Before We Ask Nurses to Speak, Do They Know They Belong?
Earlier this week, I wrote about moral courage and our ethical responsibilities as nurses. It brought me back to a question I raised during my keynote on Saturday:
Before we ask nurses to find the courage to use their professional voice, have we created environments in which they believe that voice belongs in the room?
I have been thinking about that question in relation to men in nursing, particularly in labor and delivery and maternal-newborn nursing.
What happens when a male nursing student enters an obstetric clinical rotation?
Does he receive the same opportunities to learn? If excluded from a patient's care, is it because the patient expressed a preference, or because someone assumed she would?
There is an important difference.
Patient autonomy matters. Patients have the right to privacy, dignity, and a voice in who participates in their care. Preferences may reflect religious or cultural beliefs, gender, racial biases, previous experiences, personal boundaries, or reasons never disclosed.
During my practice, I have encountered patients who preferred not to receive care from an African American nurse. I do not share that for sympathy or to characterize every preference as discrimination. Patients have the right to choose.
But respecting an individual's preference is different from allowing anticipated preferences to shape opportunities for an entire group.
When do we begin assuming what patients might prefer? When do those assumptions influence who gets to learn, practice, or advance?
Suppose a male student discovers he loves maternal-newborn nursing. Does he have an equitable opportunity to pursue labor and delivery, postpartum, or NICU?
I don't know. I am a woman and cannot presume to know the experiences of men in nursing.
But we should be willing to ask.
When we have never encountered a particular barrier, it can be easy to diminish its significance. We may take our opportunities for granted because we never had to question whether they would be available.
I do not have to share your experience to acknowledge that your experience matters.
Perhaps moral courage is not only required of the person experiencing a barrier.
It may be the faculty member who notices unequal learning opportunities and asks why. The leader who examines whether assumptions influence professional opportunities. Or the colleague willing to listen to an experience they cannot personally relate to without diminishing it.
Perhaps one of the harder things we can do is examine an environment that has worked for us and ask whether it works equally well for others.
We can respect patient autonomy while examining whether our professional environments provide equitable opportunities to learn, practice, and grow. The two are not mutually exclusive.
I would especially like to hear from men in nursing:
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