Male Nurses/female Patients

nursemike, ASN, RN · May 7, 2011

With all due respect Nursemike I've noticed you have only been a nurse for a few years but don't worry as I won't hold that against you. Currently, there are websites by female nurses that are for the sole purpose of making fun of the male patient
member. There is a website by a female nurse that pokes fun at the fact that female nurses once would strike a member with a
steel spoon if it were erect. This would even happen to young boys,some were rendered impotent.

RN almost 6 years, in healthcare almost 13. So I'm not exactly an oldtimer, but I'm not an innocent newbie, either. I haven't seen the sites you describe, nor do I know of such behavior at my facility. If I did, I would report it to the relevant board of nursing. If you post links to such sites, I will report them to the relevant board of nursing.

I don't know that I really understand your argument, here. I understand that you're arguing in the thread that male patients should be offered the option of having male nurses assigned. Forgive me if I'm mistaken--posts tend to run together after a bit--but I think you may be of the school that believes nursing has an obligation to assure there are enough male nurses available to provide a male patient who wants one. I'm not sure a few examples of misdeeds by female nurses really supports that position. There have been misdeeds by male nurses, as well--notably a case a couple of years ago of a male accused of murdering several patients. A male health care worker at my facility (not a nurse) was convicted of molesting children, including some patients at my facility. It does not mean men can't be pediatric nurses. I hope you'll agree with what I've observed, that the vast majority of nurses, regardless of gender, do their best to provide appropriate care to all patients, regardless of gender.

Even accepting that optimistic belief, I was persuaded on another thread that a significant number of female patients are sufficiently frightened by their perceived risk of abuse to require that only females be assigned to them. I would mirror that for males, as well. As far as practical, I would certainly endorse making similar arrangements for those whose religious beliefs prohibit contact with members of the opposite sex. And, within reason, such accommodations should be made for the sake of patient modesty, whether the patient is male or female. I'm not sure how far I agree with Cul2's suggestion of adjusting schedules to ensure that a male is always, or usually, present, but it's certainly worthy of consideration. It was suggested on another thread that all patients should be asked on admission whether they have a preference as to the gender of their caregivers. I'm not strongly opposed to that--my only concern is that it might tend to institutionalize a distinction that I don't really think ought to be made. And I'm not so sure it's needed. Maybe I'm dealing with a unique population, but the patients I've seen haven't been terribly reticent about voicing their needs and wants.

But there seems to be an attitude in this thread that nursing and nurses have failed our patients by not ensuring that there are enough male nurses for anyone who prefers one. And I just don't agree. I think there are numerous good reasons to actively recruit more males into nursing, and while patient preference is on the list, it isn't at the top. Our generally superior ability to lift heavy weights is still farther down the list. I guess the case is being made that there ought to be some sort of affirmative action to correct the current imbalance of genders in our workforce, but it seems to me that's saying that gender is so important that we need to bring in nurses who weren't willing to do what I did to become a nurse. Admittedly, other men may have encountered barriers I did not. I only know what I know. But my experience of nursing, in school and in practice, has been that it is remarkable in its readiness to accept anyone willing and able to become a good nurse. I'm not one of those who believes nursing has to be a holy vocation, but it is important, meaningful work that requires a level of commitment. I believe that by education prospective male nurses as to what we do and who we are, we can add to the pool of talented people who could do our job well. I don't think we can afford to lower our standards to meet some quota of gender, race, or whatever, and I don't think we especially need others who would expect special compensation beyond what other nurses get to enter the field.

I suppose higher pay across the board might attract more men. At present, women considering nursing are probably less apt to say, hey I could make as much as a plumber. Still, most of the men I've known in nursing got into it for many of the same reasons I did--decent pay, job security, benefits. I think if more men and more minority men and women knew what nursing offers, more of them would consider becoming nurses, and it's well worth making that outreach. But so many nurses have for so long been white women, that it's likely to be a while before we notice a demographic shift. And I don't think that's a failure on our part, or even a big problem. Nearly all of the very best nurses I've seen have been white women. My mentor was a white woman. She never abused anyone, never forced herself on anyone, and if you asked her to be assigned a male nurse, I'm sure she'd have quietly kept an eye on me in the background, but your chances of living through the night would have dropped significantly. At rock bottom, that's what nursing is, to me: giving people their best chance of living through the night. And I still thinks it's a problem that too many patients don't see it that way.

