FACTORS RESTRAINING CHOICE OF NURSING AS A CAREER AMONG MALE SSSIII STUDENTS

ABSTRACT
The various institutions offering nursing programmes have continued to witness very low male enrollment while female enrollment continue to increase. This situation created the problem of sex stereotype, gender bias and lack of professional autonomy which could have been addressed if men were well represented in nursing profession. This work therefore was aimed at determining the factors restraining choice of nursing as a career among male SSSIII students in Enugu Urban. The specific objectives of the study were to ascertain the personal, social/environmental, economic, job-related, career-related factors as well as determine which of the group of factors has the most restraining influence in choosing nursing as a career among male SSSIII students. A cross-sectional survey design was used for the study which was carried out in 9 secondary schools in Enugu Urban. Stratified and simple random sampling techniques were used to select the schools. No sampling technique was used to select the students as all the SSSIII students from the selected schools were involved in the study. A total population of 638 male SSSIII students from nine (9) randomly selected secondary schools in Enugu Urban were used for the study. A self-developed questionnaire in 4 point modified Likert type scale with reliability of 0.90 was used for data collection. Descriptive statistics were used to analyze data. Results were presented in tables as percentages, means, and standard deviations. Findings revealed that respondents identified “I don’t like nursing as a career” (mean 2.8; SD=1.11), “I cannot think of myself being a nurse” (mean 2.7; SD=1.05) and “Nursing will lower my ego and integrity” (mean 2.5; SD=1.03) as personal factors that restrain males from choosing nursing as a career. Findings also showed social and environmental factors that prevent males from choosing nursing as a career as “People expect nurses to be women (mean 3.1; SD=0.97), “Nursing has traditionally been viewed as a female profession” (mean 3.1; SD=0.99) and “Nurses are seen as doctors’ servants (mean 2.9; SD=0.99). “Wanting to be rich/make money (mean 3.0; SD=0.9), “Nursing being noble but not lucrative” (mean 2.7; SD=0.99) and “Nursing not being regarded as one of the highly paid jobs” (mean 2.7; SD=0.99) were also established as economic factors that discourage males from choosing nursing as a career. Findings also indicated job-related factors that hinder males from choosing nursing as a career to include “Nurses work during the weekend” (mean 3.1; SD=0.93), “Nursing jobs extend into the night” (mean 3.1; SD=0.91) and “Most nurses work in the hospital” (mean 3.1; SD=0.94). From the findings, the career-related factors that restrain males from choosing nursing as a career are “I did career research on my own” (mean 2.7; SD=0.94) and “I would consider a career held traditionally by males” (mean 2.5; SD=1.01). Based on the findings, the job-related group of factors (with group mean 2.8 and SD=0.61) had the most restraining influence on male SSSIII students in choosing nursing as a career in Enugu urban. Based on the findings of the present study, the following conclusions were made: That secondary school students involved in this study generally identified the factors that restrained males from choosing nursing as a career.  That the issue of choosing or not choosing nursing as a career do not solely depend on one single factor; rather it involves the combination and interaction of all the factors (i.e. personal, social/environmental, economic, job related and career influential factors) which hinges more on the individual decision to do or not to do something. It is therefore recommended that the media should present nursing as a gender neutral profession via strategies such as pictorial representation of males as nurses, stories of successful males in nursing and production of home videos where males play the role of nurses. Practicing male nurses should engage in career promotion programmes in secondary schools. Career counselors in secondary schools should clearly explain the career opportunities for males entering nursing.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CHAPTER ONE
INTRODUCTION
Background of the Study
In contemporary nursing practice in Nigeria, gender balancing is a topical issue.  For decades now, the various institutions offering nursing programmes have continued to witness very low male enrolment, while female enrolment has continued to increase. Solution to the problem seems to be far-fetched because  there  is  no  improvement  in male enrollments in nursing programme even though the entry requirement has been made par with other health-related professions that the society hold in high esteem . The 2004 report of the survey conducted by the Federal Ministry of Health on student nurses enrolment in Nigerian institutions covering the period of 20 years (1980-2000) indicated that the average percent of male enrolment was 4.0%.
 
