Male RN-assist with pelvic exams?

wymnwise · Sep 15, 2008

"If I can assist with all male GU items (I am female) then a male can do it with the females."
I think the issue is being missed here. The chances of a male accusing me (a female) of sexual harassment when placing a foley is significantly less than that of a female accusing a male nurse or MD of such when a pelvic exam/bi manual is performed.

That is one issue the other is patient comfort. It seems that many (not all) males and females prefer providers of the same sex. It just seem polite and considerate to either make it a rule to explain the procedure and ask or use a same sex rule of thumb, but remain flexible according to the situation.

veronicajr · Sep 15, 2008

Wymnwise, I agree :) I was just stating that as far as I'm concerned, it's not a way for people to get out of work. It's just a way to respect the patient.

TraumaNurseRN · Sep 16, 2008

What a lovely attitude you have about patients and patient rights. It is our choice as patients and it is battery if you violate that choice. Perhaps it is time for you to take a break when you refer to patients as "begggars".

I believe the poster was referencing the qoute for effect. And as a patient, yes you do have certain rights. But.....Perhaps it is time for you to take that break as you say......Or as this ER nurse would say....Break what flippin break:banghead: ...ER nurses get breaks?

wymnwise · Sep 16, 2008

I believe the poster was referencing the quote for effect. And as a patient, yes you do have certain rights. But.....Perhaps it is time for you to take that break as you say......Or as this ER nurse would say....Break what flippin break:banghead: ...ER nurses get breaks?

What effect? To say that poor patients should have no rights, or no patients should have rights?

Break? Not likely. Not until things change. With the world in the state it is in and the U.S. leading the way to the destruction of all our civil and human rights, of democracy itself, I am not about to take a break. Someone has to do it, no?

I am sorry but the bad attitude some pysicians and nurses seem to have about patients and our rights is a problem. A nurse that thinks of patients as "beggars" (it is not like she is not getting paid), and is resistant to help out a male nurse will result in delayed care, resentful care, or uncomfortable care. I have just joined this campaign. On the other hand, she sounds like she has burn out. So, again, when you get to the point where you feel that way it is time for a break. Now, you can try to make this about me if you like; but for me it is an issue. I did notice something interesting on the board. Research I have read noted that attitudes of med students regarding informed consent for things like practice exams while patients are under anesthesia changed as they went through med school. Just a note to these young students; many patients respect your sensitivities. Do not lose them as you advance through training.

veronicajr · Sep 16, 2008

"A nurse that thinks of patients as "beggars" (it is not like she is not getting paid), and is resistant to help out a male nurse will result in delayed care, resentful care, or uncomfortable care. "

I agree completely. Sure, we all have our frustrated moments, but if you're thinking this way all the time, its time for you to take a break from nursing or at least that particular specialty. No one is forcing us to be nurses. If you begrudge the care you "have" to give so much, then QUIT! Nurses like this give a bad name to those of us who do actually enjoy our jobs. And don't think that I haven't seen nursing in it's true light. I work at a county hospital in a Level 1 trauma center. It's hard work, and sure, sometimes it makes you question humanity. But in the end, I still love what I do. It bothers me that so many nurses do nursing just because it's a quick degree with guaranteed job security.

Sorry for my rant.

TraumaNurseRN · Sep 17, 2008

I still agree with the original posters dicussion about male nurses assisting with pelvic exams, putting foleys in, doing EKGs. I'm not certain what the big deal is. If a male refuses to do a procedure such as these, there is a delay in care for the patient. And yes I get sick of the excuse as well.

When one of my co-workers (male) asks me to do it, I exchange a procedure for a procedure otherwise my patients are left waiting while I do his job.

What are we saying here? Male nurses should only have to do certain aspects of the job? One poster made a comment that he'll do all the heavy lifting. That's a joke in the ER and he knows it.....The female nurses I work with do just as much heavy lifting as the males.

There are times I wish I could pick and choose what I do in the ER but I don' have that luxury.....

And again....I don't think the OPs comment about "Beggar" was meant to insight such negative comment. I further don't feel the comment is a symptom of "burn out" either.

I do suspect though that the NON medical persons who visit this site have an agenda of their own when they judge a "vent" from a nurse on these sites.

TraumaNurseRN · Sep 17, 2008

Where i work, if a female is receiving a pelvic exam, it's typically because of rape or molestation. And the "rape recovery team" is all female.
(just please warm your hands, first.)

