Should patients be allowed to refuse LPNs and CNAs? - page 5

Last night on our med/surg unit, we had an elderly woman who was in wiht consitpation. Very stable patient, vitals within normal limits, fairly negative past medical history, no home meds,... Read More

  1. by   apaisRN
    I have only had male physicians in cases like removing keloids from my earlobes. I'm not a hypocrite; if possible I don't want a man poking at me. Sorry. I go to female masseuses too. If I'm admitted emergently to the hospital, my attending may be the MAN on call that night. I'm okay with that, unless it's a gyn thing. But when I have a choice I see women.

    Nursing is different from medicine. OB is one scenario, but what about the LOL in for pneumonia? She may be fine with a male physician listening to her lungs, but she doesn't want a male nurse washing her peri area. It's NOT the same thing.

    I don't think it's reasonable for a patient to insist on a nurse of a specific gender EXCEPT for intimate tasks (except in cases of sexual abuse, trauma etc). You don't get a choice of who gives you your pills, starts your IV or helps you brush your teeth. Bed bath and foley, okay, you can have someone you are comfortable with if staffing permits.
  2. by   LPN1974
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    Last edit by LPN1974 on Mar 7, '05
  3. by   stn2003
    we have a fre. flyer on the floor who comes in and wants only female care. we provide her that, which is not hard b/c we almost always have three or four females for every male.

    when males ask for other males to care for them, we try to keep a note of this on their file so that a male nurse can be assigned to them if at all possible when patient assignments are made out. If not possible, a male aide for the more personal aspects of hygiene (which is usually the root issue). If that is not possible, we explain that only females are available and if they are uncomfortable they can have a wife/family member (son, etc) help them. Most often, the pts realize we have exhausted all of the options and agree to be cared for by who is available- who makes sure to give the pt. as much dignity and privacy as possible.

    I have gone into patients room to answer lights or calls for help and been rebuffed for not being the particular nurse that they want, and unless it is am emergency, I say ohk, I will see if that person is available, but if they are busy it may be a little bit before they can get in. If the person they are asking for is unable to come in and assist, I will return and say so-and-so is very involved in a pt. room at this time, are you sure thatI cannot help you? and if they are with it and wish to wait, document it to CYA and let them.

    male/female is a whole different ballgame than RN vs LPN vs CNA.

    If there was a pt acting up about not having anyone besides the RN coming in their room, the charge nurse, patient care supervisor, or Nursing Director for the floor would be called in there to explain scopes of practice and the way it works in our hospital (team nursing). we had a similar issue on our floor today : / very frustrating and time consuming for all involved. Not like the days are not busy enough already : )
  4. by   LPNer
    Quote from LPN1974
    No I do NOT have any "hidden negative thoughts about men in the field."
    That was uncalled for.

    Please don't make personal attacks and accusations.
    Keep the conversation on the subject, please.

    I already stated, that as a patient, I would want a female nurse for very intimate examinations, or care, and I stand by what I said. That's a patient's RIGHT to have her preferred gender of a nurse, for those kind of treatments/care.
    There is a difference, when you're the patient.
    Why would you want to force a patient to go thru something that would obviously cause her distress and embarrasement???

    If a male patient REQUESTED that I not do any personal intimate treatments or care on him, I would have NO problem to turn that part of his care over to a male nurse, and I never indicated that I wouldn't do so.
    I am very sorry you took that question as an attack on you personally. It was a simple question. A question intented to help me understand why you think we, as nurses, should not help pts understand that gender makes no difference in personal care.
    You are talking about a nurse caring for a pt, not a man caring for a potential sexual mate. There is the difference and I fear too many female nurses here are not seeing that difference! That worries me, it really worries me that so many people are seeing nurses as sexual beings instead of simply professionals.
    Again, I am sorry you took that question as a personal attack, I truly didn't mean to attack you.
  5. by   allamericangirl
    Quote from SmilingBluEyes
    Marie, the case of prior sexual abuse was addressed already. But that is a relatively small population. The rest should NOT discriminate. I see nurses who do more harm than good for our male colleagues. They SOMETIMES set them up for this.....

    For example on an OB unit I used to work in, the nurse leaving would tell her patient "you next nurse is a male, are you ok with that?" Often, the patient would say "no". Ok, now she had to reassign a female nurse to the case w/o finding out WHY there is a problem?

