1st day male in L&D

Specialties Ob/Gyn

Published

I just graduated from an LPN program. I really liked my L&D rotation so I put in an application. The Director is great and she offered me a job working as an LPN in OBGYN/PP and too cross train me as an OB tech. She even offered to pay for an IV certification class and work around my schedule when I start the RN program next fall. OB technicians act like scrub nurses during C-sections, prep patients for sections, start catheters, admit patents and help during deliveries.

I am male and the staff is all women. Today was my first day to "follow" an OB tech and start to learn that part of the job. The tech was great she treated me wonderfully and didn't have a problem with me being male.

Everything was going great my preceptor showed me where things were and I watched as she assisted with a C-section. She is a really good teacher and very nice.

I know that there are going to be some problems as a male working on L&D and especially being that I am the first (that I know of) in this hospital. My first problem popped up today, An RN asked us to strait cath a patient. The patient had been acting a little nervous from the time she was admitted but voiced no concern about me being present. My preceptor asked the patient if she would like for me to step out and of course the patient said yes. I understand that my preceptor was trying to make the patient as comfortable as possible and I'm sure she wasn't being malicious. My thinking is that if I were in the patient's position, I would be uncomfortable with anyone regardless of sex being in the room during such a revealing procedure, if they didn't have to be. Asking if I should leave implies I don't need to be there so if it had been me I would have said no too.

To make things worse a C-section patient came in with her boyfriend so my preceptor and I went to admit and prep her for surgery. As soon as we walked in the boyfriend said "I don't want any F***ing students in here." My preceptor assured him that I wasn't a student that I was a nurse (I'm actually still waiting for my permit so this wasn't entirely true). We continued to ask admission questions and take vitals. When it came time to start prepping the patient my preceptor asked the boyfriend if it was all right if I stayed. The boyfriend once again said he didn't want students in the room. My preceptor tried to explain to him that I wasn't a student but I could tell he wasn't buying it so I volunteered to leave. In this situation I can absolutely see why she asked if I could stay, The boyfriend acted like a person who wasn't afraid to cause trouble and voiced a concern about students but I wonder if I should have done something differently.

I left the room and went to the nurse's station and someone asked if I had been kicked out. The Lead Clinical Nurse overheard and said "See I was afraid this would happen, this is the second time today" she was of course talking about patients not wanting males in the room. I explained to her that the boyfriend thought I was a student but she didn't say anything.

Okay so now that you have read my long-winded story, here are my questions and concerns:

1. I think things will get better when I'm on my own and not an "extra" person in the room. But what if they don't?

2. Should patients be asked if its okay for me to stay if they appear uncomfortable?

3. Should they be asked if it's okay for me to stay if they don't appear uncomfortable with me there?

4. I am concerned about my patient's comfort and privacy but if this keeps up I won't be able to learn my job much less do it. How do I balance that?

5. I'm sure I will run into patients that request a female nurse. How should I deal with this?

6. How much is too much? If I have too many of these situations should I just look for another job?

I really want to work on L&D I like the atmosphere and think I can make a difference there.

Id also like to hear any other suggestions or opinions you have in general (both good and bad) about male nurses in L&D/ women's services.

Specializes in NICU.

I posted in your other thread. ;>P

I have worked with males in L&D and I have argued for one to be hired at a hospital I was working at because he was a great nurse and the patients loved him! I have found that with a male in the unit I just introduce them and I do not give an option ie: is it okay if he stays? because of course they will most times say "No" , He is part of the staff that's it. Unless the patient has religious beliefs that are the issue i.e Muslim in which even the doctor must be female, then there is really no reason for this to be a problem.

Women take care of men all the time and so why is it such a big deal for males to take care of females? Why is it okay for the male to be the doctor and perform routine pelvic examinations but not the nurse?

