Hooker in the house?

[anticoagulationurse]

I'm serious here and want to share a hunch and an LOL.

Did an admission visit on this fine Sunday morning for a man with whom I was familiar from a prior SNF job years ago. I remembered sort of joking around with him and he was always just shy of being inappropriately flirty and suggestive but not quite the dirty old man type. He would suggest me of his past and sexual laxity and personal history, I would shrug it off. He was never personally inappropriate so don't worry about that.

He has just been discharged yesterday from several months in SNF. He lives alone and does not have a SO. No girlfriend, just adult grown children. I sat in his home a small studio apartment which was quite disheveled from months of neglect. There were two TV's on, one pointed toward the bedroom area and blocking the view of that part of the space. The other was in the living room. Beneath the TV were many, many VHS and DVD's laying around including several obvious Media DVD's with let's just say, OBVIOUS titles and photos on the front. He apparently had not made any attempt to hide them (from me, or "his daughter":cool:). I noticed a woman's purse on the floor and did not comment on it. I also noticed his open wallet on the counter nearby and also of course, made no comment. I carried on with my professional visit.

At one point I heard a cough and rustling from the bedroom area. I asked him if there was someone there and he whispered that it was his daughter. She did not come out as I would expect most daughters to do, and participate in the visit and care of her "father". There was no further mention or discussion of her.

I highly suspect that after months in a SNF this guy had invited a booty call, possibly a paid one, as he denied having a SO. Just wanted to share some of the weird stuff we see in Home Health.

[RubyRN,CHPN]

Luv2care...don't think for a minute that none of my uncomfortable visits were not followed with an incident report. Particularly the case of the sitter allowing the pt. to watch Media in her presence and refusing to turn it off when I came to visit which was also reported to the sister agency. All were reported and involved change in policy poorly written safety policy.

[anticoagulationurse]

I did not acknowledge my suspicions about the "hooker" ("daughter") to the patient, nor did I acknowledge the Mediaos. I did not feel threatened, or harassed so therefore I don't feel it's necessary to do any reporting. He was cordial, the hiding woman was discreet. It's not like I was subjected to anything unsavory like some of you have been, and the Media was not playing on the TV's. For that I'm thankful. Perhaps he forgot I was coming and I caught him unprepared? Who knows.

I do feel there is a fine line and the situation could have gone both ways. My moral opinion about Media or unconfirmed illicit sexual behavior bears no significance for this man. He is 70 something and going to do what he is going to do. It certainly would not have been appropriate for me to say anything at the time, since the woman could have actually been his daughter (I guess), or if she was a hooker then the situation could have gotten offensive and possibly confrontational and dangerous.

Thanks for your input though, I've never heard this topic come up before in my HH experiences.

[nursel56]

It doesn't sound to me that the man left his DVDs out on purpose to harrass anyone. It sounds like this is his home and that's what he watches. Not all sexual material is "Media" anyway. Nor is all sexually explicit material illegal. My mother had some explicit books who's purpose was to educate, not harrass or exploit.

The term "perversion" is normally heard in the context of a religious or moral belief system. Many feel that being gay is a "perversion", for example. That's not for me to decide. There are many legal things people choose to engage in that I find personally abhorrent, whether they are sexual in nature or not. It isn't my job to remake someone's personal philosophy or taste in videos.

Hiring someone for sex, watching or reading sexually explicit material in the home, and sexual harrassment of nurses are all separate issues.

[Luv2care0907]

Everyone draws the line somewhere. I don't like to see people get hurt for any reason. I guarantee that you have a line. So, yes, I have one too. This let's-all-be-tolerant-of-what-everyone-chooses-where-it-regards-sex has some major flaws. Problems arising from sex do spill out into medicine because we are generally the ones picking up the pieces.

