Men Don’t Want to Be Nurses. Their Wives Agree | Hacker News Reader

Men Don’t Want to Be Nurses. Their Wives Agree

nytimes.com

29 pointsimartin2k59 comments

We should rename the profession. "Nurse" is gendered, but also poorly captures the responsibilities of the modern nursing profession.

It is batshit crazy that our first line of medical care in the US is medical doctors. For 80% of what ordinary people see doctors for, Nurse Practitioners are superior to doctors: they're more available, can spend more time with patients, and can more easily escalate cases to doctors or specialists than the patients themselves can.

What would make a lot of sense to me would be to rename "Nurse Practitioners" to "Associate Doctors".

How about "Flesh Mechanics"?

That might get a man or two interested. "Nurse" has mammary overtones.

That phrase is quite demeaning to the nurses' subjects, which is probably why you're being downvoted.

Understandable and no complaints, down-votes taken with a smile and not personally.

I don't understand your point about "demeaning" though.

Are you saying calling people under nurses care "flesh" is demeaning? Or saying the word "Nurse" has mammary overtones (it does, and I assume some sort of common root) is demeaning?

I would have down-voted the comment for being dumb rather than demeaning (admittedly it is kind of a dumb comment).

Just struggling to understand demeaning here because I'm not the kind of persons who wants to demean so maybe I should know something I don't.

The flesh part. It makes it sound like humans are just a pile of flesh. (And please don't make this into a philosophical debate about whether that captures the human condition because this is clearly not the point.)

No, no debate. Thanks for the feedback and clarification.

To put it in more tech-industry terms, doctors are either Level 2 (general practitioners) or Level 3 (specialists) health support. Adding more low-cost Level 1 health support is a great way to reduce the workloads of L2 and L3 and thus both reduce costs throughout the system as well as improve outcomes for most ~customers~ patients.

Except of course no one in this system is interested in reducing costs.

The patients, governments and private insurers are all interested in it I assume. Personally I'm more interested in increasing availability, when I need a medical certificate for a cold it's a huge pain to try and book a doctor. And then 99% of my interactions are watching them fill in paperwork and take my blood pressure, something we already rely on nurses for in hospitals.

I don't know if it will get anywhere though, doctors have a powerful union.

Government is interested in whatever their donors tell them to be interested in. That's why ACA is a trillion dollar giveaway to healthcare industry instead of net savings.

ACA also disincentives private insurers from wanting to reduce cost. Their profit is now limited to a certain percentage of the premiums, so naturally their only real way to profit is by raising the living shit out of the premiums.

Things weren't heading that way before the ACA and they aren't heading there anywhere else in the western world.

Whatever problems you have with the ACA, it's not the cause here.

I didn't say it was the cause. The cause is that the congressmen/women will sell their mom for a buck.

Sorry to burst your bubble: this works in the tech industry because the impact of a bad judgment call at L1 is not the death of a human being.

And nobody's saying that L1 health support should be uneducated (no dedicated schooling), unaided (no need for patient records indicating allergies etc.), or all-powerful (including, say, the ability to prescribe powerful doses). The argument is that there's plenty of room for people who went through a (significant) fraction of the time it takes to complete traditional medical school to earn a (significant) fraction of a doctor's earnings in order to reduce overall system costs and improve overall availability of care.

That argument comes from the wrong direction. It may indeed reduce system costs and improve overall availability, but those things are crippled by the commercial construction of US healthcare not the expense of doctors salaries.

Fix that by adopting healthcare systems from overseas, rather than increasing the mortality rate.

Countries with socialized healthcare are facing the same issue, ballooning healthcare costs, just less acutely.

That is wrong. For example, the UK's cost of healthcare as a percentage of GDP is actually declining.

The US has double the healthcare expenditure by %age of GDP vs comparable nations such as the UK or Australia, and this order-of-magnitude difference is entirely explainable as systematic inefficiencies of the insurance-led market and uncontrolled drug pricing. All that cost - and it doesn't even cover everyone.

Future generations will study the basket case that is today's US non-single-payer insurance system and write it up under chapter titles like "What the hell were they thinking" and "How not to do it".

"Associate Doctors" - seriously a brilliant idea in my eyes.

> We should rename the profession. "Nurse" is gendered

In Brazil, there are TONS of male nurses working in hospitals, and there is not stigma at all to name of the profession (at least from my various experiences with hospitals and ERs).

The fact that Portuguese has declension to indicate gender in this particular word ('enfermeiro' is male, 'enfermeira' is female) might play a role in this.

The remaining XX% (I dispute your claimed 80%, it sounds fabricated) is why so-called "nurse practitioners" must not act as though they are front-line doctors. These people have too high an opinion of their medical qualifications. What you propose will increase mortality rates due to incorrect diagnosis of serious conditions. That is entirely unacceptable.