Cul2 · May 7, 2011

Interesting comments, nursemike. Let me start by saying that, for me, gender of caregiver for intimate care isn't necessarily a big issue. As with most patients, it's contextural depending upon many factors. So, I'm not coming at this from an strong personal preference. Having taked with many men, and read about many modesty violations to both men and women, I find myself an advocate for them and for patients in general. This is not to say that these modesty violations are the norm in medicine. But it is an important issue that goes to patient autonomy, dignity and respect. Now, to a few of your comments:

" It was suggested on another thread that all patients should be asked on admission whether they have a preference as to the gender of their caregivers. I'm not strongly opposed to that--my only concern is that it might tend to institutionalize a distinction that I don't really think ought to be made. And I'm not so sure it's needed. Maybe I'm dealing with a unique population, but the patients I've seen haven't been terribly reticent about voicing their needs and wants."

Frankly, if modesty isn't an issue among patients in general and men in particular, then why worry about asking? If it isn't an issue, the patients will say it doesn't matter. The fear is, I believe, that the medical community, knowing it's an issue among a minority but significant population, doesn't want to deal with it. You know -- if you don't want the answer don't ask the questions. If you get an answer you don't want, then you may have to do something about it that may involve hiring philosophy and scheduling. Whether you or the profession thinks the distinction "ought to be made" isn't as relevant as whether the patient feels the distinction "ought to be made." If you're correct and it isn't necessary to ask the question, then why worry. Ask and most people wills say it doesn't matter.

"but it seems to me that's saying that gender is so important that we need to bring in nurses who weren't willing to do what I did to become a nurse."

You see -- in the past, using that argument when affirmative action brought in more women and other minorities to male dominated profession -- using an argument like that was considered racist or sexist. Basically, that argument says that those that most benefit from affirmative action are really not qualified, or as qualified, as the dominant population, and don't really have the dedication that the dominant population has. Bogus argument.

" I don't think we can afford to lower our standards to meet some quota of gender, race, or whatever, and I don't think we especially need others who would expect special compensation beyond what other nurses get to enter the field."

Again, bogus argument. In areas where women and other minorities have been accorded affirmative action -- were standards lowered as a rule? Are the women and blacks who got into male dominated fields less qualified because standards were lowered? If that is true, no one wants to admit it. If it isn't true, then it won't be true for nursing.

As I've said before and I'll say again and again -- any profession that is dominated by one gender (and when no significants attempts are being made to prevent that), that profession develops the "old boys/girls club" attitude -- same old same old. A gender-diverse workforce in any field, nursing included, is a more healthy workforce than one dominated by one gender alone. It's healthier, and smarter. Not smarter because there would be more men and men are smarter. Smarter because when you put the two genders together to get different perspectives and points of view, you will get better outcomes, better working conditions, better patient satisfaction. Gender diversity produces better overall results. Women have used that argument for years, and they were right. Now, when men use it, they're wrong?

Rock, LPN, RN · May 8, 2011

With all due respect Nursemike I've noticed you have only been a nurse for a few years but don't worry as I won't hold that against you. Currently, there are websites by female nurses that are for the sole purpose of making fun of the male patient
member. There is a website by a female nurse that pokes fun at the fact that female nurses once would strike a member with a
steel spoon if it were erect. This would even happen to young boys,some were rendered impotent.

In my day it was called member Envy!!!

ITSSOSIMPLE · May 8, 2011

In my day it was called member Envy!!!

I believe it still is in most psychology circles,however,dosen't diminish the harm that was done to some.

