Degendering Male Nursing Students’ Intimate Care Provision: A South African Perspective

Background: Male nursing students remain a minority group in nursing education and training programmes. They are thought to have diverted from their prescribed roles as men, leading to professional stereotypes and fear of providing intimate care. In addition, the lack of role models and support for male nurses adds to their frustration during clinical placement. The aim of this study was thus to understand male nursing students’ experiences when providing intimate care to diverse patients during clinical placement. Methods: A descriptive phenomenology design was employed. Male nursing students from two nursing education institutions in Gauteng province, South Africa, were purposively sampled based on their experiences and their exposure to providing basic nursing care requiring physical closeness and touch. Twelve (12) male nursing students participated in individual semi-structured interviews. Data were analysed using phenomenological analysis of horizontalisation, creating meaning and essence of intimate care experiences. Results: Four themes emerged from intimate care experiences, which were (1) helping others with basic physical care; (2) cultural issues related to touching naked bodies of diverse patients; (3) adherence to basic nursing care principles; and (4) discomforting reactions during intimate care and touch. Conclusions: Male nursing students are willing to provide quality care to diverse patients. However, some do not accept intimate care and touch based on gender. For male nursing students to be competent in caring for patients, they must be able to provide intimate care to diverse patients confidently and comfortably. Thus, degendering intimate care provision is essential for male nursing students—to provide care without fear of being stereotyped and misinterpreted as sexual predators. Instead, they must be accepted as nurses who are helping patients with their physical needs.

basic nursing care; cultural issues; intimate care; male nursing students; touch

[1] Hoeve Y, Jansen G, Roodbol P. The nursing profession: pub-lic image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing. 2014; 70: 295-309.

[2] Bassey SM, Bubu NG. Gender inequality in Africa: A re-examination of cultural values. Cogito: Multidisciplinary Re-search Journal. 2019; 11: 21–36.

[3] Younas A, Sundus A. Experiences of and satisfaction with care provided by male nurses: a convergent mixed-method study of patients in medical surgical units. Journal of Advanced Nursing. 2018; 74: 2640–2653.

[4] Baker MJ, Fisher MJ, Pryor J. Potential for misinterpretation: an everyday problem male nurses encounter in inpatient reha-bilitation. International Journal of Nursing Practice. 2022; 28: 1–10.

[5] van Wyk N, van der Wath A. Two male nurses’ experiences of caring for female patients after intimate partner violence: a South African perspective. Contemporary Nurse. 2015; 50: 94–103.

[6] African News Agency. Male nurse due in court for murder of four-year-old girl. 2019. Available at: https://www.iol.co.za/news/south-africa/north-west/male-nur se-due-in-court-for-murder-of-four-year-old-girl-29889898 (Accessed: 29 July 2022).

[7] Serra G. Nurse, 52, arrested after allegedly rap-ing two-year-old stepdaughter. 2020. Available at: https://www.iol.co.za/news/south-africa/nurse-52-arreste d- after-allegedly-raping-two-year-old-stepdaughter-42043234 (Accessed: 29 July 2022).

[8] Harding T, North N, Perkins R. Sexualizing Men’s Touch: Male Nurses and the Use of Intimate Touch in Clinical Practice. Re-search and Theory for Nursing Practice. 2008; 22: 88–102.

[9] O’Lynn C, Krautscheid L. Original research: ‘how should I touch you?’: a qualitative study of attitudes on intimate touch in nursing care. American Journal of Nursing. 2011; 111: 24–31; quiz 32-3.

[10] Shakwane S, Mokoboto-Zwane S. Demystifying sexual conno-tations: A model for facilitating the teaching of intimate care to nursing students in South Africa. African Journal of Health Professions Education. 2020; 12: 103.

[11] O’Lynn C, Cooper A, Blackwell L. Perceptions, experiences and preferences of patients receiving the clinicianʼs touch during in-timate care and procedures: a qualitative systematic review pro-tocol. JBI Database of Systematic Reviews and Implementation Reports. 2016; 14: 96–102.

[12] Kelly MA, Nixon L, McClurg C, Scherpbier A, King N, Dornan

T. Experience of Touch in Health Care: a Meta-Ethnography across the Health Care Professions. Qualitative Health Research. 2018; 28: 200–212.

[13] Pedrazza M, Minuzzo S, Berlanda S, Trifiletti E. Nurses’ Com-fort with Touch and Workplace well-being. Western Journal of Nursing Research. 2015; 37: 781–798.

[14] Papantoniou P. Are male nurses sexually harassed? A cross-sectional study in the Greek Health System. BMC Nursing. 2021; 20: 137.

