When we hear the word “nurse”, we think of a woman with an apron, mainly because the nursing profession in Nepal has been the exclusive preserve of females. But then the country does have a history of male nurses. The Institute of Medicine (IOM) under Tribhuvan University trained four batches of male nurses between 1986 and 1993, during which time almost 80 male nurses were produced.The enrolment of male nurses was terminated for two main reasons. One, it was a new profession for males and people were uncomfortable. “The patients would not accept male nurses. They started complaining about not getting proper as they would from female nurses,” says Tara Pokhrel, President of the Nursing Association of Nepal (NAN), the umbrella body for nurses in Nepal.
“This made our jobs tough,” says Ratna Guragain, a male nurse from the first batch at the IOM. Guragain would serve as a professional nurse for 20 years before his retirement.
The other reason for the termination of male enrolment was that the trained male nurses refused to serve in rural areas as they were expected to do.
So male nursing is not a completely new concept in Nepal. And on June 19, Nepal Nursing Council (NNC), the main nursing regulatory body in the country, once again decided to enroll male students in nursing courses starting this year in all 125 nursing colleges in Nepal. Fifteen percent seats have been reserved for male students and they will be allowed to enroll in two courses—‘Staff Nurse’ and ‘Bachelor of Science in Nursing’. If all goes according to the plan, every year 1,155 male nurses will be produced.
But what explains the NNC’s decision to enroll males again, after over two- decade hiatus?
“The society has changed. People are now more literate and understand that nursing is not an exclusive women profession. So we thought we would give it another shot,” says Goma Devi Niraula, President of NNC. “The demand is high and frankly, male nurses have become a necessity today.” The NAN played the lead role in implementing the decision, after almost three years of homework.
“We started to hear from Nepalis abroad that there was a huge demand for male nurses in other countries. This also made us consider if male nurses had become a necessity in Nepal as well,” says Pokhrel of the NAN.
There are many instances of people who have completed their Bachelors and Masters in other streams opting to take up nursing courses when they went abroad. “For instance, I personally know of a doctor with an MD who left his job in Nepal to study nursing in America,” says Pokhrel.
Even though the initial enrolment for males had to be terminated party because male nurses refused to serve in remote areas, Pokhrel is more hopeful this time. “The pay at remote government hospitals is good these days,” she says. She also pointed out the desperate need for male nurses during emergencies like the 2015 earthquakes.
The subtle pressure from the International Council of Nurses, a federation of over 130 nurses association around the world including the NAN, also played a part. In fact, Nepal was the only country associated with the council that did not have male nurses, and the council pressed for more gender equality.
Says Khusbu Sapkota, a professional female nurse, “The inclusion of male nurses will make a big difference in our field. In my time in India, patients and doctors used to prefer male nurses particularly in Operation Theatres and Intensive Care Units. This is because they are strongly built and can shift patients with ease during difficult medical procedures.”
According to Sapkota, many Nepali male patients also find it easier to deal with male medical stuff, for instance during insertion of Foley’s catheter in the male urethra.
Challenges, old and new
Nonetheless there are many challenges to male enrolment. It is possible, says Pokhrel, the NAN president, the 15 percent male quota will be difficult to fill, at least initially, mainly because of lack of awareness among prospective students of the scope for male nurses. This is why the association plans many awareness-raising activities.
When APEX approached 50 SEE graduates this year, we found just one student who was willing to enroll in nursing. The rest said they would be embarrassed to study what was still a ‘girl’s profession’. Even Anil Thapa, the sole SEE graduate who intends to take up the course, says he is doing so at the instigation of his father, a medical doctor. But given a choice he would opt out. Why? “I fear being ridiculed by my friends.”
The IOM staff are, however, convinced that many male students will enroll as it is a job that is both financially rewarding and emotionally satisfying.
Other than that, there are concerns that male students might take this course only as a stepping stone to another health profession. “In the past, over 50 percent male nurses changed their profession, to later study Bachelor Public Health or Master of Public Health,” says Pokhrel. “They wanted to serve in top positions of certain government health institutes instead of working in hospitals.”
She says she is not confident that the same thing won’t happen again and if that is the case, “there is no point in teaching nursing to male students.” Also, even though the society has progressed, Pokhrel doubts male nurses will be accepted by female patients easily as “there is a lot of physical contact in this profession, even in sensitive areas of the body.”
More than 81,000 nurses are currently registered with the NNC, and there is an over-production of nurses every year. Income-wise, governmental hospitals offer lucrative salaries but the offerings in private hospitals are comparably low. This is why there is always the risk that the new male nurses would rather choose to go abroad rather than serve in low-paying private hospitals, or even in well-paying government ones. Just as is happening with female nurses, greener pastures could also lure them abroad.