Better Life Lab

Racism Is Stopping Black Men From Solving Our Nursing Shortage

Photo illustration by Lisa Larson-Walker. Photos by Thinkstock.

Chris, a nurse I interviewed recently, is regularly mistaken for hospital housekeeping staff: “I come [to work] in my white uniform. That’s what I wear. Being a black man, I know they won’t look at me the same, so I dress the part. I said, ‘Good evening, my name’s Chris, and I’m going to be your nurse.’ She says to me, ‘Are you from housekeeping?’ ” This wasn’t the only time he’s had his occupation questioned while he’s practicing it: “I’ve walked in and had a lady look at me and ask if I’m the janitor.”

With a rapidly aging population, longer life spans, and few care facilities in many rural areas, the demand for nurses is high, and the profession has deliberately sought to recruit more men. At the same time, fields that have traditionally been male-dominated—especially manufacturing and construction—have been hit hard over the years, and especially since the 2008 recession. Consequently, some have hoped men would be attracted to nursing given that it is a field that offers stable, well-paying work in a growing industry. Yet nursing still remains predominantly female and white. While many have focused on the barriers to getting men in general to enter nursing, my research shows that black men, who are drastically underrepresented in nursing, may in fact be the group of men most motivated to enter the field, even despite an often racist environment.

For some men, gendered ideas about work can make entering a field like nursing very difficult. These beliefs persist even when labor market conditions shift so that male-dominated jobs become more scarce. Sociologist Christine Williams’ seminal study of men working in female dominated occupations shows immense awareness that they are defying gender expectations. Williams quotes one man whose interest in studying nursing led to his being teased by peers for being gay.

In a study of unemployed married men and women, sociologist Ofer Sharone finds that this pressure to pursue traditionally male-dominated work even spills over into marriages. “Unemployed men, but not unemployed women, report marital tensions due to their spouses being critical of the types of jobs that they are pursuing,” says Sharone. This culture of enforcing gendered boundaries around the profession can explain why persistent ideas about gender and femininity make professions like nursing a hard sell.

But in a study of black men in nursing, I found that they by and large were unfazed by the perceptions of nursing as a “woman’s job.” They were aware of the stereotypes about gender and nursing and obviously noted that most of their colleagues in the field were women. But for black men, the gender-based pressures to avoid this professional field were muted by other forces that they found more compelling.

For one thing, racial and gender discrimination means that higher-status jobs like law, medicine, engineering, and finance that white men may pursue aren’t available to them. While even lower status jobs like manufacturing and construction have long been areas where white men could earn comfortable wages doing skilled work, racial discrimination in these fields means that black men often face barriers to their entry, pay, and promotions. In a study of white working-class men employed in the construction industry, for instance, sociologist Kris Paap found that one way these men protect their shrinking “turf” is by reinforcing gendered and racial boundaries through social exclusion and even taunting those they don’t think belong.

With blocked routes to skilled work in construction, trade work, or high-status corporate positions, black men see nursing as a relatively welcome alternative. Another black male nurse I interviewed, Leo, told me, “This is a good job for black men. It makes you work harder mentally as opposed to work in a public setting like construction. It’s not like working in the heat, or in a field, bus driving or something. It’s a different type of taxing because it works your mind, your heart.” This helps to explain why sociologist Mignon Duffy finds that black men are a growing number of those present in lower-tier health care work (e.g., home health care aides, nursing assistants, and so forth) relative to men of other racial backgrounds.

In addition, many of the men in my study were motivated to enter the profession because they believed this field offered opportunities to be of service to black communities. Specifically, they felt that work in the nursing profession offered a way to address the long history of medical racism that has adversely affected black communities, leading to racial health disparities and gaps in treatment, care, and access. Stephen, an orthopedic nurse, told me that poor black patients who have been overlooked in the health care system will benefit from being cared for by someone who looks like them, someone “who knows the system, to be a change agent for them.” This motivation to assist minority communities is one most white men who enter nursing likely would not share, which may make black men the most primed to be recruited into the field.

But their interest in nursing rarely elicited a warm welcome and stories of being confused for housekeeping or socially isolated remain common. Kenny, a nurse in his 50s, described this painful experience as the only black nurse on staff: “[My co-workers] had nothing to do with me, and they didn’t even want me to sit at the same area where they were charting to take a break! […] When I came and sat down, everybody got up and left.”

Many black men see nursing as a desirable profession, but the nursing profession hardly welcomes them with open arms. Instead, stereotypes about black men and where they should work come from colleagues and patients, making it difficult for them to enter and advance in this field. Eliminating these barriers to recruit a demographic of men who actually want the opportunities nursing allows, rather than focusing on recruiting men who don’t see nursing as a legitimate profession, may be the best way for nursing to meet the U.S. population’s needs today—a diverse population whose demands for care we cannot currently meet.