[15] McAllister L, Callaghan JEM, Fellin LC. Masculinities and emotional expression in UK servicemen: ‘Big boys don’t cry’?Journal of Gender Studies. 2019; 28: 257–270.

[16] Thompson GN, McClement SE, Peters S, Hack TF, Chochinov H, Funk L. More than just a task: intimate care delivery in the nursing home. International Journal of Qualitative Studies on Health and well-being. 2021; 16: 1943123.

[17] McAllister M, Brien DL, Piatti-Farnell L. Tainted love: Gothic imaging of nurses in popular culture. Journal of Advanced Nurs-ing. 2018; 74: 310–317.

[18] Shakwane S, Mokoboto-Zwane S. Promoting intimate care facil-itation in Nursing Education Institutions in South Africa. Inter-national Journal of Africa Nursing Sciences. 2020; 13: 100226.

[19] Mainey L, Dwyer T, Reid-Searl K, Bassett J. High-Level Real-ism in Simulation: a Catalyst for Providing Intimate Care. Clin-ical Simulation in Nursing. 2018; 17: 47–57.

[20] Shakwane S. Journey less travelled: Female nursing students’ experiences in providing intimate care in two nursing educa-tion institutions in Gauteng province, South Africa. Health SA Gesondheid. 2022; 27: 1–8.

[21] Rehman T. Phenomenology, Symbolic Interactionism and Re-search: From Hegel to Dreyfus. Science & Philosophy. 2018; 6: 197–209.

[22] Jackson C, Vaughan DR, Brown L. Discovering lived experi-ences through descriptive phenomenology. International Journal of Contemporary Hospitality Management. 2018; 30: 3309–3325.

[23] Christensen M, Welch A, Barr J. Husserlian descriptive phe-nomenology: A review of intentionality, reduction and the nat-ural attitude. Journal of Nursing Education and Practice. 2017; 7: 113–118.

[24] Sharma G. Pros and cons of different sampling techniques. In-ternational Journal of Applied Research. 2017; 3: 749–572.

[25] Priest H. An approach to the phenomenological analysis of data. Nurse Researcher. 2003; 10: 50–63.

[26] Johnson JL, Adkins D, Chauvin S. A Review of the Quality In-dicators of Rigor in Qualitative Research. American Journal of Pharmaceutical Education. 2020; 84: 138–146.

[27] Harding T, Jamieson I, Withington J, Hudson D, Dixon A. At-tracting men to nursing: is graduate entry an answer? Nurse Education in Practice. 2018; 28: 257–263.

[28] Grant BM, Giddings LS, Beale JE. Vulnerable bodies: compet-ing discourses of intimate bodily care. Journal of Nursing Edu-cation. 2005; 44: 498–504.

[29] Achora S. Conflicting image: Experience of male nurses in a Uganda’s hospital. International Journal of Africa Nursing Sci-ences. 2016; 5: 24–28.

[30] Burton CW. Paying the Caring Tax: The Detrimental Influences of Gender Expectations on the Development of Nursing Educa-tion and Science. Advances in Nursing Science. 2020; 43: 266–277.

[31] Shahzad S, Ali N, Younas A, Tayaben JL. Challenges and ap-proaches to transcultural care: an integrative review of nurses’ and nursing students’ experiences. Journal of Professional Nurs-ing. 2021; 37: 1119–1131.

[32] Dowdell EB, Speck PM. CE: Trauma-Informed Care in Nursing Practice. AJN, American Journal of Nursing. 2022; 122: 30–38.

[33] Clair D. You want to touch me where? Using intimate touch in wound care. Wound Care Advisor. 2014; 3: 32–34.

[34] Fleishman J, Kamsky H, Sundborg S. Trauma-informed nursing practice. OJIN: The Online Journal of Issues in Nursing. 2019; 24.

[35] South African Nursing Council. Nursing Education and Train-ing Standards. Code of Ethics for Nursing Practitioners in South Africa (pp. 1–125). 2005.

[36] Tollstern Landin T, Melin T, Mark Kimaka V, Hallberg D, Kidayi P, Machange R, et al. Sexual Harassment in Clinical Practice—a Cross-Sectional Study among Nurses and Nursing Students in Sub-Saharan Africa. SAGE Open Nursing. 2020; 6: 237796082096376.

[37] MacArthur HJ. Beliefs About Emotion Are Tied to Beliefs About Gender: The Case of Men’s Crying in Competitive Sports. Frontiers in Psychology. 2019; 10: 2765.