Chaperone or not during exam

[masstudent]

I know I am probably going to get a lot of heat about this question but I am going to ask it. I am a prenursing student and work ata local free clinic as a volunteer manager. I am having an argument with the nurse who oversees the volunteers that when a male doctor performs a pelvic/breast exam that a female chaperone should be in the room. The male nurse's opinion is that it is a medical procedure and there is no reason he shouldn't be allowed in to help the doctor. My concern is for the comfort of the patient. Not all pateints feel comfortable speaking up about having 2 males they don't know in the exam room. I have been used as a chaperone before bout one of the patients became upset because she had seen me working the desk that night something I only do when we are short staffed.

I have convinced our only ob-gyn to always use a female and he now works with his wife who is a nurse so it is not a concern for him anymore. Actually when I mentioned the situation to him, he said it never crossed his mind since all of his nurses at the regular hospital are female.

So my questions are are doctors required to have a chaperone of the opposite sex in the room during a pelvic exam? A question that the clinic nurse has asked me is why isit okay for a female doctor/nurse to do a rectal on a guy without supervision? My response was that the guy can't get pregnant.

Have any guys who work ob/gyn had a lot of problems and how do you/they handle it?

[LPN1974, LPN]

Me being female there is no way I would consent to a gyn exam done by a male doctor AND a male nurse. I want a female nurse there for my support.

I would be totally too embarrassed. Why would any nurse want to subject a female patient to have to go thru that?

This is NOT about the what the nurse thinks he/she should be able to do.

This is about how the patient feels....is she comfortable or uncomfortable with it?

And another thing to think about.....put a male nurse in there assisting a male doctor with certain females and they might cry sexual abuse.

Why would a male nurse want to put himself thru that?

Like you, I think you're going to get alot of heat over this, and I think since I'm the first poster, I will also get some heat.

I was in a thread before on this site, and I took heat because of my views on this very subject.

But I don't care what anybody says.....I wouldn't consent to it, and I wouldn't expect my patients to consent to it, if I worked in such an area where females had exams.

On my job now, a male RN was just hired. I don't how this will be handled for intimate exams of the females from him. We do have a male LPN and he is not allowed to work with the females. I work in Developmental Disabilities.

[dragonflyRN]

I have always had a male ob/gyn. I have always been asked if I wanted or needed a woman present in the room. I never really thought much of it and declined. I can see why my doc asks this now. I don't think they're required, but in these days...who knows. I think they are smart to offer it. From my experience, if a patient is that uncomfortable having a male nurse, they will speak out.

[diamondmeadows, BSN, RN]

i am only a lowly pre-nursing student, but i would like to share my perspective as a patient.

if my exam were to be performed by a male, i would expect a female to be in the room for my sake and for the sake of the care provider. i agree with you that there are people who would be too embarrassed to request a female chaperone even if it made them uncomfortable not to have one present. of course they shouldn't be afraid to speak up about their care, but that's just the way some people are. for this reason, i think that if at all possible, it should be standard for there to be a chaperone the same sex as the patient.

however, i disagree with your statement about the female care provider and the male patient. again, for the benefit of the patient and the care provider, i think a male chaperone would be preferable.

[Hoping LVN2BSN]

Maybe to ensure all patients are able to express their wishes for a chaperone there should be some sort of check box on some form stating they would always like a chaperone or a female nurse or doctor. That way they don't have to ask or tell the doctor they feel uncomfortable, that in itself is not comforting.

Personally, I feel more comfortable with males, maybe because I was raised by my father? Who knows. I totally understand the second person in the room, but male or female, it's always seemed a little creepy to me because they are just standing there...watching...and watching:uhoh3: . For me that's more uncomfortable than being alone with the male.

[perfectbluebuildings, BSN, RN]

I think it should go both ways. If a female wants another female in the room when having that kind of exam, it should be available. If a male wants another male in the room, that should also be available. Not saying it always goes this way in either case, but I think that is how it SHOULD be.

[HappyNurse2005, RN]

Heck in the OB office I used to go to, the female docs/NP's also had to have a nurse chaperone for the vag exams

[llg, PhD, RN]

Maybe to ensure all patients are able to express their wishes for a chaperone there should be some sort of check box on some form stating they would always like a chaperone or a female nurse or doctor. That way they don't have to ask or tell the doctor they feel uncomfortable, that in itself is not comforting.

Personally, I feel more comfortable with males, maybe because I was raised by my father? Who knows. I totally understand the second person in the room, but male or female, it's always seemed a little creepy to me because they are just standing there...watching...and watching:uhoh3: . For me that's more uncomfortable than being alone with the male.

Great idea. Give the patients the best, non-threatening way to express their preferences possible. Make it a routine part of the "check in" procedure.

I also feel the same way about having people "just watching." That creeps me out. If I didn't trust the physician/practitioner and my own ability to speak up if something weren't right, I wouldn't be having that exam in the first place!

... but I do understand the care-giver's desire/need to have a chaperone to protect him or her from false claims of abuse.

llg

[asbigham]

I am a nursing student but have been working as an EMT in an emergency department for a while. In the ED where I work we, as EMT's are always expected to set up for the procedure, test the equipment and make sure the doc has everything they need before they come in the room and assist them durring the exam. I am not sure if it is required that someone else be in the room durring a pelvic exam but I have never seen one of our doctors/PAs perform a pelvic exam without a witness. When male doctors perform a pelvic exam we usually try to get a female EMT to assist him but as you know in the ED, things are fast pace, sometimes hands are limited and you have to make do with what you have so if there are no females around a male will assist. I have assisted plenty of pelvic exams and it doesnt bother me but I can tell that some of the pts are not as comfortable having a male observe, oh yeah, Im a guy by the way. I had a femal doc the other day ask me to assist her in a pelvic. There was female EMT there so I told the doc I would get her to do it and the doc called me a chicken and laughed. She was just joking with me i know but if you can make a pt feel more comfortable in such a vulnerable procedure I dont see why you shouldnt atleast try. Thats my 2 cents :nuke:

[Dewgrl]

:angryfire My first "female" exam was when I was twenty. I had put it off due to what I viewed as no need coupled with a very shy nature. I went to a man who became very unkind when I asked for a nurse to stay for the exam. The female(not sure her staff position) seemed irritated as well. Needless to say I am now going for my second exam at twenty seven and I found a female this time.

[RNfromMS]

This is an interesting point and I won't see why anyone should give anyone "heat" over it.

In my personal experience and I have been going for annual exams for 20 years now, the OBGYN has always pushed a button to signal for the female staffer to enter the room when he was ready to begin his pelvic exam. I never thought about it until I saw that movie about the crazy nanny who was sexually assaulted by her doctor and lost a baby. I guess that's why I don't like changing doctors because I like the trust involved. Needless to say, I have had to make changes (first one I just lost faith in, second one fell off my insurance, next one died in an accident...) Funny thing, they all do the breast exam without a female present...hmmmm. Never bothered me. Don't think if I was comfortable with the doctor it would bother me to be examed alone. That said, I had an experience where I went to my GP for a problem and, after several rule-out tests, he asked me to get undressed so he could do a pelvic exam; I refused and told him that I had a doctor for that and I did not feel comfortable with him doing it, even though he had been by GP for over ten years. He laughed it off, but accepted my wishes.

As far as work goes, a female staffer always goes with a male resident for lady partsl checks (if all the nurses are busy, there are nursing and medical students, OB techs, etc available). We have a lot of female residents who have asked us to go on checks with them, but sometimes when we are busy we explain that we don't feel it is necessary for a female to chaperone a female. (We may get in trouble for that one day.) Now....my personal opinion is that if there is family in the room (which there almost always is) why would anyone (male or female) need a chaperone....wouldn't the family member work? Just curious if anyone else felt the same way.

[mhull]

Where I work, there is always a female assistant (either Tech or Rn) with all pelvics and rectals on females. It is for the pt's comfort and the Md's protection. In this day and age, you can't be too careful. The MD's (I work with all males) will do the rectals on the males for their comfort. We will do the foleys but have a chaperone. Again it is for the comfort of the pt and our safety.