Is it right to sexually assist a paralysed patient? - page 16

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   mrsloubelle
    It is immoral and crossing the nurse /patient boundary to sexually assist a patient, paralysed or not. I certainly wouldn't do it. It is also going against my Code of Professional Conduct which I work to.

    However, the issue does need addressing.

    Roper, Logan and Tierney (1996) provide a model of nursing to aid the nursing
    process, this model contains 12 activities of living. Included is expressing
    sexuality. This can be viewed in many ways; assisting to apply make-up to a
    patient, giving advice to a couple who come to you after one has had a stroke asking for information on how they can continue their sexual relationship. This should be done by a nurse who is comfortable to talk about it and has the knowledge to answer the couples questions.

    In my training I had to formulate a plan of care on expressing sexuality (nobody else wanted to do it). Although it was easy to write putting it into practice would have been a challenge. For example; Providing privacy- not a problem if the patient is in a side room, but what if they are being nursed in a nightingale ward.

    'Nurses involved in counselling must examine their own attitudes and feelings relating to the subject of sexuality. Advice with regard to the implications of disability for the patients sexuality should be initiated only when the patient signals that they are ready to address the issue. However, the nurse may need to introduce the subject and thereby give the patient 'permission' to voice their concerns. Nurses may be prevented by inexperience and embarrassment from discussing questions of sexuality comfortably with their patient. Nelson (1977) argued that this difficulty is related to the fact that it can take individuals, including nurses, many years to form personal values regarding sex.' Swaffield (2000).
  2. by   nursebedlam
    I maybe wrong but l feel a good nurse would deal with the situation in a non-judgmental manner, l certainly wouldn't sexually please the patient myself however i would talk and listen to the patient about there needs, and try and dicuss what options are available.. perhaps a hooker, thats their line of work, it the patient could afford the funds to hire a hooker then so be it............ Bedlam
  3. by   Marie_LPN, RN
    I am NOT helping a pt. locate a hooker, either. Let Social Services field that one (if they would even do it).

    That is another job for family and friends.
  4. by   DavidFR
    Quote from stevielynn
    "We've been had" relates to our feeling that the OP is a troll who likes to stir up trouble or get his jollies by reading our impassioned responses and we were used!

    steph

    This is insulting. I find it hard to believe this remains unedited when one of my posts gets edited for simply referring to somebody as immature and unintelligent. There is less censorship on the China Daily News forum! Are the mods proud of that? I do not approve of censorship at all, I simply feel this statement is equally as insulting as mine which was removed.

    I opened this thread because I believe it is a topic of serious concern to nurses who have faced or potentially may be faced with this situation during their careers. I believe such difficult issues need to be brought out into the open, all sides considered and all points of view aired. Perhaps stevielynn, you don't believe that intelligent discussion and intellectual analysis are useful tools in finding solutions to difficult questions, but personally I do. If people feel they've "been had" then I'm afraid they miss the whole point of a forum: an arena for discussion, deabate and the sharing of views and experiences. In amongst the excellent, well thought out responses to my question (on both sides of the argument) there has been an awful lot of hysteria, pontification and at worst, bible bashing. I have in no post suggested that masturbating patients become a routine part of nursing care along with the bed bath. Nor have I suggested that nurses who are uncomfortable in this situation should be obliged to intervene directly. This is evidently a very specific situation that only some nurses are ever going to face. The issue won't go away just because you choose to ignore it.

    This is a subject debated openly in European nursing journals and the media at large. I am shocked by the number of American nurses who have stated they don't feel this is a relevant topic for discussion, it's a joke, they can't stop laughing, and they choose to demonise me for even raising the question. There appears to be a fundamental cultural difference in the European and American approaches to the intellectual debate of an uncomfortable issue. That is not a criticism, merely an observation.
  5. by   DavidFR
    Quote from donmurray
    The OP is an English occupational health nurse who lives in Paris, with 40 posts to their name. Hardly a troll. Is it not intellectual cowardice to demonise someone setting awkward ethical questions that one chooses not to think about?

