Entering forbidden territory - Value conflicts of female Muslim student nurses providing personal care to male patients: A qualitative study

Background: Saudi Arabia is now facing a critical nursing shortage and is under considerable pressure to recruit more local nurses. However, attracting Saudi Arabian women into the nursing profession has traditionally been difficult due to religious and cultural barriers.

Objectives: The study was designed to provide insights into the research participants’ experiences or awareness of conflicts between professional nursing values and the dominant religious and cultural values of Saudi Arabia.

Design: The research took the form of a qualitative case study.

Setting: The study was conducted at a leading university in Saudi Arabia.

Participants: The participants consisted of 24 female Muslim student nurses from the second and fourth years of study of the BSc Nursing degree and six female Muslim College of Nursing faculty members from the same university.

Methods: Data collection methods consisted of individual interviews and focus groups, and thematic analysis was used to analyse the data. The study used a theoretical framework based on Rokeach's (1973, 1979) theories of values and value change.

Results: All student participants were found to be experiencing conflicts between the nursing requirement to provide personal care to male patients, and their religious and cultural values relating to personal modesty. Faculty participants were aware of the presence of this value conflict, but it was not being formally acknowledged or addressed at the case study institution. The lack of official practice or policy guidance was found to be reinforcing the potential for the value conflict. Participants regarded religious values as fixed and mandatory, but cultural values as subject to change.

Conclusions: It was concluded that awareness-raising initiatives and open discussion of value conflicts should be conducted by the university to help realign the participants’ culturally influenced values with the requirements of nursing. The available Islamic guidance should also be used to clarify the institution's official position on the provision of personal care to male patients by Muslim female nurses and improve understanding of the nursing tasks acceptable within Islam.