Managing Perceptions (male nurse/student in OB)

[Works2xs]

During my current rotation (I'm a student) in OB, something kind of struck me as odd about how my postion was being represented to the patients. Let me explain a bit...

During my initial med-surg rotation last semester, I was on an ortho floor and was providing care to men and women, both young and old. When my mentor would go into a room, we'd both go in and she'd introduce me simply as "a student" and we'd proceed to provide the requisite care. None of the patients voiced any concerns during this time regarding having a guy in the room during "personal care" or when assessing wound sites below the waist.

Skip to the present...

Upon hitting the OB floor, this all changed. Now, I can't even enter a room before it's announced that a guy is in tow and is it ok if I come in and assist.

Yes, it seems to make sense. Yes, it seems appropriate to do in terms of just being polite. Yet, it still nagged at me a bit. Why?

Well, when observing my classmates going into rooms to perform skills such as D/C of a foley on a male patient, there was never any notification that a female student would be involved. No option given to opt out. No bow to modesty. Similarly, when patients are sent to other depts, such as x-ray (ultrasound), there isn't any notification that the tech's performing the work were of the opposite sex. Similarly, when the doc's were making the rounds with their entourage of students, no special steps were taken regarding modesty issues. And when it came to the OB cases, no mention was ever made that the RNFA's assisting the doc's on the C/S were men, or the anesthesiologists, etc. etc. Does it strike anyone else as a bit odd that the only people in the hospital that seem to be identified according to their sex are the male (student) nurses?

I realize that there are going to be exceptions noted by the readers of this forum. I understand that patients can refuse treatment from anyone they choose for whatever reason they find - no problem. I'm wondering, are the nurses that make this differentiation for the male part of the student body unconsciously setting an expectation that needn't be there? Regardless of who we're treating, or who's providing the treatment, isn't the "secret" to setting people at ease regarding modesty the act of performing your duties with a high degree of professionalism? If we're doing that, shouldn't the issue of our gender be a secondary consideration instead of the default one? If not, then shouldn't we be extending the same considerations to the male patient population? Does announcing a provider's gender just move the modesty issue to the fore, making it a self-fulfilling prophesy?

PS - I don't think that this was ever an act of discrimination on the part of my clinical mentors. Just an act of politeness.

[jetsetter]

I work w/several male nurses, and they have expressed the same frustration. I don't have any answers, but I think you'll find a little of this in all areas, but not as much as in OB.

Hang in there!

[fergus51]

Unfortunately for some women, it won't matter that you are a competent professional. Your gender will be enough to disqualify you from caring for them. By contrast I can only think of a couple of men who refused care from female nurses. It just isn't an issue for them like it is for women. It's not fair, but it's the reality so the nurses you work with are just doing the best they can considering that.

I don't think it has anything to do with a self fulfilling prophecy. I've had male students with me in L&D and always used their names, not their gender. "I have Brad, a student nurse with me today, is that alright with you?" Or "I have Lisa, a student nurse with me today, is that ok with you?". The women who don't want male nurses/students aren't doing it because of the nurses. I would feel a little awkward if I didn't at least let them know the student was a man. It would be a little sneaky to say I have a student, get their permission and then let them know it's a man.

[PedsER-RN, BSN, RN]

i'm sorry to hear that this is happening to you, although i'm not surprised. when i was in my ob rotation, one of my good friends (male) also had to deal with the same issues, including not being able to watch some of the vag deliveries. i've also witnessed the same thing at my work (a pedi er). i went in with a nurse (male) to assist with a foley on a pt (i think she was 16 or 17) and the mom asked if i would do it b/c she didn't feel comfortable with a male doing the procedure. we complied with the request but later the other nurse mentioned that it was frustrating to not be allowed to do his job simply because of his gender. he said "don't they see us as professionals?" i agreed but didn't really know what to say other than, yes, male nurses should be viewed as professionals and be permitted to do their jobs. granted, the pt was still a child, really, so i also understand the family's point of view regarding this particular situation.

so other than saying i'm sorry you were/are treated this way, i'm really at a loss at what to say. you might request going in with your nurse preceptor from the very beginning, rather than them going in alone and asking if it's ok for 'the male student' to come in; maybe if the families see that the nurse isn't worried about a male student nurse being involved, they'll be less inclined to exclude you from their care.

sorry this is kind of rambly.....

good luck. :)

[labcat01, BSN, RN]

It isn't just you. Many women don't want to be seen by male OBs either- I don't think it has to do with nurses specifically. You just have to understand and respect that not all women have had positive experiences with men in their life (if you get what i'm saying).