You work in the ER and that's the ony time a pelvic is done?

wymnwise · Sep 17, 2008

"What are we saying here? Male nurses should only have to do certain aspects of the job? One poster made a comment that he'll do all the heavy lifting. That's a joke in the ER and he knows it.....The female nurses I work with do just as much heavy lifting as the males."

What I am saying is this:

1. If a gender sensitive assignments can be made they should w/following considered:

2. Patients should be asked at intake how they feel, effort should be made to respect gender sensitivities, and talk w/patient when it cannot giving option to consent, request chaperon, or refuse care. Offer to let them meet the male provider before they decide if that will help.

3. Give younger girls/women priority in gender specific requirements, and have a parent present for exams of under age girls, or have a chaperon.

4. Treat patients under anesthesia as you would if they were going to remember everything you are doing to them. Never lie to a patient about who will be doing what to them while they are under anesthesia. Let them meet the residents and students.

5. Have at least one O.R. circulating be female, and assign her to watch over a female patient while she is under anesthesia.

If physician have chaperone's I do not see why nurses should be offended at the idea.

"And again....I don't think the OPs comment about "Beggar" was meant to insight such negative comment. I further don't feel the comment is a symptom of "burn out" either."

Well, we will just have to agree to disagree; nothing turns on it anyway.

'I do suspect though that the NON medical persons who visit this site have an agenda of their own when they judge a "vent" from a nurse on these sites."

Hmmm. Agenda, yes reform. (Good for you though, I want more licensed nurses for one.) Did that have much to do with my judgment? Yes, I guess it does. I find her attitude offensive and related to how I was treated, other patients have been treated,... Look, attitudes have a lot to do with how people treat each other. Classism is at the center of how people seeking health care will be treated and it should not be the case. Not in my opinion. She is not the first I have heard mouth off w/classiest B.S. One doc, for example was talking about gang practice exams and said something to the effect of just get the welfare moms, they cannot say, 'No".... but in a much more offensive tone. Like I said, on this we will have to just agree to disagree and let it go. I would rather talk about practices than attitudes; though they are related.

TraumaNurseRN · Sep 18, 2008

"What are we saying here? Male nurses should only have to do certain aspects of the job? One poster made a comment that he'll do all the heavy lifting. That's a joke in the ER and he knows it.....The female nurses I work with do just as much heavy lifting as the males."
What I am saying is this:
1. If a gender sensitive assignments can be made they should w/following considered:
2. Patients should be asked at intake how they feel, effort should be made to respect gender sensitivities, and talk w/patient when it cannot giving option to consent, request chaperon, or refuse care. Offer to let them meet the male provider before they decide if that will help.
3. Give younger girls/women priority in gender specific requirements, and have a parent present for exams of under age girls, or have a chaperon.
4. Treat patients under anesthesia as you would if they were going to remember everything you are doing to them. Never lie to a patient about who will be doing what to them while they are under anesthesia. Let them meet the residents and students.
5. Have at least one O.R. circulating be female, and assign her to watch over a female patient while she is under anesthesia.
If physician have chaperone's I do not see why nurses should be offended at the idea.
"And again....I don't think the OPs comment about "Beggar" was meant to insight such negative comment. I further don't feel the comment is a symptom of "burn out" either."
Well, we will just have to agree to disagree; nothing turns on it anyway.
'I do suspect though that the NON medical persons who visit this site have an agenda of their own when they judge a "vent" from a nurse on these sites."
Hmmm. Agenda, yes reform. (Good for you though, I want more licensed nurses for one.) Did that have much to do with my judgment? Yes, I guess it does. I find her attitude offensive and related to how I was treated, other patients have been treated,... Look, attitudes have a lot to do with how people treat each other. Classism is at the center of how people seeking health care will be treated and it should not be the case. Not in my opinion. She is not the first I have heard mouth off w/classiest B.S. One doc, for example was talking about gang practice exams and said something to the effect of just get the welfare moms, they cannot say, 'No".... but in a much more offensive tone. Like I said, on this we will have to just agree to disagree and let it go. I would rather talk about practices than attitudes; though they are related.

