Hello all! I am in my first semester of nursing school, we just started clinicals, and I have kind of an embarrassing, probably stupid question/issue...I am way too embarrassed to ask my instructors about this (or frankly, even the other students) so hopefully someone here can give me some advice.
When you are auscultating a woman's chest, and she has larger breasts, how exactly are you supposed to do it? Do you just kind of move them out of the way? Do you tell the patient that you need to move it? Also, are you supposed to auscultate through their shirt/hospital gown/bra, or ask them to remove it? Same goes for bowel sounds...I had one of my first patients get mad at me because I tried to pull her pants down a little for bowel sounds (they were so high I couldn't see her belly button, which I use as the landmark for my quadrants), and she yelled at me that I didn't need to do that to listen for bowel sounds...I thought you did because it might be hard to hear through clothing...I apologized profusely to her and she seemed to be ok, but I still feel really bad about it...I mean I certainly wasn't going to pull them all the way down, only far enough to expose her lower belly, but I probably should have at least explained to her what I was doing and why.
Anyway, I'm sorry if this is a dumb or weird question...I've never worked in the medical field at all before and I feel seriously nervous and out of my league in clinicals, and it doesn't help that I'm a pretty introverted person and have never been very touchy-feely. I don't consider myself a squeamish or conservative person (e.g. I really don't care if I'm out in public and see a woman breast feeding or something, nudity doesn't bother me, etc.), so I thought I'd be fine with the more "sensitive" parts of being a nurse, but when it comes to actually doing this to real live patients, I just feel completely lost as to what the right approach is, what you should say to the patient, what's appropriate, etc. I don't feel it's something I can really ask my instructors about and nobody else in my class seems to have a problem with this like I do, and the textbooks say zilch about it....somebody please help!
Thanks for "listening" and I appreciate any advice!!