[grinnurse, RN]

I am so sorry that you are experiencing this problem, but, I think that it would be appropriate for the primary nurse to take you into the room and introduce you by name and then let the patient see the student versus "The Guy". It does stink that men have this problem but like the other said it is unfortunately a reality and hard for some of the people that have had problems with the opposite sex and may never be trusting of other men other than the partner that they are with.

Please don't let it get you down b/c for the most part, it has been my experience that they don't give a hoot. Good luck.

[traumaRUs, MSN, APRN]

Gosh - sorry for this. I know that when I precept students, I introduce the student as: "this is Joe, he is a senior nursing student from xyz college." Then, I go from there. I also have to say that as an advanced practice student, I have had female pts refuse pelvic exams from me because I'm a student, not because I'm female.

[HappyNurse2005, RN]

I had a male pt who (politely) refused a bath from a female nursing assistant. He would have preferred a male to do it, and of the 7 nurses and 3 CNA's on that day, we had only one male, who was a RN, not for that pt.

He was kind enough to say he'd do it if he got time.

[Cute_CNA, CNA]

Honestly, I would not want a male doing personal care, like a bed bath on me. Lots of people have pointed out that I'm attractive and young, and frankly, I don't want some guy to get turned on by caring for me. I'm serious. It might not be intentional, and despite how professional he is, I think it's hard for a man to not react to a young, attractive naked woman (depending on circumstances). I remember when I was 14 and went to a male gynecologist, and by the look on his face he looked excited when he was told he was going to give me a pelvic examination. How sick is that. But even w/o that experience, I still wouldn't want a male doing certain kinds of care for me.

I think people should have the right to refuse care based on gender if they want to.

I'm sorry that this causes you to feel discriminated against, and I guess it is a sort of discrimination. It must be frustrating, perhaps demeaning. However, I think the patient should be comfortable w/whoever is giving care.

I would not want a student caring for me in some circumstances, either. It's one thing to give someone a bed bath, and quite another to do a pelvic examination. I'd be afraid the student might miss something a more experienced staff member would notice.

That's my take on that.

[CuttingEdgeRN]

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[Chaya, ASN, RN]

Honestly, I would not want a male doing personal care, like a bed bath on me. Lots of people have pointed out that I'm attractive and young, and frankly, I don't want some guy to get turned on by caring for me. I'm serious. It might not be intentional, and despite how professional he is, I think it's hard for a man to not react to a young, attractive naked woman (depending on circumstances). I remember when I was 14 and went to a male gynecologist, and by the look on his face he looked excited when he was told he was going to give me a pelvic examination. How sick is that. But even w/o that experience, I still wouldn't want a male doing certain kinds of care for me.

I think people should have the right to refuse care based on gender if they want to.

I'm sorry that this causes you to feel discriminated against, and I guess it is a sort of discrimination. It must be frustrating, perhaps demeaning. However, I think the patient should be comfortable w/whoever is giving care.

I would not want a student caring for me in some circumstances, either. It's one thing to give someone a bed bath, and quite another to do a pelvic examination. I'd be afraid the student might miss something a more experienced staff member would notice.

That's my take on that.

Ya know, you can't assume that just because your caregiver is the same sex as you that (s)he will not be having any sexual feelings...

A good professional of either sex has to learn to "detach". That being said, a certain level of trust is required of the patient-a "leap of faith" if you will.

[Altra, BSN, RN]

Honestly, I would not want a male doing personal care, like a bed bath on me. Lots of people have pointed out that I'm attractive and young, and frankly, I don't want some guy to get turned on by caring for me. I'm serious.

WOW. That's all I can say to that ...

To the OP: You're right, there does seem to be some inherent unfairness. It sounds like you are handling it appropriately. Remember, your OB rotation won't last forever. Best of luck to you. :)