Nurse Educator Chronicles: Male Student Nurse on the OB Floor

[VickyRN]

My euphoria was rudely interrupted when a staff nurse approached me with concerns about one of my students. "Do you know your student is just sitting over there, doing nothing?" She glanced in an accusatory manner towards my lone male student "Catfish," who was quietly occupying a seat in an inconspicuous area at the farthest edge of the unit.

"Catfish" was entirely bald, short and stocky, in his forties, with an engaging smile and twinkling blue eyes. He was a man of few words, but very gentle and polite. True to his nickname, he was a commercial fisherman, who was picking up nursing as a second career.

"Catfish" appeared utterly miserable and forlorn as he sat nearly hunched over. His eyes were devoid of the usual sparkle, staring vacantly at the floor. He looked as if he hoped the earth would open up and swallow him whole.

"What's wrong, Catfish?" I asked. "Why are you just sitting here?" With that inquiry, the saddest expression swept across his face and he seemed about to cry. I'd seen that look before. It was classic for a male student on the OB floor and I almost had to bite my lip to keep from smiling.

"I'm so sorry, Ma'am," was his doleful reply, "But neither my assigned patient nor anybody else will let me in their room!" I found two or three tasks to occupy his time during the remainder of the shift on the unit. But, overall, he was correct - very few moms would allow him in their rooms, even with a female escort. And, there was nothing that I, as a clinical instructor, could do about it.

Catfish suffered through the rest of the two-week rotation on the unit, trying to stay out of the way of as many new moms as possible. Not too soon enough for him, his stint in OB purgatory mercifully came to an end. He then very gratefully returned to the blissful clinical surroundings of the medical-surgical floor.

[MMCRN]

Cul2 -

I absolutely see your point, and I don't mean to be obtuse, but I submit that simply bringing up the subject indicates an inclination that there is something remarkable or unusual about the practice. When I work in the ICU I am expected to do a COMPLETE head to toe assessment on each of my patients once per shift. That includes particular attention to the peri areas since they are more prone to breakdown. We don't ask the patient if they are uncomfortable having a male as their nurse. I'm their nurse, end of story. On the other hand if a patient specifically requests no male nurses and we are able to accommodate them, then we certainly try. When I work in the ER and a patient comes in with chest pain we don't ask if they have a gender preference. I tell them I will keep them covered as much as possible, but that I need to expose their chest to do an EKG. If a trauma patient comes in, likewise, we expose the body and take care of the patient without regard to their gender. I will say that when a patient needs a foley we try to use same gender people to place them, but if a female isn't available and the patient really needs one I don't hesitate. In my hospital we are going to some pretty extreme lengths to improve our customer satisfaction numbers, but we have yet to reach the point of handing out menus wherein the patient can select their nurse based on height, weight, color, and yes...gender.

Again, if a patient has a problem with my gender and we can reasonably accommodate them I am willing to do it. That doesn't change the fact that we seem to have no problem accepting this form of discrimination when we would show zero tolerance for other forms of discrimination which I mentioned earlier. You say that it is a fact that gender matters to many people. It is also a regrettable fact that ethnicity and culture also matter to a great many people, but that doesn't mean we should excuse it by changing the way we operate. L & D is the only department in the hospital where we make such a big deal out of the gender issue. I'm just saying that we should treat these patients as we would any other patient in the hospital. All of us should be kind, caring, respectful, and professional. If a patient has a problem, by all means, address it, but don't create problems where they might otherwise not exist.

[belgarion]

I don't know what the right answer is here or if there even is a "right answer". I did talk to a couple of female nurses I work with so you can take this for what you think it's worth.

One of the nurses told me that she was a small town 18 year old when she had her first child. She said the nurse came in with a male student and approached her in much the same way a lot of posts have suggested. This was a student who was on an OB rotation and needed to learn. She was told he would be helping. Very direct, firm, and business-like. She told me she didn't know then that she could object and was "very uncomfortable" with the whole thing. Her husband worked in the oil patch and couldn't be there so maybe that was part of it. She did say if she had been given the choice she would have never agreed to the male student.

The other nurse I talked to was already a nurse when she gave birth. She too had a male student come into her room with the OB nurse and inform her that he would be helping. Again, no ifs, ands, or buts about it. Even though she knew she had the right to refuse, she accepted him because she felt as a nurse it was her "duty" to help educate new nurses. She also said she was uncomfortable but "put up with it". She also said that when she had her next child she was more assertive. She did say she knew it was silly but that was the way she felt and it was SHE who was giving birth and not the OB nurse, the student or anyone else.

So I guess the question here is this: When a woman in labor is told she will have a male student helping out, with no alternatives given, and she doesn't pitch a fit about it, is it because she truly accepts the male student or is it because she decides to just "put up with it"?

[Cul2]

"I submit that simply bringing up the subject indicates an inclination that there is something remarkable or unusual about the practice."

Attitudes vary, MMCRN. To you, the nurse, there may not be anything remarkable or unusual about you treating opposite gender patients. That's your job. That's what you've been trained to do. To a significant number of patients, there is something unusual and remarkable about the difference in bodily boundaries once they enter the hospital. Now, I'm not applying basic gender choice to ICU or LTC or ER. You do the best you can there under the circumstances. I'm talking about not deathly ill, alert, conscious, patients. And, as I've suggested, you're right. The issue of gender choice most often seems to come up in OB-GYN. And it's always about whether male nurses should be allowed to work in those areas, or whether patients should have a choice. It doesn't often come up when were talking about female nurses regularly inserting foley caths into male patients, or giving bed baths, or cna's showering male patients, or prepping them for surgery, etc. Those activities are just considered acceptable. And getting back to what you said about what is unusual or remarkable -- to some male patients, it is unusual for a female to be doing something like that. To others it's just fine. And to others it's somewhat uncomfortable but acceptable. Everyone's different. Yet the policy seems to be to just assume that it's either okay or it doesn't matter whether it's okay or not. It's just the way it is. But I do appreciate your point of view. I'm just saying that sometimes that isn't the patient's point of view.

[nursenow]

MMCRN, I don't see how anyone could put it any better/more clear than that. Good post!

[muskylounge]

This is a great topic. One I wish I could have found more "in depth" discussions on prior to my first rotation this semester. I will have to play the devils advocate and say that my personal experience was fantastic to say the least. That not a single one of my fears came true and the horror stories of male student nurses being rejected were a mere folklore.

I am not saying that it couldn't have happened. Nor am I saying that it didn't happen to anyone else this past semester or previous semesters. Its just for me personally it turned out to be only the boogyman. I do give credit to my instructor who did not even bring up gender and has not for 20 years when introducing the student nurse as being assigned to help you today. For example. When entering room she asks if its OK if a student nurse helps with the experience today and I enter with smile and badge in place. I worked on the floor for 4 weeks and did not see a vag. delivery ( I have 3 children of my own, I have seen 3 deliveries), but saw one C section and took care of 5 postpartum moms and their babies. I had a great time and none of the moms cared or said anything about gender. In fact one first time mom and dad wanted to write me a letter of recommendation. 4 of them were first time moms. One I was able to teach breast feeding as latching seemed to be difficult as this is normal for most first time moms and babies.

I still do not want to be a L and D nurse but I can say I am glad that the boogy man was just that, the boogyman and that I had a very positive experience. If you are a male student nurse and you have children take a small photo of them with you to clinicals and put them behind your badge. Show your client as a conversation piece. If you don't have any thats fine too bring pics of nieces or nephews just make sure to tell them that they are your nieces and nephews.

TTYL

Musky