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.

[Cute_CNA, CNA]

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.

steph

Yes, yes, yes!

[MarySunshine]

I wouldn't want a student watching me give birth or get a vag exam. I don't really care about gender. It's just that I want as few people as possible involved in those things. I know it's unfair...how are they supposed to learn? I will try to have a more open mind, but it's hard.

I think male labor and delivery nurses usually do well in their jobs and are able to build great relationships with their patients. I think the "student" part is a big issue for a lot of folks. That's half your problem there. And if they specifically sought out a female doctor, then they certainly won't want a male student OR nurse. So, people are refusing you for different reasons. Sorry, I know it's frustrating. You're not dealing with logic and reason here, you're dealing with culture and emotion. Because you're a student, you're more "optional." If you're the RN, you can't really poll each patient for their full feelings on the subject (obviously, they do have the right to refuse you).

If it makes you feel any better, most nurses learn MOST of what they know AFTER they graduate. So, if you don't see any births now, you could still go into L&D if you wanted and do just fine (with a good orientation). Good luck to you!

[labcat01, BSN, RN]

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 just wanted to address this really quickly- I personally (even living in a red state :chuckle ) could care less about the nurse's sexual orientation. The fact is that I have never been violated by a woman- wish I could say the same thing about a man. That's why I will always refuse a male L&D nurse and i'll lock the doors when ANY MAN walks by. If that hurts someone's feelings then i'm sorry but I won't lose any sleep over it.

Edited to say: I'm sorry if my post is harsh. I just want men- ESPECIALLY male nurses to understand that every woman has different experiences. You should try to take it personally

[Works2xs]

I just wanted to address this really quickly- I personally (even living in a red state :chuckle ) could care less about the nurse's sexual orientation. The fact is that I have never been violated by a woman- wish I could say the same thing about a man. That's why I will always refuse a male L&D nurse and i'll lock the doors when ANY MAN walks by. If that hurts someone's feelings then i'm sorry but I won't lose any sleep over it.

Edited to say: I'm sorry if my post is harsh. I just want men- ESPECIALLY male nurses to understand that every woman has different experiences. You should try to take it personally

Sorry you've had such bad experiences. What I was attempting to explore in this thread wasn't the feeling of the patient. I think there's general agreement that pts have the right to refuse.

Instead, I was looking at how other nurses treat the situation. Specifically, I was interested in whether or not a nurse's preconceived notion of how a patient might react influenced patient expectations. Or, on the flip side, if such attention was seen as critical, polite, or whatever, should the same consideration be extended to all patients, regardless of "floor" or gender. And if it's not simply because of pragmatic considerations, such as "there aren't enough men in the field to permit that level of flexibility," is that really a valid reason? Why or why not?

[Mandylpn]

In in my OB clinical rotation we had laboring/delivering moms that did not want ANYBODY (male or female) in the room touching their baby to do assessments.

[MarySunshine]

To better answer you question, yes, I do think how nurses approach it affects how the patient perceives it. If a nurse seems really positive about having a student it's going to be taken differently than if a nurse is all "Um, there's this MALE STUDENT who wants to watch. You don't have to let him...." and she herself is negative towards male nurses. It certainly would make a difference.

[rpbear]

I will put my 2 cents in as a L&D nurse. There are 3 male RN's on my floor. I love all of them and would never have a problem with them taking care of me. We live in a city that is very ethnically diverse and sometimes there are cultural beliefs that make it hard for men to take care of these women. We work around that, but for the most part these men just go into the rrom, introduce themselves as the pt's nurse and proceed profesionally. There have never been any problems as far as I know. These men are as professional and tacful as the rest of us.

We also have Air Force paramedic students with us every 6 months, all of whome have been male, and I have never had a pt refuse these students from watching or participating in thier care. I think it has to do with the way the primary RN handles the situation. I let the student walk in with me if the pt is not pushing or uncovered and introduce myself and the student and say that we will both be taking care of them.

I guess I don't give the pt the idea that having a male take care of them is something that is not normal, this is the professional that will be caring for them, and leave it at that.

I hope you follow your desires, and if L&D is something that you wan't to do then find a unit that is open to that and go for it!!!

[leogoat]

I think it's a matter of societal expectations and assumptions. Nurses have typically and historically been mostly female. Fortunately that's changing but we still have quite a way to go!

[CuttingEdgeRN]

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?

You are right, I was having a bad day and I apologize.

[mandana]

I just witnessed what the OP was referring to in the most clear way imaginable.

Just finished L/D and have several males in my class. One nurse took one male, one nurse took another male. Nurse A walked into the room and said, This is ________, he's a nursing student who will be assisting me today" and that was the end of the conversation about his gender. In one day he watched a c-sec and a vag delivery.

The other nurse had the student wait outside while she explained the situation to the mom. Guess what? The mom refused his presence.

Both women had male MD's. So sure, there could have been extenuating circumstances in the second instance, but I doubt it. I think presentation had a LOT to do with it.

[ayndim]

I just witnessed what the OP was referring to in the most clear way imaginable.

Just finished L/D and have several males in my class. One nurse took one male, one nurse took another male. Nurse A walked into the room and said, This is ________, he's a nursing student who will be assisting me today" and that was the end of the conversation about his gender. In one day he watched a c-sec and a vag delivery.

The other nurse had the student wait outside while she explained the situation to the mom. Guess what? The mom refused his presence.

Both women had male MD's. So sure, there could have been extenuating circumstances in the second instance, but I doubt it. I think presentation had a LOT to do with it.

I think it is unfair to present the option to the mom while the student (male or female) is in the room. Let the mom decide without feeling any pressure. I did have a student (female) when I had my second. But I was asked before she came in. She was great and was a doula prior to nsg school. I would have refused a male nursing student/male nurse or male dr. for personal reasons. But it would have been horrible to do so in front of the nsg student. And to be honest, my husband would have probably been rude since he is privy to my personal reasons.

I also refused a male resident during a bout of preterm labor. In this case the nurse told me a resident would be checking me and I asked if it was a male or female. When she said male, I told her either find a female resident or the nurse could do it. I realize that residents need to practice and that this was a teaching hospital (not where I normally deliver but it was early and my ctx were strong) but didn't see any reason I had to have a male resident when a l&d nurse is more than capable of doing a vag exam. Probably better at it than a first year.

[justjenny]

I understand your frustration and can only speculate as to why this is the case. During my OB rotation, the male students did not have a problem with patients refusing, etc. but they were not allowed to do an exam alone in the room. This is true of OB/GYN physicians as well....someone is present during the exam portion of the visit and a woman is not supposed to be left alone during this time.

My guesses are: even with the above rules women are still abused during exams with male health care providers....those handful of cases are highly reported by the media which is very scary to the general public. OB in and of itself is a highly litigious specialty..... it is best to protect yourself!

One example is when I had to be present in a room with a male student for a fundal check/exam.... the patient did not object to his care but treated him VERY differently than my patients treated me. She questioned everything he did/said and I found myself compelled to explain one or two things just to "help him out" so-to-speak and get her to back down...he was completely professional and appropriate but was not treated as such by the patient.

Jenny