ITSSOSIMPLE · May 8, 2011

While I appreciate your concern that male modesty should be considered as seriously as female modesty, I see nothing in the post referred to that amounts to duress. The patient is free to refuse entirely, or to refuse until a male becomes available, as he sees fit.
It seems to be an underlying assumption in this and some other threads that a patient's modesty is sacrosanct. I consider human dignity to be a fundamental value, at or near the same level as life itself. People should be respected. But providing nursing care is not disrespectful, much less an assault on human dignity. I don't get more satisfaction from doing peri care on a 20 y.o. female than a 90 y.o. male. A 20 y.o. female really has nothing more to be embarrassed about than a 90 y.o. male. Nursing can be, at times, more intimate than sex, but it isn't sex. Patient comfort is an important consideration, as is patient modesty, but if a patient is unwell enough to require hospitalization, neither comfort nor modesty is likely to be the most important consideration. Beyond a point, modesty becomes pathological. As nurses, I don't believe we are responsible to "correct" a shortage of same-sex caregivers. Rather, we should be educating our patients that it really doesn't matter what gender the caregiver is. Of course, human beings are not entirely rational, but considered rationally, a male patient's preference for only males to place a urinary catheter differs only in degree from a female insisting that only female caregivers should perform CPR if she were to need it.

Nurse mike said " Rather,we should be educating our patients that it really doesn't matter what the gender of the caregiver is."

Really,tell that to all the mammography and L&D departments in the united states. While we are on the subject if you have same

gender caregivers in these areas at most of the 3200 hospitals in the united states then you must do the same for male patients

and if not then you are traveling down a very tortuous legal road as it only takes one male patient to stand up and make a legal

Precedence.

Rock, LPN, RN · May 9, 2011

If it involves very personal areas, it should be done by a female nurse, doctor or aide.

nursemike, ASN, RN · May 10, 2011

Interesting comments, nursemike. Let me start by saying that, for me, gender of caregiver for intimate care isn't necessarily a big issue. As with most patients, it's contextural depending upon many factors. So, I'm not coming at this from an strong personal preference. Having taked with many men, and read about many modesty violations to both men and women, I find myself an advocate for them and for patients in general. This is not to say that these modesty violations are the norm in medicine. But it is an important issue that goes to patient autonomy, dignity and respect. Now, to a few of your comments:
" It was suggested on another thread that all patients should be asked on admission whether they have a preference as to the gender of their caregivers. I'm not strongly opposed to that--my only concern is that it might tend to institutionalize a distinction that I don't really think ought to be made. And I'm not so sure it's needed. Maybe I'm dealing with a unique population, but the patients I've seen haven't been terribly reticent about voicing their needs and wants."
Frankly, if modesty isn't an issue among patients in general and men in particular, then why worry about asking? If it isn't an issue, the patients will say it doesn't matter. The fear is, I believe, that the medical community, knowing it's an issue among a minority but significant population, doesn't want to deal with it. You know -- if you don't want the answer don't ask the questions. If you get an answer you don't want, then you may have to do something about it that may involve hiring philosophy and scheduling. Whether you or the profession thinks the distinction "ought to be made" isn't as relevant as whether the patient feels the distinction "ought to be made." If you're correct and it isn't necessary to ask the question, then why worry. Ask and most people wills say it doesn't matter.
"but it seems to me that's saying that gender is so important that we need to bring in nurses who weren't willing to do what I did to become a nurse."
You see -- in the past, using that argument when affirmative action brought in more women and other minorities to male dominated profession -- using an argument like that was considered racist or sexist. Basically, that argument says that those that most benefit from affirmative action are really not qualified, or as qualified, as the dominant population, and don't really have the dedication that the dominant population has. Bogus argument.
" I don't think we can afford to lower our standards to meet some quota of gender, race, or whatever, and I don't think we especially need others who would expect special compensation beyond what other nurses get to enter the field."
Again, bogus argument. In areas where women and other minorities have been accorded affirmative action -- were standards lowered as a rule? Are the women and blacks who got into male dominated fields less qualified because standards were lowered? If that is true, no one wants to admit it. If it isn't true, then it won't be true for nursing.
As I've said before and I'll say again and again -- any profession that is dominated by one gender (and when no significants attempts are being made to prevent that), that profession develops the "old boys/girls club" attitude -- same old same old. A gender-diverse workforce in any field, nursing included, is a more healthy workforce than one dominated by one gender alone. It's healthier, and smarter. Not smarter because there would be more men and men are smarter. Smarter because when you put the two genders together to get different perspectives and points of view, you will get better outcomes, better working conditions, better patient satisfaction. Gender diversity produces better overall results. Women have used that argument for years, and they were right. Now, when men use it, they're wrong?