The Nursing and Midwifery Council of Nigeria (N & MCN) in its 2005 and 2010 reports on student nurses enrolment gave the average percent male enrolment from 2001 to 2010 as 5.8. Specifically, in the School of Nursing, University of Nigeria Teaching Hospital (UNTH), Enugu, out of a total of 63 students who enrolled in nursing programme in 2010, only 9 were males, and in 2011 and 2012, it was 9 males out of 61 and 6 males out of 60 respectively. The average male enrolment in absolute terms was 10.6%. In the School of Nursing, Bishop Shanahan Hospital, (BSH) Nsukka, the average male student enrolment was also 6 from 2000 to 2010, while in 2011 and 2012, out of 51 and 47 candidates that enrolled, only 3 were males respectively. The scenario was the same in the School of Nursing, Enugu State University Teaching Hospital, (ESUTH) Parklane, Enugu, where average male enrolment in nursing programme was 8 from 2002 to 2011. In 2012, out of 110 candidates that enrolled, only 8 were males. (Admission Files from respective schools, 2001-2012; see appendix XII, XIII and XIV). From the above, it is obvious that the proportion of male enrolment in nursing programmes in Nigerian nursing educational institutions has remained persistently low over the years.
The relatively small number of males enrolling in nursing programme is responsible for the corresponding small proportion of males in nursing profession in Nigeria (Daramola, 2004). Male enrolment into nursing depends on whether the individual choose nursing as a career or not since it is not possible to enroll into a programme without choosing it. Career choice is a complex decision for students since it determines the kind of profession that one intends to enroll in and pursue in life. The decision to choose nursing as a career should be considered as a stepping stone to increasing the enrolment of males into nursing programme. As students try to make career choice while in secondary school, they face problems of matching their career choices with their abilities, school performance and the profession to choose. Today, one has to make due career planning as well as exhaustive career research before making a career choice so as to adjust with the evolving socioeconomic conditions (Wattles, 2009). Most of the secondary school students do not have accurate information about occupational opportunities to help them make appropriate career choice and selection. The selection of a career is among the most critical decisions in a student’s life time. This decision has a far-reaching impact on the person’s future in terms of lifestyle, status, income, security and job satisfaction. The decision for males to choose and enroll in nursing is the basis of this research.
 
Exploring and finding the various factors that restrain males from choosing nursing as a career may be a solution to low male enrolment into nursing and to the nursing manpower shortage in the long run. According to Hewitt (2010), career choice is influenced by multiple factors such as personality, interest, self concept, culture, identity, role model, social/economic/ environment, stereotypes of gender, globalization and resources (information, financial or economic). These factors may interact to influence or determine males’ aspiration, choice and enrolment to pursue nursing. In order words, the choice a person makes, the values a person holds, the social class in which a person belongs and aspires to belong, the interest the person has, the resources, gender, and career prospective of a profession/occupation, all enter into the decision and choice of a career one choose and enrolls into. Hence, the choice of nursing as a career for males is not merely a decision of a moment but a product of combination of many factors which this study sets out to find as it relates to factors restraining males from choosing nursing as a career.
 
Statement of Problem
In Nigeria, gender imbalance is more striking in nursing profession than in any other field of science. Research reveals that low male enrolment into nursing programme represents males as minority group in the profession. This no doubt creates the problem of sex stereotype and gender bias for the profession as males see themselves and are seen by the society as a minority group in a female dominated profession. This situation has equally created some professional image problems that could have been addressed if males are well represented in nursing profession. For instance, the problem of professional autonomy for nursing which is still lingering due to gender imbalance and delayed decision making on issues affecting the profession has continued even till date. There is no doubt that males owing to their natural makeup are better equipped and favourably disposed to formulate policies that will shape the organization and enhance growth in the profession.
 
A case in point is the issue of nursing placement and internship programme which would have received more vigorous and immediate attention had men been at the helm of affairs in nursing profession. Males by their nature are pillars; they act as shield and provide security wherever they find themselves. They take decisions, oversee the growth, expansion and development of whatever endavour they engage in. By their traits, males are more outspoken and have more bargaining power than females. They are better equipped to handle situations as supervisors and managers. They are capable of enforcing attitudinal change, overcoming weaknesses and maximizing human potentials as well as predisposed to carrying out administrative responsibilities with strength and vigour.
 
The problem of nurses not being well represented in the nation’s political leadership circle can also be directly related to few number of males in nursing profession. The females who constitute majority in the profession are not naturally disposed and equipped to play active politics like the men as they are occupied with family affairs and can hardly have time for nocturnal political meetings as men do. Consequently, as a result of relative low number of male nurses in health policy formulation, programme design, planning and implementation even at the Ministry of Establishment where far-reaching management decisions affecting professions are made, nurses do not have a voice in matters affecting the profession. Hence, other medical professionals take decisions that affect nurses.
 
Furthermore, males are required urgently and in large numbers so that there will be enough male nurse educators that would act as role models and mentors for the males that still want to pursue the career.            Moreover, in clinical areas, there are certain roles and functions in nursing profession that demand masculine attention such as lifting of patients, holding psychiatric patients, attending to emergency cases in the theatre and orthopedic wards etc. Women are very fragile and may not be able at all times to cope with some of these energy demanding responsibilities.
 
Considering the above urgent importance and problems identified, there is the need for males to be well represented in nursing profession. But there seems to be no hope as records available to the researcher reveal that in some secondary schools in Enugu State, out of 452 male students that graduated in the past three years (2009-2012), only 5 males aspired to be nurses (2009-2012 School Year Books). The question begging for answer is: why are few males choosing nursing as a career when in theory equal opportunities for male and female exist in all areas of any career? The foregoing present the problems which necessitated this study as no such study had been carried out in Enugu State Nigeria. Hence, the need to ascertain the factors restraining males from choosing nursing as a career.
 
