Ever have a patient comment on his lack of size?

Nurses General Nursing

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I felt so embarrassed. :imbar

I had to cath this man who was in his 40's, he ended up having to go for emergency surgery, he was in agonizing abd pain with a perfed bowel. When I went to cath him he managed to mentioned that it was all shriveled up. (Incidentally, he actually appeared to be a normal sized male)

The surgeon actually wasn't sure if he was going to survive surgery, but he did come back with an A-line, CVP line, and a brand new ileostomy. On the second day I had him, he managed to go more in depth into the fact that he "doesn't have much down there that any girl would be interested in" and comments like that. Honestly, this man was totally average looking.

He was a very gentle man, mid 40s, gainfully employed, who still lives with his mother, who was really nice. I just didn't know how to handle this. I think this must have been a life long insecurity. I almost said to him that he wasn't actually small, he really wasn't, but I didn't want to act like I really notice this. But, I do have vast experience with this aspect of nursing, I do notice if a man looks either unusually larger or smaller than the average, and this man definately was actually probably better than average, especially since he was in a cold hospital room in agonizing pain.

Anyone ever run into this issue?

Specializes in DOU.

As a student, I wonder what would be so wrong with simply telling the poor guy that he looks "normal" to you? He's probably lived with such anxiety over this for so long, it might be very meaningful for him to hear it from someone who sees so many memberes.

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As a patient rights advocate I find the sexual overtones of this thread

somewhat alarming. First, there is absolutely nothing funny about someone's insecurities. PERIOD!

Second, in 2006 there were 329,000 breast augmentation surgeries

performed in the U.S. Talk about insecurities! Finally, remember that the

general public looks at these threads as well!

Somewhat? Try spending some time at the nurses station in a level one trauma center. I worked police security as a second job in the ER for several years. I found the sexual overtones very alarming!

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As a student, I wonder what would be so wrong with simply telling the poor guy that he looks "normal" to you? He's probably lived with such anxiety over this for so long, it might be very meaningful for him to hear it from someone who sees so many memberes.

That approach might work for some guys. For others it won't. As one other poster pointed out, such innocent comments might be construed the wrong way. To counsel a patient in that way might overstep the boundaries of nursing, unless it is agreed that counselling is part of the nurses treatment options. I can't see how it would be in the OP's case. A simple, "I didn't notice" might be the best response overall.

Also, guys don't like to be reminded how many memberes a nurse sees. Like it makes anyone an expert.

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Specializes in PACU.

When I was younger I read in my mom's Cosmopolitan magazine (yeah, yeah, I was bored and going to the bathroom and it was all that was available) that flaccid size does not correlate with erect size. Some comment to that effect might make someone feel better without directly saying anything about his member size in particular. The "I didn't notice" response also sounds appropriate, but might somewhat irritate a patient that knows it is truly tiny.

It is a delicate issue and I can imagine how it might be distressing even for "normal" or above average sized guys to have near-strangers handling their genitalia. I know enough to not worry much about, but I still was slightly uncomfortable when I had an inguinal sebaceous cyst removed and had my member pretty much flapping in the breeze due to the practical inability to adequately drape it. There's a certain vulnerability that having yourself exposed and manipulated creates even if you know that it's necessary and nothing to be ashamed of.

I believe that my experience there has helped me to better keep that in mind when caring for patients. I find that talking to patients about something innocuous and preferably of interest to the patient during such intrusive procedures is an excellent way to avoid awkward feelings or comments.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.
That approach might work for some guys. For others it won't. As one other poster pointed out, such innocent comments might be construed the wrong way. To counsel a patient in that way might overstep the boundaries of nursing, unless it is agreed that counselling is part of the nurses treatment options. I can't see how it would be in the OP's case. A simple, "I didn't notice" might be the best response overall.

Also, guys don't like to be reminded how many memberes a nurse sees. Like it makes anyone an expert.

That was my feeling on the matter. I wanted to be nonchalant about the subject and pretend like it was something I never really pay attention to. I'm not particularly curious about this, and avoid glancing 'down there' whenever possible, but definately can't help but noticing at times, esp anatomical extremes.

