I'm just a student but an issue came up in class that really had me We were discussing med administration and lady partsl suppositories. One of the male students in class asked if he would "have" to do that for a pt., or if he could delegate to another nurse. The part that most surprised me was that my nursing instructor told him it was fine, she had male nurses she worked with who refused to insert foley's on females and other procedures involving the peri area of women.
This just seems so unprofessional to me. A pt. is a pt. and if they need care, it's our job to provide it. I understand that we're in a crazy litigious society and she mentioned one male nurse who brought a female aide in when doing foley's and things (I understand that a lot more). But honestly, the tone from this male student and one other in class was more like "that's so gross, I can't handle it" rather than "I'm scared for my license".
Is this common? I've had male OB/GYNs care for me personally and didn't think twice. I guess it just made me uncomfortable the sexual implication that they seemed to be projecting onto a medical procedure. Am I just out of touch?
As Mike said well, kindness and consideration and respect for our selves and colleagues is an important part of who we are and what we do. It is, and should be, IMO a part of our hierarchy of values.
As JBudd knows from other conversations, one of the reasons I work the shift I do is that my colleagues (everyone from the housekeeping lady to the Charge) tend to play nicely together. We don't waste a lot of energy on questioning motives, etc. We take care of our selves and each other, and from that position of strength take pretty good care of our patients.
The thing is, maybe that all just happened by 'accident'. Yet, our ethics in theory and practice should NOT be a matter of accident; and I sense that we often leave them to that.
I argue that by existential reality we are all moral beings. Our spirituality and morality defines who we are. Many of us seem to think we can check that at the door when we start work. 'And if you choose not to choose, you still have made a choice.' (Rush) That, too, is a moral position. I think it is an untenable position over the long haul. What's more, some of us are part of cultures/religions whose beliefs and requirements are so clearly presented that just ignoring them or putting them on hold is not only undesirable; it is impossible.
As JBudd succinctly said (unlike my long-winded tirades!) "Nurses cannot separate their own spirituality from their practice anymore than they can suspend the rest of their ethics and morality. " So, I argue, we should be explicitly examining, questioning, clarifying, and applying our ethics much more than we consciously do or are taught to do.
Hence, my stirring the pot here. IMO, this is no mere exercise. It is what defines who we really are. What kind of human beings we are defines what kind of nurses we are. We can't park that at the door.
I'm lucky in that nothing that comes out of any orrifice of the human body male or female grosses me out. I've dug out my fair share of impractions.
I also do not give lady partsl suppositories or insert foleys on alert and oriented females. Because if I have to drag a female witness, (I always have a witness just like a male doc doing a pelvic exam would), then the female can do it for me and I'll do something for her in exchange.
I'm more flexible with confused or comatose patients because there isn't that element of being afraid of false accusations or the patient being uncomfortable with a male nurse being that intimate.
Right or wrong, judge me if you will, but this is how I practice and it's worked well for me.
Really, it makes a whole lot of common sense, your approach. It seems like a huge waste of time to drag another person in and would likely add to the embarrassnent of the patient. Your approach is respectful, considerate, and good time management!
I GUESS MY MISCONCEPTION OF THE FREQUENCY OF RELIOGIOUS EXEMPTION ABUSE HAS MISGUIDED MY THOUGHT PROCESS. THIS HAS BEEN A HUMBLING YET EDUCATIONAL DISCUSSION 4 ME. I AM NOW BETTER PREPARED FOR THE VAST NUMBER OF CHALLENGES I CAN EXPECT 2 FACE AS I MATURE AS A NURSE. THANKS FOR ALL THE FEEDBACK. EVEN IF I SEEMED 2 REJECT SOME OF IT, IT ALL REALLY HELPED. I SHARED THIS WITH SOME FELLOW STUDENTS, AND THEY SEEMED TO BE IN AGREEMENT WITH YOU PROS.
I would have to hear the other side of the story to make a detailed comment on this thread. I know that some clients, esp mat-nb, may be unconfortable with male nurses and male nurses with them. Nursing is a profession career; we need to act the part of the professionals we are or are becoming.
I have been an LPN for 12 years and have always cared for female patients without regard for gender as long as the patient did not mind. I first noticed an inconsistency in concern for patient wishes while working as a CNA before that. When ever a female patient refused to allow a male staff member to care for them much effort was made to accommodate the female patient. However, if a male patient did not want a female staff member to care for him the same amount of effort was not generally made to accommodate his wishes.
