Young female patients

[corbinRN]

I work with a pediatric sedation team in the hospital as a care partner (it's like an ANA) and today I had a 15 year old female. I had to place ECGs on her, but I just kind of handed to a female nurse to do it. If the female nurse wasn't there to do it, should I have done it, or what should I have done? I want to be sensitive to the pt and realizing that I'm a 21 year old man, it might be embarrassing and awkward for the 15 year old woman.

[nursinguy]

The original post of this thread had nothing to do with race, I don't understand why you keep trying to interject it into the discussion.

The information I have previously posted is factual - do the research and you will find that out.

You can not force care on a patient that has refused you as a provider, regardless of their reason. If you attempt to do so, you are committing a crime (assault and/or battery, depending of the state's specific statute) that can result in your arrest and imprisonment.

That's true, but the reality of of a sexual assault/abuse case, especially where a minor is involved, is that when it comes down to a "he said-she said" situation, unless you can provide a credible witness to the contrary or prove you had no access or opportunity to commit the alleged abuse, the overwhelming odds are that the judge or jury will believe the victim.

Not even comparable to the discussion at hand. And again, I don't understand why you insist on interjecting race into the discussion.

(As an aside, the rape charges against Kobe Bryant were dropped after the victim told prosecutors she didn't want to proceed, shortly after which she received a large financial settlement from Bryant.)

Part of a nurse's responsibility as a patient advocate is to respect the patient's autonomy while helping them be as comfortable as possible through the procedure or treatment process. Attempting to accommodate a patients discomfort with care involving exposure of intimate areas to caregiver of opposite sex isn't that hard to do, especially for female patients. It should also be done for male patients if they request, but that can be a little more difficult due to the predominance of females in the nursing profession. The bottom line is that the patient's wishes trump provider ego every time, and attempting to browbeat or coerce them into accepting care by a provider they are not comfortable with is unethical.

Race and sex are something we are born with, therefore it is relavent to the discussion. Discrimination on either is something out of the control of a person, no one gets to choose, therefore people should not be allowed to discriminate on either. Thats how it is a proper analogy and very relevent.

[nursinguy]

Lots of good posts here!! All the points about pt comfort level and privacy are valid points.

However, in my eyes, the biggest issue isn't about ones character, integrity or discrimination, it is about the accusation. Once you have been tagged, true or not, your tagged. Even if it is proven wrong, you still have the tag. You can be the greatest nurse ever but you will still have the tag. What if your accused again even though it isn't so? It would not be pretty. It is just like a nurse in a 12 step program; she might be clean for years but when there is a narcotic missing, guess who they go to first.

Just protect yourself and your license; don't take it as a personal attack on your integrity.

So a male nurse should live in fear? Like this was nazi germany? Do you understand what you are saying?

[sharkdiver]

Lots of good posts here!! All the points about pt comfort level and privacy are valid points.

However, in my eyes, the biggest issue isn't about ones character, integrity or discrimination, it is about the accusation. Once you have been tagged, true or not, your tagged. Even if it is proven wrong, you still have the tag. You can be the greatest nurse ever but you will still have the tag. What if your accused again even though it isn't so? It would not be pretty. It is just like a nurse in a 12 step program; she might be clean for years but when there is a narcotic missing, guess who they go to first.

Just protect yourself and your license; don't take it as a personal attack on your integrity.

Exactly my point Jeff. Why take the risk if it's not necessary?

[mama_d, BSN, RN]

To the OP: I think (as a mom and big sister) that you've gotten some good suggestions on how to handle the situation, and thank you for your concern for her comfort. Especially given her age and the unpredictability of teenage girls. I really like the suggestion to have a parent in there with her if it's feasible.

As far as the debate which has resulted in the whole discrimination issue, at the facility I work at, we do try to accomodate the few patients who we get who are blantantly racist or sexist or whateverist. We're not going to change decades of belief in one hospital stay, and they often make the caregivers uncomfortable. I've been "fired" because I'm white, because I look just like someone's evil sister-in-law, because I look too young, and because my voice was too low pitched. Not that I agree with it going on, and not that we're always able to accomodate them, but that what the patient wants (especially in this Press Gainey age) is of the most import. And honestly, if Mr. Jones has a swastika tatooed on his forehead, I'd rather have the white/non-Jewish staff care for him than make a black/Jewish staff member be forced to deal with his BS. (True example, unfortunately, of one of our recent patients.)

As a side note on the "living in fear" issue...all nurses live in fear to some extent, why else chart as CYA as we do? We're in a sue happy nation and can't ignore that...it's not about being male, it's about being in the profession you're in.

[groovy jeff, RN]

So a male nurse should live in fear? Like this was nazi germany? Do you understand what you are saying?

Hey Nursinguy-I do understand what I am saying.There are several points that we all need to look at:

1. We all have different perception of the events around us. A pt that is sedated or in a poor frame of mind might see something harmless as an assault. Yes it is a misunderstanding; but why deal with the hassle if you don't have to.
   
2. We live in a litigious society and there are those out there that would take advantage us. The easiest way to prevent this kind of thing is to have a witness or many of the other things that were talked about.
   
3. Any pt has the right to refuse treatment from a nurse of any creed, race, nationality, religion, gender, hairdo, looks, scrub top, beard, on and on....... It doesn't matter why, they just have the right!
   
4. I am sure that your a person of integrity as are most of us. This thread isn't about our morals or standards, what is right or what is wrong. This is about trying to do the right thing by the pt, making them more comfortable, and avoiding any potential problem.
   
