How do you handle female patients your age or younger?

[DanGIT1322]

How do you handle procedures like urinary catheters, breast exams, etc. when it comes to women? I always try to have a female nurse if available or have a female stand by in the room if I absolutely must do it. Any tips on keeping it professional and avoiding accusations? Thanks.

[guest1159390]

May I ask, in all seriousness, where are you performing breast exams?

[emtpbill, ASN, RN, EMT-P]

Last year I had an attending doctor berate me because when he asked me if the suppository that he ordered had been given to the 17 year old girl. I told him I was just waiting for Nurse Jenny to finish up with her patient to "assist" me. He went off and I just very calmly informed him I wasn't gonna go near a 17 year olds rectum without a chaperone.  The attending just walked away grumbling under his breath.  And this wasn't for any type of stat medication for any life saving treatment (ie. Diastat).

   I asked every nurse that was working that day in the ER with me if it was the right call.  100% agreed with me. 

[Maxx0763]

Personal observational experience working in a clinical setting. The dynamics are such only females are required female chaperones when it's a male healthcare provider performing an intimate exam on a female. If a female healthcare provider is performing an intimate exam on a male, the chaperone will be always be exclusively FEMALE. In an ED setting female healthcare providers (whether it be a physician,  RN, etc) will examine a males genitals alone without a thought or think its an intrusion on his privacy, or modesty. Never a scenario exist other than Media, or if you live in Antarctica will there ever be a male healthcare provider with a male chaperone examing a females genital alone. The female healthcare provider may require a chaperone most likely for her protection against physical harm perputrated by the male patient. It's for the protection of females in all scenarios. All other scenarios are not applicable. The primary reason it's pervasive sexual perception and power dynamics in sexual inter action between males and females. If your a male, though know fault of your own, you're viewed as a sexual predator/oppressor, and if you're a female you're viewed as a sexual prey/victim/oppressed. It's like the tale of the wolf and the sheep, and the fox and the henhouse. You would never let the wolf interact with the sheep without a shephard present. Nor would you allow a fox in the henhouse alone without the farmer present. Even if you never once ate a sheep or hen, you could never be trusted to be alone with them. On the flipside, a sheep, or hen can inspect an injured wolf, or fox alone without fear of repercussion. It's primal, immature, rudimentary, but true. Women feel always threatened by the opposite sex, well men if they feel it, will not express it, or be believed. Coupled with fiscal liability and damaged reputation from the corporate viewpoint, it's strictly enforced for females, but trivial issue to equate it for males. They may say its equal policy, legally, but is lax and rarely enforced equally due to that prior power dynamic, and social perception. There are other issues involved between male/female interactions which are relative and strengthens that belief, but that's most likely the primary reason. It may not be politically correct to say, and to a certain extent you may disagree, but that's reality. If not, it wouldn't be currently practiced, expected, and accepted.

[NYC Nurse]

DanGIT1322 said:

How do you handle procedures like urinary catheters, breast exams, etc. when it comes to women? I always try to have a female nurse if available or have a female stand by in the room if I absolutely must do it. Any tips on keeping it professional and avoiding accusations? Thanks.

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I have a female nurse come with me and she will lead procedure. or he will do it alone or with another female nurse. I don't even bother asking if they are comfortable with me doing it. I don't want to risk them saying I did something inappropriate and there are no witnesses. 

[toomuchbaloney]

Maxx0763 said:

Personal observational experience working in a clinical setting. The dynamics are such only females are required female chaperones when it's a male healthcare provider performing an intimate exam on a female. If a female healthcare provider is performing an intimate exam on a male, the chaperone will be always be exclusively FEMALE. In an ED setting female healthcare providers (whether it be a physician,  RN, etc) will examine a males genitals alone without a thought or think its an intrusion on his privacy, or modesty. Never a scenario exist other than Media, or if you live in Antarctica will there ever be a male healthcare provider with a male chaperone examing a females genital alone. The female healthcare provider may require a chaperone most likely for her protection against physical harm perputrated by the male patient. It's for the protection of females in all scenarios. All other scenarios are not applicable. The primary reason it's pervasive sexual perception and power dynamics in sexual inter action between males and females. If your a male, though know fault of your own, you're viewed as a sexual predator/oppressor, and if you're a female you're viewed as a sexual prey/victim/oppressed. It's like the tale of the wolf and the sheep, and the fox and the henhouse. You would never let the wolf interact with the sheep without a shephard present. Nor would you allow a fox in the henhouse alone without the farmer present. Even if you never once ate a sheep or hen, you could never be trusted to be alone with them. On the flipside, a sheep, or hen can inspect an injured wolf, or fox alone without fear of repercussion. It's primal, immature, rudimentary, but true. Women feel always threatened by the opposite sex, well men if they feel it, will not express it, or be believed. Coupled with fiscal liability and damaged reputation from the corporate viewpoint, it's strictly enforced for females, but trivial issue to equate it for males. They may say its equal policy, legally, but is lax and rarely enforced equally due to that prior power dynamic, and social perception. There are other issues involved between male/female interactions which are relative and strengthens that belief, but that's most likely the primary reason. It may not be politically correct to say, and to a certain extent you may disagree, but that's reality. If not, it wouldn't be currently practiced, expected, and accepted.

Your reality.  

[DavidFR, BSN, MSN, RN]

Redd.CCRN said:

May I ask, in all seriousness, where are you performing breast exams?

Breast surgery, usually in an oncological context. After some procedures you have to verify that the breast is warm and supple. Some patients have a flap after breast surgery and standard flap observations as are common as in burns and plastic surgery apply. 

[Barriss Offee]

Same way a male doctor would examine a female patient. Use professional and courteous language. Get a chaperone. 

I wouldn't think too hard about it. I know I don't, and I follow my simple rules with no issues.