Wow... I can't believe a man would refuse to do nursing cares and procedures. I'm a man and in nursing school right now, I've taken care of tons of female clients both in a dementia unit and hospitals for clinicals and don't feel uncomfortable at all providing sensitive cares. If the patient were to request someone different based on my gender (which has hardly happened to me) i would of course respect their wishes. I feel it's most important to be sensitive, provide proper draping and always explain what you're doing. This past summer in an internship I was doing peri care on a woman who couldn't due it herself due to obesity and she told me it was the most sensitive care she recieved from either an man or woman. We just all have to remember that we're professionals trained to do a skill with sensitivity and care.
As a male nurse, I find it difficult to believe that male students feel that they can refuse to perform procedures that they consider "icky" and that instructors will excuse male students from working on females.
During my clinical rotations I had female patients who refused to be catheterized by a male (me). That was their prerogative. During LPN school I had to to actively hunt for a female pt who would agree to be catheterized by me. Later, during one delivery in my RN Maternity rotation, I had to serve as a "stirrup," that is, I held up a woman's leg as she was delivering her child. I was expected to fill out a flow sheet on a new mother's condition including the status of her stitches, lochia, etc. When I worked as a staff nurse in a nursing home, most of the patients were (no surprise) elderly females. Some would refuse care from a male, some were already displaying mental status changes from a suspected UTI and would scratch anyone who tried to catheterize them, and then there were some did not mind a male nurse.
I do not see how I could be taken seriously by colleagues if I am unwilling to deal with female pts. I routinely have a female aide accompany me with all catheterizations of female patients without regard to mental status. If an alert, oriented pt refuses, that is her choice. However, if you were the DON or supervisor of a health care agency, would you readily promote a male nurse who refused to perform procedures due to "ickiness?" If you were a new grad, would you want a preceptor or a supervisor who couldn't handle a routine catheterization?
I understand that the public often assigns some kind of sexual overtone to peri care. This is sometime expressed in the "naughty nurse" lingerie/costumes that are seen in catalogs and satires. However, I find that a nurse's uniform is a major turnoff to me. I associate scrubs with work and my work often involves trying to get ten hours of labor completed in eight hours, as well as feeling dehydrated from working in buildings that are too warm because the eldery and debilitated feel cold no matter how much I perspire. I don't have time to fantasize, I just hope that the next catheterization will be finished quickly so that I can get to the remaining treatments before the incoming shift arrives at the nurses station and starts looking for things I may have missed while they are waiting to take report from me. None of these work issues stimulates my love life.
All "ickiness" aside, I have been a nurse for well over 15 years and have always gone by the same rules the physicians use.....no female exams without a chaperone. This is more for legal CYA than anything else. I have no problems giving any type of care that is needed, but the media and others have the propensity to protray male nurses (and other males in more female dominated professions) to be predatory in nature. It doesn't matter to me if hte pt is alert or comatose......no female peri care of any type unless it is emergent. The consistency of doing this would play into a defense should somethign arise also. If you ALWAYS do it the same way, there is no question what happened. I have told every nurse I work with that I will do their male foleys or other precedures if they need for the exchange of doing any female foleys, etc. I haev never had one balk at me. They have always understood my point and agreed with me that it was better from a legal standpoint.
Right or wrong, the perception of many in the public is that a man has sex on his mind more than not, and a male doing peri care would "obviously" not be able to control himself. It wouldn't matter if nothing happened if it were my word against the patients. I am a man and am automatically guilty until proven otherwise. And since (especially in this day and age) the patient is always right, I stand a very good chance of losing my job (not to mention my livelihood should the hospital reoprt it to the BON). Why take the chance? This is one battle I will forego when standing up for equal rights. It's just not worth it. Let's look at the shear numbers....male nurses account for about 10 - 15% tops of all nurses. That leaves 85 - 90% female. I find it hard to believe that a court of law or BON is going to believe you as a male nurse couldn't find SOMEONE to perform the procedure for you. Their thought process will be "Of course you should have found at LEAST a chaperone to perform this type of procedure". I know all the arguments of equal rights, the "fair is fair" thoughts, etc, but is it REALLY worth putting your livelihood in jeopardy? Isn't it safer and more prudent to at least have a chaperone? WE all know as nurses the perception of the public isn't necessarily right, but why cause the fuss?
