RESEARCH

 

Male students' motivations to choose nursing as a career

 

 

I Noordien^I; J Hoffman^II; H Julie^III

^IM Nursing; School of Nursing, Faculty of Community and Health Science, University of the Western Cape, Cape Town, South Africa
^IIMCur; School of Nursing, Faculty of Community and Health Science, University of the Western Cape, Cape Town, South Africa
^IIIPhD; School of Nursing, Faculty of Community and Health Science, University of the Western Cape, Cape Town, South Africa

Correspondence

 

 

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ABSTRACT

BACKGROUND. Men comprise approximately 11% of the nursing population globally, and 9.1% of the South African (SA) nursing workforce. Nursing workforce shortages require strategies for recruiting new nurses, including more males. A university in the Western Cape Province, SA, reported an increased enrolment of males to the nursing programme, and wished to understand the factors motivating this, in order to improve the recruitment of males.
OBJECTIVE. To determine factors that motivated male students to choose nursing as a career, and to determine any association with demographic characteristics.
METHODS. Data were collected from a stratified sample of 218 male undergraduate nursing students at a residential university in the Western Cape, using a structured questionnaire to determine their demographic profile and extrinsic and intrinsic motivating factors behind their choice of field of study.
RESULTS. Most respondents were single black males aged 18 - 25 years, with no dependents, who originated from the Eastern Cape Province of SA. The majority started their nursing studies when aged 20 - 24 years, and had no prior healthcare or nursing experience. The highest scoring intrinsic motivating factors were wanting to make a difference in society and a desire to help people. The highest scoring extrinsic motivating factor was wanting a stable career, while the lowest scoring extrinsic motivating factor was flexible work hours in nursing. When considering extrinsic motivations, having dependents/children was significantly associated with potential salary and other monetary benefits as well as career mobility.
CONCLUSION. Men choose nursing as a career for both altruistic motivations as well as monetary benefits. These motivations should be used to attract more men into the nursing profession.

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Since the mid-19th century, nursing has traditionally been a female-dominated profession, with a small number of males entering it.^[1] Men in nursing are challenged by barriers such as stereotyping, sexism and socialisation issues.^[2] Those men who enter the nursing field may have initially been drawn to the clinical setting, but these challenges often cause them to respond by working in high-tech, low-touch specialty areas and administration.^[3] Some countries have instituted equity targets that include recruiting more male nurses to meet clients' preferences.

Despite societal needs for quality healthcare, research notes that males account for only of the nursing population globally, and 9.1% in South Africa (SA).^[4] Recruiting more males into the profession is one way of addressing the demand for more nurses, simultaneously meeting the need to diversify the nursing profession.^[5,6] Successful recruitment strategies should take into account the motivation of potential nursing incumbents.

Men who choose to enter the nursing profession are either intrinsically or extrinsically motivated. Intrinsic motivation is an incentive to engage in a specific activity because pleasure is derived directly from the activity.^[7] The intrinsic motivating factors for most men choosing nursing range from altruistic desires to a sense of achievement and self-validation.^[8-10] In contrast, extrinsic motivation is inspired by an external incentive to engage in a specific activity.^[7] Some of the extrinsic motivating factors for men choosing nursing as a career include salary, employment security, flexibility in terms of working hours and returning to the workforce, travel opportunities and the influence of family and friends.^[8-11]

Although males remain a minority within this female-dominated profession, a university in the Western Cape Province, SA, reported an increased enrolment of males in the nursing programme. The 20% male enrolment for the undergraduate nursing programme is higher than figures reported globally and elsewhere in SA.^[4] The university was interested in uncovering the factors motivating male students to enrol in the undergraduate nursing programme, in order to improve the recruitment of males.

The objectives of this study were therefore to: (i) identify the factors that motivated male students to choose nursing; and (ii) determine the association between demographic characteristics and motivating factors.