I agree with Claudia. On my small (6 LDRP) unit we have one male nurse. He does not do L & D but is frequently at births as the nursery nurse and also takes care of pp patients. He is ADORED by his patients. They often remember him and will even ask for him to be their pp nurse next time! Part of the reason they are able to distinctly remember him is because he is the only male nurse. He also happens to give excellent care! Occasionally (more likely rarely) we will have a pt who indicates on her birth plan she wants no men in the room so obviously he won't take care of those patients. He is also careful with some of those "off" patients that make HIM feel uncomfortable. This really is rare though. I've worked with him for 2 years and can think of maybe 4-5 instances where this has come up. Often he is even able to take care of those "difficult" pp patients that kick other nurses out of their room.

We now have a male OB tech who is a nursing student that wants to do L & D when he's finished with school. He also has had minimal to no problems with patients.

I think that being matter of fact and giving good care will diffuse most situations. Asking the patient if you can be in the room is really counterproductive to the situation. Many women *choose* to see male OB/GYN's. Why they would refuse to have a male nurse baffles me. Good luck and hang in there. Sounds like you might have more resistance from the staff than the patients. Just get over that hump and you'll be fine!!!

Anita

I have not worked with a male nurse in L&D so this is my opinion, but I also do not see why women would have a problem with male nurses when they see male doctors. That is a mystery. I delivered my first child in a naval hospital and had a few male nurses care for me. I didn't care a bit. And none of them asked me if I "minded" their presence.

I agree that you should treat your patient care matter of factly and that you should not ask if they mind having a male nurse or if you are in the room. I think if they bring the issue to the forefront on their own and prefer a female, then it is in their best interest to try to arrange that. Maybe you could gently bring this to your preceptor's attention as well. You need to learn and have experiences.

No matter what, I believe things will get better for you and that you should follow your heart and stay in L&D if that area is your true love.

Specializes in cardiac, diabetes, OB/GYN.

It is difficult to get accustomed to being treated differently simply because you happen to be the opposite sex of what is usually expected. Thats an age old prejudice and all women are aware of it as in most professions we still somewhat and sometimes hugely suffer from it. However, that has not stopped women from forging ahead for equal rights and treatments. That isn't to say the battle hasn't been difficult or even that the "war" is in any way over. Persistance and time have a way of making a difference. Your small steps are necessary and even crucial in a journey that will hopefully culminate in nursing attracting and embracing male AND female participants..We need you...Hang in there. You can't change the way people think. You can only change or adjust your approach to things. Men in labor and delivery situations (and I am talking significant others here) often bring with them their insecurities and need for control, since it is such a genre that there is often a feeling of loss of control. A female nurse sometimes is non threatening to a person with these issues. A man, in his insecure opinion, poses more of a threat, UNLESS there is a male doc involved. It is all about hierachy, or at least, that is often so. I , in the past, might have said, welcome to the world of not being treated fairly as I am a woman and see it first hand. NOW I would offer, take a deep breath, hold your ground, keep it humorous, enjoy your patients and don't base your judgements on a few cases..NURSES need to get accustomed to the idea too as nursing has traditionally been one of the FEW areas where women are allowed to rule, as it were...All change takes time. You can do it....You WILL do it, but you can't expect the world to move along at your pace. Good luck. I hope it works out well for you......

That is so wrong that they keep asking if it is alright for you to be there. Would they ask the patient if a male doctor could be in the room? You are a professional, and if you were being treated professionally, your sex wouldn't even enter into it. Of course if she's asking, then that is planting the seed in the patient's mind that maybe you shouldn't be there for some unknown reason. I think I would talk to the preceptor and ask her not to do that anymore, and if you get no results that way, I would go to the supervisor.

I worked with a male RN in L&D in California, and not once ever did anyone ever have a problem with him. I think sometimes they were startled to see him come in the room as the OB nurse, but they all loved him (the husbands and the wives) shortly after meeting him, and he did as well as or better than the female nurses. He was a happily married man, and that just happened to be his field he chose.

Good luck, and don't let that phase you. Sounds like the staff needs to get used to the idea before the patients will feel comfortable.

Specializes in cardiac, diabetes, OB/GYN.