5. There was a new thread last week in the Male Nurse Forum on how one of our brothers-in-arms was accused by a elderly female pt of sexual impropriety and admin talked to him and that was that. Then there was another complaint that was investigated and the lady's husband notified the police and they came to the hospital and grilled this nurse for 3 hours. Even though he did nothing wrong, now there is a stigma
   
6. Lastly I (and anyone else that are concerned about these kinds of issues) should be taking the advice of another poster, my buddy Suesquatch and getting some malpractice/liability insurance. Doesn't matter if I am guilty or not. if the hospital doesn't back you, your all done.

Right or wrong doesn't matter, you get smeared in the process regardless of guilt; so why take a chance?

[Bobylon]

..............Now I'm a middle aged realist................

Ahhhh, so there's more than one of us

[SuesquatchRN, BSN, RN]

Ahhhh, so there's more than one of us

And again, http://www.nso.com

Don't leave home without it! It is, except maybe in TX, under $100 for a year, they will represent you should you require counsel and the facility has thrown you under the bus -

Malpractice insurance, $x.

Peace of mind, priceless.

sirI, one of our admins and an incredibly bright person, is a forensic, advanced practice, and legal nurse. If you search these forums she advises that NO ONE set foot into a clinical environment without it.

[nursinguy]

Hey Nursinguy-I do understand what I am saying.There are several points that we all need to look at:

1. We all have different perception of the events around us. A pt that is sedated or in a poor frame of mind might see something harmless as an assault. Yes it is a misunderstanding; but why deal with the hassle if you don't have to.
   
2. We live in a litigious society and there are those out there that would take advantage us. The easiest way to prevent this kind of thing is to have a witness or many of the other things that were talked about.
   
3. Any pt has the right to refuse treatment from a nurse of any creed, race, nationality, religion, gender, hairdo, looks, scrub top, beard, on and on....... It doesn't matter why, they just have the right!
   
4. I am sure that your a person of integrity as are most of us. This thread isn't about our morals or standards, what is right or what is wrong. This is about trying to do the right thing by the pt, making them more comfortable, and avoiding any potential problem.
   
5. There was a new thread last week in the Male Nurse Forum on how one of our brothers-in-arms was accused by a elderly female pt of sexual impropriety and admin talked to him and that was that. Then there was another complaint that was investigated and the lady's husband notified the police and they came to the hospital and grilled this nurse for 3 hours. Even though he did nothing wrong, now there is a stigma
   
6. Lastly I (and anyone else that are concerned about these kinds of issues) should be taking the advice of another poster, my buddy Suesquatch and getting some malpractice/liability insurance. Doesn't matter if I am guilty or not. if the hospital doesn't back you, your all done.

Right or wrong doesn't matter, you get smeared in the process regardless of guilt; so why take a chance?

I understand you think you are protecting yourself, but a basless charge can be laid against you even if you have a female in the room.

Also realize you are promoting the idea that male nurses can not be trusted and must be watched. Even if you think you are not, everytime you have a another person in the room watching and a female does not do this with a male pt, you are promoting that males are less trustworthy than our female counterparts.

[SuesquatchRN, BSN, RN]

Also realize you are promoting the idea that male nurses can not be trusted and must be watched. Even if you think you are not, everytime you have a another person in the room watching and a female does not do this with a male pt, you are promoting that males are less trustworthy than our female counterparts.

Males are less trustworthy as regards sex than females. How many nun sex scandals have you ever read about?

Gevalt.

[nursinguy]

Males are less trustworthy as regards sex than females. How many nun sex scandals have you ever read about?

Gevalt.

It is no wonder that nurses have the stereotype as being very judgmental and bigoted after reading all the posts here.

[AirforceRN, RN]

Males are less trustworthy as regards sex than females. How many nun sex scandals have you ever read about?

Gevalt.

Ouch...that one stings.

I don't know about the rest of the men here but it upsets me to think that I have to be more careful in my profession than my female counterparts when dealing with the female population. Is there anything I can do to change it? Not really. We just have to deal the best we can. What upsets me even more is...

a: people seem to think that if a young girl accuses us of some wrong doing, she is more likely to be believed than a professional, college educated, registered nursing male.

and

b:there is a huge double standard here. Male patients of any age are expected to take whoever happens to walk through their door.

I understand that males are more likely to be the abusers...its sad, its unfortunate but yes...as Sue has pointed out...it is true. But is there really that much sexual impropriety occuring in hospital settings where male nurses are convicted (not accused, not charged but convicted) of assault that we have to constantly adjust our workload? Or is this just the result of fear mongering and manipulative females that think they see an opportunity to make some money and ruin someone's life? I'd like to see some stats on how many male nurses or techs are accused and/or convicted of such crimes. I think the results would speak for themselves.

[stelon]

nursinguy, I believe the reason everyone is saying having a female go into the room with you isn't just to watch you because you're not trusted or anything. It is to protect YOU from any potential accusations. This way you have a witness instead of having to deal with the "he said, she said" fun.

I've had patients accuse myself and others for all sorts of little things, but an accusation of improper touching or something along those lines is going to be taken much more seriously than "I TOLD her to bring me another pillow three HOURS ago." when you were never told in the first place.

Granted, it is not fair that the system works this way but it is what it is. Patients have a right to refuse care from any individual based on whatever they want. Sex, age, race, anything. We are not here to judge the individual's beliefs/feelings but to help get them healthy again, and this includes accomodation when possible.