Nurse in room for hemorrhoid checks?

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So in my area there is a story about a healthcare provider who was accused of inappropriate things recently. The tapes weren't reviewed before he was taken into custody but that's beside the point. It got me thinking...

For checking patients for hemorrhoids do you have a nurse in the room like for paps and pelvics? You are getting a bit up close and personal so I was just curious. I'm new and checked a couple of people already but didn't think anything of it until today and thinking about this story.

Specializes in Cardiac, Home Health, Primary Care.
I'm an ER nurse and I insist on my male physicians, nps, pas, never being alone in a room with a female pt ever! I do this to look out for my coworkers. I always document I am in the room, especially during any type of invasive or intimate exam. In one of my ERs we actually had a patient attempt to have a physician arrested for "inappropriately" touching her while removing a c collar. She came up with this a few weeks after she had been treated and released. Luckily, I not only documented I was in the room, but that I was the one who took off her c collar at the physician's direction. I've seen outstanding physician's careers ruined by just accusations like this. Be very careful. Have a chaperone if you are a male provider, nurses included. I've also seen male nurses suspended pending investigation for things like this that have been later found to have not merit.

Oh the crazies! Is it the other way around also? I'm a female and have had a male patient complain of hemorrhoids. I didn't even think about needing a second person in the room because, again, it was similar to a suppository to me. Our checking for an impaction on my home health patients. So now that I've considered liabilities of it I'm curious what others do.

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Specializes in Pedi.
No pelvics by the dentist though the GYN's might get more business if they have laughing gas.

The dentist in question was accused of touching a young female patient inappropriately. He got arrested and media got all over it before a proper investigation was performed because, apparently, there are cameras in the rooms that haven't been reviewed. Interesting stuff.

The Practice did an episode on that very subject back in the late 90s/early 00s.

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Every times I read something about chaperones (here or in other places), I feel so baffled. It doesn't make much sense to me. Up until very recently, I did not even know this was a thing. I should say that I am not from the United States, so perhaps it is a cultural difference. Or maybe because legal actions are so much more common. Don't get me wrong, I can appreciate the liability side of things but I cannot help to wonder if we're not doing a huge disfavor to the patient/client by imposing a third party for any intimate procedures. This is a matter of trust, between the caregiver (be it a physician, nurse, or otherwise) and the patient, but also one of dignity I would think. At the very least, it should be presented as an option, not mandatory. And I am willing to bet many patients would rather not have someone else present.

On a personal note, I've never encountered a situation where a caregiver even hinted at having a chaperone during any procedure. It's just not done here but I would have been quite vocal about it if it had happened. Vocal enough to refuse care, if it came to it. I understand my opinion on this might not be a popular one but I would encourage anyone to consider if they are truly advocating for their patient by allowing this, let alone encouraging it.

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We always use a chaperone for any assessment of the pelvic, groin, or breast area. Regardless of the sex of the provider. It is just what we do. I am surprised that they are our practices where this is not automatically done,it is just what I am used to. As a home health nurse visiting patients in nursing homes and assisted living facilities, we did not follow this rule, so it took a little getting used to.

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We always use a chaperone for any assessment of the pelvic, groin, or breast area. Regardless of the sex of the provider. It is just what we do. I am surprised that they are our practices where this is not automatically done,it is just what I am used to. As a home health nurse visiting patients in nursing homes and assisted living facilities, we did not follow this rule, so it took a little getting used to.

As a staff nurse in the ED, I once had a physician ASK me to leave the room while he completed his physical assessment of a young man's member. He later said "he didn't want to embarrass the patient."

I wasn't the only one he did that to.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

I have a chaperone for both paps/pelvics & testicular exams in sport's physicals. I will ask the parents to stay in the room, they can face the corner/wall while I do the exam but they are in the room while I am checking for hernias in those teenage boys. I am a female provider but in this day & age you can't be too careful. This was policy in a previous job at a clinic. All genital exams require chaperone in the room.

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Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

I always request a chaperone when genitals are involved. Not that I don't trust people. I just don't trust people. My first two years of practice were behind bars. I trust no one these days.

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Specializes in Internal Medicine.

I always have a witness present if it's going to involve private areas or I know the patient has a history of making accusations with other providers. Even then, this doesn't prevent accusations from being thrown around.

The practice I work at recently had a patient accuse an NP student of inappropriate touching even though the preceptor was in the room as well as an MA. The actual visit didn't involve anything remotely private in nature and went fine with the accusation not being reported until days later. This patient obviously had a past in doing this because they reported the student and preceptor to the BON, and the MD that owns the practice had to submit documentation to the State Medical board. When all the government parties involved got the story and required documents, the whole issue was dismissed rather quickly, but it still created a major headache for the practice, and this was with witnesses present. It also cost the practice a few grand to get ahold of an attorney simply to have on standby and review a single chart.

The bottom line is that it never hurts to have extra witnesses. Chances are something that obnoxious will never happen you, but all it takes is for one crazy person to bring it all down if you're not careful.

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Specializes in Peds Urology,primary care, hem/onc.

The state I practice in (DE) has a state law that any minor who is getting a genital/breast exam must have a chaperone in the room. The law was made after it was found that a local pediatrician was molesting his patients for decades (it made national news). He would take the children to another room without the parents "to examine them". It was sick and nobody questioned it for years.

Now the chaperone can be any adult over the age of 21. For the younger kids the parent/guardian is in the room (obviously- even without the law I would never examine alone). For teenagers, I advise them of the law and that I have to have someone in the room with me. It is then their choice whether it is their parent or one of my coworkers. I typically talk to them alone when I walk them to the bathroom to do their urine specimen so we can discuss things they may not want their parents to hear. We have to document in each exam who the chaperone was and the name of that person.

I will say by GYN (who is a female) did not have a chaperone when she did my pelvic. It did not bother me though b/c I am very comfortable with it.

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"Cameras in the rooms..."

Now THAT is indeed interesting! Cameras in the rooms recording procedures being done to patients' private parts? Hmmmm. Patients at this facility give consent to their private parts being recorded...to be reviewed by whom later?

It doesn't matter if you are the same or opposite gender or if you are a female provider performing a procedure on a male patient. You can still be accused of rape or other 'inappropriate activity'. Watch out if the male that you're performing on isn't gay and later try to sue you for the 'emotional distress' of having a female chaperone in the room staring at his nakedness. I've seen and heard it all. Some of these patients are crazy (literally), love drama, and always looking for somebody to sue.

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We live in a society where everyone wants to lawyer up and get a quick payout. When I was an RN I placed catheters in men and women all the time and just did not have enough staff for a chaperone every time. You place EKG leads on women and have to move the pendulous breast from one side to the other (I always apologized for doing that) and never had an issue with a patient. With kids I did always have someone in the room besides the parent who wanted to stay.

As an NP I do not have to perform pelvic exams or ever require the patient to undress, but I see lots of crazy folks who get referred because the PCP is at their wits end. What is to stop one of these people from making false claims. Do you take a chaperone in the room every time?

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Specializes in PICU, Sedation/Radiology, PACU.
"Cameras in the rooms..."

Now THAT is indeed interesting! Cameras in the rooms recording procedures being done to patients' private parts? Hmmmm. Patients at this facility give consent to their private parts being recorded...to be reviewed by whom later?

It sounds like the cameras the OP mentioned (2 years ago) were in a dentist's office. Quite a different expectation of privacy than visiting your GYN.

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