Re: Male RN help Originally Posted by AllAngelsRN
People with documented psych issues or so called "trouble makers" will not get you in trouble. If they do, the investigation will not lead to you being in trouble and will end up like your co-worker as unfounded.
I find this statement quite offensive. People with mental illness are not trouble makers - they have legitimate illnesses and past traumas that may distort their perceptions and reality. As well people with mental illness and other vulnerable populations are actually at higher risk of abuse than other populations so the fact that someone has a mental illness does not necessarily invalidate their reporting of abuse.
Now to the OP. The reality in dealing with folks with mental illness is that sexual assaults or abuse as well as hallucinations and delusions can alter how someone perceives men and their intentions. For someone who has been abused sometimes even simple touch can feel very violating. Nursing care that involves physical contact can be misinterpreted as something 'wrong' because of the feelings (fear, terror, horror, helplessness) and painful memories it can bring up. Delusions and hallucinations can completely distort the whole event and situation. Accusations that come out of such misinterpretations or distortions are not intentionally evil - they come from that individual's reality and that to them, the experience of the situation was inappropriate.
Boundaries are really important - sometimes even being too friendly or too nice can be misinterpreted as 'something more' and then the patient feels rejected when that ends or the RN doesn't work with them etc... One thing that can help is to be sure to explain everything you are going to do so their are no surprises in care - i.e. they weren't expecting to be touched there or moved that way...for someone who has been abused by a spouse - it could be that even holding her arm tightly while turning could trigger difficult feelings or make her feel threatened. So being very clear on what you are doing before you do it helps to reduce the unexpected. If you know someone has a tendency towards perceptions that may not be accurate then male or female you should have someone with you when providing care. The point someone else made about not coming across as arrogant/ powerful / controlling is important too...the more low key and non threatening someone is the less chance the person will react. Size - being bigger male or female can be threatening too so physical posture - talking at eye level instead of towering over the bed helps. Another helpful approach is to give the patient lots of space, approach slowly, stay in their line of vision, avoid moving belongings, linens without asking etc... Also letting the patient know as part of your 'explaining what you are about to do speal' that if they feel uncomfortable or aren't sure what you are doing to speak up and ask. And understand if they do make an unfounded accusation that it really isn't personal - it is a reflection of their illness, their pain, their past, their personality and their perceptions.
There are people with and without mental illness who make knowingly false accusations shearly out of spite or anger or pure evil or whatever...but in my experience in psych - these are few and far between.
I work with RN's, about equal male and female- quite a few have been through what your colleague is going through, and it isn't fun. A nurse is a nurse but you are still male or female and patients don't just see you as their nurse but also as a person. Sex is just one of factors that can inadvertently cause problems - female nurses can end up in similar situations for other reasons as well.
It is great that you are there as a support for your colleague.
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