Nurse Educator Chronicles: Male Student Nurse on the OB Floor

[VickyRN]

My euphoria was rudely interrupted when a staff nurse approached me with concerns about one of my students. "Do you know your student is just sitting over there, doing nothing?" She glanced in an accusatory manner towards my lone male student "Catfish," who was quietly occupying a seat in an inconspicuous area at the farthest edge of the unit.

"Catfish" was entirely bald, short and stocky, in his forties, with an engaging smile and twinkling blue eyes. He was a man of few words, but very gentle and polite. True to his nickname, he was a commercial fisherman, who was picking up nursing as a second career.

"Catfish" appeared utterly miserable and forlorn as he sat nearly hunched over. His eyes were devoid of the usual sparkle, staring vacantly at the floor. He looked as if he hoped the earth would open up and swallow him whole.

"What's wrong, Catfish?" I asked. "Why are you just sitting here?" With that inquiry, the saddest expression swept across his face and he seemed about to cry. I'd seen that look before. It was classic for a male student on the OB floor and I almost had to bite my lip to keep from smiling.

"I'm so sorry, Ma'am," was his doleful reply, "But neither my assigned patient nor anybody else will let me in their room!" I found two or three tasks to occupy his time during the remainder of the shift on the unit. But, overall, he was correct - very few moms would allow him in their rooms, even with a female escort. And, there was nothing that I, as a clinical instructor, could do about it.

Catfish suffered through the rest of the two-week rotation on the unit, trying to stay out of the way of as many new moms as possible. Not too soon enough for him, his stint in OB purgatory mercifully came to an end. He then very gratefully returned to the blissful clinical surroundings of the medical-surgical floor.

[Rajiv]

We are more conservative here in the Philippines, and yet during my entire rotation as a student nurse, i cannot recall any instance of rejection from my OB patients. Not even during my stay in OB ward as a staff nurse considering my gender, they just simply regard me as their nurse. I thought Americans are more accepting with this kind of set up than us Filipinos. I was proved wrong with this story.

[Nurse2b1994]

I can completely relate to "Catfish" and his struggles! I am a male nursing student, in his early forties, and I had to endure four painfully long weeks in OB/L&D. I am single, have never been married, and have no kids, so I had no baseline or idea what women went through during pregnancy! Also, like Catfish, most of the moms wanted nothing to do with a male nursing student touching them in any form or fashion...and I was perfectly ok with that! :) However, a couple of the Postpartum nurses "adopted" me and let me follow them when they did their assessments. As an observer, I was less threatening I suppose because the moms were more receptive to letting me be near them. So, I got a little experience in OB but not the "total" experience. Finally, I befriended the nurses in the nursery and me, and the nurses, and the babies had a grand ol time!!! At no time did I ever feel more uncomfortable in my nursing career than I did during those four weeks. But, whatever doesn't kill ya, makes you stronger I suppose! Graduation in four weeks!

[Albert4]

I had a great time during my (all too short) rotation through the maternity floor. I never had a patient balk at all, and that included when I was working with the lactation consultant.

[misterk1]

I know how that feels. I was in the Army Practical Nurse course and doing my OB rotation, this was 1995. I had a patient that was having trouble with her baby latching on. I being a male nursing student tried different things like using a nipple to try to get suction on the patients inverted nipple. The patient was determined to breast feed and wouldn't try a bottle. I finally asked one of the staff nurses to come in the room with me and suggested that she get her husband to come and suck her nipples to stimulate them erect. I was very nervous being a male, but I covered myself by getting a female nurse in the room to cover myself.

[sleepybunny005]

We (male student nurses/registered nurses) can do nothing about it.. It is their preference.. Especially if it is a private hospital.. In lying-ins, there are no problems like this (in the Philippines)..

..in our hospital, to prevent situations like this, the delivery room do not hire male nurses in the area.. That is because to prevent doing nothing.. When I was assigned in the delivery room before, for any procedures to be done to the mother, we would always get out of the room.. And if ever we failed to remember, our female classmates (who happens to be our partner) would ward us off the room.

..for me if I would become a dad, I'd feel the same way as most do, not to have a male nurse to take care of my wife.. It's a sensitive time.

