Ever have a patient comment on his lack of size?

Nurses General Nursing

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

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 neuro, ICU/CCU, tropical medicine.

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!

there is actually a newer dx, called:

Small member Syndrome

http://www.sexuality.about.com/od/glossary/g/small_member_syn.htm

it involves obsessive anxieties, often reflecting the larger "body dysmorphic disorder", and sometimes, even psychosis.

interesting info.

leslie

Key issue: Lives with his mother.

Seriously, have you ever known very many men that were out-of-college, lived with their mother, that dated much?

I may sound cold, but his mother is probably verbally abusive...may be a Norman-Bates-type issue....he lived with his mother and she was forever telling him how worthless he was, so he never had the courage to leave. Women are going to see older men that still live with their mother as odd, and may not go out with them even if they have an attraction.

Stress may have contributed to his bowel problems as well.

He needs massive counseling.

Specializes in ED, ICU, Heme/Onc.

The comments about lack of size or how long it's been since 'anyone' has been 'down there' crosses age and gender lines - at least in my experience. I usually say something along the lines of "this is the emergency room, you are having a catheter placed into your bladder, it is certainly understandable that you are not at your best" (notice how I leave myself out of that statement - it is completely intentional).

I think that if this patient keeps mentioning the catheterization, a simple "I didn't recall anything out of the ordinary" and allowing him to express his fears isn't out of line in this case. Especially since he has a brand new illeostomy, and all the body image issues that go along with it. It is not your job to make a patient feel sexually desirable (please don't!), but you are well within your scope of practice to put a patient's mind at ease. I'm sure that he's embarassed that a strange woman saw him naked and scared. That's pretty powerful stuff.

Good luck with this - it is not easy dealing with these delicate issues.

Blee

When I worked for a DME company, one of my responsibilities was to teach men how to use the penile pump for erectile dysfunction. Because it uses a ring, size does have to come up. I frequently heard comments such as, "I'll probably need the smallest one they make".

I never answered those in a personal manner. I would simple say, " average circumference range is ___". I left it for them to do what they wished with the info. I've done the same with issues of length, tho that did not come up as often because circumference was the important measurement.

I think a majority men might have something like this cross their minds. Some actually mention it. There is some very good advice being given here.

Specializes in LTC, med-surg, critial care.

I had a patient ask me to cath him since all the morphine I was giving him was making it harder and harder to pee. He'd been in and out of the hospital so he knew this would happen. He told me that he needed a 14Fr instead of the standard 16Fr that comes in the kit because "I have a skinny member." Uh, ok.

Specializes in Nursing assistant.

I had one man about my age apologize for his size, and I just said "apology accepted"...

This is why I work in OB. He needs to talk to someone else, like psych nurse, sex therapist, etc. His member size is none of my concern.

Actually when i saw the title of this post I had to smile in memory of one gentleman.

He was an older gentleman I had to cath him. He was very small and virtually shriveled up inside himself so to speak. I could not get hold of anything.

I was having trouble finding it. and absent mindedly I spoke out loud to it. "come on don't be shy." He responded, "Lady I can't help it." I felt bad as I thought I was only thinking those words not actually speaking them out loud. Poor fellow.

Key issue: Lives with his mother.

Seriously, have you ever known very many men that were out-of-college, lived with their mother, that dated much?

I may sound cold, but his mother is probably verbally abusive...may be a Norman-Bates-type issue....he lived with his mother and she was forever telling him how worthless he was, so he never had the courage to leave. Women are going to see older men that still live with their mother as odd, and may not go out with them even if they have an attraction.

Stress may have contributed to his bowel problems as well.

He needs massive counseling.

This could be why he's insecure. Has he made any inapropriate comments?

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