Nursing intervention for schizophrenic patient having sex?

Smitty08 · Oct 22, 2009

I think the context would be important to look at here. Are they out in a common area of a psych. unit having sex. UMMMM...I think that would need to be quickly re-directed. I'm asssuming you are seeing them, so they must be having sex out in the open. Nope we don't condone that in this society, needs intervention! However, can they have sex in the privacy of their own space. Sure. Another question I would have is are they psychotic at the time or are their symptoms managed - this would speak to the issue of judgement/competency on their part and might impact your response/intervention/teaching. Just my :twocents:

Whispera, MSN, RN · Oct 23, 2009

Context is absolutely important. Consider what is acceptable by society as ok as far as sexual activity is concerned. Then anything that is acceptable by society should be acceptable in psych patients, and anything unacceptable in society is unacceptable in psych patients.

I think there's a gray line here in patients that have altered thinking though, and in those who have no boundaries. If there's any possiblity one of those involved could be unable to decide for his or herself, then staff has to step in and stop things from happening. In those cases, if the other person can't behave appropriately, it's up to staff to see that he or she DOES....even if that means isolation or 1:1 supervision.

kiwipsychnurse · Nov 5, 2009

i'm sure the area you work in has polices around sex and keeping patients safe. For a start walking in on someone having sex is not the norm in a hospital setting.

If they are a couple (in a relationship) and you walk in on them and they are community based (living in a community home/flat) then I'm sure this would be no different to walking in on two people with no mental illness having sex.

Someone with a mental illness still has the same sexual needs and desires as someone without a mental illness.

davebigs · Nov 5, 2009

I would let them finish and then have a talk with them.......

tewdles, RN · Nov 5, 2009

Sort of depends...did I walk into a patient room and discover them have sex (in private)....or....did I walk into the day room and find them on the billiards table.

No crime in sex between two consenting adults. We could have long discussions about competency to give consent, etc...another thread.

pezamistik · Nov 6, 2009

Psychiatric units in hospitals often have "no physical contact" rules preventing patients from touching each other, even if both parties consent. This includes the privacy of the patients' rooms, so I would have to say it should be stopped.

BILLIE39 · Jun 29, 2010

As a nurse I struggle about the concept of patients with sexual needs. Particularlly if they are elderly, or mentally ill. I just as healthcare professionals we should re-direct patients to sexual counsellors etc. We shouldnt be seen to be getting involved in that area. To me nursing is about promoting good physicall and mental health. Where does sexual need come into it. Sex is a luxury and not a need. Psychiatric patients are admitted to wards to get better. Sod that sexual intervention - that wont make them better.

Yosemite, RN, ASN, EMT-I · Jun 29, 2010

I had an argument with a collegue, I am not a psychiatric nurse rather a pediatric nurse.
What do you do when you see 2 schizophrenic patients having sex? will you stop them? or let them because its a physiologic need? help pls.

Thank goodness I've never had to deal with that, personally.

I work in an acute care crisis unit. It is coed, the rooms are NOT, of course. Each client is assigned a room, usually with a roomate. Unless their rights have been denied legally, they have access to "common areas" of the unit ONLY. Another client's room is NOT a common area, hence they have NO right to go there... sex or no sex, even if invited in by the current occupant. Those who are not psychotic, have signed a contract to not engage in sexual activity. Those who are psychotic are presumed to be incompetant to give consent, hence would be stopped from such activity; the liability is just too great and it is presumed would be upheld in court if challenged... I've not heard of such a challenge. A client who is returned to competancy would more likely have success in litigation for being allowed to engage in sexual activity, arguing they were not "protected" from themselves while in a vulnerable state than they would having successful litigation about not being allowed to endanger themselves through sexual activity (STD's, violence, post-event guilt, etc.).

Clients are to have at LEAST Q 15 minute checks for safety, that is line of sight, by staff. Staff cannot be forced, in the line of duty, to be subjected to offensive situations, except non-threatening verbal statements. It is assumed that racial, sexual statements will be offensive to some/most other clients and presumed as presenting a danger to themselves when other clients become upset, or counter therapuetic to other clients and their right to a safe and therapeutic environment... hence it will be stopped if verbal redirection is not possible.

Clients privacy is secondary to their safety. (Note the ".") Masturbation in the privacy of their shower or bathroom, if done discretely, is of course permissable.

Thanet · Jul 5, 2010

Part of a patients assessment would be whether they are capable to consent to a sexual relationship.

And part of that capability would be whether they were able to have this relationship with appropriate protection, appropriate place, appropriate time etc.

With the above in place the OPs original post would then be..

"What do you do when you see 2 ... patients having sex? will you stop them? or let them because its a physiologic need? help pls. "

7student7 · Jul 7, 2010

In a psych hospital I think you need to assume they probably aren't thinking very clearly and don't have the ability to give consent. I don't think I've ever caught two patients fooling around where I didn't think that one of them was probably taking advantage of the other in some way. Better safe than sorry. Definitely do not let them. They need to be focusing on their own recovery in a psych hospital anyway, not on a new relationship. I recently caught two patients together and I told the nurse and it turns out that patient #1 had been known in the past to overly-fixate on other patients and they were really glad that I caught them early. The situation actually did escalate and we ended up having to put patient #2 on a 1:1 observation. So much paper work, ugh. Can you image having to write that incident report? We had a funny conversation about whether or not "humping" or "embracing" or something else was the appropriate wording to document what happened. :lol2:

BILLIE39 · Jul 7, 2010

I think we need to stop promoting the idea that sexual needs are important in mental health. I as a nurse never discuss sexual needs with a patient. Even if its part of healing process. As a nurse i think i have more important things to do.