Is it right to sexually assist a paralysed patient? - page 9

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   PennyLane
    Quote from steel magnolia
    David, is the reason it was probably discussed so openly on a non-nursing board is because the people involved did not have a license to protect, were these people significant others or close friends of the involved party, so naturally, they may feel more inclined to provide relief?? Would you kindly post the link?
    I agree, perhaps the issue was discussed in a less negative light on the other board, which you said is non-nursing, because it's much easier to discuss something hypothetically if you know that you'll never be faced with that situation. "Easier said than done." It's offensive to many of us because we are educated, highly trained and skilled professionals (or professionals-to-be) and the idea of nurses being responsible for performing a sex act on deblitated patients is demeaning and degrading to the whole nursing profession. Do you think doctors would entertain this idea? I don't think so. As many others have said, I did not go into nursing to become a prostitute or relieve anyone's sexual tension, whether they be male or female. The whole idea makes me a little sick.
  2. by   flowerchild
    I have had several male patients ask this of me during my years as a nurse. I never did it b/c I know that is not my job. However, I do believe that humans are sexual beings. If I thought that the patient would truly benefit from being manipulated, I would probably refer the patient to a social worker so they could help set something up or possibly a sex therepist. If the person was totally unable to feel anything in the area, then I'd refer to psych, obviously the person needs help to cope.
    Quads have lost so much of their lives, I understand why they would have issues here. As a nurse we must help the patient in what ever way we can. Obviously that doesn't mean taking it into our own hands but there are things we can do to help. To dismiss the patients frustrations is not right, nor is inserting our own beliefs into the equation.
    I have taken care of many quads in HHC. Some do have feelings there. Others don't. I had one young guy, motorcycle accident, that had a prostitute come to the house on a weekly basis. His parents set it up. Fine by me. To each their own. If a man wants this then it should be up to him or his family/ or her/ to set it up. He was a pretty happy guy, and that one hour, was the highlight of his week.
    As for the dirty ol man who asks for no other reason except for the fact that he is a ............., I wouldn't give him time of day and would not go back to his house again. I had this happen once, he tried to give me things when I went on a visit, then he started getting fresh, next visit he grabs me, I reported it and did not go back. The HHC was negligent here, they sent another nurse in my place. I found the guy the next day on the FDLE's web site as a sexual molestor. The HHC continued to send staff, alone despite my warnings. I told the nurses who took over the case, and they chose to make the visit. ??????????? Not me!
    Back to the topic.
    Asking a nurse to do it is inappropriate in most cases imo. But, if someone has no one and is really needing asst. then where else to turn? People tell nurses and docs things they would never ask of, or reveal to anyone else. When someone is genuine, it's actually touching to think of the nerve and trust that someone has to even bring up such sensitive subjects.
    OP, forgive the folks here who have big problems with this subject. Many of us have been raised to think that sex is dirty and is a taboo subject. Many other countries would have different views on this subject b/c people from those countries are open and free thinking about their own sexuality and sex in general. Americans in general are not. So obviously most of us would never agree to do such an act, in the name of health, or not. It wouldn't matter the outcome, the reason, nor the etiology, it just isn't going to happen here. By law, the act could possibly be considered sexual molestation in some circumstances. Certainly the employer would fire the nurse and turn them into the board if the employer was aware of what occurred.
    I'm probably a bit more open minded than many, I'm the nurse who did the visits at the nudists house. It was pretty funny really, they were not pretty people, I'd walk in the door and say " Ugghh, (eyes rolling) PLEASE go put some cloths on!" and they did but not my patient. She was in bed under a sheet, but it made the head to toe assessment and care easier for me! LOL.
  3. by   mrdoc2005
    I will say NO to this one. But, to the post about the book.... If you read a book that talks about nursing in the 1800's you will see that nurses were normally prostitutes. And yes, part of their job as a nurse was sexual. Thus, it is totally possible for you to have read about this in a book.
  4. by   canoehead
    Aside from any sexual assistance being illegal and against the hospital conduct code we have to keep in mind that it changes the relationship between two people. So the nurse-patient relationship could become complicated with feelings of love, or of rejection on both sides, making it almost impossible to work on other rehab issues. Why jeopardize the progress in the rest of the patient's life by including sexual assistance-they need to find some other way to deal with those feelings. We can talk about how they can find a solution for themselves, but we cannot be part of the solution.

    Another point that I am surprised no one has brought up. If you consider providing sexual release part of the job it has to be an equal opportunity intervention. Gotta include the old, the unattractive, and those with nasty personalities. On a gut level, that makes it incredibly distasteful.

