can a nurse refuse to give vaginal cream to a patient?

[Ms.RN]

I have a patient whose been complaining of itching and burning in lady parts area. So doctor prescribed a lady partsl cream for her but the problem is a nurse that has her is refusing to administer it to her. She says "This patient is competent to be able to insert lady partsl cream by herself" Yes, this patient is able to do it herself but she asked a nurse to do it for her, but this nurse is still refusing. Can a nurse refuse to do it or is she being very unprofessional?

[Lovely_RN, MSN]

I don't know enough about the patient in the OPs post to make a judgment. If she seemed normal enough I would just double up my gloves and do it. However, I have experienced many mentally ill people at my job who want me to touch their genitals for their own gratification and being asked to do that makes me feel sexually harassed. I've had male patients who can do their own peri-care if the CNA is not attractive but as soon as a cute young one comes on the unit they can no longer lift a finger for themselves.

I'm not trying to be funny but I worked a double shift on the same floor and the CNA in the AM was very plain. The resident was able to feed himself and do about 90% of his own care. Next shift we had a pretty young CNA and all of a sudden he was acting like a complete invalid. He couldn't even lift his fork and he wanted to be toileted every five minutes. I've experienced this myself when I was a young CNA working in the hospital, I walked into a room and a young male patient was sitting in a chair buck naked with his member standing straight up telling me to wash him. I was like :rolleyes:hmmm that's funny cuz when I saw you eating breakfast you were using your two hands to feed yourself.

I also have a female resident who is very narcissistic and demanding and she is always asking me to look at her lady parts or telling me that her butt itches. Even when I am not working on her floor! I have been in the cafeteria getting my meal and she will call me over to her and ask if I am working with her today. If I'm not I will say no then she will proceed to whisper to me that her butt or lady parts itches and ask me if I will come to her room to take a look. Trust me this ladies complaints are not being ignored she has had numerous gyn consults and nothing is ever found. The docs will usually prescribe some sort of lady partsl cream for her but it's a constant thing with her.

I don't know...people like that make me feel creepy.

[UND1981]

Refusing to provide treatment prescribed by a doctor is wrong unless the nurse feels it is not in the best interest of the patient. I would ask why this patient refuses to self administer this medication, instruct her on how to do it properly, and educate her about what she will need to know before going home. People are usually cooperative if you uncover the fear that is driving their actions and deal with that.

If she is truly acting out inappropriately, administer the cream with two nurses present.

[CHATSDALE]

an overweight patient may look like a 'able-bodied' person but may be unable to do this herself

to assume that the patient is a pervert may show that the nurse has a problem with her own feelings about the 'private parts' of a patients

[Fun2, BSN, RN]

That's true, Chatsdale, and some may just have a 'phobia' about touching themselves.

[BEDPAN76]

On a heavy med pass, I don't have time or patience to argue.I would just put it in and be on my way. Only takes a few seconds! Why make a big deal out of it???? :hehe:

[nightmare, RN]

If I have a patient with redness and itching then yes I put in the cream, why? because I can see exactly where the redness is which,unless they are double jointed, they can't.

[rkitty198, BSN, RN]

Refuse to give a lady partsl cream as a medication? mmm, easy answer- GIVE IT.....Why would you refuse anyhow? Just because a person is able bodied to take pills would you leave them to do it themselves. Would you do wound care teaching and then leave the supplies in the room so they can do it themselves? just because they will have to do it at home?

It is a medication and as a nurse we are to follow orders and give medications.

Did the nurse even know if the patient has ever put or placed anythign into the lady parts? Was the patient in the hospital for other reasons? What if she was feeling badly that day. Some patients will tell me they feel like I can do it better than they would when it comes to stuff with their bodies.

I agree to give the patient the tools to enable them to feel responsible for their bodies, but to refuse to medicate a patient is against our duties as nurses.

[Virgo_RN, BSN, RN]

We don't know enough about the patient in the original post to form an informed opinion on whether the nurse should administer the med or not. How old is the patient? Does she have any cognitive or physical deficits that would prevent her from being able to administer the cream? All we've got to go on is that the OP says she is able to do it herself, but we have no information on the patient's physical or mental condition other than that, so this is all speculation.

[leslie :-D]

i was too, going to suggest what sharon said, about md writing order as "pt may self-administer" and leave at bedside.

that's provided pt is truly 'able' to do it herself.

how do we know if she has/hasn't any psych dxs?

i personally could not put my foot down and "let her do it herself".

for whatever reason she refuses to do so (which s/b investigated), in good conscience, could not let someone's fungal infection fester.

it's my duty to educate and encourage...

just as it's my duty to treat with beneficience as to prevent further injury or harm.

if i suspected potential harrassment or litigation from pt, i would have a witness.

but i am close to 100% sure, i would end up applying the vag cream.

leslie

[One Flew Over]

Also, there are a lot of freaks, weirdos, choose your favorite descriptive word here who get off on that kind of thing.

Write me up. I wouldn't do it either.

We have one at the LTC I work at. Just because it's not a male patient doesn't mean there couldn't be a sexual harassment thing going on there.

Just saying, there might be a valid reason (such as that) behind the nurse's refusal. Besides, if the patient can do it for themselves why wouldn't they? Sounds strange to me.

Now if they can't do it for themselves, regardless of anything else, it just has to be done.

[diane227, LPN, RN]

You don't have to have a doctors order to teach a patient.

[Ruby Vee, BSN]

i have a patient whose been complaining of itching and burning in lady parts area. so doctor prescribed a lady partsl cream for her but the problem is a nurse that has her is refusing to administer it to her. she says "this patient is competent to be able to insert lady partsl cream by herself" yes, this patient is able to do it herself but she asked a nurse to do it for her, but this nurse is still refusing. can a nurse refuse to do it or is she being very unprofessional?

first, if the patient is complaining if itching and burning, they know where the cream needs to go even without "taking a look down there." it needs to go where the itching and burning is. if the patient is able to do it herself, she should do it herself. if she isn't able, that's another story. but what we know because the op told us, is that the patient is able to do it herself.

second, why is the op policing the nurse's practice? if you're supervising the nurse then you must have some nursing experience and you'd know whether it's professional to refuse to administer lady partsl cream to an able bodied patient in your area of practice. if you're not supervising the nurse, then why do you care?