 

Methods

This descriptive cross-sectional study was conducted among male students registered for the undergraduate nursing programme (N=218) at a residential university in the Western Cape. This setting was chosen because this school offers a 4-year Bachelor of Nursing (B Nursing) programme and a 5-year extended programme offering an additional foundation year, which prepares students to join the mainstream 4-year programme in their second year of study. A total of 920 female students and 218 male students were enrolled in the B Nursing programme in 2018. The researchers used stratified random sampling, as the population was divided into subgroups according to year levels of study.^[12] The entire male student population (218) from both undergraduate programmes was included.^[13]

Instrument

Respondents were asked to complete a questionnaire consisting of two sections, one on demographic characteristics and the other on their motivations for choosing nursing. The demographic section included information about their age, gender, level of nursing, province of origin, year of matriculation, prior nursing experience, marital status and number of child dependents.

The section on their motivations for choosing nursing as a path of study consisted of 15 questions. Intrinsic motivation was assessed using 5 items asking about different personal and internal motivations for choosing nursing, for example: 'I have a desire to help people' and 'I want to make a difference in society'. Extrinsic motivation was determined using 10 items, for example: 'my parents encouraged me to do nursing', 'nursing has flexible working hours' and 'potential salary and other monetary benefits'.

All items were scored on a 5-point Likert scale ranging from 0 = strongly disagree to 4 = strongly agree. Items were used as individual responses, and no scale total was calculated owing to the varying nature of the intrinsic and extrinsic motivators covered. The questionnaire was assessed for face validity by nurse academics who were responsible for teaching and selection of undergraduate students and offering the B Nursing programme.

Data analysis

SPSS version 26 (IBM Corp., USA) was used to analyse the data. Responses to each motivator were converted into a percentage of total agreement for each item, where a response of 'strongly disagree' (0) equated to 0% agreement with the motivator, and a response of 'strongly agree' (4) equated to 100% agreement with the motivator. The average percentage agreement for each motivator was determined for the sample using this method, in order to determine the primary motivators.

Pearson's correlation testing was performed to determine the association between the demographic factors of age, level of study and number of children, and the motivational factors. A one-way analysis of variance was used to determine if there were differences in motivation between groups.

Ethical considerations

The ethical principles of informed consent, respect for autonomy, confidentiality, anonymity and beneficence were adhered to in this study. Ethical clearance was given by the Human Sciences Research Ethics Committee of the University of the Western Cape (ref. no. HS18/2/2) and permission was obtained from the head of the School of Nursing prior to data collection.

 

Results

A response rate of 65.5% («=143/218) was obtained. Of these, 12 (8%) male students were enrolled in the foundation year and 92% (n=131) in the B Nursing programme at the following levels: 1st year = 25% (n=35); 2nd year = 27% (n=39); 3rd year = 20% (n=29); and 4th year = 20% (n=28).

The main findings relating to the demographic profile of the male students indicated that 77% (n=110) were classified as black, with 84% (n=120) aged 18 - 25 years. The majority (95.8%; n=137) were single and most (79.7%; n=114) had no children. The majority (83%; n=119) of these male students came from either the Eastern Cape Province (44%; n=63) or the Western Cape (39%; n=56). The origins of the remainder were spread across the other provinces of SA.

Table 1 gives an overview of the main findings on the year in which the students matriculated, age when they first considered nursing as a profession and age upon entering the nursing programme.

 

 

A slight majority (53%; n=76) had been studying prior to starting the nursing programme, while most (88%; n=126) had no prior healthcare or nursing experience.

Motivations for choosing nursing

Table 2 summarises the intrinsic motivating factors for choosing the nursing profession in this sample, according to the percentage of agreement with various statements. The intrinsic motivator with the highest level of agreement (91.61%) was wanting to make a difference in society, followed closely by the desire to help people (89.86%). The intrinsic motivator with the lowest level of agreement (55.77%) was having always wanted to be a nurse.

Levels of agreement with extrinsic motivating factors are displayed in Table 3. The highest level of agreement on extrinsic motivating factors was on wanting a stable career (88.81%) and a variety of career paths available (86.71%). Factors with the lowest levels of agreement in this sample were flexible work hours in nursing (40.91%) and nursing as a second option for studies (38.64%).

Association between demographic profile and motivation

No significant associations were found between demographic factors and intrinsic motivations for choosing nursing. When considering extrinsic motivations, it was found that having dependents/children was significantly associated with potential salary and other monetary benefits (r=0.18, p<0.01) and upward career mobility (r=0.22, p<0.01).

