Men in Nursing: What Was It Like During the 1900's?

For most of the twentieth century, men were effectively shut out of nursing, then clawed their way back in. The few who stayed faced discrimination, some odd built-in advantages, and a set of experiences worth recording before the people who lived them are gone.

How few men there were

The number of men in nursing fell sharply in the early 1900s and only began climbing again from the 1950s, partly to find work for men after World War II and partly as gender norms loosened. For most of earlier history there were probably more men than women caring for the sick in institutions, but by 1930 fewer than 1 percent of U.S. nurses were men. By the 1970s the figure was only 2.7 percent. It has since risen to roughly 12 to 13 percent, and the trend is still upward. The pattern looks similar across much of the world.

Men had always done this work. In ancient Rome the nosocomi, all men, staffed the hospitals. Religious and military nursing orders, like the Knights Hospitallers during the Crusades, cared for the sick and wounded. Even in the Crimea, where Florence Nightingale began her famous work, male orderlies provided most of the care.

Nursing became a female profession only after formal nursing education arrived alongside modern medicine in the 1800s. In patriarchal Victorian society it was one of the few acceptable careers for a woman outside the home, and it slotted neatly into the existing order: women caring, in a position subordinate to the male doctors. Men still nursed the wounded in the American Civil War, but the U.S. Army Nurse Corps was reorganized in 1901 so that men could not serve as nurses until 1955.

Getting in was the first barrier

Men were largely kept out by being denied the chance to qualify. Many nursing schools simply refused to admit them. That held until 1982, when the U.S. Supreme Court ruled in Mississippi University for Women v. Hogan that barring a qualified man from a state nursing school violated the Equal Protection Clause. The Court found that the policy only reinforced the stereotype of nursing as women's work.

So why would any man take this on, against the odds and the stereotypes? The reasons were as varied as anyone's.

"I was in a hospital and decided then and there to become a nurse, after another patient said the one male nurse on the unit must earn a fortune, being the only man among so many women," Danthe said, laughing, when asked why he chose it. A textbook bit of gender stereotyping for the time.

Henry's path was more deliberate. "Career aptitude tests at school pointed me toward caring work. I was a medic during compulsory military service, even worked in a military hospital, but never considered nursing until afterward. I realized I couldn't afford to study psychology part-time without a steadier qualification. I had the background and knew what I was getting into, and nursing let me keep studying on the side."

Being the only man in the class

A man admitted to a nursing course was often the only male in his class, sometimes in the whole school. By most accounts the female students accepted them easily. "College days were wonderful," Henry said. "We all played football together, male and female, without a ball. Endless arguments about whether it was out or whether it was actually a goal."

Family, friends, and the wider community were less kind about the choice. And there was discrimination inside the training itself. Both men recalled being the default demonstration model: "I always had to be the model for anatomical positions, movements, and bandaging," Henry said. "Sometimes I was so trussed up the next teaching period was wasted unraveling me." Danthe got pulled constantly for pre-op shaving, catheter insertion, and heavy lifting in other units, simply because he was a man. "I'd have to drop my own patients, then scramble to finish my work later."

Mixed-sex student residences were frowned upon, so schools improvised housing for the handful of male students. Danthe was glad to be exempted from the rule requiring first-year students to live in the nurses' residence and stayed home instead. Henry was housed in the night shift quarters with other qualified staff.

The discrimination went deeper than logistics. Into the late 1970s and 1980s in many countries, men did not receive the same training as women. In the United Kingdom, men were admitted only to certain parts of the nursing register until 1951. In varying degrees, men were barred from obstetrics, pediatrics, and from nursing female patients at all. "We were seen as either gay, pedophiles, or rampant heterosexuals. We weren't allowed near women. We weren't allowed near children. They couldn't decide where to put us," recalled Don Fraser of New Zealand, who was even made to dine with the orderlies, apart from the female students. Danthe still resents how narrow his operating-theater exposure was: "We were only allowed in the Ear, Nose and Throat theater, never the general ones."

The uniform

Until the 1970s the men's uniform was a white top buttoned at the side, with a high mandarin collar, paired with wide white pants that "flapped in the wind." When narrow stovepipe pants came into fashion, Danthe hated the flapping ones. "I had my mother take them in, and the next morning the male supervisor chased me out of the unit, refusing to have a 'ducktail' on his ward." His tutor agreed the narrow pants looked better and sorted it out. Henry, who bought his own uniforms rather than wear the hospital issue, remembered a friend's first day: proudly starched and eager to serve, the friend was beckoned by an elderly patient with a call of "Waiter!"

On the job

Studies generally show men are accepted as part of the nursing team, treated as equals by colleagues. Being a minority sometimes even helped, since men carried society's gender privilege into the work. One concrete advantage last century was better service benefits, especially in government jobs, back when men were assumed to be the breadwinners. "Men were paid higher salaries than women in the same category," Danthe said. "We also had a pension fund, housing allowance, and medical benefits that women didn't get at the time." Even now, men in nursing tend to earn more on average than women. There is a known counterpart to the glass ceiling here, the "glass escalator," where men in a female-dominated field rise faster than their female peers.

In many countries, students on clinical placement counted as part of the hospital workforce. "After only my second month in training, I was put in charge of a male medical unit of about 30 patients on night duty," Henry said. "My military medical experience helped, but it was an enormous responsibility." Whether that came from his experience or from gender privilege, or both, is an open question. Either way, his superiors clearly saw a capable nurse.

The privilege cut both ways. In the 1960s Danthe was recommended by his matron for paid study leave to complete a one-year course in nursing administration. The Chief State Nursing Officer phoned the matron to ask: "What would a male nurse be doing in nursing management?"

Both Danthe and Henry (not their real names) are now retired after full careers. Danthe moved from hospital work into regional nursing management, then served as a professional officer at the national nursing association, eventually becoming Chief Nursing Officer for international health liaison at the National Department of Health. Henry moved into nursing education and retired as a Professor of Nursing Science, having earned a Ph.D. centered on professional nurse caring.

With the nursing shortage and shifting views on gender and work, recruiting more men into nursing is now a real priority. Getting to an even split means breaking down the old stereotypes about nursing in general, and men in nursing in particular. That part is on all of us.