Male Urologic Dilemma - page 8

First, let me say that I am not asking for medical advice. I am under the care of my PCP and am paying the big $$ for that. I guess I am just looking for social advice, a shoulder to cry on, words of... Read More

  1. by   leslie :-D
    aw, 58.....:icon_hug:
    your relief is palpable.
    job well done!

  2. by   TazziRN
    Hey, youngest tried to claim my new toy as her own.....ever get into a tug of war with a three-year-old???
  3. by   NurseyBaby'05

    I'm so glad everything turned out okay with both the procedure itself and the results!
  4. by   58flyer
    Quote from Agnus
    I am sleep deprived an out of line.
    Wake up sleepyhead........:smilecoffeecup:
  5. by   58flyer
    Quote from TazziRN
    Hey, youngest tried to claim my new toy as her own.....ever get into a tug of war with a three-year-old???
    Better hang on to that key chain, it may be awhile before I can get back to Alaska to get you another one.
  6. by   luvmy3kids
    Quote from 58flyer
    Thank You Jennifer :icon_hug:
    Awwww, I just saw this and wanted to say you are welcome!! I hope things are still going well!

  7. by   58flyer
    i did a follow up visit to the uro doc yesterday afternoon. the good news is that everything is still fine. i thought i would pass along a discussion i had with the doc which i found disturbing to see if any of you feel the same way as i do about it.

    after i was led to the exam room and told to wait for the doc, i noticed that no one had cleaned up after the last patient. the paper was still on the exam table with a bloody mess all over it. ewww! that's a mental image i didn't need. . i just sat in the chair and tried to ignore it. the doc came in all happy and said that the ua was clear, i was in great health and see you later. he said to be sure to come back if i ever have any more problems. i said to him, "if i may have a few minutes i'd like to discuss that very subject." here is our discussion as best as i remember it from yesterday.

    me blue

    what percentage of your patients are male?

    it varies, anywhere from 50 to 75 percent.

    given the extremely personal nature of urologic care and the potential for embarrassment and social discomfort, why don't you feel the need to have more of your assistive staff male? i still see an all female team here.

    i really leave the hiring decisions to my staff manager. i know it would be better to have some men here but i know there are not very many men nurses around. and i'm not sure it would be legal to advertise for men only.

    i don't think you would have any trouble with the discrimination police in specifying men since you treat men in your practice. the og/gyn places don't seem to have any trouble in having an all female staff, since they treat women only, and they don't seem to have issues with hiring only female assistants. i don't see where you would have any problems.

    well, we don't advertise anyway, so maybe your right. we get applications all the time and we just select from them when we have an opening.

    good, have you personally checked to see if any males are applying?

    no, i just leave that to my staff manager.

    does your staff manager understand the importance of having some male assistants when it comes to the care of men?

    we've never discussed it.

    i think you should, after all it is your practice. i can say for myself that i would not have allowed you to perform this procedure if you were not able to do without the female assistant. i am sure i am not the only man who feels this way. urologic precedures are tough enough as it is and the presence of a female may make a modest male decide to just not have it done and live with a problem. patients have to be able trust their doctor and be comfortable with the care or else they choose to live with a problem longer than they have to.

    the problem i have with male assistants is that they are limited to male patients only. they shouldn't work with women.

    i don't think you would have trouble with giving them assignments since most of your patients are men anyway. why would you think that men should only work with men and women can work with both sexes?

    (shrugs) just the way it is i guess, and i have to think about liability.

    on a different note, i noticed that you refer to your assistants as nurses. are they in fact rns or lpns?

    no, they are medical assistants, we have no nurses here. but most of the patients call them nurses, and we just don't want to confuse anyone, so to make things easy we just use the generic term nurse for the medical assistants.

    i don't want to sound mean but i think it's dishonest to call a medical assistant a nurse. there is a huge difference between the two in terms of training and professionalism, and many patients know the difference nowadays. even the sign you have the door here (pointing to it) says to request the nurses for assistance of needed. it may even be illegal to refer to a medical assistant as a nurse, since they haven't earned the title.


    you might want to look into it.

    ok, i will, but we're just trying to make it easy for everyone here.

    i think a cost effective way to identify these people would be to have a namg tag made up for your staff members to wear that gives the first name and the title "medical assistant" , that way no one gets confused. name tags are cheap.

    yea, i'll look into that. you think that's a really a problem for most patients?

    most no, but imagine if you treat medical personnel and they have earned their titles and degrees the hard way and they come and see you referring to unlicensed persons as a nurse. they know the difference.

    none have ever said anything.......

    i did steer the conversation around to just how much the medical assistant would have done if i had allowed it. the doc told me that she would have done the sterilizing of the penis, the insertion of the lidocane gel into the urethra, and the application of the clamp. then she would have informed the doc that the patient was ready for the cysto. i find this scary. not only would the unchaperoned female medical assistant have been exposing and touching the genitals of a male patient, but penetrating him as well. i find it jarring enough to know that they are allowed to assist on a highly sensitive procedure, but to actually perform a portion of it unsupervised to me is shocking to the conscience. i think this is way beyond the scope of an ma. i guess i shouldn't be surprised though when i realize that unlicensed techs are doing catheterizations all the time. but i am still disappointed. i bet most facilities won't allow unlicensed male assitive personnel to do such intimate procedures on female patients.

    and people wonder why many men hold back and delay care when it comes to the personal stuff.

    oh, and the doc also told me that another, larger uro practice in town does have male assistive staff. now i am left to wonder why my own pcp staff not find this out for me? i'll be on the phone on monday....:angryfire
  8. by   cardiacRN2006
    58-glad the UA was normal. Just based on the dirty exam room would make me want to leave this practice. Gross!

    I'm glad you had the conversation with the Dr about MAs. Sounds like you need to get yourself over to that other practice!
  9. by   Tweety
    I agree the dirty room would have been enough for me to say. "Thanks for the great news and for what you've done thus far. I'm not coming back because you don't have the courtesy to have a clean room in which to ask me to wait." End of discussion.
  10. by   leslie :-D
    the grossly contaminated room, speaks volumes of their standards of care.
    and so, i am not surprised at the lack of interest re your concerns, flyer.
    time to move on.

    and great news about the ua.

  11. by   58flyer
    Quote from Tweety
    I agree the dirty room would have been enough for me to say. "Thanks for the great news and for what you've done thus far. I'm not coming back because you don't have the courtesy to have a clean room in which to ask me to wait." End of discussion.
    Great point Tweety. I really wish now I had brought up the contaminated room. But after getting on the doc about the other issues I felt that was enough for now. I am just too nice sometimes. You would think after 30 years in LE I wouldn't be, and I can assert very well in protecting and advocating for others, as well as dealing with certain types of people. But when it comes to dealing with people who have offended me personally, I am just too darned nice. If I had taken time to think of the next patient who would be brought into that contaminated room, I might have had a different attitude.

    I hope I didn't come across as bashing MAs. The situation is not their fault. They are just doing what they're told by the docs.

    Anyway, I am done with that place. The next time I need this type of service I know where to go.