Gender Bias in Critical Care Nursing - Essay Example

Research Proposal Gender Bias in Critical Care Nursing Your Full of  Introduction Advances in healthcare and technology have led to an increase in demand for critical care nurses. While the demand for critical care nurses has increased, supply has not kept up with this rapid pace, which has resulted in an acute shortage (Halcomb et al. 2012). Halcomb et al. (2012) found, among other things, that female nursing students were significantly less likely to show an interest in seeking employment in critical care areas. They noted that this observation was consistent with the findings of other studies, which found an “overrepresentation” of male nurses in critical care but did not explore this issue further (p. 2234). According to the 2011 US census, women accounted for 91.6 percent of registered nurses (Landivar, 2013). The lessened interest of female nurses in working in critical care has thus had a major impact on the availability of nurses for work in critical care. The conceptual definition of the proposed research is that specific characteristics of critical care work can be identified and then show that they contribute significantly to the lower interest of female nurses. With better understanding of the key job characteristics that correlate to female nurses’ interest in critical care, it should be possible to develop programs designed to overturn this perception and lead to more graduating female nurses being willing to consider work in critical care. This could have a major impact on addressing the acute shortage of nurses willing to work in critical care. For the purposes of this research proposal it is assumed that the “total rewards” model used by HR professionals to modify employee attraction can be applied to modifying a graduating female nurse’s perception of critical care nursing as a future career path. This HR model believes that job attributes can be strategically altered to change a nurse’s level of interest. (“WorldatWork,” 2007). Accordingly, the research question is the following: What are the key characteristics of work in critical care with a strong correlation on the perceptions of graduating female nurses of this field as a viable career alternative? A quantitative survey of graduating nurses from West Coast University will be used to measure the total reward factors that correlate to the relatively low perception of critical care as a desired career path. Study Framework The study conducted by Halcomb et al. (2007) examined the relationship between student experience, socio-demographics, and overall interest in seeking work in critical care. The proposed research will differ in two key aspects. Halcomb et al. identified that the most important socio-demographic factor as a predictor of interest was gender (p. 2233). Accordingly, the proposed research will take a narrower view of socio-demographics and focus solely on gender. The research will consider what factors account for the difference in how the two gender groups view critical care as a future career option. Conceptually, socio-demographic characteristics are not readily altered. Educators and hospital administrators have a limited ability to discriminate based on age, gender, or ethnicity. The focus of this research is to discover the factors that are readily amenable to program development. In this light, gender will be considered when making critical care jobs more female-friendly. Halcomb et al. looked at student experience and perceptions of critical care primarily through the lens of the technical aspects of the job function. The proposed study will instead examine the relationship of a broader set of job attributes that rely on the “total rewards” model used by HR professionals to attract new employees to specific jobs. The “total rewards” model holds that several employment factors, such as compensation, benefits, and work life amenities, and not just the technical aspects of the job function can be set and modified to deliver desired employee attraction and retention (“WorldatWork,” 2007). The work of Kloster et al. (2007) supports this broader view, as they concluded that changes to educational programs alone cannot change graduate nurses’ preferences for work areas. Also, changes to working conditions must be considered. It is also assumed that nurses are most flexible in their potential career choice when they are beginning their careers, so focusing on nurses who have just graduated from college is appropriate in this regard. The Halcomb et al. (2007) study also focused on graduating nurses. Review of the Literature Halcomb et al. (2012) found male nursing students were more likely than female students to report a higher level of confidence and interest in seeking employment in critical care areas. This finding was unsurprising to the investigators because of a previous study demonstrating the overrepresentation of male nurses seeking employment critical care in Canada and the overrepresentation of male nurses employed in critical care nursing in countries such as Australia and the Netherlands (p. 2234). Tracey and Nicholl (2007) confirm the findings of Holcomb et al. (2012) in that they found substantial evidence of gender-based differences in career progression in nursing, yet they also note that previous studies have not addressed the specific reasons why this is so. Tracey and Nicholl (2007) provide insight into the complex set of factors to consider when looking at gender differences in the perception of potential workplaces. In particular, they describe how career choices are determined not only by individual choices but also social structure. Dassen et al. (1990) provide insight into the influence of gender regarding nursing careers in critical care. Dassen et al. (1990) found that male nurses were more likely to be attracted to critical care for cultural reasons. For example, they were more likely to be career focused than female nurses. The study by Dassen et al. (1990) is