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.
Like I said, I'm not concerned with any aspect of discrimination. And I don't deny the right of any patient to refuse care from any particular person.
I was just odd to me. As a patient, there's always that niggling little fear (at least among some populations) that you'll be embarrased in front of a care giver of the opposite sex. But you bury the notion, trusting in the professionalism of the nurse, doctor, tech, etc. In my experience, as a patient, the health care folks have always managed to put any fears to rest by their professional attitudes.
From the other side of the relationship....
Does making an effort to note the difference just putting any fears of sexual connotation right up front? Sort of like Adam and Eve taking a bite of the apple. Before, they didn't care about being naked. Then, suddenly it was a big deal. By saying, "Hey, here's a GUY. Do you mind if he sees you in your alltogethers?" we're plonking the ol' apple right on the patient's bedside table. It's sort of like since we're making it an issue, it becomes an issue. That's what I meant by creating a self fulfilling prophesy.
Then there's a slightly different approach. We seem to manage to avoid the issue with the female nurses just (I suspect) as a matter of pragmatism. There simply isn't any choice in the matter so why bring it up. With men, however, there is a choice. So it gets offered. Just seems that if you left it to the same pragmatism, men could practice their craft the same as their female counterparts.
Anyways... no big deal. Just looking to sort out and thought a few other viewpoints could help.
Oh, btw.. I really enjoyed the L&D part of the rotation. Some of the best experienes I've had as a student to date. Don't know if it was just a function of total care vs. team care or the environment itself.
I completely understand what you meant about making it an issue by even brining it up, I just disagree. It is an issue long before any woman gets to the L&D unit. Male docs have been dealing with this for a lot longer. Women in L&D chose their OB months before they got there and many choose a woman ob because they don't want a man seeing their parts. Many women would not appreciate us ignoring a providers gender until after they give permission for them to participate. It puts them in a very awkward position in a very vulnerable time if they then realize you're a man and have to say "Well, I know I said I didn't mind a student, but I don't want a male student". I don't even have the student in the room with me when I ask patients if they are willing to have a student because they shouldn't feel pressured in any way.
I completely understand what you meant about making it an issue by even brining it up, I just disagree. It is an issue long before any woman gets to the L&D unit. Male docs have been dealing with this for a lot longer. Women in L&D chose their OB months before they got there and many choose a woman ob because they don't want a man seeing their parts. Many women would not appreciate us ignoring a providers gender until after they give permission for them to participate. It puts them in a very awkward position in a very vulnerable time if they then realize you're a man and have to say "Well, I know I said I didn't mind a student, but I don't want a male student". I don't even have the student in the room with me when I ask patients if they are willing to have a student because they shouldn't feel pressured in any way.
I can certainly see the point. So, let's say I decide that L&D is where I want to practice. As a nurse, rather than a student, should a female nurse have a conversation with the expectant mom at time of admission regarding whether or not she wants a staff nurse who's male? Should this be regular procedure? Are laboring mothers the only patients who need this level of attention? How about a woman on some other floor? And what about the male patients? Should they be given similar choice?
(By the way, the nurses I've worked with asked me to wait outside the room when they sought permission. No bait and switch.)
I can certainly see the point. So, let's say I decide that L&D is where I want to practice. As a nurse, rather than a student, should a female nurse have a conversation with the expectant mom at time of admission regarding whether or not she wants a staff nurse who's male? Should this be regular procedure? Are laboring mothers the only patients who need this level of attention? How about a woman on some other floor? And what about the male patients? Should they be given similar choice?
(By the way, the nurses I've worked with asked me to wait outside the room when they sought permission. No bait and switch.)
To answer most of your questions, I don't know. Men can and do work in L&D, and I don't know how supervisors deal with that. I have found that most women don't care, so it isn't too much of an issue but there have certainly been times when I have asked if they were ok with a male doc (the residents were sometimes exclusively male). Some of my more religious or conservative patients were not comfortable even having their husband in the room, so you can imagine how they felt about having a man they've never met do a vag exam on them. I wish it was different, but I have to accept that. I wouldn't have a problem with the question being asked on admission.
