I think I'm professional, but now I'm not so sure, after I told some American friends that as a male nurse, I don't catheterize women.
'That's sexist' was one of the kinder comments, while one of the more rational comments said - "We are professionals. As long as we behave in a professional way, then we should all have to do the same job."
I naturally asked 'does this mean we're nurses first, and men/women second?' and they didn't give a concise answer.
Am I the only male who thinks that it is harder for a female patient as well as for a male nurse to do such an intimate procedure?
Am I the only nurse who thinks that gender does matter? What harm does it cause if I choose not to do a procedure when there are capable people around who could do it just as well, plus make it easier for the patient. As a male nurse, I need a female chaperone if doing such a procedure on a woman anyway, so why not make it easier for everyone and simply keep the male out of it altogether?
But what does being a "Professional" mean? From what I'm hearing from others it sounds like I am a sexless machine capable of doing it all because that is what I am paid to do. Instead I think of myself as a caring carer. I have my faults and biases. I make mistakes and I sometimes let my feelings help make my decisions. But I have a big heart and I do the job because I care first. I enjoy making people laugh when they're sick. I enjoy being able to make a difference in people's lives. I also do the job recognizing my faults, and if I ever think that my views/faults may jeopardize a patient, I know to get someone else to take over that patient's care. I guess I'm not a very successful Sexless Professional. But I can live with being called sexist and unprofessional, just because I sometimes refuse to do female catheterization. I'm sure there's a lot worse things I could be.
A couple of extra points to mention:
For the record, the female staff used to ask me to catheterize the men, and they'd do the same for my female patients, and we never had a problem.
Also it's strange, but apparently I'm allowed to catheterize little old ladies, but not young women. Sounds a bit ageist to me. Do the feelings of older people not matter as much as those of young people? Naturally I'd never contemplate such a procedure on a young woman.
I have read. And re-read. And re-read the OP. I'm just not getting the open hostility towards him. I think in his situation I might feel the same. Unlike the US, he's in a country where male nurses are an anomaly. That alone could immediately make him a little paranoid. The patients likely think it's a little strange. Then the added need for a chaperone required by his hospital might make a patient wonder about his motives. They're not going to understand it's to protect the nurse, not the patient and I highly doubt any of us would say "This is Nancy. She's just here to make sure that you don't accuse me of being inappropriate while I do this intimate procedure so you can't sue the hospital". If I didn't know any better I'd probably think "why the heck does this guy need supervision. Has he done something wrong before?" And then there's the power position we as nurses do have over our patients. He has a point when he says that some women may very much prefer a female but are afraid to say it or don't want to offend the person who will be taking care of them after the procedure. It happens. I think I understand his thought process as being why not take that uncomfortable decision for the patient out of the equation. Why put the patient in that position in the first place? I never got a sense that he didn't want to do female caths because he couldn't control his urges and that he was sexualizing the procedure. But let's face it, the presence of the chaperone DOES sexualize it. When I worked in the ED we generally did have foleys placed by a nurse/tech of the same gender. We traded off. It just seemed like the right thing to do. At least for our unit. I think the title of the thread was a mistake and inflammatory but I'm not getting the sense that the OP is the jerk everyone here is making him out to be.
Here's the thing, it's like with breast feeding. If it bothers you because you're being exposed to someones "intimate parts" you are sexualizing it, because if you weren't, it wouldn't bother you.
If you can't look at a lady parts as just another part of the human body, your brain is still identifying that part of the human body as something sexual and not simply a body part in need of a procedure.
Now, that doesn't mean that we're not uncomfortable at first, or that it's something we're just thrilled with doing. It doesn't mean that the patient won't be uncomfortable and it's not the same as being uncomfortable because your patient is uncomfortable.
I too am a male nurse, and I work in a LTC setting, where the female population is from an entirely different era (showing an ankle was considered risque). When confronted with the need to cath a lady, I explain the need for the procedure, what the procedure entails, and then I ask if they are comfortable with me doing it. I also make sure they are aware that a female staff member will be with us the entire time. I get a few refusals, but unlike those of you in the hospital setting, I have had time to build a trusting bond with most of the residents, so it isnt often I am refused. In the event I am, I gladly take on a task that my female nurse co-worker needs doing so its a fair trade off normally :)
I have read. And re-read. And re-read the OP. I'm just not getting the open hostility towards him. I think in his situation I might feel the same. Unlike the US, he's in a country where male nurses are an anomaly. That alone could immediately make him a little paranoid. The patients likely think it's a little strange. Then the added need for a chaperone required by his hospital might make a patient wonder about his motives. They're not going to understand it's to protect the nurse, not the patient and I highly doubt any of us would say "This is Nancy. She's just here to make sure that you don't accuse me of being inappropriate while I do this intimate procedure so you can't sue the hospital". If I didn't know any better I'd probably think "why the heck does this guy need supervision. Has he done something wrong before?" And then there's the power position we as nurses do have over our patients. He has a point when he says that some women may very much prefer a female but are afraid to say it or don't want to offend the person who will be taking care of them after the procedure. It happens. I think I understand his thought process as being why not take that uncomfortable decision for the patient out of the equation. Why put the patient in that position in the first place? I never got a sense that he didn't want to do female caths because he couldn't control his urges and that he was sexualizing the procedure. But let's face it, the presence of the chaperone DOES sexualize it. When I worked in the ED we generally did have foleys placed by a nurse/tech of the same gender. We traded off. It just seemed like the right thing to do. At least for our unit. I think the title of the thread was a mistake and inflammatory but I'm not getting the sense that the OP is the jerk everyone here is making him out to be.
Excellent synopsis! I agree completely. Thank you.