I am perfectly well aware that when we go into homes, we have to overlook a great many things. I don't ask, as a rule, because it is none of my business and I don't want to get into a debate over sex with a client. They are clients and I'm there to do a service for them regarding medical care, not try to change them. But if someone has Media sitting out in plain view with a picture that is indecent, which would generally be on the cover of a video like that, I think I would have a problem. I wasn't sure if that was what was being shared here. I had done a CEU on the topic of sexual harassment and believe it or not, that type of thing was considered mild harassment. The CEU did say that most people do not report mild harassment. I have done some counseling outside my nursing career and Media has been the source of serious issues for people both in the industry and those who buy it. That's why I hate it so much. I have seen people unnecessarily hurt.

[nursel56]

Not even judges always agree on what the "line" is regarding sexual imagery. There's a semi-humorous cliche regarding that "we know it when we see it", but by and large those videos are legal. Yes, there are those who become addicted to Media and some who will blame Media for their own crimes. Ted Bundy did that. Even if we ignore for a moment that Bundy was a lying, self-serving sociopath, it still wouldn't prove that the Media caused him to murder all those women.

In the OP's post, the man was in his 70s, had just returned recently from a skilled nursing facility, and the room was in a general state of disarray. From that I can say it's very unlikely the DVDs were left out to intentionally shock or even mildly harrass anticoagulation nurse. He was embarrassed and came up with a cover story (we assume) about the young lady being his daughter. That doesn't even come close to a definition of harrassment.

If the "let's-all-be-tolerant-of-what-everyone-chooses-to-do-where-it-regards-sex" attitude could be changed tomorrow what would be the nurse's role to intervene in a legal activity that she personally had a problem with? I don't much care for the wreckage that ensues when an older guy decides to cheat on his wife of 40 years to take up with a 25 yr old with an active herpes infection or someone who coerces their spouse into a swinger group-- but what should I as a nurse do about that? All sexually active adults should get safe-sex education.

You're right about the healthcare impact of bad choices people make. When people cross the line from responsible use of anything it spills over into the medical realm. Over-eating, over-drinking, over-drugging, over-smoking. Adultery, promiscuity and sloth. But still- other than counsel and educate people at risk, we can't do too much about it if it's not illegal and there is no intention to harrass someone.

In my experience it's been pretty obvious when someone's activities are meant to shock. and there should be zero-tolerance for that. I would be writing that one up and would refuse to go back to their home. I've had a couple of incidents like that and. . . nope uh-uh not gonna be "tolerant"!

[Luv2care0907]

That was well said. I am sure that I would try to ere on the side of this being an unintentional incident. I would probably turn the covers of the videos over, personally, if they were as bad as some of this stuff is. As I recall, in this sex harassment presentation, another example of mild harassment was a doctor saying, "That's a pretty shirt you're wearing today." I had never even considered that before but apparently the point was that what appeared to be harmless was a potential warning signal. Nobody wants to charge someone with misconduct if it is not intentional. OTOH, I think many problems escalate unnecessarily because we want to ere on that side. Do you agree? Ted Bundy is actual a class example A of this. These girls were killed because they did not ere on the side of caution. They didn't want to judge or consider that this handsome young man with a broken arm might not be telling the truth.

I agree that these things put us between a rock and a hard place. We would report alcohol abuse. I would. I would at least counsel the family members on where to get help if nothing else. I wouldn't just pass it off especially if it was effecting other family members. On that one, I speak from experience.

There is a little extra weight gain and dangerous obesity. The problem is that our society is a little unrealistic where it comes to weight, imo. Is the weight gain post pregnancy, for example? One of the genetic reasons that people put on weight is to have it for leaner times. Only America does not seem to have those times. So our country has a lot of overweight folks in it. I don't put that in the same category in my mind as alcohol abuse.

[anticoagulationurse]

Interesting discussion here. I would like to add that even mild harassment is that which is unwanted. That is NOT to say I wanted to see his Mediaos or the woman in the next room, but I was indifferent and personally unaffected by it, so therefore it was not unwanted and that is why I do not consider it harassment. Kind of like pain, harassment is subjective and and individual response.

[2ndyearstudent, CNA]

I've ran into a couple suspiciously attired "PCAs" here and there that I suspected might be performing some very specific ADLs. They sat quietly and watched TV while I did my cares and never bugged me at all.