[MMCRN]

I love my wife and children enough that I am more concerned that they get the BEST care rather than worrying about whether her nurse has a member. Let's face it, to a normal male a woman in the process of giving birth does NOT engender thoughts of a sexual nature. I realize that this is a sensitive subject for many people, yet most of those same people have no issues with a male physician providing care. In my view those people do not need to have their prejudices reinforced by the hospital. If they find the situation completely unacceptable they are free to go somewhere else. Maybe I'm insensitive, but that's just one guy's opinion. And yes, I do realize that my opinion will probably never prevail. I think that to some extent this will always be seen as a female profession.

[Cul2]

So I'm not sure what I'm reading here. I realize this is a sensitive area and quite controversial. But it seems what's being described is just an accepted form of discrimination. Maybe even legal discrimination under the BFOQ regulations. But it's clear that female patients almost always can have a female nurse if they choose. I also that in most cases, if a male nurse is available, a male will be granted the same right.

[Jussurfin]

canoehead said:

I don't think anyone should ask if he can help- just notify the patient that "this is Catfish, a nursing student, and he's going to be following along and helping me today." So much depends on how the patient is approached.

Many here agreed that that this is a respectful and professional approach. Others have dissented, in so many words, it is not. I agree with the latter.

This is tantamount to holding a 'figurative gun' to the patient's head. In realty, it is called 'imposing your will.' I don't know about the rest of you, but I take exception with anyone who tries to impose their will on me and I let them know it.

The patient had been given NO choice in the matter, Granted, the student may have a reason to be there, but the patient, if he / she is to be shown respect and treated as a human being, should always be asked and given a choice. The patient has the final say so in the matter!

The sad fact of life is that most humans are clueless about human relations. One of the most important human relations lessons that everyone should know:

People will do almost anything you ask of them PROVIDED

YOU GIVE THEM A REASON!

Here is what I would say in this position as an instructor:

Hello Mr. / Mrs. etc xxxxx. This is Bob. Bob is a nursing student who wants to learn as much as he can to provide the best care possible to nice people like you when he gets his nursing license. Would you mind helping Bob today by allowing him to tag along with me?

As you said, so much depends on how the patient is approached.

[MMCRN]

Just out of curiosity, would you extend the same courtesy if the student was an African-American Female? What if the student was an Obese female? What if she was a Hindu female? I doubt you would bring those differences to the patient's attention beforehand and get permission for them to participate in care. By addressing the gender issue differently you are letting the patient know that you are not quite comfortable with this, and potentially creating a problem where none may have otherwise existed. To look at it from the patient's perspective, how would you handle the situation if the patient objected to a particular caregiver expressly because of that caregiver's race, culture, or outward appearance (weight)?

I don't think that taking the assumptive approach is holding a gun to the patient's head. In my particular situation, if the patient had expressed objections I would have respected her wishes. I think it is interesting that when the issue was pointed out to the patient beforehand, their inclination was to say no, but when it was put to the patient in such a way that this sort of thing is "business as usual" the patient expressed no objections. They didn't even act particularly shy.

[RNsharkinaj]

I was there in person at one time, it is very uncomfortable being a male nursing student anyway, let alone on an OB floor. I strongly feel that we should not be required to do a clinical rotation in L and D, unless we decided to.

[Merlyn]

Amen and if the women doesn't let us on the OB Unit. Don't put OB/GYN on the state boards. During my training never felt a mother's contraction never took care of a patient. What I did was fold bandages.

But OB/GYN was on my boards.

[Cul2]

To MMCRN who wrote: " By addressing the gender issue differently you are letting the patient know that you are not quite comfortable with this, and potentially creating a problem where none may have otherwise existed."

That's one way of looking at it, and that's how it could be perceived by the patient. On the other hand, by addressing the gender issue you may also be perceived is recognizing a reality that some caregivers just don't mention (as demonstrated by some of the response on this thread). That reality being: Gender matters to many people. It's not so much what you say but how you say it.

If you say it in a way the shows you're uncomfortable, then that's how it may be perceived. But if you say it with a confidence and respect for the patient, then you also may be bringing a much hushed subject into the open and giving it less power -- and the patient may react positively. I'm not talking here about racial or gender discrimination based upon stereotyping and prejudice and hate. I'm talking about people who just don't feel comfortable with opposite gender care -- both men and women. I also agree with the poster who disagrees with using intimidation and or the power of authority to "get" patients to back down as far as permitting students to work with them and learn. Try honesty.

Most reasonable people will respond positively when treated honestly with respect. On the other hand, if they feel you're pushing something on them or if they feel jerked around, they may remain resentfully silent, but you've lost their trust. It's always best to be confidently honest and open with patients. Sure, it may involve risk on a nurse's part, but that's part of the job.