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 see both sides of this. I see you are right in the attitude of it not hurting to ask a co-worker to do a female cath. However, someone else made a good point....what happens if you need to do a bedbath? I know most institutions have CNA's that have this part of the job, but some don't. It opens a can of worms. I guess I'd conclude that you might ask for help to make it easier on you and the patient, but you should be prepared that it is still your job, IF you do need to go ahead and do it because no one else can and this is your patient.
I have no idea what creating a professional, comfortable environment for all patients and all procedures has to do with America's healthcare "being a business". Really....I have no idea what that means. I also don't know how a male straight cathing a female pt who has given him the ok is not compassionate.
Surely, giving patients the option is compassionate. I think you're (once again) assuming that we just force our patients to do things/be okay with things.
I also don't know what the difference between giving a bed bath/peri care/whatever is from straight cathing. Please elaborate the difference. If you are doing all that like you say you are, why are you refusing to straight cath?
Sigmund Freud just helped me out with that answer.
Because straight cathing is a form of penetration.
I think the patient can choose but the nurse should be ready to just do their job business as usual.
If I wasn't comfortable having a male insert a cath on my very alert and oriented 17 yr old daughter on a quiet unit I would just request a female. But unless I or she does make a request, do your job.
Though I wouldn't want someone bringing in their gender hypersensitive discomfort, that would be weird.
I didn't realize though that a female had to be present for a male to perform caths and such on a female. If that's the case then that sure underlies a potential issue, if you can't provide the care without a witness (on the sole basis of being a female patient), then it seems a reassignment or a female stepping in for those procedures would be logical.
So you'd be fine with a man doing that with your 18yr old daughter? Maybe you are fine with it, but is your daughter?
Would you feel comfortable with a gay male nurse catheterizing you 18 year old son? If not, why is it any different? If so, then you have many more problems that just your discomfort with catheterizing a female patient.
Are there men here who have done a cath without a chaperone? That's certainly different from the countries I've worked, although I can't say if it has just been hospital policies, or something more. The hospitals figured it protected the patients and the nurse.
I remember clearly my 2nd week as a nurse (in the gynae ward) and my preceptor told me to cath a post of hysterctomy whom the surgeon had forgotten to cathetrize. It was a disaster, as she told me it's not hard to do, and stop complaining and go ahead and do it. I'd never done a cath on anyone before, let alone told to go and do it on a post op woman. Fortunately my preceptor had to come to my rescue, but I'll never forget her callous attitude. In fact most the nurses were hostile to their first ever male, especially a useless new grad, but i did learn a few tricks to help protect a patient's dignity, which I rarely saw the female staff do.
Anyway, to the American nurses out there, I'm curious how many of you have worked abroad and what your experiences were in the role of gender.
Oh, and one last thought. For those who say they're fine with a male doing certain things, and think patients don't mind - it is possible that some patients don't really feel comfortable, but don't feel they should/can complain. Just saying.
Are there men here who have done a cath without a chaperone? That's certainly different from the countries I've worked, although I can't say if it has just been hospital policies, or something more. The hospitals figured it protected the patients and the nurse.
I remember clearly my 2nd week as a nurse (in the gynae ward) and my preceptor told me to cath a post of hysterctomy whom the surgeon had forgotten to cathetrize. It was a disaster, as she told me it's not hard to do, and stop complaining and go ahead and do it. I'd never done a cath on anyone before, let alone told to go and do it on a post op woman. Fortunately my preceptor had to come to my rescue, but I'll never forget her callous attitude. In fact most the nurses were hostile to their first ever male, especially a useless new grad, but i did learn a few tricks to help protect a patient's dignity, which I rarely saw the female staff do.
Anyway, to the American nurses out there, I'm curious how many of you have worked abroad and what your experiences were in the role of gender.
Oh, and one last thought. For those who say they're fine with a male doing certain things, and think patients don't mind - it is possible that some patients don't really feel comfortable, but don't feel they should/can complain. Just saying.
My male coworkers do it all the time. If the woman wants a female in there, they get a female in there. If they want a woman to do it, a woman does it. But 99% of the time, it isn't a problem because we're professionals and do a bang up job of gaining trust with our patients.
