By KN Kumar
The image of the nurse in India, as across much of the world, is still shaped by a powerful stereotype: that of a compassionate woman in white, tending to the sick with gentle care. While this image evokes respect, it also perpetuates a gendered narrative that has far-reaching consequences for the nursing profession and society at large. Nursing’s feminization is a legacy of both colonial and social forces. Florence Nightingale’s reforms, while revolutionary, also solidified the idea of nursing as “women’s work.” In India, this was reinforced by social norms and institutional practices, including gender-based reservations that persist either formally or informally. An 80:20 female-to-male ratio is still observed, justified by perceived “appropriateness” for patient comfort and care, reinforcing the stereotypes and limiting the opportunities for men even as the profession’s scope and complexity have grown far beyond traditional caregiving.
The North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) in Shillong has become a focal point of this debate. The Hynniewtrep Youth Council (HYC) has been actively demanding the formal implementation of an 80:20 female-to-male nurse recruitment ratio at NEIGRIHMS, aligning with practices at AIIMS, New Delhi, JIPMER, etc.
In early 2025, NEIGRIHMS issued a job advertisement to fill 105 Nursing Officer posts (backlog vacancies) without specifying any gender ratio. The HYC expressed concern that this would lead to a disproportionate number of male nurses being recruited, which they argue is unsuitable given the patient demographic and cultural sensitivities. The HYC president highlighted that some female patients, especially in sensitive wards such as the MICU, PICU, and ICU, often felt uncomfortable with male nurses attending to them or their children. The Council also pointed out that only a few departments at NEIGRIHMS cater exclusively to male patients, making a high proportion of male nurses unnecessary. The NEIGRIHMS clarified that the advertised vacancies were not for fresh recruitment but for ‘Backlog Vacancies’ that arose from non-acceptance, non-joining, resignations, or non-availability of suitable candidates in various categories from previous recruitment cycles. Recruitments at NEIGRIHMS are conducted according to the ‘Model Roster and Regional Roster’ mandated by DOPT guidelines. Currently, there is no provision in the existing Recruitment Rules for an 80:20 female-to-male ratio. NEIGRIHMS had requested the Ministry of Health and Family Welfare, Government of India, for such a provision in July 2024, but the Ministry, in August 2024, had advised against adopting such a ratio. This decision has sparked protests by the HYC.
The controversy underscores the complex intersection of gender, culture, and healthcare delivery in the Northeast and highlights the challenges of balancing inclusivity with local social realities. It is often argued that women are naturally more considerate and compassionate, and thus better suited to nursing. Scientific research does show that, on average, women tend to score higher on measures of empathy and compassion, possibly due to both biological factors (such as higher oxytocin release) and socialization. However, these are average differences with significant overlap—many men are deeply compassionate and effective caregivers, and individual variation far outweighs group averages. Moreover, contemporary research and patient feedback refute the belief that men cannot be as gentle, concerned, and compassionate as their female counterparts. The skills that define a good nurse—clinical competence, communication, problem-solving, and empathy—are not exclusive to any gender. Nursing is a profession grounded in science, critical thinking, and teamwork, as much as it is in compassion.
Stereotypes Harm
Everyone
Labelling nursing as “women’s work” perpetuates stereotypes that harm both men and women. Men face stigma, lack of support, and discrimination, while women are boxed into caregiving roles, undermining their natural potential for other professions and career advancement. Gender-based labels such as “male nurse” are injurious, as they preserve sex-segregation and reinforce stereotypes that affect both men and women in the profession. Men entering nursing often face scepticism and questioning of their masculinity. Male nurses sometimes encounter resistance from colleagues or are assigned only physically demanding tasks, reinforcing their role as exceptions rather than equals.
A gender-diverse workforce brings a wider range of perspectives, skills, and experiences, which can improve patient care and workplace culture. Research shows that de-gendering nursing and building a gender-balanced workforce strengthens the profession and optimizes its ability to serve society. Besides, modern healthcare ethics demand respect for the dignity and unique attributes of every individual, regardless of gender. Excluding or discouraging men from nursing based on presumed biological differences is discriminatory and does not align with contemporary values of fairness and equality.
India stands at a crossroads. India, like much of the world, faces a severe shortage of nurses. There are over three million registered nurses in India. The World Health Organisation’s recommendation is three nurses for a population of 1000 people. The current figure in India is 1.7 per 1000 people. In 2021, a group of nursing and midwifery organisations came together to highlight this acute shortage of nurses through their campaign titled ‘#NurseMidwife4Change’. They claimed that India would need at least 4.3 million more nurses by 2024 to meet the WHO standards.
To meet this challenge, we must move beyond outdated notions of who can be a nurse. Artificially limiting the profession to one gender reduces the talent pool and makes it harder to meet the growing demand for healthcare services. De-gendering the nursing profession is not just about fairness or equality—it is about building a stronger, more effective healthcare system for all. Encouraging more men to join nursing is essential to address these shortages and ensure better patient care. While social and perhaps biological factors may influence the development of empathy, compassion is not exclusive to women. Men can and do develop these qualities, especially in supportive educational and professional environments. The idea that only women are suited for caring roles is a social construct, not a biological fact. Male nurses now make up only about 11% of India’s nursing workforce; several barriers persist for them.
Policies should encourage applications from all genders and focus on building a workforce that reflects the diversity of the population. Integrate feminist pedagogy and gender-sensitivity training into nursing curricula. This means challenging stereotypes and empowering students to see nursing as a profession for everyone. Challenge the public perception of nursing through media, outreach, and education. Campaigns that showcase male nurses as competent, compassionate professionals can help break down stereotypes and attract a broader range of candidates.
The ongoing debate at NEIGRIHMS exemplifies the challenges and complexities involved, but also the urgent need for dialogue and reform. Balancing cultural sensitivities with inclusivity and merit-based recruitment is essential. Let us envision a future where nursing is seen as a noble, respected profession open to all, regardless of gender. Let us support policies and practices that value merit over stereotypes, and let us celebrate the contributions of every nurse—man or woman—who dedicates his/her life to caring for others. By breaking down barriers, we can ensure that India’s nurses, of all genders, are empowered to lead, heal, and inspire. This may call for a wider discussion, for the original policy of 80:20 was implemented at the AIIMS way back in 2019. It is not that anyone is at fault, as of now. HYC insists that NEIGRIHMS follow the practice that is nationally adhered to, while the Director, NEIGRIHMS, cannot violate the current recruitment rules of the DoPT. While acknowledging that short-term expediency always overwhelms the long-term concerns, I urge the stakeholders not to lose sight of the future. A future that demands that we act from now on!
(The writer is former member of the IAS)