Nurse Educator Chronicles: Male Student Nurse on the OB Floor - page 6

It was a happy productive morning on the postpartum floor. I was busy with my group of clinical students overseeing “BUBBLEHE” assessments, reinforcing breastfeeding techniques with the new moms,... Read More

  1. by   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 penis. 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.
  2. by   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.
  3. by   Jussurfin
    Quote from canoehead
    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


    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.
  4. by   MMCRN
    "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."

    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.
  5. by   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.
  6. by   Merlyn
    [FONT="Arial Black"]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.:angryfire
  7. by   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.
  8. by   MMCRN
    Cul2 -
    I absolutely see your point, and I don't mean to be obtuse, but I submit that simply bringing up the subject indicates an inclination that there is something remarkable or unusual about the practice. When I work in the ICU I am expected to do a COMPLETE head to toe assessment on each of my patients once per shift. That includes particular attention to the peri areas since they are more prone to breakdown. We don't ask the patient if they are uncomfortable having a male as their nurse. I'm their nurse, end of story. On the other hand if a patient specifically requests no male nurses and we are able to accommodate them, then we certainly try. When I work in the ER and a patient comes in with chest pain we don't ask if they have a gender preference. I tell them I will keep them covered as much as possible, but that I need to expose their chest to do an EKG. If a trauma patient comes in, likewise, we expose the body and take care of the patient without regard to their gender. I will say that when a patient needs a foley we try to use same gender people to place them, but if a female isn't available and the patient really needs one I don't hesitate. In my hospital we are going to some pretty extreme lengths to improve our customer satisfaction numbers, but we have yet to reach the point of handing out menus wherein the patient can select their nurse based on height, weight, color, and yes...gender.

    Again, if a patient has a problem with my gender and we can reasonably accommodate them I am willing to do it. That doesn't change the fact that we seem to have no problem accepting this form of discrimination when we would show zero tolerance for other forms of discrimination which I mentioned earlier. You say that it is a fact that gender matters to many people. It is also a regrettable fact that ethnicity and culture also matter to a great many people, but that doesn't mean we should excuse it by changing the way we operate. L & D is the only department in the hospital where we make such a big deal out of the gender issue. I'm just saying that we should treat these patients as we would any other patient in the hospital. All of us should be kind, caring, respectful, and professional. If a patient has a problem, by all means, address it, but don't create problems where they might otherwise not exist.
  9. by   belgarion
    I don't know what the right answer is here or if there even is a "right answer". I did talk to a couple of female nurses I work with so you can take this for what you think it's worth.

    One of the nurses told me that she was a small town 18 year old when she had her first child. She said the nurse came in with a male student and approached her in much the same way a lot of posts have suggested. This was a student who was on an OB rotation and needed to learn. She was told he would be helping. Very direct, firm, and business-like. She told me she didn't know then that she could object and was "very uncomfortable" with the whole thing. Her husband worked in the oil patch and couldn't be there so maybe that was part of it. She did say if she had been given the choice she would have never agreed to the male student.

    The other nurse I talked to was already a nurse when she gave birth. She too had a male student come into her room with the OB nurse and inform her that he would be helping. Again, no ifs, ands, or buts about it. Even though she knew she had the right to refuse, she accepted him because she felt as a nurse it was her "duty" to help educate new nurses. She also said she was uncomfortable but "put up with it". She also said that when she had her next child she was more assertive. She did say she knew it was silly but that was the way she felt and it was SHE who was giving birth and not the OB nurse, the student or anyone else.

    So I guess the question here is this: When a woman in labor is told she will have a male student helping out, with no alternatives given, and she doesn't pitch a fit about it, is it because she truly accepts the male student or is it because she decides to just "put up with it"?
  10. by   Cul2
    "I submit that simply bringing up the subject indicates an inclination that there is something remarkable or unusual about the practice."

    Attitudes vary, MMCRN. To you, the nurse, there may not be anything remarkable or unusual about you treating opposite gender patients. That's your job. That's what you've been trained to do. To a significant number of patients, there is something unusual and remarkable about the difference in bodily boundaries once they enter the hospital. Now, I'm not applying basic gender choice to ICU or LTC or ER. You do the best you can there under the circumstances. I'm talking about not deathly ill, alert, conscious, patients. And, as I've suggested, you're right. The issue of gender choice most often seems to come up in OB-GYN. And it's always about whether male nurses should be allowed to work in those areas, or whether patients should have a choice. It doesn't often come up when were talking about female nurses regularly inserting foley caths into male patients, or giving bed baths, or cna's showering male patients, or prepping them for surgery, etc. Those activities are just considered acceptable. And getting back to what you said about what is unusual or remarkable -- to some male patients, it is unusual for a female to be doing something like that. To others it's just fine. And to others it's somewhat uncomfortable but acceptable. Everyone's different. Yet the policy seems to be to just assume that it's either okay or it doesn't matter whether it's okay or not. It's just the way it is. But I do appreciate your point of view. I'm just saying that sometimes that isn't the patient's point of view.
  11. by   nursenow
    MMCRN, I don't see how anyone could put it any better/more clear than that. Good post!
  12. by   muskylounge
    This is a great topic. One I wish I could have found more "in depth" discussions on prior to my first rotation this semester. I will have to play the devils advocate and say that my personal experience was fantastic to say the least. That not a single one of my fears came true and the horror stories of male student nurses being rejected were a mere folklore.

    I am not saying that it couldn't have happened. Nor am I saying that it didn't happen to anyone else this past semester or previous semesters. Its just for me personally it turned out to be only the boogyman. I do give credit to my instructor who did not even bring up gender and has not for 20 years when introducing the student nurse as being assigned to help you today. For example. When entering room she asks if its OK if a student nurse helps with the experience today and I enter with smile and badge in place. I worked on the floor for 4 weeks and did not see a vag. delivery ( I have 3 children of my own, I have seen 3 deliveries), but saw one C section and took care of 5 postpartum moms and their babies. I had a great time and none of the moms cared or said anything about gender. In fact one first time mom and dad wanted to write me a letter of recommendation. 4 of them were first time moms. One I was able to teach breast feeding as latching seemed to be difficult as this is normal for most first time moms and babies.

    I still do not want to be a L and D nurse but I can say I am glad that the boogy man was just that, the boogyman and that I had a very positive experience. If you are a male student nurse and you have children take a small photo of them with you to clinicals and put them behind your badge. Show your client as a conversation piece. If you don't have any thats fine too bring pics of nieces or nephews just make sure to tell them that they are your nieces and nephews. :spin: