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?

[hippienurse]

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

Where I go that is the same, the is always a second person to observe so that both are protected.

[LauraLou]

At my hospital, it doesn't matter if the doctor is male or female, a female nurse must be present when a pelvic exam is present. That protects both the pts and the doctor.

I personally once had a male doctor who performed a pelvic exam without his MA or nurse present. He didn't do anything improper but I felt very uncomfortable and vulnerable. I didn't realize I would feel that way before he started, so I didn't think to ask for a chaperone.

[Male Nurse 35 years]

I think that this, at least for the male nurses I know, has become an emotionally charged topic. Most of my nursing career has been as a RN with the first 14 years as an LPN. As both a male nurse and a patient, I have experienced both sides of the issue. Every chaperone or assistant for any of my exams has always been of the doctor's choosing or the hospitals where I was getting treatment in. Whereas a woman undergoing the genitalia exams had a woman chaperone, I have never been afforded the opportunity to have a male if a chaperone was needed for an exam. I normally state that I don't want a chaperone present just because a male chaperone is not available. I have been ostracized for even requesting that a male tech or nurse do outpatient testing of a sensitive nature or told to go somewhere else to get treatment. Many times my insurance dictated where I got treatment at not leaving me with options.

I know that there are two standards of care that emphasize to women their right to a chaperone of the same sex as they are and deny men the right to have a male chaperone just because a male chaperone is not available. I have been told privately, off the record by doctors, that they cannot afford to hire male staff and keep the current female staff for the women's exams. They therefore elect to hire just female staff for all the patients.

I also think that the issue goes even further than just the issue of chaperones. I have never been offered a patient gown for my routine rectal exam in the last 20 years. I have heard of patients stating that they are never offered gowns if they are male whether the provider was female or male. Men go to a medical office fully clothed but yet are routinely expected to strip to the waist for chest x-rays or EKGs and never given a gown to maintain privacy or humility. Staff will leave the door to the room open or walk in and out of the room with the male patient in varous stages of undress. Women medical providers are just as guilty as their male counterparts; they have no issue with telling a male patient to drop his pants and bend over the exam table without ever giving him a gown or a drape. Where I work, in a large primary care outpaient clinic that treats 12000 patients per year, 95 % male, men are just a number. The women that come in are afforded every privacy in the book which all patients should get.

One of the most demeaming things that any medical professional, whether male or female, can say to a patient is that the person providing the care has done the same procedure hundreds or thousands of times before and understands how the patient feels at that moment. The irony is that the female medical staff, whether doctors or nurses, say it much more often than their male counterparts. While women understand all too well how a sexual exam can turn into a humiliating experience, very few women ever have to worry about a male tech doing their mammogram or being the chaperone for their pelvic exam. It is very rare that a male patient has a male tech do his scrotal ultrasound, or be the assistant for a routine colonoscopy. Regardless of what people profess, they practice differently from what they preach. I have met very few female colleagues that want me as a male nurse present for their female exams or procedures. Yet they routinely expect me to allow them to practice their profession just because they are a " professional". Most of the female colleagues I work with are insulted when a male patient tells them he wants a male nurse performing his test or procedure. But it is quite appropriate for them to demand a female nurse for their needed medical procedure.

Times are changing things; I just wish that, as I get older and have more invasive outpatient procedures being done, that I, as a male, could get male nurses for my procedures. I had a heart cath a year ago and had 6 different nurses looking at my genitalia and groins. All 6 were female. I was only in the outpatient testing area 4 hours. The women practiced professionsal nursing. However, they are still looking at my genetalia and groin while stating that they have done this hundreds of times before. It does not releve my frustration when I am treated as a piece of meat and not a patient that deserves to maintain my humilty and humanity as a male patient.

[justalady]

I work for a large health care organization at which I also receive medical care. Every two years, I endure a PAP smear, pelvic exam and breast exam. Yesterday, I went in for my first exam with a new doctor- my previous doctor having left the company. The OB/GYN was a woman. We chatted a bit, with me undressed and in their fabric cape plus paper drape. As she asked me to lay back to begin the exam portion, the LPN reappeared and started to put on gloves. I stopped and asked whey she was present. The doctor indicated that our organization now requires them to be present for all female exams done by either men or women. I told her I would rather the woman not be there. The doctor indicated she was present to protect both of us. I was highly offended because essentially she was telling me the patient was not trustworthy.