Cul2, I appreciate your advocacy for patients' needs and rights, and I respect your willingness to discuss this and other matters as a mature adult. From many of your posts, I strongly imagine that you and I are not so different in our actual practice. On threads relating to obesity, I've argued vigorously that being brutally honest is often more brutal than honest, and I don't mean to argue from an opposite perspective in terms of patient preference. In the cultural context in which I live, mid-America, modesty is certainly important. As a nurse, I've had contact with some patients from other cultures in which "modesty" goes far beyond that which is familiar to me, and I don't mean to disparage their customs, or the more familiar ones of my neighbors. But I've also had contact with patients from cultures compared to which ours might seem prudish. I've also occasionally encountered patients--as it happens, only females, but I recognize it can be just as true for males--with traumatic histories that make intimate contact with the opposite sex difficult or even unbearable. I agree with you that context is important. I've cared for a few women who have had histories of abuse, including at least one who was admitted for injuries sustained during a rape. My experience has been that approaching these (and other) patients with respect and genuine caring has gone far in overcoming difficulties. Indeed, one of my oddest nursing interventions has been dancing with a rape victim. But I don't take that to mean it would be prudent for me to be running rape kits in the ER. Each patient is unique, and even the same patient may be very different at different times. When I argue that gender shouldn't matter, I don't mean "take it or leave it." But I do believe it's a professional standard we can work toward while recognizing that not every patient will get there at the same time, or even ever. And I continue to believe it is at least largely our place to define our role. That definition must necessarily give consideration to patients' needs and might, in very rare circumstances, include dancing, but I think you'll have to admit that if it were entirely up to the patients, there are some who would expect to have their car detailed prior to discharge. Lest there be any doubt, I recognize that accommodating modesty is a matter of meeting a need, not catering to a whim. And yes, patients are entitled to considerable input in evaluating their own needs. But if they are completely free to order off the menu, autonomy becomes autocracy. I think it is a legitimate nursing function to educate patients as to what their needs are. Religious beliefs arguably add value to people's lives, but if modesty or psychological disorders deter patients from meeting their needs, they become a liability. We won't liberate patients from their hang-ups overnight, nor probably over a generation, and they shouldn't be made to suffer in the meantime, but excessive modesty does not make people happier or healthier. I further believe "excessive" can be defined objectively. If I can't pee with my cat watching, my life isn't significantly impaired. If I can't bear for my doctor to see me naked, it is.

As for my "bogus" views on affirmative action, there was, awhile back, one black player in the NHL. I don't remember his name, but it wasn't Jackie Robinson. I'm sure there may have been other black men who would have been interested in playing hockey if the sport weren't so predominantly white, but I don't see that as the fault of hockey. Men are scarce in nursing because fewer men apply to nursing school, and even among those who become nurses, men are more likely to leave the field. I, too, believe nursing would benefit from more diversity, and I believe it would be well worthwhile to try to reach out to men and other minorities to encourage interest. I've seen, on these boards, stories of discrimination against men, and it's possible some of them are valid, but if it were at all pervasive, I don't understand why I've never seen it.

My arguments against affirmative action in nursing are bogus only if the "racist" and "sexist" arguments against affirmative action in general are bogus. They aren't. Affirmative action has not succeeded as a matter of choosing minorities from among a pool of equally qualified candidates. Job descriptions have been changed and less qualified candidates have been chosen in order to achieve quotas. That can arguably be justified to correct a situation created by historic injustices, but if the gender imbalance in nursing can be attributed to any injustice, it is only that for so long women had so few other options. Reverse discrimination against women in nursing would simply be punishing the victims. I'm unequivocally in favor of encouraging people who are not white women to consider nursing, but I don't believe it is necessary or desirable to extend them special advantages to do so.

