Mon, September 26, 2011
For Chen Zhijie's first birthday, his family organized an old Chinese ritual. Chen was asked to grab one of the carefully-prepared objects on a table, including a pen, scales, a ruler, money and a stethoscope. The object he would pick up would predict his future career. Chen chose the stethoscope.
"I like medical treatment," said Chen, now 22. Chen is an intern at Ruijin Hospital. However, his choice of career did surprise his parents: he is interning as a nurse, not a doctor. Two years ago, Chen chose nursing as his major when he entered junior college. He stood out among the other students as males account for only 4 percent of all the nursing students in the college.
The question Chen answers most is why he chose to enter the nursing profession. "Why can women enter a traditionally male-dominated industry but men can't enter an industry that traditionally employs women?" Chen said. "Would anyone ask a woman why she wants to be a doctor, a cop, or a CEO?"
Chen's attitude perhaps was not understandable 20 years ago. In 1985, the Nursing School of Shanghai Medical University (later merged with Fudan University in 2000) first opened its doors to males. However, each of the first five male students ultimately furthered their studies and became doctors after graduation.
In 1990, the school enrolled another two male students. However, when they became sophomores, both of them transferred to other majors. "These boys didn't choose the major out of interest. They wanted to use nursing as a springboard to become doctors," said Li Yin, director of the students' office of the Nursing School of Fudan University.
In 2001, the Nursing School of Shanghai Jiao Tong University enrolled its first 16 male undergraduates. All of them were offered jobs in first-class hospitals as soon as they graduated. The great demand for male nurses soon made nursing an option worth considering among male students.
The ratio of male nurses increased from less than 0.1 percent in 2005 to 0.80 percent this year. But the figure still lags far behind developed countries. In the UK, male nurses accounted for 11.20 percent of all nurses in 2010. In Australia and the US, male nurses accounted for 10.70 percent and 9.40 percent respectively in 2009.
In Shanghai, male nurses mainly work in comprehensive hospitals, children's hospitals and mental institutions. District hospitals and community health centers rarely recruit male nurses. According to the head nurses of Ruijin Hospital and Huadong Hospital, two first-class hospitals in Shanghai, the lower income and social status as well as the high turnover has led to a shortage of male nurses in China.
Most comprehensive hospitals don't think the recruitment of male nurses is a major priority, said Li Yin. Because of the high turnover, they must consider whether these male nurses can bring enough benefits to cover the cost of training and other allowances before they are recruited.
Victims of sexism
According to a survey about patients' attitudes towards male nurses conducted in 2010, only 14.70 percent of women were willing to be treated by male nurses, while 79.40 percent of men agreed to receive treatment from someone of the same sex.
Liu Qukai is one of the first male nurses with a bachelor's degree in Shanghai. On his first day in the fluid infusion room of Ruijin Hospital, he rejoiced when he discovered the first patient he would treat was a man. However, when Liu asked to pull the syringe out, the stubborn man warned him that he feared the pain and asked Liu to find a female nurse for help in case he was not careful and made a mistake. Liu was embarrassed as he was treating the patient before a curious crowd who wanted to witness the skill of this new male nurse. "I have a thick skin, and I don't care what others say," Liu told the Global Times.
Zhang Li, a 30-year-old female white-collar worker, has only ever seen male nurses on Hong Kong television dramas. "It's better for a male nurse to serve male patients. I would feel embarrassed if a male nurse injects my backside," Zhang said. She admitted that though it's natural for female nurses to care for male patients, she can hardly accept a male nurse or doctor in gynecology.
Male nurses mainly work in operating rooms, intensive care units and emergency rooms. "Most hospitals don't want male nurses to work in wards for fear that the widespread social prejudice will influence the performance of the nurses," Liu said.
Tougher, stronger, calmer
Currently Liu Qukai is the only male nurse in the emergency room of Ruijin Hospital. Every day he comes across different kinds of people. Some are rude and have bad tempers, and some make unwarranted accusations and shout at medical staff. Liu also said that compared to female nurses, male nurses are not easily deterred and can better stand the pressure from these patients and their relatives.
The head nurse of the emergency room at Ruijin Hospital, Pei Guiqin, said male nurses have more strength, which is essential in the rescue of patients. "The process of cardiopulmonary resuscitation, an emergency procedure which involves chest compression, can last for a long time without pause. Male nurses are able to finish it more easily. They are also more efficient in removing patients from stretchers to operating tables and sickbeds."
When the female nurses don't feel comfortable and ask for leave, Liu is the one to take their place. Sometimes he works both morning and afternoon shifts without any rest. "All the female colleagues like to work with Liu," Pei added.