I really think that the only time this stuff should be considered is when a patient ASKS for THEIR fear or need be accommodated. It's one thing to cater to their needs/beliefs/feelings, but another to assume their feelings would be XYZ because of situation ABC. Most cases - when I worked floor/stepdown, we had the time to explain to patients that they needed a catheter and educate them about why - they had time to ask questions and voice concerns. I'm an OR nurse, I've taken care of preemies, and I've taken care of the very elderly. I've put foleys in all ages of patients. In the OR - patients are almost always anesthetized, but it's part of my job. If it's a necessary procedure, I don't see what the issue is.
I'm a young-ish female and in routine situations, I would prefer a female provider (which is why my PCP is a female). In a non-routine and/or urgent/emergent situation - I don't really think I'd care that much if I needed a procedure or exam to be completed by a male nurse, NP, PA or physician. I'd probably have bigger problems and concerns. When I had emergency surgery I had a catheter, and I really did not care who was caring for me so long as my needs were met competently and professionally.
If I had kids, I'd be more concerned that my kids' needs were met than the gender of the provider caring for them. I'd make sure things are explained in an age-appropriate manner, and I'd be there for my kids in whatever ways they needed. If it were necessary, I don't think I'd care who met the need so long as it was done competently and professionally.
I really think that the only time this stuff should be considered is when a patient ASKS for THEIR fear or need be accommodated. It's one thing to cater to their needs/beliefs/feelings, but another to assume their feelings would be XYZ because of situation ABC.
But what if the patient is too embarrassed or afraid to express their fears?
As a female nurse I understand your quandry. Since you have to have a female chaperone its probably easier for the female to do it and for you to do something to assist the female coworker. Most hospitals I have worked at the patient care tech/critical care tech/CNA did the caths and to avoid having to pull 2 people off the floor the girls did the girls and the male patients were asked who they preferred. I only see it as an issue if you were the only qualified person (had students or something to chaperone) and you refused.
I read the majority of the posts. There are many concerns. One is there is a cultural difference that we all need to take in to consideration and respect. 2. My mother always preferred male nurses, she said they were nicer than the females. 3. I have had to cath males who were very uncomfortable, stating that their wife was the only person who has seen and touched them. I was respectful and explained I would be gentle, I used lidocaine and explained the whole procedure, he was thankful I had helped him feel better, it did not change the fact that he was uncomfortable with the procedure. 4. I have worked with male nurses that have gone in and explained to the female patient that they were their nurse and would be cathing them, they were professional and the patient excepted that. they did not need a chaperone, unless it was requested. 5. we need more males in nursing. 6. In the Er where I worked on occasion the staff was all male, so they needed to do what needed to be done. 7. If a female does not want a male I will cath them in exchange for the male nurse to do something for me. It is a give and take. 8. If you enter a room with uncertainty then the patient will be uncertain of your skills, not that you are a male nurse. 9. 37 years ago when I started nursing we had male orderlies that did the male foley care. Then it became the female nurses job when they cut those positions. As we increase the male nurses they will need to take on the role, because there may not always be a female to do it for them. 10. know your job and skills, enter with confidence, respect the patients wishes if the deny your assistance. 11. I have been asked by parents to not take care of their child because they didn't like my style, I respect that and we changed assignments, but this is not always possible. Sometimes you have a patient that you have a personality conflict with and it is best to change assignments for the proper care of the patient, change if possible, it may not always be, so you have to do what you can and maintain respect. As nurses we must be ever changing and flexible in our role. Sometimes things are just what they are and we need to do the right thing for the patient with informed information. we can not presume that all will be the same, they are all individuals with different cultural beliefs, and needs, it is up to the nurse to assess those needs and to make a decision based on the information we have to work with, within the constraints of the resources we may have available.
But what if the patient is too embarrassed or afraid to express their fears?
At the point that we're assuming things without evidence (i.e., the patient hasn't said anything, is not visibly uncomfortable, etc), why stop at caths? Maybe female patients just all hate having male nurses. We can't ask them, because even if they say they don't mind they might really be too embarrassed or afraid to express themselves. I assume caths are different than listening to breath/heart sounds, but how would I know? I can't ask my patients, because no matter what they tell me they might really be too embarrassed or afraid to be honest.
I'm more than happy to do whatever it takes to help my patients - even if it means asking someone else to do something or switching assignments - but I draw the line at paternalism and assuming I know what my patients want better than they do without any evidence.
FlyingScot, RN
2,016 Posts
I have read. And re-read. And re-read the OP. I'm just not getting the open hostility towards him. I think in his situation I might feel the same. Unlike the US, he's in a country where male nurses are an anomaly. That alone could immediately make him a little paranoid. The patients likely think it's a little strange. Then the added need for a chaperone required by his hospital might make a patient wonder about his motives. They're not going to understand it's to protect the nurse, not the patient and I highly doubt any of us would say "This is Nancy. She's just here to make sure that you don't accuse me of being inappropriate while I do this intimate procedure so you can't sue the hospital". If I didn't know any better I'd probably think "why the heck does this guy need supervision. Has he done something wrong before?" And then there's the power position we as nurses do have over our patients. He has a point when he says that some women may very much prefer a female but are afraid to say it or don't want to offend the person who will be taking care of them after the procedure. It happens. I think I understand his thought process as being why not take that uncomfortable decision for the patient out of the equation. Why put the patient in that position in the first place? I never got a sense that he didn't want to do female caths because he couldn't control his urges and that he was sexualizing the procedure. But let's face it, the presence of the chaperone DOES sexualize it. When I worked in the ED we generally did have foleys placed by a nurse/tech of the same gender. We traded off. It just seemed like the right thing to do. At least for our unit. I think the title of the thread was a mistake and inflammatory but I'm not getting the sense that the OP is the jerk everyone here is making him out to be.