If anything is considered.....how comfortable is the female patient with a male nurse doing this procedure.
I could not blame any male co-workers I work with if he would ask me to do the procedure or at least be in the room with him when he does it. We have to protect both the patient and the male nurse.
I've met only one male nurse who refused to do that type of personal care on female patients--and he recently left for the ministry. (I think it was just more convenient to get a female nurse or aide to do the work as he was at his desk a lot.)
Actually, 99% of the time it is a female patient not wanting a male nurse to give personal care. In those cases...it's A-OK with me.
I don't see it as an option for the male student or nurse to refuse it based on gender, but obviously, a patient has the right to refuse it.
However, if a patient is willing, to me, a male nurse should be treated no differently than any female nurse who refuses to do a procedure because they just "don't like" to do them...probably the wrong profession.
Having a moral objection is one thing, but lord knows there is a laundry list of procedures that won't make my day, but if it has to be done, it has to be done.
I am a male R.N.C.C.N. and I graduated in 1992. Having a male nurse was eye popping for some in those days, cool to others and the occasional "are you gay"? So I had some barriers to overcome. I was a dedicated hockey player and played that sport for 20 years of my life so I was sometimes banged up when dealing with my patients, broken nose, stitched up lip, raccoon eyes and I really had to watch my language because if I'm stressed I can let out the odd profanity. But, I am well disciplined when it comes to my physical and emotional behaviors. I am not 22 years old anymore. I have a beautiful southern belle wife (Texan) with 2 wonderful kids and we have amazing friends and families, both my wife and myself. kd870218 hit it right on the head, it's professional. We are professionals in the health care industry folks. This does not include just male or female gender, we have the multi-culture and religious sect. Respect your patients and their wishes. I am an experienced RN, and very very rarely and I refused to perform a duty on a patient because of them being a female. It comes down to common sense. If a patient appears uncomfortable with you because you need to carry out a Doctor's order ie: foley insertion, vag supp.or ointments.. (lets face it your patient would have to be fairly compromised not to be do the supp. or cream thing OK) and you see signs of this from their demeanor or the patient mentions this either to you or another co-worker, then it's inappropriate for us male or female nurses to not try and find an alternative such as a female or male coworker who your patient would feel more comfortable with. If you nurses male or female are not performing your skills on all walks of life then your skills are going to be sub standard. My patients have to have confidence in me. Ask yourself how you would like to be treated in a certain situation and that is how to treat your patients, because for a male RN its not the female issue so much as the female, language, culture situation. Respect, assess the situation, be professional, use common sense and keep your skills sharp and there should never be an issue. Good luck.
We were discussing med administration and lady partsl suppositories. One of the male students in class asked if he would "have" to do that for a pt., or if he could delegate to another nurse. The part that most surprised me was that my nursing instructor told him it was fine, she had male nurses she worked with who refused to insert foley's on females and other procedures involving the peri area of women. 
Medic09, BSN, RN, EMT-P
441 Posts
As Mike said well, kindness and consideration and respect for our selves and colleagues is an important part of who we are and what we do. It is, and should be, IMO a part of our hierarchy of values.
As JBudd knows from other conversations, one of the reasons I work the shift I do is that my colleagues (everyone from the housekeeping lady to the Charge) tend to play nicely together. We don't waste a lot of energy on questioning motives, etc. We take care of our selves and each other, and from that position of strength take pretty good care of our patients.
The thing is, maybe that all just happened by 'accident'. Yet, our ethics in theory and practice should NOT be a matter of accident; and I sense that we often leave them to that.
I argue that by existential reality we are all moral beings. Our spirituality and morality defines who we are. Many of us seem to think we can check that at the door when we start work. 'And if you choose not to choose, you still have made a choice.' (Rush) That, too, is a moral position. I think it is an untenable position over the long haul. What's more, some of us are part of cultures/religions whose beliefs and requirements are so clearly presented that just ignoring them or putting them on hold is not only undesirable; it is impossible.
As JBudd succinctly said (unlike my long-winded tirades!) "Nurses cannot separate their own spirituality from their practice anymore than they can suspend the rest of their ethics and morality. " So, I argue, we should be explicitly examining, questioning, clarifying, and applying our ethics much more than we consciously do or are taught to do.
Hence, my stirring the pot here.
IMO, this is no mere exercise. It is what defines who we really are. What kind of human beings we are defines what kind of nurses we are. We can't park that at the door.