The present study describes the nurses’ point of view about the social and cultural challenges that they may face while creating their professional image. Traditional historical aspects of nursing indicate that the occupation embodies universal characteristics of the feminine. The results of this study revealed four key themes that emerged from the thematic analysis, which are interlinked with themes and sub-themes [22] relating to the social and cultural challenges facing the nursing profession: 1) gender-based discrimination, 2) inappropriate portrayals by the media, 3) issues around marriage settlement, and 4) identity from a religious perspective (Table 3).
Gender-based discrimination
The first theme that emerged from the study findings was gender-based inequality, or rather gender-based discrimination. Muslim societies mainly give preference to female nurses to care for their patients [23]. Butler [24] argued that the concept of a “natural sex” predates socialisation, which is the basis for being gendered. In patriarchal societies, it is obligatory for women to fulfil the needs of men [25], which perpetuates strict adherence to gendered roles. When men enter a female-dominated profession like nursing, their roles do not conform to the predominant hegemonic masculinity [26]. A staff nurse summarized this aspect as follows:
My female friend’s brother does not consider nurses to be good professionals – neither male nor female nurses. His point of view about nursing professionals is no more positive. I wish he would marry a nurse so he could understand their situations and how the judgement of societies is purely based on cultural stigmas. (Participant 8)
Inappropriate portrayals in the media
The study results illuminate another important theme related to the visibility and portrayals of the nursing profession in the media. The media disseminates a stereotypical image of nurses, along with the concept of objectification, which involves ignoring a person’s intellectual capacities only because of her gender identity. The public objectifies female nurses as handmaidens of doctors and to provide pleasure for their sexualized gaze. Buresh, Gordon and Bell [27] explained in their book “From Silence to Voice: the Truth about Nursing” that a key cause of the global nursing shortage is the lack of real respect for nurses, which devalues the nursing profession on the basis on performativity [24]. A ward head nurse from the ICU department, with 12 years of work experience, said:
I remember a drama serial called “Nurse” that was aired during my childhood. The image of nurses was that they took money from patients’ relatives for the sake of their poor families. The story of this drama was about kidnapping a newborn by a nurse for the sake of money. (Participant 5)
Issues around marriage settlement
Marriage settlements for nurses in this society also emerged as a challenge. The intimate nature of the nursing profession violates the social and cultural taboos in relation to bodily contact [28]. The public uses derogatory slang for nurses, such as calling them “sleeping pills” for physicians. Butler [29] explained the implications of language, which can be manipulated and used as a source of power in patriarchal culture. In this way, speech acts on women’s bodies as on a passive medium, in such a way that, in nursing, public slang leads to a sense of unsatisfactory performance. A head nurse with 12 years of work experience commented:
My former partner broke off our engagement just because I wanted to continue within the nursing profession. Now my present partner does not want me to continue further with my job in nursing. He wants me to leave this profession and join another. And just to satisfy him, I am studying an MSc in Psychology besides my nursing job. (Participant 9)
Identity from a religious perspective
The final theme emerging from the study results was the social identity of nurses from a religious perspective. Muslim societies stigmatise nurses for their interactions with male patients [12]. Within the nursing profession, the natural touching of bodies and patient privacy is an integral part of the nurse–patient interaction, regardless of culture. Butler [19] explained that gendering is a way to mark persons as subjects deserving of respect. Something strange happens to women, turning them into objects because of their feminine identity. In Catholicism and Islam, the covering of the female head signifies humility, submissiveness and dutifulness, and the nurse’s uniform also shapes a negative stereotypical image of their gendered, grounded nature within a dominant organisational culture [30]. A deputy chief nursing superintendent shared her experience of 18 years in the following way:
I had the experience of attending a male patient who belongs to a religious family. His wife said to me: “I am very much worried about Pakistani nurses; how will you protect yourself on the day of Akhrat (The Day of Judgment)?” (Participant 10)