    Thank-you. Well said and succinctly put.
  6. by   caroladybelle
    [QUOTE=Roland Also, I know of many "average guys" who lack for the loving relationships you claim are so easy to obtain. It's tough enough for those of us who are "average" let alone someone who can't move most of their bodies. I have a good friend from high school that makes 80K a year working for Verizon, and has over 200K in the bank. He is "dorky" looking and lanky, not to mention shy, but very nice/smart. He is thirty four years old and has never had a girlfriend (he confided to me that if he doesn't find one in the next year or two that's he's going to Nevada so he can at least say he's not a virgin!) If "average" guys like this have trouble finding girls then you seriously mean to tell me that people who are profoundly disabled can usually do so? Of the five or so people I still speak to from highschool who are married FOUR have admitted to me privately that the primary reason that they got married was for regular sex! I truly believe that if prostitution were legal that many if not MOST guys would refrain from marriage until their late 30's or longer. Okay, I'm digressing, but I really am floored how easy you seem to make it seem for people to find "significant others" when they are disabled.[/QUOTE]

    Roland, Roland, Roland,

    I never said the relationships are easy. A excellent relationship, a true relationship is never easy and requires work and ocasional frustration. It is never just handed to you on silver platter and it is not a matter of logic.

    I am a traveler, which means that I take 3-6 month assignments across the great fruited plain of this country. So far, every city that I have gone to, I have know not one person when arriving. I weigh 165 lbs, and do not remotely look like Elle McPherson. I work in a female dominated profession in specialties that do not lend to attracting a lot of eligible men. I am plain and average and make considerably less than your friend. I do not wear sexy clothes. I am not a sparkling conversationist. I am almost 40.

    I have yet to leave an assignment that I did not have friends and men that wanted to stay/keep in touch/come back to stay permanently because they valued relationships with me. Recently, I had a Bronch for a health threatening condition and had people dropping everything to help. Within four weeks of starting an assignment, people were asking me to eat Thanksgiving Dinner with their families. IN NEW YORK CITY!!!! not reknown for it's friendliness. I've been flirted with by Orthodox Jewish guys for goodness sakes. (And I am so obviously not Orthodox)

    If the main reason that your friends married "mainly" to have sex, I feel very sad for state of their relationships and they need professional help. And as far as your friend, WHY SHOULD THE 80,000 A YEAR and 200,000 IN THE BANK even be mentioned? There are two sentences about your friend ...money and looks - things that are significant but not the most important to people of good values. What the heck does the money mean anything in whether someone is able to maintain a loving relationship? Just by you mentioning it, tells me something about you and your friend's priorities in life....and it isn't about having good wholesome healthy relationships.

    Money is helpful but it doesn't make the relationship. Plain or attractive looks do not make the relationship. Being a good loving, caring, intelligent human being is much more important. And if you think that money buys that or looks attract that, you are sadly mistaken.

    Carolina
  7. by   jrvb
    Quote from DavidFR
    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 the patient to ejaculation to relieve his frustration? Is it actually having sex with the patient? Is it permitted where you are? Could you do it?
    Davidfr-

    The French are not well perceived here as it is without you being their representative. I knew there was something funny about that country.
  8. by   DavidFR
    Quote from jrvb
    Davidfr-

    The French are not well perceived here as it is without you being their representative. I knew there was something funny about that country.

    You jump to conclusions. I am not French, nor am I a representative for any nation.
    Perhaps you would like to clarify just what it is you find "funny" about France?
  9. by   nursebedlam
    Quote from LPN2Be2004
    I am NOT helping a pt. locate a hooker, either. Let Social Services field that one (if they would even do it).

    That is another job for family and friends.
    I never suggested you had to, one day in your career you might see that a hooker attends a patient of yours, l've seen it happen many years ago. Smiles however l was glad l didn't have to change the sheets.
  10. by   Shotzie
    That's another whole topic, David. Let's stick to the subject at hand.

    ...."I believe such difficult issues need to be brought out into the open, all sides considered and all points of view aired. Perhaps stevielynn, you don't believe that intelligent discussion and intellectual analysis are useful tools in finding solutions to difficult questions, but personally I do. If people feel they've "been had" then I'm afraid they miss the whole point of a forum: an arena for discussion, deabate and the sharing of views and experiences. In amongst the excellent, well thought out responses to my question (on both sides of the argument) there has been an awful lot of hysteria, pontification and at worst, bible bashing. "....

