Is it right to sexually assist a paralysed patient? - page 12

How do you deal with the paralysed patient with frequent erections? Have you ever been asked to assist? I've never faced this but have seen a heated discussion on another forum. Is it humane to bring... Read More

  1. by   steel magnolia
    I don't think anyone here has been discounting the fact that human beings have sexual needs. I do not appreciate the implication that just because some would find mandating sexual relief by the nurse personally deplorable and degrading, that we have no empathy for a pt's needs beyong the medical.

    I am sure I will spell it wrong, but I think lflagini said it best a few pages ago, when she made the analogy to the pt returning home and having no one there to fill this need. We should be helping pt's to cope with this loss, as we would help them to cope with the loss of a leg or a breast.

    I found that story of the nurse from the book compelling. I couldn't stop thinking about it. I think that she did what she thought was best for the pt at that given time, out of compassion. But, she wasn't crying throughout for nothing. If I were in her shoes, I am not sure I could have done it, but I place no fault on her for doing it. I am not sure what I would have done instead, but I don't think I could have done that.
    Last edit by steel magnolia on Apr 7, '04
  2. by   ferfer
    Quote from RN-Josey
    Wow, you make such an eloquent, persuasive, and well thought out argument. Clearly your enlightened postings raise the professionalism of this entire chat board. I thank you for engaging in mature dialogue on the topics and responses that you personally find distasteful. And using a revamped version of the old childhood classic of "I know you are, but what am I!" is pure genius. Clearly I dare not engage in a battle of wits with someone who comes armed with such snappy barbs.
    Look, I need to apologize for the things that I said on here to you RN-Josey. I was being immature and disrespectful of you. I felt offended and responded poorly and had no right to do so. This feels really strange (apologizing to a computer screen!!) but I still need to respect that everybody on here is entitled to respect and to disagree with my opinion.
  3. by   CarVsTree
    I'll tell you what. I was told that paraplegic patients are unable to "feel" anything below the area of the injury to the spine. Therefore, if he is disabled from chest down, he cannot "feel" the erection and he therefore would not "feel" the orgasm, nor would he know if he were in pain. There in lies the problem.
    You're assuming that a pt. is para/quadriplegic due to SC injury. I had a pt. in clinicals who was a quad r/t spinal muscular atrophy. He could feel everything including a considerable amt. of pain. In fact, he was my first male perineal care pt. and I was a bit embarrased, knowing he was A&O and could feel everything. He, however is so used to complete care, he continued to talk throughout and made me feel comfortable.

    For the record, (I think I already posted) regardless of whether or not a pt. can feel anything, I would NOT perform sexual favors. Not in my scope.
  4. by   Palpitations
    No, I was not assuming. I was going off of the question that was made by David. I also said how I would go about fixing the situation. I don't think that it's funny for any patient to be in this predicament. I feel that it may be embarrassing to them or that it could be harming them physically, so it should be treated as if was a medical condition, not a sexual condition. I don't know why that when it comes to the genitals people (even nurses) freak all out. It is part of the body and that part can be hurting. We're not kids in elementary school! Sheesh! What if it were your brother, father, or son? Would you be more concerned? Or would you think of it as a sexual problem? If you do, that's your problem. I am a nurse and I'm trying to think like one. Help your patient and don't be silly about it. You don't have to have sex with the man to fix it.

    Melinda

    Quote from suemom2kay
    You're assuming that a pt. is para/quadriplegic due to SC injury. I had a pt. in clinicals who was a quad r/t spinal muscular atrophy. He could feel everything including a considerable amt. of pain. In fact, he was my first male perineal care pt. and I was a bit embarrased, knowing he was A&O and could feel everything. He, however is so used to complete care, he continued to talk throughout and made me feel comfortable.

    For the record, (I think I already posted) regardless of whether or not a pt. can feel anything, I would NOT perform sexual favors. Not in my scope.
  5. by   Palpitations
    One more thing. The patient that I had with the penile prothesis was not paralyzed in any fashion. He was just sick. I believe that he was in for COPD. Just wanted to get that straight.

    Melinda
  6. by   CCU NRS
    I obviously did not read all 15 pages but will be perusing this topic for a while to read the most interesting. Here is my opinion.

    Switch this around a little bit, If this was a female she would not have an erection so to speak, but she could easily claim sexual frustration and ask for assistance with completing the act of orgasm, if there is no appendage that is erect and making it obvious do you think the issue would arise(no Pun intended)Would you feel the same compassion for a female that wanted to ease her tension? Males also get erections when they need to urinate as in morning wood, has this Pt been cathed lately or do they have an indwelling cath or supra-pubic cath? Are you actually speaking of a quadriplegic? If so then the erection is completely psycosomatic not involving actual contact but sexual desire or fantasy these things can be brought on simply by the prospect of someone touching the penis because the person has not had contact for some time. I would suggest that you explain that the best way to deflect the erection is for the Pt to think of something else.

