Ever discussed sexuality with peds patients?

Here.I.Stand, BSN, RN · Jun 18, 2015

but, you see, that is also who abusers protect themselves. also, the OP has come back to clarify that it is often the child who brings it up to the healthcare provider.

True, but this parent isn't abdicating responsibility just because some parents are predators.

I like Jory's suggestion for researching assessment methods

JenTheSchoolRN, BSN, RN · Jun 18, 2015

I'm also a school nurse. I've had questions asked by students as young as 9 & 10 and I direct them back to their parents/guardian/caring adult. These questions often come from girls after they get their first period, which if that happens it school, I am most definitely calling the parent. And if more than a simple innocent question comes up, it gives me pause and I reach out. Puberty for some girls can start at 8 or 9 and breast development can gather some of those girl unwanted attention they do not understand. Also, I work in an urban area where I often found out students that young can be using the internet with no monitoring. You google anything and Media comes up. Ugh. And don't get me started on urban dictionary. And so much on TV/media uses sex to sell everything, including clothing to the "tween" population.

I also teach sex ed, but in 7th, 8th, and 10th grade (kids 12+) and not without parental permission. My curriculum is geared around parents/guardians being their child's educator and using any fact based lesson I teach as a gateway for conversation with their child.

I feel some kids will ask me questions as a health care provider because they want a fact based answer and are uncertain if they can get it elsewhere.

LadyFree28, BSN, LPN, RN · Jun 18, 2015

I feel some kids will ask me questions as a health care provider because they want a fact based answer and are uncertain if they can get it elsewhere.

To add: as a Pedi ER nurse I have gotten support from parents to answer the question to solidify their own home teaching; I think sometimes the challenge in some cases are the parents that do get exasperated when we have to give their teens those questions without them around-I only had one case but I was able to conduct my interview nonetheless.

It does get hairy when sexual assault is involved-but that takes a multi-disciplinary approach, which I'm grateful for.

TekkenDanser, BSN, MSN, RN, APRN, NP · Jun 20, 2015

Yes, research assessment methods! That is what we are hoping to do for healthcare providers who find themselves in the situation of a curious child that is asking questions. It may not be an appropriate topic for discussion for patients who are not exhibiting any curiosity about sexuality. Fine. But it would not be a sufficient response to tell your pediatric patient, "Sorry, but we can't discuss this until you are old enough. You should not be asking these kinds of questions."

The research topic was chosen from a personal experience with this. We are hoping to equip healthcare providers with an assessment method that can be used to prepare them if such an encounter arises. The initial pilot study is to do exactly this- figuring out if this is a meaningful study by surveying, in our chosen sample, nurse practitioners.

NurseGirl525, ASN, RN · Jun 21, 2015

Kids 6-10 years old? This age range is way too young. If my son is "curious" he is to come and talk to me and ask his questions. Now, if he is a teenager around 14, and feels for whatever reason he could not talk me say about being gay, and he had some questions regarding safety and sex, then I would want him to talk to his physician. But this should not be part of an assessment. In my opinion, this is a private matter between a child and their parents. Not to be assessed by people in the pediatrics office.

You are going to find many parents that feel the way I do. A 6 year old is really too young to understand these issues and I would never want anyone bringing these issues to his attention. I wanted to keep him as innocent as I could, as long as I could.

At nine, he is starting to be aware of sexuality and ask questions. I answer them for him as best I can. But I as his parent get to decide how to do this appropriately. You need to find another topic. I'm still blown away by these ages you are wanting to study.

SnowShoeRN · Jun 21, 2015

I am an RN and student in a Psych NP program at Northeastern University. I have teamed up with two other nurse researchers to investigate the interactions between nurses and young children, ages 6-10 who have brought up sexuality questions. They may have expressed curiosity about LGBT lifestyles, or something made you think that as a nurse you should bring it up as part of a complete assessment.
This is a multi-disciplinary topic and we would like to hear from any and all nurses who have had encounters with this type of pediatric patient. How did you handle the situation? What is your specialty (if you have one)? Would you be wiling to participate in a survey regarding this topic?
As an RN, I have not had many opportunities (or maybe not enough time) to get involved in research, but I am grateful that as a nursing student, I am encouraged to participate in the research process to promote nursing professionalism and evidence-based practice. I would be so grateful to get even a handful of responses... Or a suggestion of a way to reach out to more nurses...