    She should set it up differently, if you ask me. She could say, " I am leaving now, and introducing you to your next nurse, who will be Dave, RN. You will be in good hands in his care". Men are in nursing; it's time to embrace this. Men have been doctors for centuries and most women accept this, except in sexual abuse and certain cultural cases. Other than that, yes they should "deal". And we should be HELPING our male colleagues, not hurting them.
    The only problem that I have with what you are saying is this:
    If a female pt is 65 years old or older she was born in or before 1940. Most women born '40 or before never had sex with a man before they were married, and when it was time to go to bed with their husbands, they went to the bathroom undressed and put on a nignt gown that went from their neck down to their feet, keept their panties on, turned out the light in the bathroom, walked into a dark bedroom, jumped into bed with their husband, pulled the covers up to their neck and went to sleep. In the morning they grabbed a big robe and covered themselves up as fast as they could. Hubby hardly even saw them in their nighties, or undies, let alone naked. The only other man most of these women have ever exposed themselves to was their doctor, and it was a miserable experience for them, but it was ok, because it was their doctor.

    I was born in 46 and am in with the wild baby boomers ...but when I first was married I did the same thing, except the nighties were a little sexier and around 30 I stopped the panty thing at bedtime. I have been married 3 times and for most of the past 39 years. With each new hubby, I had the same modesty issues, and it took some time to loosen up. Don't think hubby #1 ever saw me completely nude, hubby #2 and I were probably married three or four years before I was ever comfortable walking around nude in front of. With hubbie # 3, I still have some embarrassment about because now my body isn't the most gorgeous thing to be parading in front of someone. I had the same doctor (OBGYN) for 20 years and always felt wierd going in for my pap tests, and he delivered both of my kids (for heavens sakes!).

    Had to go in to the hospital a few yrs ago and had a male CNA of a different race than mine, and a male nurse. They were very nice, highly professional people. I had to have bed baths, and when I could do regular baths I had to have assistance because I was on an IV. Being of a different race didn't bother me. Being of a different gender did! :imbar I didn't let these two guys know how very wierd it was for me ... I gritted my teeth, didn't want to seem like a square or spoil sport, but I was just mortified whenever I had to be exposed in front of them... bed pans, baths, etc. I silently "freaked" every time. Many women are a little that way, even in front of other women. Even younger women.

    I am now a CNA, doing my clinicals in a LTC, and am highly sensitive to how some of the older men seem embarrassed having me provide personal care for them.

    I don't think it is that guys are not accepted as nurses. I think it is an issue with modesty and self-consciousness, not about getting competent care.
  6. by   SmilingBluEyes
    Quote from allamericangirl
    The only problem that I have with what you are saying is this:
    If a female pt is 65 years old or older she was born in or before 1940. Most women born '40 or before never had sex with a man before they were married, and when it was time to go to bed with their husbands, they went to the bathroom undressed and put on a nignt gown that went from their neck down to their feet, keept their panties on, turned out the light in the bathroom, walked into a dark bedroom, jumped into bed with their husband, pulled the covers up to their neck and went to sleep. In the morning they grabbed a big robe and covered themselves up as fast as they could. Hubby hardly even saw them in their nighties, or undies, let alone naked. The only other man most of these women have ever exposed themselves to was their doctor, and it was a miserable experience for them, but it was ok, because it was their doctor.

    I was born in 46 and am in with the wild baby boomers ...but when I first was married I did the same thing, except the nighties were a little sexier and around 30 I stopped the panty thing at bedtime. I have been married 3 times and for most of the past 39 years. With each new hubby, I had the same modesty issues, and it took some time to loosen up. Don't think hubby #1 ever saw me completely nude, hubby #2 and I were probably married three or four years before I was ever comfortable walking around nude in front of. With hubbie # 3, I still have some embarrassment about because now my body isn't the most gorgeous thing to be parading in front of someone. I had the same doctor (OBGYN) for 20 years and always felt wierd going in for my pap tests, and he delivered both of my kids (for heavens sakes!).

    Had to go in to the hospital a few yrs ago and had a male CNA of a different race than mine, and a male nurse. They were very nice, highly professional people. I had to have bed baths, and when I could do regular baths I had to have assistance because I was on an IV. Being of a different race didn't bother me. Being of a different gender did! :imbar I didn't let these two guys know how very wierd it was for me ... I gritted my teeth, didn't want to seem like a square or spoil sport, but I was just mortified whenever I had to be exposed in front of them... bed pans, baths, etc. I silently "freaked" every time. Many women are a little that way, even in front of other women. Even younger women.

    I am now a CNA, doing my clinicals in a LTC, and am highly sensitive to how some of the older men seem embarrassed having me provide personal care for them.