 

Discussion

The findings reveal that the majority of respondents matriculated between 2013 and 2014. This could be attributed to the introduction of the 5-year extended programme in 2013. According to the Council of Higher Education,^[15] the intention of the extended programme is to enable underprepared but talented students to achieve academic success in higher education.

The majority of the respondents (n=85; 60%) first considered nursing as a career between the ages of 18 and 25 years (mean 19 years). This corresponds to the results of a study by Stanley et al.^[16] that indicated that in comparison with female students (82.8%), only 47.8% of male respondents had considered nursing as a career before the age of 20 years.

The study also revealed that the majority of respondents (n=71; 50%) started their nursing careers between the ages of 20 and 24 years. Stanley et al.^[16] found that the majority of their female respondents (71.3%) started their nursing careers before the age of 20 years.

The study indicated that the motivation of 'wanting to make a difference in society' was identified as topmost for overall motivation (intrinsic and extrinsic), as well as being the most important intrinsic motivator (91.6% agreement). Similar results were reported in a study by Haigh,^[9] where 73% of the male nursing students in Western Australia chose the same intrinsic motivation factor. The 'desire to help people' was ranked second highest intrinsic motivator for the male student nurses, with 89.8% agreement. This confirms the findings of similar quantitative studies;^[11] the study by Haigh^[9 reported that 84.1% of male nursing students in Western Australia stated that a desire to help people was their main reason for choosing nursing as a career.

The 'variety of career paths' was identified as the second most important motivation (extrinsic) factor, with 86.7% agreement. Haigh^[9] reported similar findings, stating that 71.4% of the males in the study selected variety of career pathing as the second reason for choosing nursing. Twomey and Meadus^[10] reported that males found nursing to be very versatile, and indicated this as their fourth-most important reason for choosing nursing as a career.

'Variety and challenges of the work' was ranked as the third highest motivation (intrinsic), with 80% agreement. Male nurses in Canada indicated nursing as a 'challenging and responsible profession' as their third motivation, according to Twomey and Meadus.^[10]

'Being able to travel overseas' was ranked third for extrinsic motivation, with 81% agreement. This finding is similar to that reported by Twomey and Meadus,^[10] but much higher than the 60.3% reported by Haigh.^[9]

 

Conclusion

Most of the respondents were single black males aged 18 - 25 years, with no dependents, who came from the Eastern Cape. The majority started their nursing studies between the ages of 20 and 24 years, and had no prior healthcare or nursing experience.

The intrinsic motivating factors with the highest level of agreement indicated by the respondents in this study were wanting to make a difference in society as well as a desire to help people. The motivating factor with the lowest level of agreement was having always wanted to be a nurse.

The extrinsic motivating factors with the highest level of agreement indicated by the respondents were wanting a stable career, and the variety of career paths available. The extrinsic motivating factors with the lowest level of agreement were the flexible working hours of nursing, and nursing as a second option for study.

No significant associations were found between demographic factors and intrinsic motivations for choosing nursing. Regarding extrinsic motivations, significant associations were found between having children/dependents and potential salary and other monetary benefits as well as upward career mobility.

We recommend that schools of nursing should collaborate with high-school guidance and career counsellors during recruitment drives. This strategy will ensure that potential nursing students are given accurate information about the nursing profession and undergraduate nursing entry requirements.

Declaration. This article was based on a study done by IN in partial fulfilment of her Master's thesis at UWC.

Acknowledgements. The authors acknowledge Leverne Gething for providing editorial support, and Emma Wagener for support with statistics.

Author contributions. IN, JCH and HJ conceptualised and designed the study; IN co-ordinated the data collection; IN, JCH and HJ participated in the data analysis and manuscript organisation; and IN, JH and HJ wrote and approved the final and revised manuscript for this publication.

Funding. We express gratitude towards National Research Foundation for funding provide throughout preparation of this publication.

Conflicts of interest. None.

 

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Correspondence:
H Julie
hjulie@uwc.ac.za

Accepted 24 August 2020