Purpose of the Study
The purpose of this study is to find out factors that restrain male senior secondary (SSSIII) students from choosing nursing as a career in Enugu state.
 
Objectives of the Study
The specific objectives of the study are:
(1)       To ascertain the personal factors that restrain male secondary school students from choosing nursing as a career.
(2)       To determine the social/environmental factors that prevent males from choosing nursing as a career.
(3)       To ascertain the economic factors that discourage males from choosing nursing as a career in Enugu State.
(4)       To ascertain job-related factors that hinder males from choosing nursing as a career in Enugu State.
(5)       To determine the career related factors that restrain males SSSIII students from choosing nursing as a career.
(6)       To determine which of the group of factors that has most restraining influence on male SSSIII students from choosing nursing as a career.
 
Research Questions
In pursuance of the set objectives of the study, the following research questions were posed.
(1)       What personal factors restrain male secondary school students from choosing nursing as a career?
(2)       What social/environmental factors prevent males from choosing nursing as a career as a career in Enugu State?
(3)       What economic factors discourage males from choosing nursing as a career?
(4)       What job-related factors hinder males from choosing nursing as a career in Enugu State?
(5)       What career related factors restrain male SSSIII students from choosing nursing as a career?
(6)       What group of factors has most restraining influence on male SSSIII students from choosing nursing as a career?
 
Significance of the Study
The findings from this study will be of benefit to nursing profession, prospective males that want to be nurses, the health sector and society at large. The findings revealed the factors that restrain males from choosing nursing as a career and indirectly reduce the number that may enroll to study nursing and inversely lowers the inputs of males towards the growth of the profession. It will also give insight to prospective male nurses on factors that hinder their aspiration to be a nurse and will aid in finding out how to overcome such
hindrances. The findings also revealed factors that encourage or reinforce gender bias in the profession as well as help to detect some of the factors that reduce the output or input of males in provision of nursing care services to the masses. To policy makers and the society at large, findings from this study reinforced the need for holistic guidance and counselling services at the secondary school level so as to provide a wide variety of career choices and equally emphasize the fact that no career is superior to the other or exclusive preserve of any gender. Finally, findings from this study will add to the existing literature on this topic and serve as point of reference to other studies.
 
Scope of the Study
The study covered male SSIII students from government schools from three local government areas in Enugu Urban. The choice of government schools was based on the fact that they have homogenous regulations governing them than schools owned by religious and private bodies (individuals). The choice of SSSIII students was predicated on the fact that they are the prospective career choosers at the point of decision making. They are not biased or been exposed to any career at this level. The study was delineated to identifying the personal, social/environmental, economic, job-related, career-related factors that prevent, hinder, discourage or restrain males from choosing nursing as a career as well as determine which of the group of factors that has most restraining influence to choosing nursing as a career among males SSSIII students.
 
Operational Definition of Terms
For the avoidance of ambiguity, some recurring terms used in this study are defined operationally as follows:
 
Restraining factors to choice of nursing: In this study, restraining factors to choice of nursing refer to all factors or phenomenon which can be personal, social/environmental, economic, job characteristics and career related factors that inhibit, prevent, hinder, discourage or restrain males from choosing nursing as a career in Enugu urban as measured by the items in the Restraining Factors to Choice of Nursing as a Career Questionnaire (RFCNCQ).
 
Choice of nursing as a career: In the context of this study, this is defined as choosing nursing as a career, wanting to do or not to do, to enroll or not, to pursue nursing as a career or not.
 
Career Choice: In this study, this implies selection between two or more career options or vocations to pursue.
Personal factors: This entails person’s likes, dislikes, wants, interest, values, makeup, influence of traits, self perceptions, opinions, ability, views, feelings, acceptance to do or not to do.
 
Social factors: This refers to things, facts, experiences, activities, events, and interactions that influence individuals in the society to make a career choice such as culture, laws, regulations, relationships with people, influence of others, social status, approvals, public recognition, public opinion, public perceptions/views, events, activities, situations, interests and interactions in the society.
 
Economic Factors: Refer to individual’s ability to make a choice based on considerations such as earning capacity, cost of training, amount of time spent, financial worth or value, competing demand/supply, job availability and competition, supply of money, financial comfort, being able to afford what one wants monetarily or its equivalent.
 
Environmental factors: In the study, environmental factors refer to forces/issues that affect people’s life such as interactions, views and opinions, problems, culture, politics, technology, societal perceptions around or within a place etc operating/obtained in a setting which affect choice of career or vocations of an individual.
 
Job-related factors: Refers to characteristics, attributes, or things inherent or peculiar to a career or vocation, such as time of work, what to do, work responsibilities, occupational hazards, working environment, educational requirement, nature of vocation or career.
 
Career-related factors: Refers to what or things that can influence one to choose or not to choose a career such as peers, friends, parents, teachers, mentors, family members, family business, preferred school subjects, and existing jobs.