    I don't think it is that guys are not accepted as nurses. I think it is an issue with modesty and self-consciousness, not about getting competent care.
    ANd most doctors before 1946 were MALE, yet woman accepted it. They did ALL "intimate" care for them, too....delivering their babies, GYN care etc. How is it they can accept the doctors being male, yet not nurses? I still don't get this!!!!!
  7. by   SharonH, RN
    Quote from SmilingBluEyes
    ANd most doctors before 1946 were MALE, yet woman accepted it. They did ALL "intimate" care for them, too....delivering their babies, GYN care etc. How is it they can accept the doctors being male, yet not nurses? I still don't get this!!!!!
    I don't buy it either Deb. MOST people understand, regardless of cultural or generational mores that they will be losing some privacy and that people of opposite genders may provide intimate care. MOST people get that.


    I think people choose which bits of the past they want to take with them. I see elderly people using cell phones, computers, driving cars, and using credit cards. They lived through WWII, the Depression, the Civil Rights Era and the Vietnam war. They have adapted amazingly well to those changes in society but having a male nurse is just too strange? Naaaaa......


    We may have to accomodate their requests but we do not have to normalize it by as you stated setting the male nurses with questions like "Are you okay with that?"
  8. by   SmilingBluEyes
    I mean, what will these women EVER DO IN THE OR where maybe 5 or 6 opposite-gender people will definately see them "exposed" and under anesthesia, yet? Or in an ambulance, where most paramedics are MALE? or the ED in a true emergency?

    Nope, don't buy that preference thing, unless, like I said in extreme or unusual circumstances such as prior sexual abuse history or established cultural mores.
  9. by   flashpoint
    Not that this is what the post is supposed to be about, but...for things like a foley, etc, I would rather have a female. One of my good friends at work is male and he agrees...if he were going to have a foley inserted he would rather have a male...not that all nurses haven't seen all parts or anything, but it's just a little more comfortable. However, I would not refuse anyone in an emergency or if there were no one else available.

    A male OB nurse delivered my first baby and it was just an awesome experience. He gave the most amazing foot rubs and did better breast feeding instructions than I have ever seen. If I had been given a choice of him or the female that was on duty, I probably would have taken the female...I am glad I didn't have a choice...I would have missed out on an amazing nurse.
  10. by   ktwlpn
    Quote from SharonH, RN
    I don't buy it either Deb. MOST people understand, regardless of cultural or generational mores that they will be losing some privacy and that people of opposite genders may provide intimate care. MOST people get that.


    I think people choose which bits of the past they want to take with them. I see elderly people using cell phones, computers, driving cars, and using credit cards. They lived through WWII, the Depression, the Civil Rights Era and the Vietnam war. They have adapted amazingly well to those changes in society but having a male nurse is just too strange? Naaaaa......


    We may have to accomodate their requests but we do not have to normalize it by as you stated setting the male nurses with questions like "Are you okay with that?"
    I can't explain it-I can tell you what a resident of mine says...Yes-a doctor delived her babies but she was asleep during the delivery-and that does not count (according to her).Her husband NEVER saw her naked butt-and she guesses that the undertaker will be the first guy to see it in broad daylight...She can barely figure out the payphone-never used a credit card,computer or even drove..She is not going to change now. I agree that we have to do what we can to help our male counterparts become accepted but there is a segemnt of society that is not going to change and in my opinion should NOT be forced to....they'll die out eventually-and then you'll only have ignorant s.o.'s in l&d--"I don't want no male nurse looking at my old ladies poontang" I see the difference clearly-I just can't put it into words that make sense
  11. by   mercyteapot
    I can see both sides of the debate-within-a-debate. I was fairly traumatized by a male gynecologist when I was around 21 (I wasn't abused, he was just very rough and not at all sensitive. It was only my third annual exam and I didn't have another one till four years later!) When I finally did go in for another, I asked if a female was available and one was. No prob, Bob. Now, of course, with this kind of visit, I could schedule with whoever I pleased and could have just gone elsewhere if a woman couldn't have seen me. But the woman who dxed my pregnancy was able to convince me that the male ob she referred me to was worth considering, and she was absolutely right. I can't imagine any woman having been more sensitive or competent than he was. Like I said in an earlier post, I would try to accommodate the request for a male or female nurse, if it was possible. If it wasn't, then the patient would have to choose betwixt a competent available person or delaying their care. I think I'd handle it the way the doctor who referred me to my OB handled her suggestion, though. She sat down and went through all the reasons she thought the male was the right doc for me. Most times a bit of "education" goes a long way towards enlightening our patients.
  12. by   LPN1974
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    Last edit by LPN1974 on Mar 7, '05
  13. by   SmilingBluEyes
    Ok anyhow back to the OP. Can/should patients be able to refuse LPNs/CNAs in any situation of their choosing/preference?

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