Experiences of Male Nurses Providing Internet-Based Home Nursing Services: A Qualitative Study

For decades, the image of a nurse has been almost universally female, a perception rooted in history and reinforced by the sheer number of women in the profession. Yet, as populations age and chronic illnesses become more common, the need for medical care is stretching beyond hospital walls and into the private spaces of people's homes. In China, a system known as "Internet Plus Nursing Service" has emerged to bridge this gap. Through a digital platform, patients can request professional care at their doorsteps, allowing those who are bedridden or have limited mobility to receive treatments like wound care, tube maintenance, and catheter changes without the strain of traveling to a clinic. While this model offers a lifeline to many, it also places nurses in a unique and often unpredictable environment. Unlike a hospital, where teams of colleagues are nearby and the setting is controlled, a home visit is a solo mission. The nurse must navigate unfamiliar spaces, manage their own supplies, and build trust instantly with a family that may have never met them before. In this shifting landscape, the gender of the nurse becomes a significant, yet complex, factor in how care is received and delivered.

A team of researchers from Zhengzhou Central Hospital set out to understand exactly how male nurses navigate this specific world. They conducted a series of in-depth conversations with eleven male nurses from various hospitals across Henan Province. These men, ranging in age from twenty-six to thirty-seven, had between four and thirteen years of experience and had collectively performed hundreds of home visits. The researchers asked them to share their stories, focusing on the moments when their gender mattered most: the advantages they felt they possessed, the barriers they faced, and the support they needed to do their jobs safely and effectively. The goal was not to simply count how many men were working in this field, but to understand the texture of their daily reality.

The men described a reality where their gender identity was neither a simple superpower nor a simple handicap; rather, it was a tool that worked differently depending on the situation. On one hand, many reported feeling a distinct sense of security and capability when entering a patient's home alone, especially during evening hours. They noted that their physical strength was often an asset when it came to moving patients who were weak or helping to position heavy equipment. In moments of unexpected trouble or emergency, several felt that their presence provided a calming influence that helped manage the situation. However, this same physical presence could become a hurdle when the care required intimate contact. When a male nurse arrived to perform a procedure on a female patient, such as inserting a urinary catheter or cleaning a private wound, it often triggered immediate hesitation or refusal from the family. The nurses recounted having to explain their qualifications and reassure skeptical families before they were even allowed to begin their work.

Conversely, for male patients requiring similar intimate care, the presence of a male nurse was often a relief. Families frequently expressed that they felt more comfortable with a man performing these tasks on a male relative, viewing it as a matter of modesty and convenience. The researchers found that the male nurses learned to read these social cues quickly. They discovered that while a patient's initial reaction might be shaped by gender stereotypes, that reaction could change rapidly once the nurse demonstrated professional skill. A smooth procedure, a clear explanation of what was happening, and a respectful attitude often dissolved the initial doubt. The men learned that their competence was the ultimate bridge to trust, capable of overcoming the initial awkwardness of a stranger entering a private home.

Despite these personal strategies, the nurses faced systemic challenges that had little to do with gender but were amplified by the nature of working alone. The home environment was unpredictable; one house might be spacious and clean, while another might be cramped, unsanitary, or lacking the necessary equipment. The nurses had to carry their own supplies, and the fear of forgetting a critical item or running out of materials was a constant source of anxiety. Furthermore, the digital platforms that connected them to patients were often criticized for being difficult to navigate or for failing to provide clear information about costs and service details. Some patients were unaware that such a service existed, while others were put off by the cumulative fees for travel, treatment, and materials. The nurses felt that without better support from their hospitals and the platforms, they were left to manage these risks entirely on their own.

The study concluded that for male nurses to continue providing these vital services, the system needs to evolve to support them. The researchers suggested that hospitals and platforms should work together to provide better training, specifically focusing on safety, risk assessment, and communication skills. They recommended that scheduling be made more flexible so that home visits do not simply become unpaid overtime added to an already full day. Perhaps most importantly, they argued that the way services are marketed and assigned should be more thoughtful. By allowing patients to indicate their preferences regarding the nurse's gender before a visit is scheduled, the system could prevent the awkwardness and refusal that often occur when a nurse arrives at the door. The findings suggest that while being a man in a female-dominated field presents unique challenges in the home care setting, it also offers unique strengths. The key to unlocking the full potential of these nurses lies not in changing the nurses themselves, but in building a support structure that recognizes the complexity of their work and the specific value they bring to the patient's home.