    I must admit, there was a young hunk when I was 20 that tempted me, and of course I said no because of the rules of conduct. Being older and wiser now I can understand why those rules exist, and I don't believe they should be changed because they would threaten the effectiveness of the rest of the relationship-along with making all nurses look like cheap hookers.
  5. by   Alnamvet
    My only response is what nursing school did this poster go to, and what experience does he have to get to the point of asking such a question? Does one have to go on a public forum and ask such a question....a question that should have been answered by the poster himself in a fraction of a nanosecond. The price of freedom, I guess.
  6. by   ktwlpn
    [QUOTE=DavidFR]
    I posed this question because on another forum (not a nursing forum) I read the post of a Dutch nurse who said he had responded to the request of a patient unable to bring himself to ejaculation by helping him do so. He says he reported his actions. Given the situation I think his actions were humane and kind. QUOTE] "Humane and kind" Dood-we have all taken care of patients whose daily lives are a living hell...Putting a pillow over their heads could be considered "humane and kind" But it ain't legal......
  7. by   nurseunderwater
    Quote from ktwlpn
    Dood-we have all taken care of patients whose daily lives are a living hell...Putting a pillow over their heads could be considered "humane and kind" But it ain't legal......
    touche' - :chuckle
  8. by   renerian
    Yes I have been faced with this problem, request, but I quickly declined the request. Very uncomfortable for me.

    Veteran we think alike LOL I would not want to write that P&P either.....big smile.....

    renerian
  9. by   fins
    Some stray thoughts on this issue:

    1. Good Lord, people, aren't staffing ratios bad enough already? If your hospital implemented this, and they use acuity-based staffing models, how do you measure acuity for this? Age? Seventeen (marginally) hornier than seventy. Time since the last release? Never mind the professional implications, never mind the moral implications - think of the PAPERWORK!

    2. I guess it would tend to inflate pay scales.

    3. Isn't this what candy stripers are for? (Oh, wait, sorry, that was a dream I had when I was sixteen.)

    4. If the patient was paralyzed, how would he leave the money on the dresser?

    5. I have an idea for a compromise. If a patient is having trouble with this, I could go in. I'm 6'2", 300#, and was once described as looking "like an axe murderer having a bad day." The patient won't have an orgasm, but it would be DAYS before he has an erection to worry about again. Think outside the box, people!
  10. by   gwk
    this CANNOT be a serious question??? where r your ethics if that were your child in a coma ...would it be acceptable gimme a break
  11. by   Clarvina Streisand
    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.
    My thoughts exactly.
  12. by   lady_jezebel
    I am NOT a low dollar prostitute. That is NOT the role of nursing. We are not there to sexually satisfy our pts. Jeez, the whole idea of this scenario takes the profession of nursing back 2 centuries. If he needs to be jacked off, he can find a girlfriend or move to Nevada & hire someone legitimately. This applies equally to non-paraplegic patients!

    We are legally allowed to diagnose spiritual or sexual problems (to a degree), and there is nothing wrong with talking to a pt, hearing his/her concerns, and connecting them with the correct legal & legitimate resources -- but in no way would I equate "praying" with a pt to sexual gratification. We are legally licensed to treat spiritual, sexual, physical, mental, etc... problems by TALKING with the pt & making referrals. Praying is like talking & being a presence. It is not unlawful touching. We are NOT licensed to to have sex with them. In fact, this is prohibited in every state & against our code of ethics as described by the ANA.
    Last edit by lady_jezebel on Apr 6, '04
  13. by   caroladybelle
    Quote from DavidFR
    It shocks me that some nurses are not even prepared to consider the torment a highly sexed immobile patient may go through, dismissing the suffering as simply "not an ADL" Suppose this was somebody who was used to making love or masturbating every day? And now he can't.

    Doesn't free speech mean anything to nurses?
    I love that phrase "torment" - have you ever heard of the word "control?

    Sure free speech means something to nurses. So does the phrases "sexual harassment", "lawsuit" and "breach of conduct".

    I posted a thread once regarding the fact that every state in which I am licensed (6 states) lists as requirements for the licensee to be of "good moral character". Who judges that character and what does it mean for nursing as a profession? I doubt if masturbating a patient falls in "good moral character" for the majority BON members.

    Florence Nightengale once wrote that she wanted nurses to be "of plain countenance and older woman" so that they could be taken seriously when dealing with patients. As Florence took care of men from battle for much of her career, one would presume that she was familiar with virile men, and yet to my knowledge, never gave any regs for "relieving" patients, like she did for hygiene and other pertinent nursing issues.

    Is sex part of ADL's? It depends on the patient. I am unmarried and celibate at this time. Since sex was part of my life, can I force a total stranger to give me sex, because I am "entitled" to it. Obviously, No. A young man's wife dies of breast cancer. They had sex regularly. Is part of Hospice's post mortem counseling to include sex by a nurse/counselor of his choice? No. A woman is in regular relationship that ends, is she "entitled" to sex?, No. Do they feel "torment", sure they do, but most of us adults learn to deal with controlling ourselves as responsible beings.

    A patient be regular user of cigerettes, does that mean that s/he can light up randomly in the hospital and that we provide the cigerettes? A patient feels like they need a gun for protection and keeps one at home and uses it regularly, do we provide them a gun to keep in the bedside drawer? A patient uses Speed or snorts Cocaine as part of their ADLs at home, do we provide it for them and help them administer it in hospital? After all, it is a regular part of their lives.

    They curse or use abusive language at home. They may beat their spouse as part of life. Are we to be required to permit ourselves to be beaten or cursed or spit on?

    Sorry, not part of my job to masturbate strangers, hand them a gun, let myself be beaten or cursed, or to get cocaine for them, even if it is part of their "normal" ADLs.

    If they have a partner to assist them, I will be happy to give them "time alone" for their private activities.

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