In the perfect world nurses could go into your ER room 2 by 2, how about 3 at a time, one bring you your steak and potato, the other a magazine, and the other to fluff your pillow.....but most nurses I work with in the ER, don't have time or the numbers on a team to do that. Resources, resources, resources......If a female patient comes into the ER, requests only a female doctor and only female nurses....that's sooo unrealistic is laughable. (It's an Emergency Department...emphasis on emergency)I'm not sure why you aren't getting this. A nursing shortage is going on....and will be of major concern for years to come. Perhaps you should rquest to shadow an ER RN in a busy ER and then CHANGE THE SYSTEM.

wymnwise · Sep 18, 2008

In the perfect world nurses could go into your ER room 2 by 2, how about 3 at a time, one bring you your steak and potato, the other a magazine, and the other to fluff your pillow.....but most nurses I work with in the ER, don't have time or the numbers on a team to do that. Resources, resources, resources......If a female patient comes into the ER, requests only a female doctor and only female nurses....that's sooo unrealistic is laughable. (It's an Emergency Department...emphasis on emergency)I'm not sure why you aren't getting this. A nursing shortage is going on....and will be of major concern for years to come. Perhaps you should request to shadow an ER RN in a busy ER and then CHANGE THE SYSTEM.

Hmmm. I ask for very little care, and do whatever I can for myself. Hell, nurses tell me, "hey we are supposed to do that for you." when I go get my own drink from the dinning hall. On the other hand if I had a nurse who had your attitude; I would demand another nurse, and yes he could be male (if I liked him better) so long as I was not sedated. For a non-emergency sedated procedure, I would not allow most men, and certainly not you. I want people who respect my autonomy rather than look at it as a nuisance.

1. I was talking more about surgery and clinic than E.R. I assume foley training goes on pre surgery not E.R.

2. I allow exceptions or true emerg. as does the laws on informed consent, and I have said so, before.

3. MY husband worked E.R. and still every effort was made to be sensitive

Unrealistic expectations are often a result of medical provider propaganda and lies. (again not talkin' about E.R.) If a surgical patients request for female staff is unrealistic, there is plenty of time (in non emergency situations) to adjust those expectations.

FACTS:

1. Women are being lied to about who, how many, and what will be done to them in O.R.

2. Women in clinics are often asked for consent for "a couple of nursing students" to "observe" an exam. Then six, eight or more medical/nursing students are brought into the room (often most men) to learn and practice breast, pelvic, and rectal exams each one in turn.

This lack of fully informed consent for intimate exams leaves women with trauma so similar to rape they call it "medical rape". Rather than listen so many in the field chose to degrade the women further. It is quite simply patient abuse.

I am not saying every clinic and hospital are doing this sort of thing, but enough do it that women are upset and organizing, already forced through one law about practice exams. Again, not a perfect law, but a start.

I understand unrestricted access to our bodies without informing us of what you were doing had been a privilege of the medical profession for some time. Practice exams on sedated women has gone on for centuries. But, in the absence of consent it is wrong.

So, to the woman asking the original question.

If your training this male to do the foley was done without this sedated woman's consent, your instinct is correct, it is like RAPE. Did she give consent? Unless she was verbally informed of trainee participation, and consented, then no it is not informed consent. Was it a bad thing to do? Well, when you do not seek her expressed consent, then how bad it was to do depends on how she would feel about it if she knew? If she were to find out, how would she feel about it? Given she has a right to know who touches her, and a right to determine who touches her, the determination of how bad it was has to be filtered through her perspective. Look, if all this training is so harmless, why don't all you nurses let the students train on you, your daughters, mothers, wifes?

wymnwise · Sep 18, 2008

I'm a male RN, who left ED nursing ten years ago, and just returned. When I left, male nurses had nothing to do with "intimate" procedures on female patients. At my new ER, I have been told that I am to insert foleys and assist male MDs with pelvic exams on female patients.
If anything, I think that all the sexual abuse news should make it even more imperative that I avoid doing these things. Some of the male MDs agree with me. Your opinions?

I think you have every reason for concern. The first reason should be that some of the women may not like it. What to do? Just very politely ask the women first and respect their answer. Do that and you should have no problem. Listen to an insensitive doc more than the patient and you both have problems.

wymnwise · Sep 18, 2008

I'm not a male, but where I work only females assist with pelvics, whether the MD is male or female.
Typically, our males do foleys on males, and our females do foleys on females.

hmmm. So this is in E.R.? Perhaps what is "unrealistic" is thinking one can go on acting like men and women are the SAME, that gender differences do not make a difference and not expect to have a problem sooner or latter.