on point except for the fact that it was published 14 years ago. It is noted by Tracey and Nicholl (2007) that social structures are constantly evolving and changing how individual career choices are made. In particular, Tracey and Nicholl (2007) found that there were significant differences between older female nurses and younger female nurses when it came to career planning. This suggests that caution must be taken into account when considering older studies because they may reflect a social structure that no longer exists today. Andrews et al. (2012) studied the effect on gender of job satisfaction for rural RNs in Canada. The researchers looked at multiple factors, including socio-demographic characteristics, employment characteristics, and perceptions of work life. The researchers concluded that there were more similarities than differences between male and female RNs for factors that affect job satisfaction. The study also illustrated the difficulty of isolating gender as an independent factor. In this particular study, males were considered separately from females, yet the male group had other socio-demographic differences as well. In general, the males surveyed were younger, more likely to be single, more likely to be working full-time (as opposed to part-time), and more likely to have advanced diplomas. The proposed study would focus on a narrower band of ages and nursing graduates with a more common educational background. With fewer variations than other socio-demographic factors of the proposed survey population, the proposed research should make it easier to focus on gender differences alone. Kloster et al. (2007) found that career choice perceptions are not static and instead change during the course of a nurse’s education. However, they caution that changes to educational programs alone cannot change graduate nurses’ preferences for work areas. Changes to working conditions must also be considered. Methodology The study will be quantitative in nature, as the goal is to understand the correlation between aspects of work in critical care and critical care nursing as a career choice between male and female nursing graduates. The analyses will be multi-variant as opposed to descriptive. The reason is that multi-variant results are more amenable to regression analyses. A multiple regression analysis is useful to examine the relationship that exists between the variables (Burns and Grove, 2011, p. 398). A cross-sectional survey will be designed with closed-end questions to examine which aspects of the expectations of employment in critical care influence graduates either toward or away from this field of practice. No descriptive data will be elicited. This is similar to the data collection approach taken by Holcomb et al. (2011). Those researchers also created a cross-sectional survey that examined both student characteristics and experience. However, the proposed survey will focus on different aspects of impressions and allow for a separate analysis of the two genders of graduating nurses for critical care practice. The survey instrument will be constructed to illicit a new graduate’s gender and his/her intentions to seek employment in critical care, such as whether or not the student is likely to look at this career choice. Participants will also answer questions about the different aspects of working in critical care (see Appendix B). I am concerned that some graduating nurses may be willing to express publically their perceptions, so this rules out a group discussion format. There may even be reluctance to express negative concerns during one-on-one interviews. As a result, I chose an anonymous online survey as the design most likely to help the nurses feel most comfortable to express their candid perceptions. Sample size, type, methodology, and inclusion/exclusion characteristics: The study group will not be randomly selected. The target population to be surveyed would be graduating nurses from West Coast University in a specific calendar year, so approximately [ ] nursing students. Data collection process: When students enter their last semester during the calendar year they will be sent an online survey that can be responded to anonymously. Quantitative data collection is often unstructured and carried out through one-on-one interviews and discussions. However, for this research we propose to use more structured techniques similar to those used by Halcomb et al. (2011). In particular, we intend to use a survey questionnaire consisting entirely of multi-variant questions to be administered online. Method of protection of human subjects: In consideration of the right to privacy and confidentiality of the students taking the survey, the following steps will be taken: Students will be asked to electronically sign their informed consent (See Appendix A) Surveys will be collected anonymously Individual surveys will be retained in an encrypted database and not released Only group results where the data of specific individuals could not be traced will be released Data Analysis The data will be analyzed through a linear regression analysis. A regression analysis will then be conducted separately for male and female participants. The researchers propose to use IBM SPSS 20.0 for Windows or similar linear regression software to perform the proposed analysis. The findings will be displayed in a series of tables and charts accompanied by a discussion of the results. The method for displaying the findings is stated below. The following table is proposed: Table 1: Perception of critical care characteristics by gender Table 2: Multiple regression analysis of job characteristics and interest in pursuing a job in critical care Other tables and charts will be considered helpful to present the data and results in a manner easy for the reader to comprehend Summary and Conclusions The research focused on a problem significant to nursing, which is a lack of female nursing students seeking employment in critical care. The research