Maybe the female nurse asking the question of whether or not the patient minds the presence of the male delivery nurse isn't even aware that it is SHE who isn't yet at ease....

I would agree with you on that one!

Specializes in cardiac, diabetes, OB/GYN.

DayRay, I seriously like to steer away from the male/female demarcation line on most points, but there are some times when they just do exist. I was revisiting this topic and thinking that, as women, we are so accustomed to treating the patient as we would want or expect to be treated, that our issues can't help but surface. For example, as a woman, I am more aware about the vulnerability and body issues women have that some men don't really consider to be vital. I have, on occasion, now that I think about it, even asked a patient and her husband or significant other how they felt about being in the room during either a straight cath or sve. NOT because I didn't think that he didn't belong there, but because it is so personal. Yes, so is sex and birth but in a labor and delivery situation, when it is ALL about loss of control and the feelings that accompany that sense of helplessness, sometimes just asking both parties what they prefer helps them both take a break as it were. I have had people scoff at that and tell me in great detail that it is no big deal, yet, I have also had people tell me ( both the patient and/or the significant other), that they would rather step outside for that. OR, sometimes you have more than one family member..I have even had occasion when neither the patient or her father wanted to leave. Should I immediately suspect some PMH of sexual abuse, as I would when some patient refuses a lady partsl exam, or should I continue assessing the situation for further factors and interaction. I guess, as a man in that situation, it would seem and in many cases, probably does seem stereotypical and even unfair to have that question asked but, I really don't think it is always about that. There are myriads of layers to this whole issue and each day will uncover yet another one. You surely are aware that often, but not always, men tend to think in shades of black and white while women think in shades of gray...My point is, perhaps you might take the people aside and aske them, in a non defensive arena, if they automatically ask that question, as I do, with all my patients, of anyone in the room, or were they more aware to ask the question simply because you are a man in a high female area. People have the authority deal going when it comes to male or female doctors, but, as a rule, in the past, people were brought up with the idea that men were the doctors and therefore, powerful and a buffer zone of sorts between the male/female issue...I think if you just be yourself, introduce your self and tell the person you will be their nurse for the shift and figure out your own style of approach,as we all do, radiate confidence and knowledge, as we all at least try to do, everything will work out. You cannot be all things to all people, but as a nurse, you simply have to try. Again, good luck and welcome to the fold....

Some excellent points have already been made, so I won't repeat what's been said.

I just wanted to add that it might help your learning experience if you talk to your preceptor, and suggest that maybe you can lead the interactions with the patients. By that, I mean...It would likely help if you could enter the room first, and introduce yourself as their nurse, start talking with them, and doing your assessment.

I have noticed that when I am being oriented to a new unit, under a preceptor that just leads the interaction (goes in 1st, introduces me as the new kid on the block)...It changes how the patient and family members perceive me. They often see me as inexperienced, since the preceptor is speaking for me, even though I might have more experience than my preceptor! LOL!

I realize that you are new in nsg, and don't have more experience than your preceptor. But, you are still capable of introducing yourself, and asking questions about pain, any SOB, visual change, or N/V...You can still start to build repoire by asking about this baby (Is this a boy baby, or a girl baby? Any names picked out?), or asking the name of the family members present (and introducing yourself to them individually). You can also introduce your preceptor by name, and say that you are working together, and joke how they are getting 2 nurses for the price of one!

Your preceptor can then be YOUR shadow, instead of the other way around, and just casually add her 2 cents if she sees the need to assess something that was overlooked.

Welcome to OB! We're glad to have you!!!

Specializes in cardiac, diabetes, OB/GYN.

Excellent point about going in first and introducing yourself as the patients nurse. That sets the tone. Maintain their dignity as much as possible and try to identify with the husband or significant other. I often will tell the husband/SO that I realize it will be difficult for them to watch the person they care about suffer even a little and this is one time that they can't fix it. We often, as we have worked together for so long, will go in tandem and work together developing rapport for and with more than one staff memeber, when one is available. Welcome!

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