That suggestion of "Associate doctors" is a travesty that would simply further confuse a public already beset by snake oil salesmen and the false hope of "alternative".

What you are asking for - what you have listed as the positive outcomes - is properly handled by a patient advocate. These are rare today, I would see it grow as a profession.

What you are asking for - what you have listed as the positive outcomes - is properly handled by a patient advocate. These are rare today, I would see it grow as a profession.

I wonder if there is a way to structure payments such that doctors fill this role. It would be convenient if their incentives were so well aligned with patient interests.

It'd be yet another aspect of a healthcare system that gets hijacked by commercial interests, which is already the principal reason that US healthcare costs 17% of GDP when other countries deliver equal quality for 9%.

Are you talking about patient advocates getting hijacked or about properly structured payments getting hijacked?

I'm saying there is no payment structure you can a) devise and b) implement, without inadvertently creating a whole secondary financial sector to exploit and debase it. The word "properly" cannot attach.

We should absolutely not rename the profession. All it does it put it the title on the euphemism treadmill[1]. Instead we should look to break down sterotypes through positive role models and portrayal in the media.

[1] http://englishcowpath.blogspot.com.au/2011/06/euphemism-trea...

Someone with a shallow familiarity with feminism like myself won't find anything surprising here. That patriarchy (which is a set of commonly held attitudes) disadvantages men as well as women is well understood. That many women have patriarchal attitudes is also well understood.

However, don't assume that these things are fixed. Highly feminine occupations such as film editor and software engineer have long since "flipped" to being male-dominated professions. Nursing could easily be next.

Or, you know, we could all grow up as a society but I'm seeing no evidence that this is likely to happen.

It is well known that men favor working with things and women favor working with other people. So in a society that provides complete equality you will find that some professions are dominated by a particular sex. Nursing is dominated by women because far more women enjoying working closely with people than men do. That is not going to flip.

The feminist idea that all professions should end up with about 50% participation if there is true equality is patent nonsense.

Being that we're hairless apes who rely on clothing, fire to break down our food, and a host of other technologies just for basic survival, I'd say our natural biology is pretty damned unimportant when it comes to such high level behavior such as preferred profession in the Western world.

Your culture and your language are by far much more responsible for your desires and actions. Just look how easily mankind is swayed by mere words to go to war!

I have thought about this a lot, and yet when you observe little kids, little boys want to play with trucks and cars, and little girls like playing with dolls. Nobody has to tell boys to play with cars or toy guns. They just like them. Obviously everybody's an individual. But by and large I think there are trends at such a young age it's apparent that the gender differences in occupational choices aren't just due to culture.

Your big assumption here is that kids are ignorant of culture and pay no attention to non-explicit signals. This is demonstrably and wholly false.

I think that boys just plain will prefer the cars over the doll if you give them the choice, regardless of culture. The story of David Reimer is instructive. The boy at 22 months had a botched circumcision. So the doctors just chopped off his balls and made a vagina for him. He had a horrible time becoming a "girl" and as soon as he was told he was a boy as a teen immediately reverted and lived the rest of his life as a boy as much as he could. The reason his parents told him anyways was because he threatened to take his own life, hating to see the therapist who was trying to make him act like a girl.

https://en.m.wikipedia.org/wiki/David_Reimer

And what about biological males who would rather dress and act like the women in their society?

How does this anecdote prove that it was biology and not the same kind of transgendered cultural preferences?

Born an uncultured male, raised an American boy, prefers life as an American woman.

Born an uncultured male, raised an American girl, prefers life as an American man.

As far as I can tell this only shows that adult gender expressions have very little to do with biology or childhood.

Are babies born gay? You might as well be asking if babies are born doctors or poets!

"In experiments, male adolescent monkeys also prefer to play with wheeled vehicles while the females prefer dolls — and their societies say nothing on the matter."

https://www.google.com/amp/s/amp.livescience.com/22677-girls...

This suggests there may be something deeper than expectation from culture and society.

Monkeys don't have language and culture.

This study suggests nothing about the impact of culture and society on human individuals.

Isn't that the point? Monkeys don't have language and culture, but males and females still prefer different types of things, giving evidence to the argument that it is not simply culture influencing children's toy preferences

This is a study about monkeys. How does this and why should this apply to humans?

Because we both evolved from a distant ancestor, any behavior we share is very likely to be an evolutionary trait.

Little boys and girls also don't want to eat their vegetables or pick up their toys.

What do babies have to do with socialized adult behavior?

I'm not saying that biology has no impact on behavior, I'm saying that it barely has any impact when compared to the influence of language and culture.

Well the research says you are wrong. This is not exactly exiting bed time reading but shows my point.

https://www.researchgate.net/publication/38061313_Men_and_Th...