As far as asking men if they'd prefer a female or male nurse, I don't know what to tell you since I haven't had an adult male patient since I was in nursing school. I think you probably already know that there aren't enough male nurses to make that possible though.
I have heard other male nurses and students complain about not being able to witness the actual birth. However, L&D patients are always female and the birth involves a significant amount of focus and monitoring on womens lady partsl area because that is where the baby comes through (unless it is a cs). Birth is a feminine experience (only women can Directly experience birth) and some women feel better able to form a nurse patient relationship with a female nurse. Also, patients on other med surg floors may not refuse a male nurse as much because peri care/gu assessment is a part of the focus but not as big of a part as in L&D.
Also, I think people assume that the nurse will probably be female in any unit seeing that 90% of nurses are female and when the nurse is male, gender is more of an issue/focus for a patient. However, I think as more men become nurses, patients in general will be less focused on the nurses gender. When women started becoming Md's people would refuse care for many reasons- i.e I've always had a male Dr., I feel more comfortable with a male Dr., etc etc. Reasons that had nothing to do with their actual competance.
Personally I feel more comfortable with a female ob/gyn so mine is female however with general medical issues I couldn't care less if the MD is male or female.
I had these same troubles when I was in OB clinicals as well. At the begining of the class our instructor asked each of us what one goal we had for the rotation, mine was to see a vag birth. However, everytime a birthing situation would come up the instructor told me the pt refused having me sit in. I totally understand that some females are uncomfortable with males present for this, but while I was in clinicals many of the births were performed by male MD's. I had it happen again when I did a rotation in a teen clinic where female pts were given pelvic exams by male physicians, but refused a male nurse to sit in on the procedure. I followed one pt through each step at the teen center from enterance in the door, through the nursing exam, and some educational classes. Not allowed in at time of pelvic exam, but was allowled and encouraged on the after exam counseling.
What really bothers me with this whole thing is that there is a double standard with nurses as well. As a nurse I can accept that there are times when gender may make a difference and that pts have a right not only to refuse, but also for the nurse to step up and prevent a situation from becoming uncomfortable before it happens. i.e. doing foley caths on the 16 yr old females, or pelvic exams on someone presenting for sexual assualt etc. However, at least were I work, when these types of pts require lady partsl type care and I ask a female nurse to help, I get so much grief about how I need to take care of my own pts and gender does not really matter. I have offered many times to perform male caths and male procedures for them, so I see it is not a one way street.
birth involves a significant amount of focus and monitoring on womens lady partsl area because that is where the baby comes through (unless it is a cs). Birth is a feminine experience (only women can Directly experience birth) and some women feel better able to form a nurse patient relationship with a female nurse. Also, patients on other med surg floors may not refuse a male nurse as much because peri care/gu assessment is a part of the focus but not as big of a part as in L&D.
This part of this post really got me thinking. Let's replace as well as possible "birth" with "TURP" (for those pre-nursing that would be trans-urethral retrograde prostatectomy"). Just playing around with words here; I italicized the words I switched:
Having a "TURP is a male experience (only men can directly experience a TURP) and some men feel better able to form a nurse patient relationship with a male nurse. Also, patients on other medsug floors may not refuse a female nurse as much because peri care/gu assessment is a part of the focus but not as big of a part as on a male GU floor.
Ok, first off, VegRN, I am totally not picking on you, it's just that your post got me to thinking. How what would most of us nurses who are female think if all male GU surgery patients refused us? I mean, I could deal with it, but I would think they (the men refusing female nursing care) were being silly. I mean all you do all shift with a fresh TURP patient is assess the urine, empty the foley, assess the member, adjust the catheter tape, clean the member, assess the urine, empty the foley, irrigate the foley, clean the member. . .
