Deep-seated sociocultural beliefs and practices appear to be a major stumbling block to Barbados fully utilising a segment of its population that could help address the brain drain of its nurses.
Research has found that males who enter the profession continue to face societal stigma and are often ridiculed. The findings of a study by PhD candidate Wasim Worrell of the Cave Hill campus’s Department of Government, Sociology, Social Work and Psychology have implications for other Caribbean countries that face similar shortages of nurses, like Barbados.
The World Bank has estimated that three times the number of English-speaking CARICOM nurses were working abroad than in the region — mostly in the United States, the United Kingdom, and Canada.
In its 2009 report entitled The Nurse Labour and Education Markets in the English-Speaking CARICOM: Issues and Options for Reform, the institution suggested that the gap between demand and supply of nurses will widen by over 7,000 by 2025.
In his research presented during Cave Hill’s 60th Anniversary Graduate Research Symposium hosted by the School for Graduate Studies and Research, Worrell offered insights into challenges facing male nurses. His topic was “Using Participant Sketches to Explore the Experience of Professional Socialization”. He said although there had been a significant increase in the number of men pursuing careers in nursing over the decades, they remained underrepresented.
Using biographical data, participants’ diaries, and interviews, he analysed the work experiences of ten male nursing students operating at the Psychiatric Hospital in Barbados. Many admitted nursing was a last option. Some were influenced by family members in the profession who had travelled overseas and were successful. For those nurses, he said, they viewed the profession as a stepping stone to working abroad.
He said some participants recalled being ridiculed and being thought of as ‘soft’ for their choice: “Some of the cultural views were, ‘My friends laughed at me.’; ‘We’re only going to last a week.’; ‘Are you actually doing this?’; ‘Can’t you find another job to do?’”
They also recounted stereotypical views, disillusionment, dissatisfaction with pay and barriers to further training: “They believe that people still saw nursing as a woman’s job, and they had to navigate that. Sometimes, men in practice were not allowed to go to specialty areas such as neonatal. They were denied certain clinical experiences. I also found that even in the terminology you’d find notes signed by the ward sister and even books referring to nurses as females.”
He said the participants’ sketches also provided valuable information about perceptions of the nurses and made it easier to broach certain topics that the males initially found difficult to discuss.
Worrell was one of three presenters during the segment on Advancing Health Research in the Caribbean. The others were Dr. Elizabeth Mandeville and Tricishanna Henry.
Dr. Mandeville, a Master of Philosophy (MPhil) student in Public Health, looked at “Factors Influencing Pharmacological Adherence to T2DM Treatment: The Role of Social Inequalities in an Advancing Technological Age”. Her research is critical given that Type 2 diabetes is regarded as a global public health crisis, having been responsible for the death of millions of people worldwide. She noted that Barbados has a diabetes prevalence of 18.7 per cent compared to the global average of 10.5 per cent in 2021.
She also confirmed that pharmacological adherence to Type 2 diabetes mellitus treatment can reduce disabilities caused by the diseases, mortality rates and healthcare expenditure. At the same time, it was found that social inequalities can impact pharmacological adherence. Therefore, she studied patients living with the disease who were between the ages of 25 and 65 years in public primary healthcare clinics.
Her study was done at a number of polyclinics that were selected based on the 2016 Barbados Survey of Living Conditions that showed the areas with the highest poverty index.
In the first phase of her interview, which involved 30 patients and 22 healthcare workers, she found that social problems and psychological factors affected adherence. There were complaints about access to healthy foods; poor support systems, especially for the elderly; financial challenges; a lack of communication between the healthcare workers and the patient; and frequent shortages of medications in polyclinics. Additional factors were stress, depression, anxiety, beliefs, attitudes, and preferences.
“There needs to be a greater focus on the management of the disease, and an individualised model of care is needed. The global theme was then inferred and showed that a patient-centred Type 2 diabetes mellitus management strategy is needed to improve adherence among low socio-economic patients living with Type 2 diabetes.”
Like Dr. Mandeville, Tricishanna Henry is conducting a two-phase study. Her research on “The Use of Cannabidiol to Reduce Blood Pressure in an Increased Systematic Vascular Resistance Model in Wistar Kyoto Rats” could prove timely since many Caribbean countries have budding medical cannabis industries.
Cannabidiol (CBD) is a naturally occurring chemical or one of the main phytocannabinoids in the most common type of cannabis plant, cannabis sativa. The chemical has therapeutic benefits, including in the management of epilepsy.
Hypertension is a major cause of cardiovascular diseases, and Henry zeroed in on its vascular effect.
The Preclinical and Health Sciences student explained, “When this occurs it is referred to as endothelial-dysfunction in which there is an interference with the release of chemical mediators such as nitric oxide. Nitric oxide is a major mediator that produces vasorelaxation and decreased blood pressure. So in endothelial-dysfunction, there is a decrease in nitric oxide, [and] hence, a decrease in vasodilation resulting in increased systemic vascular resistance which leads to hypertension.”
Although she noted conflicting results between CBD and hypertension, she said studies have shown CBD had a vasodilator effect (dilation of the blood vessels) that can be of benefit in hypertension. Therefore, in phase one of her study, human aortic endothelial cells will be grown. CBD will be administered in increasing concentration to the cells and assessed. Phase two involves five groups of male rats. The treatment will vary for the different groups for comparison purposes and closely assessed and analysed. Henry said these phases will be done only after the necessary ethical approval had been obtained.