But that wasn't my first reaction. I started to cry. I was so uncomfortable. I told her that if this was a requirement henceforth, I would never be coming back for another PAP smear. Here I am, in a room unclothed, and meeting a strange woman for the first time. That stranger will shortly be poking around in my nether-regions. That's bad enough. Then to be told that a second stranger was required to stand there and watch the first stranger work- that was terribly uncomfortable. I can't begin to tell you how uncomfortable. To lose the control over the situation, made things worse.

My background is in legal, risk management and compliance. I understand why they might have made the requirement. I get that. I might have made the same recommendation. At the same time, as much as I want to be helpful and realistic, and make the doctor comfortable, this is my body and my emotions we're talking about. At this particular point in time, when I am feeling incredibly vulnerable and having to share personal details with one stranger, I cannot deal with a second stranger in the room. In this situation, I care more about myself than the doctor. How can you create trust on both sides if you are saying, right from the beginning, that one of you is not trustworthy?

The doctor did allow the nurse to leave, and I did allow the exam to continue, but I am still very uncomfortable about this situation. The idea that the chaperone protects both the patient and the doctor is not true. I felt very unprotected. I felt like I was not trusted and I was extremely vulnerable both physically and emotionally.

I wonder if the best thing to do is to ask all patients (male or female) being treated by male or female physicians, if they would like to have a chaperone present? Whichever way they respond, respect it.

[samirish]

I would not want the exam done by a male doctor and male nurse. It would feel way too intimidating for me...not to mention weird.

[CrunchRN, ADN, RN]

as a former ob/gyn office nurse of 10 years I would say it only takes 1 allegation or misunderstanding and no one will believe the males if there was not a female chaperone.

Not saying it is right, but that is the reality.

[DebblesRN, ASN, BSN, RN]

I think that this, at least for the male nurses I know, has become an emotionally charged topic. Most of my nursing career has been as a RN with the first 14 years as an LPN. As both a male nurse and a patient, I have experienced both sides of the issue. Every chaperone or assistant for any of my exams has always been of the doctor's choosing or the hospitals where I was getting treatment in. Whereas a woman undergoing the genitalia exams had a woman chaperone, I have never been afforded the opportunity to have a male if a chaperone was needed for an exam. I normally state that I don't want a chaperone present just because a male chaperone is not available. I have been ostracized for even requesting that a male tech or nurse do outpatient testing of a sensitive nature or told to go somewhere else to get treatment. Many times my insurance dictated where I got treatment at not leaving me with options.

I know that there are two standards of care that emphasize to women their right to a chaperone of the same sex as they are and deny men the right to have a male chaperone just because a male chaperone is not available. I have been told privately, off the record by doctors, that they cannot afford to hire male staff and keep the current female staff for the women's exams. They therefore elect to hire just female staff for all the patients.

I also think that the issue goes even further than just the issue of chaperones. I have never been offered a patient gown for my routine rectal exam in the last 20 years. I have heard of patients stating that they are never offered gowns if they are male whether the provider was female or male. Men go to a medical office fully clothed but yet are routinely expected to strip to the waist for chest x-rays or EKGs and never given a gown to maintain privacy or humility. Staff will leave the door to the room open or walk in and out of the room with the male patient in varous stages of undress. Women medical providers are just as guilty as their male counterparts; they have no issue with telling a male patient to drop his pants and bend over the exam table without ever giving him a gown or a drape. Where I work, in a large primary care outpaient clinic that treats 12000 patients per year, 95 % male, men are just a number. The women that come in are afforded every privacy in the book which all patients should get.

One of the most demeaming things that any medical professional, whether male or female, can say to a patient is that the person providing the care has done the same procedure hundreds or thousands of times before and understands how the patient feels at that moment. The irony is that the female medical staff, whether doctors or nurses, say it much more often than their male counterparts. While women understand all too well how a sexual exam can turn into a humiliating experience, very few women ever have to worry about a male tech doing their mammogram or being the chaperone for their pelvic exam. It is very rare that a male patient has a male tech do his scrotal ultrasound, or be the assistant for a routine colonoscopy. Regardless of what people profess, they practice differently from what they preach. I have met very few female colleagues that want me as a male nurse present for their female exams or procedures. Yet they routinely expect me to allow them to practice their profession just because they are a " professional". Most of the female colleagues I work with are insulted when a male patient tells them he wants a male nurse performing his test or procedure. But it is quite appropriate for them to demand a female nurse for their needed medical procedure.