Another thought; are homosexual female nurses okay to work in L&D? Are homosexual male nurses okay to work in L&D? Are bisexual nurses okay? Should any nurse with any "non-mainstream" sexual tastes be forbidden to take patients that require GU assessment?
I have no illusions of L&D nursing changing in this respect in my lifetime but in my opinion it is only because it is what people (women specifically) expect. It's going to change around the same time that older patients start accepting nurses with piercings, tattoo's and pink hair.
I do kinda have an axe to grind in that my husband tried (and succeeded) in breaking into a traditionally female area (more so than general nursing). He dared to take a job in NICU. You wouldn't believe the resistance and prejudice he encountered, and some downright hostility. This all from his fellow nurses, never a problem or complaint, or even comment from the parents (except to ask him to please sign up to care for their child again).
Having said all that I support any woman's right to refuse a male caretaker of course. I'm just saying we need to start expanding our thinking. Kudos to all you guys out there specializing in L&D.
I think L&D is different from a TURP but if a man wants a male urologist he certainly has that right. Not being a man myself, I don't know if a man would prefer that it was a man looking at his member rather than a woman. My dad would never have a female for a family doc.
QUOTE: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 end QUOTE.
I am trying hard to remember getting "turned on" by caring for a young attractive male patient (I am female). To CUTE_CNA > What you are lacking in professionalism, you make up for it with your high self esteem?:roll
I think this was rather a rude comment, and I don't think you have experienced the things I have. And since you have no idea what it's like to be me, or know who I am at all, what right does that give you to pass judgment? Further, what does MY professionalism have to do with how I'm being cared for?
This is difficult and probably not a problem that will get solved.
Pelvic exams are extremely embarrassing - for alot of women, including me. The post about having a male gyn and a male nurse in the room for a pelvic exam in a doc's office made me cringe . . . .two males in the room? That would be very uncomfortable and actually a bit intimidating for me. The reason for the female nurse in pelvic exams is really to protect the doc from getting accused of anything of an abusive nature . . and to protect the feelings and privacy of the woman.
Now granted, for me when I was in transition during labor all I wanted was the baby out and it would not have bothered me to have a male nurse - this situation is different than the doc's office though - usually there is a husband, S.O. or family member present at the delivery of a baby and a pelvic/pap exam is usually just the woman herself. I've never had my husband present for that.
As hard as it is, I don't think males should feel discriminated against or even offended. This is a uniquely female thing . . . and some of are pretty modest. Please don't take it personally.
It isn't that we don't like you, we just aren't comfortable showing off our wazzoooo.
Works2xs
193 Posts
Interesting replies.
Like I said, I'm not concerned with any aspect of discrimination. And I don't deny the right of any patient to refuse care from any particular person.
I was just odd to me. As a patient, there's always that niggling little fear (at least among some populations) that you'll be embarrased in front of a care giver of the opposite sex. But you bury the notion, trusting in the professionalism of the nurse, doctor, tech, etc. In my experience, as a patient, the health care folks have always managed to put any fears to rest by their professional attitudes.
From the other side of the relationship....
Does making an effort to note the difference just putting any fears of sexual connotation right up front? Sort of like Adam and Eve taking a bite of the apple. Before, they didn't care about being naked. Then, suddenly it was a big deal. By saying, "Hey, here's a GUY. Do you mind if he sees you in your alltogethers?" we're plonking the ol' apple right on the patient's bedside table. It's sort of like since we're making it an issue, it becomes an issue. That's what I meant by creating a self fulfilling prophesy.
Then there's a slightly different approach. We seem to manage to avoid the issue with the female nurses just (I suspect) as a matter of pragmatism. There simply isn't any choice in the matter so why bring it up. With men, however, there is a choice. So it gets offered. Just seems that if you left it to the same pragmatism, men could practice their craft the same as their female counterparts.
Anyways... no big deal. Just looking to sort out and thought a few other viewpoints could help.
Oh, btw.. I really enjoyed the L&D part of the rotation. Some of the best experienes I've had as a student to date. Don't know if it was just a function of total care vs. team care or the environment itself.