It’s rewarding, a flexible job that offers variety, “a passion, a science and an art that will always be needed”. That’s how male-identifying nurses describe their job. Another reason for loving their job: They help break down gender roles and stereotypes. Still, women nurses are overrepresented. In Asia, Europe, America and the Pacific, man nurses make up 15-20% of the workforce. In Africa as a whole, about a third of all nurses identify as men. Perhaps these numbers are not surprising. Still, it’s important to explain the reason for this disbalance: Typical nursing qualities are generally associated with womanhood. Think of being caring, devoted and at the service of the patients. Let’s have a closer look at the origins and effects of the gendered nursing role.

The history of nursing this entry discusses focuses on Europe where, in the Middle Ages and even before, women healers practised medicine based on empirical knowledge, practice and experience. Though their remedies were not clinically tried and tested as is the standard nowadays, many of their cures were fairly effective. In fact, herbal remedies discovered by medieval women healers are still being used today. The fungus ergot, for instance, was used as a painkiller for mothers giving birth and is still a principal drug to speed up labour and recovery after childbirth. Besides, women healers studied bones and muscles. In that same period, male health practitioners trained at university relied on religion, astrology and superstition in their healing practices.

The training of male physicians at universities made it easy to establish medicine as a profession and bar women from medical practice. Starting from the 14th century, the Church, state and male medical practitioners initiated campaigns against women healers all over Europe. Not only were women denied access to university, but they were also prosecuted for practising medicine – sometimes as witches.

Female healers were not attacked as incompetent (because they weren’t, at least not compared to university-trained practitioners at the time). Instead, their empiricist way of working was linked to sexuality and presented as a surrender to the senses, that is, to the Devil’s arena. Over the centuries that followed women were portrayed as “ignorant”, “superstitious” and unable to work in an “objective”, science-based profession, effectively excluding them from the medical domain.

Although women did not get to work as medical experts, they were still present in hospital settings by the early 19th century: as nurses. Their tasks required no medical knowledge, most of their work consisted of feeding and cleaning the sick. Nursing was not deemed respectable: Nurses were often lower-class, unschooled and sometimes engaged in prostitution and thievery. It was Florence Nightingale who established the image of the nurse as a selflessly devoted, obedient lady who followed her natural instincts to care. Nightingale insisted that her nurses obeyed male doctors. When she and a group of women nurses arrived in the Crimea to help out in battle, none of them was allowed to lift a finger until the doctors gave an order. This example shows how nurse training emphasised character, not skill. The image of the male doctor, by contrast, was built around intellect and competence.

The history of women in medicine is thus wrought with sexism. For a long time, the only medical work women were allowed to do was nursing, which explains why today by far most nurses identify as women. The fact that women nurses were told to subject themselves to male doctors explains why nursing is still seen as a “lesser” occupation. This in turn accounts for the huge pay gap between nurses and doctors (whilst it must be noted that women earn less than men regardless of their function; male-identifying nurses make more than women nurses in, among other places, the US, UK and the Netherlands).

The underrepresentation of men in nursing matters, because it upholds the idea that men cannot care. This not only places an undue burden of care on women but may also lead men to suppress their empathetic and emotional side. Next to that, patients sometimes wish to be looked after by a man nurse, think of male patients who get a catheter. Campaigns like #MenDoCare and Men in Nursing Together in the UK attract men into the profession. Such initiatives are important but must be paired with broader societal change than normalises men doing care work.