I think that there is a lot of merit in an undertaking such as this. At this point in your research it sounds like you're looking to do more of a smaller qualitative study exploring nurses' experiences with conversations that have already happened, which I think is great. The implications could enable us to better understand parental involvment in their children's lives as well as nurses' comfort levels in addressing these issues and how that may have influenced future interactions with the child.

With my experience in camp nursing, I had a handful of kids under the age of 10 come to me with sexuality questions. I had one boy - 7 years old - with 2 moms who was curious about how his moms might have another baby and I instructed him to address the questions to his moms when they came to pick him up at the end of camp. I also had a few girls who started their periods, but all of them knew what was happening. I did talk 1 girl through how to use a tampon and spoke matter-of-factly to a few kids about how if they don't like boys or girls right now that's okay. They might like them in a few years, or they might like someone of their own sex and that whatever happened they could deal with it then. I had a lot of very bright kids who had trouble living in the moment. Lots of "what if" questions.

All of my discussions were brief, simple, and matter-of-fact. But I also think they arose out of the fact that the parents weren't around to address many of these issues. Otherwise, kids this age tend to go to their parents first. And in the vast majority of the cases, whether through me, the camp director, or the kid them self, the parents ended up being in the know eventually. But most of the kids who came to me with sexuality questions were much older than 10.

I had many discussions that summer about safe sex, the importance of feeling safe in a relationship, the emotional ramifications of having sex too early, LGBT issues in older teenagers, eating disorders/body dysphoria, and self-harm. All with kids between the ages of 13 and 17.

When I was getting my master's degree, most of my research and papers dealt with LGBT issues in regards to the nursing role. I researched and presented on specific needs of LGBT families from a nursing standpoint, the dearth of LGBT-specific health statistics and needs in nursing literature as opposed to medical literature, and I examined nurses' attitudes of LGBT patients and how that can adversely contribute to patient care and patient outcomes. While I certainly agree that children are way too sexualized in this culture and need to NOT be, there is also truth in the fact that they can and do come to us - as medical professionals - with sexual question - at many points throughout their lives. And that how we handle these encounters are very important. Just as any adult (heterosexual or LGBT) may shy away from providers or regular health maintenance visits in general due to a bad experience, kids can be even more impressionable.

Feel free to private message me if you have any further questions or would like to include me in your survey. I'd be happy to help. Best of luck! :)

SnowShoeRN · Jun 21, 2015

Yes, research assessment methods! That is what we are hoping to do for healthcare providers who find themselves in the situation of a curious child that is asking questions. It may not be an appropriate topic for discussion for patients who are not exhibiting any curiosity about sexuality. Fine. But it would not be a sufficient response to tell your pediatric patient, "Sorry, but we can't discuss this until you are old enough. You should not be asking these kinds of questions."
The research topic was chosen from a personal experience with this. We are hoping to equip healthcare providers with an assessment method that can be used to prepare them if such an encounter arises. The initial pilot study is to do exactly this- figuring out if this is a meaningful study by surveying, in our chosen sample, nurse practitioners.

Sorry. I think I missed this. Are you looking specifically to survey NP's or just getting a feel from the forum for now?

TekkenDanser, BSN, MSN, RN, APRN, NP · Jun 21, 2015

I actually just sent an e-mail to my research preceptors to see how they felt about limiting it to a group of RNs in general or NPs. Both of them are APRNs and I am a student in the Psych NP program. I think we are hoping to recruit FNPs, Pedi NPs, and Psych NPs, but if that sample population is too limited and there are not enough encounters to investigate, then we would have to consider expanding the inclusion criteria. I am also hoping to get their opinion on whether or not we should modify the age group to 8-12 year olds. I would like to see if this age group is particular in terms of developmental stages, based on current pediatric research.

I really appreciate your post and would definitely be interested in learning as much as I can from the research and experiences you have already acquired. In Massachusetts, I believe the topic of sexuality, specifically LGBT issues, are more "socially acceptable" in general. I wonder if this contributes to youth in Mass being more likely to inquire about these things than in other states, which is why we are also looking at regional differences. As mentioned, youth nowadays are more exposed to media in various formats and are highly influenced by them. In Boston, especially, youth will grow up being exposed to way more variations in the way people live their lives than perhaps a less urban area. I will PM you!

TekkenDanser, BSN, MSN, RN, APRN, NP · Jun 21, 2015

I can't actually PM you until I have a certain number of posts...

SnowShoeRN · Jun 21, 2015

I can't actually PM you until I have a certain number of posts...

I just PM'd you.