Your feelings seem to stem from hostile coworkers, not actually a patient situation in which the patient was comfortable. I'm not sure why your preceptor throwing you to the wolves has anything to do with women not wanting a man....but whatever.
I remember clearly my 2nd week as a nurse (in the gynae ward)
This is probably not germane to the original discussion, but I have to ask...
Why would someone who is uncomfortable with female anatomy (uncomfortable catheterizing females, etc.) take a position on the gynecology ward? Again, this does answer the question of "should males catheterize female," but it makes the whole situation a little more bizarre.
This situation is not just about sex. I don't think the vast, vast majority of American women who prefer female gynecologists make that choice because they think most male OBGYNs are thinking about sex the whole time. Not many women (who aren't religious nuts) are going to care if their gynecologist is a lesbian, either. There is nothing sexy about a pelvic exam or a catheterization. And a catheterization is far, far more invasive than a bed bath including pericare; anyone who says it isn't doesn't get it. Part of it is modesty/shyness, part of it is comfort knowing that the care provider really "gets" it (feelings, body, anatomy, etc). Most women seem to get over any feelings of shyness after menopause (some before that, and some never do). That's why most older ladies don't say anything about it, and nurses with experience have seen that over time and usually don't bother suggesting a female nurse. But there's nothing wrong with women preferring a female, at any age.
I don't want to make this about survivors, because I think it's not just about that, but I can tell you that as a survivor there's no way I could have a man do any such procedure. It's not because I would think he's thinking about sex or about assaulting me or anything like that. I've learned to be comfortable with women in intimate situations (YES, IT IS INTIMATE; INTIMATE DOESN'T MEAN "SEXY") over time, but not with men outside of romantic relationships. I don't want to disclose my survivor status to everyone who takes care of me--no one wants to do that. A simple "Could I have a female nurse to do that?" should be enough. No response about "I promise I'll be very professional" or "I'll have a chaperone." Not every survivor has an issue with this, for sure, but considering how many women are survivors, it's nice to give them some space.
On the other hand, I don't really like the "chaperone" deal. I think when a man has to have a chaperone to do some procedure, it does imply that the woman might not be safe with the provider. If she asks for a woman to be present, okay, but automatically having one--I don't like it. I get it, but don't like it.
As for why it's different the other way around, and women nurses are expected to do catheters on male patients--that's a function of our society, I think. Men are used to having women as caregivers, period. And very few men are survivors of sexual abuse by women--whether they are survivors or not, most women have grown up with at least a certain amount of fear of that. Men don't develop that fear. I have had the occasional man ask if I can get a male nurse to do a catheterization or a suppository, though. I call a friend (sometimes from another floor) and none of them have ever made an issue of it.
Specializes in Med-surge, hospice, LTC, tele, rehab.
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.
If this works in your hospital (where the females cath the females and the males cath the males), and no one minds then what's the issue? As I mentioned before, it doesn't work in all hospitals due to different patient loads and the fact that another nurse simply may not always have time to stop (not that they are not compassionate to you or the patient) and cath another nurse's patient.
For example, if I am trying to start an IV on my patient or am in the middle of a sterile dressing change when a male nurse asks me to come cath their female patient, I won't be able to do it for awhile and his patient suffers in the process because she has to wait. It's not really practical, especially if the male nurse is the one who is uncomfortable with doing the procedure on his patient while it may be a non-issue for his female patient.
I have NEVER understood why males need a "chaperone" to do female care, but females do not when providing male care.
I have a male OBGYN and I LOVE him and would pick him over any of the females we have around here. I grew up with a male primary care provider. For most who feel uncomfortable with a provider of the other sex, it is because their parents have instilled that fear in them (other than those of course who have suffered trauma or assualt).
I have no issue with any male providing care on me, other than the OP who sounds pretty pervy at this point.
NursesRmofun, ASN, RN
1,239 Posts
I see both sides of this. I see you are right in the attitude of it not hurting to ask a co-worker to do a female cath. However, someone else made a good point....what happens if you need to do a bedbath? I know most institutions have CNA's that have this part of the job, but some don't. It opens a can of worms. I guess I'd conclude that you might ask for help to make it easier on you and the patient, but you should be prepared that it is still your job, IF you do need to go ahead and do it because no one else can and this is your patient.