will identify problems and the solutions will be proposed to fix them. The research will be of great interest to those wanting to understand the key reasons why female nursing graduates do not gravitate toward critical care roles. It is critically important to the nursing profession that nursing schools not only graduate technically competent nurses but also that they try to meet the demand for nurses in the fields required by the nursing society. References About Critical Care Nursing. (2014). Retrieved March 4, 2014 from http://www.aacn.org/wd/publishing/content/pressroom/aboutcriticalcarenursing.pcms?menu= Andrew, M.E., Stewart N.J., Morgan D.G., & D’Arcy C. (2012). More alike than different: a comparison of male and female RNs in rural and remote Canada. Journal of Nursing Management, 20(4), 561-570. Doi:10.1111/j. 1365-2834.2011.01195.x Bromstein, E. (2014). Survey: The top 10 most attractive professions for men and women. Retrieved on March 6, 2014 from http://www.workopolis.com/content/advice/article/dream-date-professions/ Dassen, T.N., Nijhuis, F.N., & Philipsen, H. (1990). Male and female nurses in intensive-care wards in the Netherlands. Journal of Advanced Nursing. 15(4), 387-393. Doi:10.1111/1365-2648.ep8529915 Halcomb, J., Salamonson Y., Raymond D., & Know N. (2012). Graduating nursing students’ perceived preparedness for working in critical care areas. Journal of Advance Nursing 68(10):2229-2236. Doi:10.1111/j.1365-2648.2011.05911.x Kloster, T., Hoie M., & Skar R. (2007). Nursing Students’ career preferences: A Norwegian study. Journal of Advanced Nursing. 59(2):155-162. Available from: Academic Search Premier, Ipswich, MA. Accessed March 16, 2014. Landivar, L.C. (2013). Men in Nursing. Retrieved on March 4, 2014 from https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf. Stevens, J., Browne, G., & Graham, I. (2013). Career in mental health still an unlikely career choice for nursing graduates: A replicated longitudinal study. International Journal of Mental Health Nursing. 22(3), 213-220. The WorldatWork handbook of compensation, benefits & total rewards a comprehensive guide for HR professionals (pp. 1-13). (2007). Introduction: Exploring the Key Areas. Hoboken, N.J.: John Wiley & Sons. Tracey. C. & Nicholl, H. (2007). The multifaceted influence of gender in career progress in nursing. Journal of Nursing Management 15(7) 677-682. Doi:10.1111/j.1365-2934.2006.00677.x Appendix A: Informed Consent Study Title: Graduating Nurses’ Perception of Work in the Field of Critical Care Investigator: Mercy A. Kendry Ms. Kendry is a student nurse studying the perception that graduating nurses have about working in the field of critical care. Currently there is an acute shortage of critical care nurses. Although the study will not benefit you directly, it will provide information that may help nursing institutions make changes to their programs and work environments so that critical care nursing is more attractive to graduating nurses to alleviate the shortage. The study and its procedures have been approved by the appropriate people and review boards at the West Coast University of Dallas. The study procedures might cause you emotional upset. The study procedure involves responding to an online survey. Participation in this study will take approximately 15 minutes. You are free to ask any questions about the study or about being a subject. Please call Ms. Kendry at (888) 888-8888 if you have further questions. Your participation in this study is voluntary and you are under no obligation to participate. You have the right to withdraw at any time and your relationship with West Coast University will not be affected. The study data will be encoded so that they will not be linked to your name. Your identity will not be revealed while the study is being conducted or when the study is finally reported or published. All the study data will be collected by Ms. Kendry, stored in a secured place, and not shared with any other person without your permission. I have read this consent form and voluntarily consent to participate in this study. ________________________________ __________________ Subject’s Signature Date I have explained this signature to the above subject and sought his or her understanding of this informed consent __________________________________ Ms. Kendry Appendix B: Study Questionnaire The purpose of this study is to determine if male nursing students’ perceived interest in a career in critical care nursing is different from female nursing students. Assuming there is a difference in perception, the research study will explore factors that may contribute to this difference in perception. 1. Are you in your final semester of study for a BSN? 2. Are you male of female? M/F 3. Are you likely to explore critical care as a career option upon graduation? Y/N If you answered no then please skip to question 3. However, if you answered yes then please indicate on a scale from 1 to 10 the importance of the following factors that contributed to your decision (1 indicates no importance at all and 10 indicates critical importance). i) Prior clinical experience ii) Working in a hospital environment iii) Pace and excitement iv) Work schedule v) Helping patients in dire need vi) Expected salary vii) Opportunity for advancement viii) Opportunity for further education ix) Another reason I would consider critical care Please describe. 1. Please indicate on a scale from 1 to 10 the importance of the following factors to your decision (1 indicates no importance at all and 10 indicates critical importance). i) My education has not prepared me adequately for critical care ii) I do not like working in an hospital environment iii) Critical care work is too demanding iv) I do not like the hours v) Critical care work is too bloody vi) Critical care does not pay enough vii) Critical care is a dead end career viii) I have a passion for another field of nursing Please describe ix) Another reason not to consider Please describe Read More