Times are changing things; I just wish that, as I get older and have more invasive outpatient procedures being done, that I, as a male, could get male nurses for my procedures. I had a heart cath a year ago and had 6 different nurses looking at my genitalia and groins. All 6 were female. I was only in the outpatient testing area 4 hours. The women practiced professionsal nursing. However, they are still looking at my genetalia and groin while stating that they have done this hundreds of times before. It does not releve my frustration when I am treated as a piece of meat and not a patient that deserves to maintain my humilty and humanity as a male patient.

I personally do not want a male nurse being the assistant or chaperone during a pelvic exam. That's just my preference.

Honestly, even during a pelvic with a female practitioner, I have always seen them bring in another nurse during the exam to collect whatever specimen.

I cannot tell you how many foley catheters I have inserted into men, or how many groin preps for heart cath, or how many enemas I have given to a male patient in my career. Never have they asked for a male nurse to do it. I never thought to ask, but something to think on now for sure. I always try to protect my patient's privacy during any procedure though. I'm the queen of modesty, so I expect it for everyone because it is how I want to be treated.

I think that your personal preferences should be honored for intimate exams. It's a particularly vulnerable position you have to be in, so you should be made to be as comfortable and stress free as possible in my opinion.

[KaroSnowQueen, RN]

My personal opinion is that the female witnesses the GYN exam for the protection of both the doctor and the patient. Two males does not meet the requirement and could make the patient feel extremely uncomfortable. There have been through the years, complaints of sexual abuse and rape by physicians, even dentists. On the other hand, a female patient will think twice about making a false accusation (and there are those kind of folks out there) with another female present.

I think the reason there aren't male chaperones for female physicians and male patients is that its a lot harder for a female to force a male into sexual situations that he is not wanting to engage in. Due to just anatomy and to sheer physical strength. I know there are some women out there who could pick up a car but most aren't that strong.

I've had my GYN now for 15 or more years. He didn't have a chaperone for several years although it was a large practice and many MA's available. Once he asked me if I needed a chaperone and I said 'No, if you act up I"ll kick you in the head.' The next year a chaperone came in unsummoned!!! I don't know if I upset him by my answer or if it was just a practice change.

[58flyer]

Times are changing things; I just wish that, as I get older and have more invasive outpatient procedures being done, that I, as a male, could get male nurses for my procedures. I had a heart cath a year ago and had 6 different nurses looking at my genitalia and groins. All 6 were female. I was only in the outpatient testing area 4 hours. The women practiced professionsal nursing. However, they are still looking at my genetalia and groin while stating that they have done this hundreds of times before. It does not releve my frustration when I am treated as a piece of meat and not a patient that deserves to maintain my humilty and humanity as a male patient.

Male Nurse, I assume that as a nurse yourself you are comfortable with speaking to other nurses in the medical environment. Couldn't you have advocated for yourself and reminded them that this is not about them, it's about the patient? You say they were professional even as they made unprofessional comments. Was it really necessary that all 6 females see your genitalia?

Nothing is going to change unless YOU speak up and advocate for yourself and other male patients. Working as a healthcare professional puts you in a perfect place to effect change. Speak up at staff meetings at your facility and suggest ways that men could be professionally treated. The status quo is not acceptable.

As a patient I would not remove any amount of clothing unless provided with a gown or other coverings, and firmly refuse any "strip as you go" exams regardless of the sex of the provider.

[rn/writer, RN]

The idea that the chaperone protects both the patient and the doctor is not true. I felt very unprotected. I felt like I was not trusted and I was extremely vulnerable both physically and emotionally.

You need to do what you need to do to feel safe. But the docs need to be able to protect themselves, as well.

One accusation of misconduct can cast a shadow over a career or even end it. Patients can misinterpret what's taking place--they aren't in the best position to see what is being done. Others outright lie, hoping for some kind of settlement to keep them quiet. Patients who are narcissistic or histrionic or who have a heightened sense of drama have been known to play games. Still others who have a history of sexual assault or abuse may experience a flashback as vulnerable areas are touched.

These things are not common, but they aren't unheard of either.

There is no need to take this personally. It isn't about trusting the patient. It's about docs being able to protect their own practices and lives.

That said, if this is not something you are comfortable enough with to endure, you should find a doc who is willing to work with you.

[StayingFit]

My personal opinion is that the female witnesses the GYN exam for the protection of both the doctor and the patient. Two males does not meet the requirement

I don't think that I understand this. How would a male nurse not meet the requirement? If the idea is to have a witness, in order to protect the patient and the doctor, why would a male nurse not suffice?