Cul2 · May 10, 2011

nursemike:

"Each patient is unique, and even the same patient may be very different at different times. When I argue that gender shouldn't matter, I don't mean "take it or leave it." But I do believe it's a professional standard we can work toward while recognizing that not every patient will get there at the same time, or even ever."

Yes, I don't think we're far apart at all. There are the extreme cases. But I'm not really talking about them. I'm talking about most people in the middle who can go either way depending upon the complex contexts with an emphasis upon whether they feel safe, respected, and treated with dignity. That happens most of the time. Not always. One reads on this blog occasionally of the "not always" cases.

And I'm not necessarily a fan of affirmative action. I'd rather the nursing profession, led by the men in nursing, take the lead in encouraging more men to enter the profession.

Anyway -- interesting discussion. I appreciate the opportunity afforded on this blog to get my views across.

nursemike, ASN, RN · May 11, 2011

Twice in my career, both early in my career, I've been refused for a female patient by someone other than the patient. First time, the patient's mother was an employee at my facility, and the patient wasn't able to speak for herself. I don't know whether I was refused because I was male or because I was inexperienced, but I was relieved, because the patient definitely needed a better nurse than I was. The other time, the patient's boyfriend, on learning she would have a male nurse, vigorously objected and I was reassigned. Even then, I knew that was wrong--it was the patient's prerogative, not the visitor's--but even now, I know it avoided a lot of potential BS. The only thing I would change about the latter instance is that we should have made sure (and maybe the new nurse did) to interview the patient away from the boyfriend, because his behavior should have been a warning sign of a possible abusive relationship. I'm not saying everyone who cares about their loved one's privacy is an abuser, and I'm not sure it relates to this discussion, but I thought it was interesting.

Rock, LPN, RN · May 11, 2011

I have had female patients on my service. The hospital, however, was mainly male because they were American seamen.

When the occasion arose, and the patient required personal care, I called upon a female nurse or attendant. It's even in your favor not to provide personal care, because you never know when a female patient could accuse you of performing a function that was considered to be unprofessional.

ITSSOSIMPLE · May 12, 2011

Twice in my career, both early in my career, I've been refused for a female patient by someone other than the patient. First time, the patient's mother was an employee at my facility, and the patient wasn't able to speak for herself. I don't know whether I was refused because I was male or because I was inexperienced, but I was relieved, because the patient definitely needed a better nurse than I was. The other time, the patient's boyfriend, on learning she would have a male nurse, vigorously objected and I was reassigned. Even then, I knew that was wrong--it was the patient's prerogative, not the visitor's--but even now, I know it avoided a lot of potential BS. The only thing I would change about the latter instance is that we should have made sure (and maybe the new nurse did) to interview the patient away from the boyfriend, because his behavior should have been a warning sign of a possible abusive relationship. I'm not saying everyone who cares about their loved one's privacy is an abuser, and I'm not sure it relates to this discussion, but I thought it was interesting.

Wow,you would want to interview the patient,the boyfriend.Would you request a psych exam on him! Personally,that is over

the top. How about requesting a psych exam on all women receiving a mammogram or women in L&D and why they don't

prefer male caregivers. How about requesting a psych exam on all men who prefer only male caregivers in intimate exams

but wait (we already do that and we call them sexist).

Last time I checked with every Bon in the united states it was considered unprofessional conduct to badger or bully a patient!

Bill E. Rubin · May 13, 2011

Wow,you would want to interview the patient,the boyfriend.Would you request a psych exam on him! Personally,that is over
the top. How about requesting a psych exam on all women receiving a mammogram or women in L&D and why they don't
prefer male caregivers. How about requesting a psych exam on all men who prefer only male caregivers in intimate exams
but wait (we already do that and we call them sexist).
Last time I checked with every Bon in the united states it was considered unprofessional conduct to badger or bully a patient!

Whoa, dude, why the hostility? Mike has a valid point. He witnessed what appeared to him controlling and jealous behavior and just said that in hindsight, he wondered whether getting the pt alone for further assessment would have been warranted. That's not bullying, that's advocating, mate.