other campaign difficulties.

Despite this, a total of 12 Ramsay members from hospitals in Sydney and the regions joined with NSWNMA officials to coordinate the campaign and take part in negotiations.

These bargaining representatives from across NSW ensured members from all Ramsay hospitals had a voice in the campaign.

The new agreement protects all existing conditions and provides a pay and allowance increase of 3.5 per cent over two years with back pay to July 2021.

After the company withdrew its claims for cuts to nurses’ and midwives’ working conditions, Ramsay members voted to accept the agreement.

In the run-up to negotiations the NSWNMA surveyed members to find out what changes they wanted in the new agreement.

A record number of surveys were returned, showing members’ top concerns were improved staffing levels and improved pay.

Missed meal breaks and insufficient notice of rosters were also priorities to be addressed.

The NSWNMA drew up a set of claims focusing on staffing ratios, fair rostering and better pay.

Three negotiation meetings were held before the COVID-19 lockdown in June 2021, which then forced negotiations to go online.

Ramsay wanted cuts to conditions

NSWNMA General Secretary, Brett Holmes, said the meetings gave member leaders the opportunity to speak candidly about staffing and other concerns.

“Despite a hostile attitude from the company during negotiations, our bargaining reps raised many situations where staffing was an issue, backed by examples in support of the claims,” he said.

“During the campaign over 2200 Ramsay nurses and midwives signed a petition calling for staffing ratios, a safer skill mix, ACORN standards, the ability to take meal breaks and fair rostering.

“However, Ramsay flatly refused to consider any of our claims relating to ratios.

“They maintained that their existing staffing arrangements provided safe patient care but refused to provide information on the formula, citing ‘commercial-in-confidence’.”

Ramsay came to the table with their own demands for cuts to working conditions, including greater “flexibility” in rostering, but later withdrew them after members stood together to reject them.

The new two-year agreement will expire on 31 March 2023. It includes the following pay and allowance increases:

  • 1.5 per cent increase backdated to the first pay period on or after 1 July 2021
  • 0.5 per cent increase from the first pay period on or after 1 January 2022
  • 1.5 per cent increase from the first pay period on or after I July 2022.

Ramsay is the largest private hospital operator in Australia, with 72 private hospitals and day surgery units.

‘A lot of people were happy to put their names to the petition, which was signed by over 2200 people.’— Deanna Hayes

COVID-19 lockdown hindered Ramsay negotiations

An NSWNMA member representative on the enterprise agreement (EA) bargaining committee, Deanna Hayes from St George Private Hospital, said COVID-19 made it harder for members to campaign for a better agreement.

“I think the public health regulations and general level of uncertainty during the pandemic made nurses less likely to take action to press their claims. People didn’t know what was happening to their hours, and how COVID-19 would impact the community.

“The COVID-19 lockdowns in NSW interrupted our bargaining process and forced us to meet with management online. COVID-19 caused a hiatus in the middle of negotiations.”

Deanna said it was disappointing the company “cried poor” and claimed it could not afford to pay a substantial wage increase, despite Ramsay’s share price rising through most of the negotiation period.

“Yes, some procedures were postponed, but every Ramsay nurse like me who got redeployed to vaccination hubs or rural areas had their costs covered by NSW Health. And a lot of private hospitals took public patients by agreement with NSW Health.”

According to the Australian Financial Review, Ramsay CEO Craig McNally’s pay tripled to $5.9 million in the 2021 financial year, and the company’s statutory profit is up 58 per cent despite lockdowns.

The Commonwealth government’s $1.3 billion rescue package more than compensated for bans on elective surgery, with Ramsay receiving almost $1 billion in subsidies from governments in Australia and Europe. Even without these subsidies, revenue was up 3.9 per cent.

Around 430 Ramsay nurses and midwives were deployed to support the public health system during the COVID-19 outbreak.

“They claimed Ramsay had their own method for working out safe staffing but wouldn’t say what this was, because it was ‘confidential’,” said Deanna.

“A lot of people were happy to put their names to our petition, which was signed by over 2200 people, because they don’t always get meal breaks due to inadequate staffing.

“They tell stories of being on night duty with just one other staff member and 20 post-op patients.”

She said the company was dismissive of these examples of staffing shortages that the bargaining reps passed on to them from their workplace colleagues.

“We tried to explain it to them numerous times, but they wouldn’t accept that what we were saying
was true.”

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The Lamp is the magazine of the NSW Nurses and Midwives’ Association. It is published bi-monthly and mailed to every member of the Association.

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