    Your view of what you have read seems to be entirely different from the responses I have read. You got exactly what you requested...a variety of views and discussion...an opinion poll of how nurses feel about the possibility of performing such an intimate, personal act upon a patient. That some feel strongly that sex should remain between two people who have an emotional bond between them does not mean they were not open to the discusssion.
    They came, and they told you what they thought. Why do you condem the nurses? What would you have thought was appropriate responses?
  11. by   nursemeow
    Just wanted to comment on RN-Josey's opinion. First off we all know that masturbating patients or giving them sexual pleasure is wrong. No offense and honestly I don't think the topic would even make it to the "ethical board" Just being honest. it's like duh. However, the "hypocrisy" that you heard is basically people making comments within 2 minutes without deep thought, because thankfully it doesn't take alot of thinking to answer this question. I feel you are reading too deeply into other people's comments. Of course as nurses most of us would pray or venture out of our "scope" of nsg. for a patient and their family...every minute nurses do without thought. However, if any professional nurse would consider having sex/acts with their patient I would offer the advice of seeking help. So before you call everyone hypocrites, relax....Yikers....I am sure it goes on, but I hope not where I am because I will not keep my mouth shut. Oh and beyond all the ethcial crap.. IT'S AGAINST THE LAW!!!!!!!!!!!

    sometimes I just wonder



    Quote from RN-Josey
    Whether or not a nurse would choose to relieve a patient if faced with this situation is something for the nurse to decide at that moment, keeping in mind that there definitely could be legal and job repercussions if some kind of prior approval was not obtained.

    I want to comment, though, more on the hypocrisy I hear stated throughout this thread. Several nurses have stated that this is an inappropriate question because either it's not something we are trained to do or because it is not a vital life or death function. And the tone used by these nurses is very sanctimonious and puritanical when making these arguments. I would ask these very same nurses, however, if they have ever prayed with a patient at the patient's request, or if they had encouraged prayer from a patient who hadn't brought the subject up themself. Prayer is neither something we are trained to do in nursing school nor is it a "vital" life or death function. Yet I will bet money that many, if not most, of the nurses who practically condemned the original poster for even asking the question would not think twice about praying with a patient, and probably have done so many times in the past. Thus their arguments about only doing what is medically necessary don't hold water, and in fact reveal them as hypocrites who object purely on their own moral grounds, not for any medical or professional reason.

    And just for the record, I am not opposed to a nurse praying with their patient if that helps comfort the patient. I also don't see a problem with a nurse objecting to masturbating a paralyzed patient on moral grounds (or objecting to prayer for the same reason). However, be honest in stating the reasons why you approve or disapprove, and don't act judgemental to those who hold a different moral viewpoint than your own.
  12. by   tattooednursie
    I think i'm going to be sick. That is immoral!
  13. by   DavidFR
    Quote from Shotzie
    Your view of what you have read seems to be entirely different from the responses I have read. You got exactly what you requested...a variety of views and discussion...an opinion poll of how nurses feel about the possibility of performing such an intimate, personal act upon a patient. That some feel strongly that sex should remain between two people who have an emotional bond between them does not mean they were not open to the discusssion.
    They came, and they told you what they thought. Why do you condem the nurses? What would you have thought was appropriate responses?
    I don't condemn anybody who gave a considered opinion, for, against or neutral.
    I do object to the people who say they laughed, they thought this legitimate ethical question was a joke, I am a "troll", I only posed the question to stir people up and they feel they have been had, they knew there was something funny about "that country" (an allusion to the fact that I live in France, hence I'm "funny") etc. etc. Such comments represent a much lower level of intellectual discussion than I am used to. In my original post I never even stated my position, I simply posed a question, so the hysterical backlash in some posts was somewhat unwarranted in my view.
    Evidently we have not been reading the same posts.

    Can we consider the broader ethical question and not keep making references to what is and isn't legal in the US (where many of us don't live). Can't we consider whether some laws need to be changed? Can we stop assuming that anybody is suggesting we all get horny with our patients. I don't believe anybody has said or suggested that, and constant allusions to porno nurse scenarios simply cheapen the debate. This can hardly have been a moment of sexual pleasure for any nurse who has actually done this.

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