Actually, you've shown nothing. No-one's denying these differences exist. The question's whether they're mutable. And gender expression is clearly mutable, you just need to visit an old art gallery to see that.

So you'd expect most managers and CEOs to be women right, because that's a job about working with people?

Be careful of statements about human nature whose only evidence is "it's well known that". You can easily ascribe cultural attitudes to something more fundamental without realizing it.

I'd argue that most managerial positions are working with systems and processes. People happen to be a part of those systems and processes. Which is why managers call their underlings "resources" - screws and bolts that can be moved around to make the system more efficient.

Whilst I have sympathy with your cynicism 1) that's not true of _good_ managers and 2) processes are the raison d'etre of HR, which is hardly a male-majority profession.

I would argue that HR is much more about dealing with people, and managers are responsible for providing systems for the people to work effectively in. Especially if you are upper management, you aren't going to be working with people most of the time, you are going to be finding ways to make them work more effectively in a systemic way.

It's funny, everyone thinks HR is about dealing with people, whereas it's actually about processing them. Processing entitlements, processing grievances, processing legal documentation, processing disciplinary procedures. Your line manager's the one with a personal relationship with you.

Mind you, quite a few people think an HR officer is the right person to go to with a problem. This is a _very_ bad idea. HR's job is to protect the firm, not the employees (sometimes this involves pushing out someone senior, but that's unicorn-level rare). If you want someone to represent your interests at work, it's time to unionize. :)

"It is well known that men favor working with things and women favor working with other people." The problem is that you use the status quo as an argument for why things cannot change. There have been a lot of things in history that were "well known" until they stopped being that way. I'm not ignoring the fact here that certain gender-specific evolutionary hardwiring exists. But that does not rule out that there could be ways to get more men to work closely with other people. Such as, as suggested by a commentator above, renaming professions. By the way, doctors work with people, and doctors are often male. It's likely more about status than the degree of work with people.

There is way more mockery targeted at men who like my little pony then on women who like boy shows.

People tend to look down on men who do feminine anything.

This is because women remain looked down upon.

(Unacceptable, but a disturbing reality today)

A woman presenting up, masculine is seen as tough, bold, generally positive terms.

A man, doing anything feminine, is presenting down.

Of course, all of that is silly, rooted in cultural norms too.

We have a lot of work to do before people get past this sorry state of affairs.

People should do what they can and feel good doing.

I think it's because people find certain roles more attractive. Men doing physical work, women doing nurturing roles are found attractive by more of the population.

I think that the women who find males nurses unattractive simply find them unattractive, rather than looking down upon their own gender. It seems a bit of a stretch and a really nasty thing to claim that these women have internalised misogyny.

It is not a stretch. Both men and women are complicit in reinforcing gender roles and perceptions.

Agreed

Women who find males nurses unattractive simply find them unattractive and that is fine. Then there are women and men who look down on male nurses or would feel ashamed in front of friends if their husbands/familly started to work as nurses. That is different and unfair. Calling it sexism (or internalised sexism) is accurate.

There are women who believe that women are less capable in a lot of ways - and expect that from their own children. Partly it is what they internalized in childhood and partly because it can be convenient excuse.

Social value is based on attraction. If a woman feels ashamed of her husband being a nurse, it's because, since most people don't feel this is attractive, society doesn't feel it's attractive. She has chosen a partner that most women would reject as he has low income, making it hard to provide for her children, and is concerned with nurturing rather than competition, which is an undesirable trait for her male children to have.

There is absolutely nothing wrong with wanting a partner who has social value, and you have no right to shame anyone for their biological desires.

I didn't speak to misogyny.

Did make a status argument.

Your point on attraction has merit. I am not sure low attraction is the same as looking down on others.

Very good article. My dad was a nurse for 25 years, and I remember in his graduation photo he was the only man with about 30 women.

I looked for the part about "Their Wives Agree" and didn't find it. What did I miss?

"Ofer Sharone, an assistant professor of sociology at the University of Massachusetts, Amherst, has studied middle-aged white-collar professionals who have lost their jobs. He found that some men who might have been willing to consider lower-paid jobs in typically feminine fields encountered resistance from their wives, who urged them to keep looking.

“Marriages have more problems when the man is unemployed than the woman,” Professor Sharone said. “What does it mean for a man to take a low-paying job that’s typically associated with women? What kind of price will they pay with their friends, their lives, their wives, compared to unemployment?”

This is even more telling when you consider that the husband's employment status is the best predictor of divorce[1]. I wonder if some jobs result in an even higher incidence of divorce than unemployment.

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[1] http://www.asanet.org/sites/default/files/attach/journals/au...

Is this just in the US? In the UK I have had male and female nurses all over.

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