Methods:
The study was done using qualitative content analysis, resulting in themes. Data was collected using focus groups. The format of the group interview was informal and conversational. Focus groups allowed interaction between participants who were sharing daily practice as male nurses working in Jordanian hospitals. Each focus group was considered a group with a common interest. Ethical approval was granted by Research & Ethics Committee of the Faculty of Nursing at The University of Jordan (No 8/23/4/2015).
Participants: Inclusion criteria for the participants were: male; nursing education completed in Jordan; working in a hospital in Amman, Jordan as a registered nurse; at least five years’ experience as a nurse. Twenty-one male registered nurses, who met the inclusion criteria, were invited to participate in focus groups. Each of the four groups contained 4 to 6 participants who all worked in the same hospital sector (government, private, not-for-profit or university affiliated).
Data Collection: Data collection occurred during 2015 in a private conference room at the Jordanian Nursing Council (JNC), in Amman, Jordan. A semi-structured interview guide was used to stimulate the discussion. It included questions and prompts related to: decision to become a nurse, advantages of nursing as a career, disadvantages of nursing as a career, perception of the work environment, and satisfaction with nursing as a career. Following each guided question, the moderator requested more detailed explanations. The moderator intervened as little as possible, to avoid disturbing the flow of conversation, and to encourage focus on the issues that the participants themselves considered important.
Each group lasted about 90 minutes. Experienced researchers conducted the groups in Arabic, the native language of the participants and researchers. During the interview, one researcher acted as a moderator while a second researcher acted as an assistant moderator, taking notes that could be used to clarify what was recorded. Everyone spoke and understood Arabic. The focus group sessions were audio-recorded and transcribed verbatim. The audiotapes were translated into English by a professional translator and reviewed for accuracy by the Jordanian research team who are fluent in both Arabic and English.
Data Analysis: The focus group transcripts were analyzed using the qualitative content analysis approach as described by Polit and Beck (2008). This method utilizes the qualitative data obtained from the focus groups and presents it in an integrated manner of themes and subthemes. Two of the researchers independently read and reread the focus group transcripts noting data clusters which were then grouped into themes. After independently establishing themes, the two researchers compared their results and worked together to form consensus.
Rigor and Trustworthiness: Methodological rigor was addressed using the criteria established by Lincoln and Guba (1985). Credibility was promoted through independent reading of the focus group transcripts by the two researchers who speak Arabic (Jordanian team). They immersed into the data by reading the focus group transcripts several times to look for nuances and context. Their independent clustering of data into themes was then reviewed by both for consensus of themes.
Demographic data about the participants and a description of the setting where they work provided context to the data which can enhance transferability. In addition, by utilizing a theoretical framework and including implications for nursing education and health care policy, it is more likely that the findings will demonstrate some transferability, at least to other countries with similar religious and social characteristics. Dependability was enhanced by utilizing four focus groups that represented the various health care sectors (private, university, government) that exist in Jordan. To promote confirmability, an audit trail, including field notes and memos was maintained by the researchers.
Results: Four major themes emerged from the data. They are: choosing to become a nurse; satisfaction with the career; impact of working in a predominantly female profession; and professional adaptation. Each theme had several subthemes. Choosing to become a nurse included: rank in secondary school exams, support from family, job security and economic stability, and professional interest. Satisfaction with the career included the following subthemes: nursing as a virtuous profession, the intersection of science and art, and being in a people oriented profession. The impact of working in a predominantly female profession contained four subthemes: professional empowerment and autonomy, professional self-esteem, emotional labor, and productivity. Professional adaptation included: the rewards and drawbacks of being a male nurse, positive and negative aspects of the work environment, and gender recruitment biases.
Conclusion: The male nurses were overall satisfied with their nursing careers, in spite of the fact that it was not always their first choice for university study. The men viewed themselves as more productive as nurses than their female counterparts, as well as overall better able to do the work of nursing. Regarding professional self esteem, there were notable differences between men who worked in private sector hospitals and those who worked in the government run hospitals, with those in the government hospitals lacking pride in being a nurse. Gender recruitment bias was perceived as both negative and positive. The men indicated that some hospitals limited the number of men that that hired, even going so far as to post a sign that said there were no jobs for male nurses.