When Liu was in middle school, he was a long-distance runner and won several prizes in his county. "It's quicker for me to recover my strength," Liu said. "So I tend to take more initiative. When the female nurses care for the patients, I care for the female nurses."
Now Liu has been promoted to group leader and must delegate duties to other nurses in medical emergencies. When a patient is sent to the emergency room, Liu is the first to decide what to do.
Liu has taken part in the emergency treatment of the Jiaozhou Road fire victims and many big traffic accidents. "It's challenging. Every decision is related to the survival of patients. I must remain composed and make the critical decisions," Liu said.
Nurses are not as well regarded as doctors in most parts of China. However, Liu believes that whether a patient can recover from a disease depends 30 percent on the doctors' treatment and 70 percent on the nurses' care. A hospital can't operate with only doctors – it requires cooperation between doctors and nurses.
Finding self value
Huadong Hospital is one of the few hospitals in Shanghai that have male nurses working in the wards. Most of their duties involve making beds, administering injections, and changing the IV drips and oxygen bottles. When Lu Dayuan began his career as a male nurse in the wards, he couldn't get used to the "girlish" atmosphere. "I like to talk about stocks, cars and sports while female nurses like to chat about clothes, shoes and soap operas. Once I even questioned why I should stay here," said Lu.
However, later he gradually discovered that his status as a male nurse attracted more attention. Whenever he made some progress, the patients would take notice and give him encouragement. "I learned a lot from the way my female colleagues think," Lu said. Now he takes a positive attitude towards this sex imbalance. "Things become less exhausting when men and women work together," he added.
Pei Jingqi is a new male nurse working in the digestive medicine department of the hospital. Last year, he interned in nearly 10 departments. The tall and slender Shanghai native has cared for babies in the new-born room, played with the naughty children in pediatrics, and even fed patients with split-personality disorders. "The moment when a dying man was rescued, I felt a strong sense of achievement," Pei said.
When Pei was a child, he frequently fell ill and went to hospitals. "My motivation is to thank those nurses and doctors who cared for me in my childhood," Pei said. But his favorite place of work is the operating room. "Through various operations, I gained much medical knowledge. I can see and use different kinds of instruments as well. Perhaps the operating room is more suitable for male nurses."
High turnover
Zhu Yanfen has been working in the operating room of Huashan Hospital for about six years. He's also one of the few nurses from Shanghai who were dispatched to the Sichuan Earthquake site in 2008. Hailing from Nantong, Jiangsu Province, Zhu married his wife in Shanghai. His son was born four months after the earthquake. "I wasn't satisfied with my current situation," Zhu told the Global Times. Almost every day, he has to work overtime and works nearly every Saturday to earn additional money.
"I have to support my family," Zhu said. Currently the family rents an apartment in Shanghai. Including the overtime income he earns on Saturdays, Zhu earns around 5,000 yuan ($783) to 6,000 yuan a month, which is not enough to buy an apartment.
Huadong Hospital has recruited 10 male nurses since 2009, but three have left their posts. All the male nurses the hospital recruited in 2007 have resigned. According to Chen Yuan, director of the Nursing Administration of Huadong Hospital, one male nurse resigned last year and now works as a salesman for an American medical equipment company. He used to work in the operating room and is quite familiar with medical equipment, which made him a good candidate for such a company.
"I don't think they resign because they don't like the job," said Chen. "There are too many temptations outside. As they found other more lucrative occupations, they left."
The emergency room of Ruijin Hospital recruited two Shanghainese male nurses in 2006 and 2007, but one of them resigned because of marriage problems. "Male nurses were not well-received by people outside of the medical circle. Sometimes parents of male nurses' girlfriends opposed the marriage even though the girlfriend had accepted her boyfriend's chosen profession," head nurse Pei Guiqin said.
According to the vice president of the Nursing School of Shanghai Sibo Polytechnic Institute, who refused to be named, some of her male students study nursing because they want to become nurses abroad after graduation. After they pass the language test and obtain an international nursing certificate, they can work as nurses in Australia, Canada or New Zealand, where nurses enjoy better benefits and higher social status.
"Hospitals should take measures to keep good talents," Li Yin said. "The future of nurses' careers in China isn't clear enough. The highest position a male nurse can reach is head nurse, which isn't enough to keep them in the job. In many Western countries, a professional nurse can become a specialist nurse who has expert knowledge in a certain department, such as respiratory diseases or the emergency room."
Li added that currently all nurses do both specialized nursing and daily care regardless of their educational background, and that this is not always appreciated by nurses who have higher degrees. "Nurses' responsibilities should be further divided according to the required knowledge and their specific skills," she said.