    Lastly from my own personal experience as a teeneager I had a physical performed by a female doctor and had a similar experience the thought of her touching me got me excited shall we say, she firmly thumped my scrotum at the base of my penis and the erection quickly subsided, I am not sure if this method is apporved but I did not complain and it releived the embarrassment I assumed she used medical expertise to deflate the situation as it were.
  7. by   CCU NRS
    Quote from critcarenurse16
    My stomach hurts from laughing so hard-- I think I wet myself too...LOL. I'd also like to know where this has been 'hotly' bebated--besides here of course. Of course this is completely inappropriate. Any sexual contact with a patient is way out of context of nursing professionalism and should be grounds for termination. Think of this as well; patients in the hospital setting are acutely ill and are on medication that can affect orientation, LOC, decision making ability and so on. Therefore sexual contact with a patient may be seen as assult. Let someone else take care of his sexual needs at HOME. I for one don't want my ICU or ED contaminated.
    I actually did here a story from a previous member about a person working a LTC facility that as part of ADLs shaved a female(pubic area),actually shaved every female on her assignment because this was procedure at her previous place of employment, when a Hispanic family found their Grandmother shaved in this manner they made complaints and called Social Services and the CNA was actually arrested and convicted of sexual assault. This for simply shaving the private area without permission so I beleive here in the USA sexual assault can be charged for any contact.

    Granted this was without permission and I am assuming the Pt's we are discussing would be quite willing to be assisted in this matter.

    ps to OP not all eidting is done by Monitors or Moderators for instance I edited this post to correct a couple of spelling errors.
    Last edit by CCU NRS on Apr 7, '04
  8. by   Shotzie
    Roland,
    I am not at all surprised that you think prostitution should be not be illegal, nor am I surprised that you think it would be OK for your own wife to participate in such activities.
    But try to stick to the point please. We have one issue to discuss and we certainly do not need to have other volitile topics inserted for other "rabbit trail" discussion. Also, it would help if you tried very hard to remember that more talk is not better talk. Be precise and SHORT.
  9. by   CCU NRS
    Quote from Roland
    Okay, but all I'm saying is that if your going to be nonjudgemental about one thing (that many find morally objectionable) then you should also be the same about another. If having a nonjudgemental attitude is the point, then the specific subject shouldn't matter. Again, I am not talking about nurses or doctors providing these services almost EVERYONE agrees that is not appropriate. Rather, we are addressing whether or not people who cannot provide self-stimulation, and who do NOT have significant others to provide such an experience SHOULD be able to procure that service like any other (from professionals willing to provide that service for a fee). Here are two possible scenarios that could overcome the "prostitution" objection:

    1. Create a volunteer organization that would provide manual stimulation to qualifying disabled individuals (the specific guidelines would need to be rather specifically, and exhaustively defined, and codified). In the same way that many volunteer to build homes, serve in Haiti, work in homeless shelters, and do other things it is likely that some would be willing to volunteer for this service.

    2. Apply research into direct, NEURAL stimulation designed to elicit physiological orgasm. There is a good deal of evidence to indicate that this can be done technologically, and this would overcome many if not most objections.

    I always try to propose concrete solutions rather than just engage in idle debate.
    So do you think PT (physical therapy) should include this in their care plan? Not being facetious, do you really think this is a vialble solution. If so then would sexual release or satisfaction be a routine need for all clients? We are all human and all have needs. I understand we are talking about primarily people that can not perform this fucntion for themselves. Should it however be addressed on admission,1. What is you current level of sexual activity? 2. Do you perform this act alone or with your S.O.? 3. Do you require assistance with this fucntion during your hospitalization? Can you see this eventually being incorporated into every careplan?

    also to the topic of technologically assisting do you feel that you would be willing to enter the room and place an assistive device and then stand aside and wait/watch until the orgasm subsides and then remove said device and clean the Pt of ejaculate? Again for females would you see this as seriously as males being that there is no visible erection? Also with females this could be considered and invasive proecedure since some females require both clitoral stimulation and vaginal fulfillment.
    Last edit by CCU NRS on Apr 7, '04
  10. by   CCU NRS
    wow just looking at how many of us are actually reading this thread it is quite a topic huh
  11. by   mattsmom81
    Lordy, someone here will likely think it falls under 'right to healthcare' thus a nurse SHOULD provide it.

    This is touchy (no pun intended) for many because for generations female nurses have suffered with sexual innuendo. It gets tiresome.
  12. by   TweetiePieRN
    Quote from shotzie
    but try to stick to the point please. we have one issue to discuss and we certainly do not need to have other volitile topics inserted for other "rabbit trail" discussion. also, it would help if you tried very hard to remember that more talk is not better talk. be precise and short.
    amen!!!! i think this everytime i read one of roland's posts!
  13. by   jkaee
    Quote from DavidFR
    And this is sad. I never even came down one way or the other in my initial post, yet people choose to laugh because I posed the question? This is a fundamental difference between this forum and other (European or Asian dominated) forums that I go on. Eleswhere if somebody doesn't like a question that's been posed or disagrees with a point of view, they'll argue vehemently, often heatedly (with less censorship than this forum) but to laugh and call somebody's question ridiculous is very impolite. I would suggest if people laugh it's becuase they are uncomfortable with this topic, have never been faced with issue and don't wish to think of the sexual needs of the disabled/handicapped/paralysed. I have never faced this issue personally, and in my current job am unlikely to, but having read about it elsewhere I was prepared to consider the issues. It saddens me that nurses wish to simply dismiss the issue or "laugh" as opposed to engaging in inetlligent disussion. Whatever your viewpoint, discussing these things helps formulate the best poicies in patients' interests. Simply laughing at the issue discredits the patients' problem.


    Just for the record, I edited my post because it wasn't showing up right on the board, and I had to tweak it around a bit. The mods. did nothing to my reply.

    Once again, I must state that I don't think any nurse here said that they wouldn't counsel, or arrange for therapists or counselors for the type of patient in question. You asked us if we would assist a patient achieve orgasm or release, and the majority said no. No one is "laughing" at the patient or the situation that he is in, if anyone was laughing, it was because the idea of sexually stimulating a patient so he could relieve himself is preposterous. That's all, don't read more into it than what's there.

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