Incidentally, I've had the patient again, I did perceive some intangible oddness about him, and something odd about the relationship between him and his mother, now that he's feeling better. He struck me as a social drop out, conspiracy theorist type by some of his comments, with OCD overtones. He started doing his own ostomy bag emptying on his own, so he was beginning to cope with this alteration in eliminatory function and body appearance. No more comments on lack of size, his foley was out and he was voiding on his own.

You mentioned the nurses station, I just wanted to comment here that I didn't share this story about his insecurities in report, it seemed very personal.

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:yeahthat:

Yes I have, but the comments about his member didn't stop there - 'nuf said?

I don't know. It sounds like he may be looking for something more from you, but not necessarily with regard to his perceived lack of endowment. It sounds like he has some serious self-esteem issues, so I would approach it on that level.

You might just matter-of-factly say something to the effect of, "you look average to me," and move on very quickly to self-esteem issues.

Good luck!

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Specializes in ICU, telemetry, LTAC.

The first male patient I cathed, had a bladder tumor blocking the foley. My preceptor finished putting it in there. He screamed and cried, and it was fairly jarring for me as well, particularly since he started crying the next day when I went into his room. Not like we were going to go through that again, but anyhow. We didn't know he had a tumor in there, they found that out after I went home. There hasn't been another one quite as traumatic as that.

Everyone's got their umm... thing that will be useful to distract them, sometimes you do well and sometimes you don't. Education works for some, humor for others (not about the equipment, find something else that's funny) and completely unrelated conversation for others. One ole feller did remark on size and I had to go and say the dumbest thing that came to mind: "it's okay, size don't matter." (Then I thought, oh WTH didja say that for!!!) The patient may have been demented but he had enough sense to say "well what are you staring at it for?" I will not ever say that again to a patient. Eek.

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I've heard this comment enough times to realize it's going to happen from time. As a male, I took it as the person was confiding in me and that's how I handle it. Something to the effect "Don't be so hard on yourself, there is no need for that." Working in LTC, the subject has never came up again with the same resident (usually rehab folks).

As another poster noted, there is a condition called Small member Syndrome that involves males that fall within the normal range, but have body image issues that are real to them but have no basis in reality.

In any case, I wanted to convey these comments are heard by males also. It may not necessarily be directed toward female nurses to make them uncomfortable. Any other guys out there have similar experiences?

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That was my feeling on the matter. I wanted to be nonchalant about the subject and pretend like it was something I never really pay attention to. I'm not particularly curious about this, and avoid glancing 'down there' whenever possible, but definately can't help but noticing at times, esp anatomical extremes.

Incidentally, I've had the patient again, I did perceive some intangible oddness about him, and something odd about the relationship between him and his mother, now that he's feeling better. He struck me as a social drop out, conspiracy theorist type by some of his comments, with OCD overtones. He started doing his own ostomy bag emptying on his own, so he was beginning to cope with this alteration in eliminatory function and body appearance. No more comments on lack of size, his foley was out and he was voiding on his own.

You mentioned the nurses station, I just wanted to comment here that I didn't share this story about his insecurities in report, it seemed very personal.

If you didn't share this story about his insecurities in report because

you say it seemed very personal, then why are you sharing them here.

I really have to wonder what you real motive is for starting this

thread. Seems odd to me!

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Specializes in Nursing assistant.
I only hope you did not say that to an actual patient. :no:

Yes I did. I was embaressed and he thought it was funny...

Why?

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Specializes in Nursing assistant.
Yes I did. I was embaressed and he thought it was funny...

Why?

Whoops, spelled embarrassed incorrectly...that's embarrassing...

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Yes I did. I was embaressed and he thought it was funny...

Why?

Seems to me if he apologized to you for being small and you accepted his apologies then you are agreeing that he was small. Sorta like you saying to someone "sorry about my fat hiney" and they say "apologies accepted."

(not saying you have a fat hiney, I was just using that as an example):bugeyes: :cheers:

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