Nursing intervention for schizophrenic patient having sex?

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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.

You may not think sex is important to mental health and that it is a luxury and not a need, but I strongly disagree and I can guarantee you that a significant number of your patients (and colleagues) will disagree as well. If you are not discussing sexual matters with your patients (unless they are children), then you are not fully addressing their health and well-being. I feel my patients need to be comfortable enough to come to me and say that they've stopped taking their meds because they cannot participate in sex or have no desire to do so when they take them. If they aren't comfortable enough with me to let me know they have had an erection for 4 hours, then it becomes a very significant health issue. If a marriage is suffering because one of the partners has very low libido, then it most certainly is a mental health issue. If someone is engaging in high risk sexual behavior related to their bipolar disorder or impulsivity, then it needs to be addressed in an open, non-judgmental manner.

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This was one of my questions on the RN NCLEX 2 years ago......with minimal info.....

makes for interesting conversation. I really don't remember what I answered ;-)

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Specializes in Psych.
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.

I can only hope you are joking! :confused: The ramifications of a hyper-sexual Bipolar? The rape or incest victim? The depressed pt. who has lost all interest...might be effecting marriage or relationship? Hello!? Ignoring a patient's sexual health or lack thereof is like saying "I will take care of this patient, except for their left arm, I'm too busy for that part of the patient"

On another note; whats worse on an inpatient psych unit than walking in on 2 patients having sex? Walking in on 2 co-workers having sex. Only happened twice (that I know of) and Lord knows, that was 2 times too many:lol2:!

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Specializes in LTC, Alzheimer's patients,Cardiac.
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.

To many people this may be true but to many others it is not. Sexuality is very important, and is certainly not a luxury...it is innate. I work with many "elderly" patients that are just as interested with sex as they were 30 years ago...do you ignor it? Make light of it? No... that would not be the right thing to do. I have one patient that loves to spend time playing around (if you know what I mean) so I redirect him to his room so that he can do what he wants away from everyone else. He goes away every time...where hes needs to, his room. He is a happier person because I do not try to stop him from doing what he wants..I just suggest a different enviroment for it..what is wrong with that???

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To me sex is secondary - the main concern is to get a patient to concord with their medication and see the value of taking their medication in order for them to live with their mental illness and the symptoms they have with it. The important thing to me is to get a patient to manage their lives successfully and understand the importance of looking after themselves. Sexual need is secondary

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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.

To me sex is secondary - the main concern is to get a patient to concord with their medication and see the value of taking their medication in order for them to live with their mental illness and the symptoms they have with it. The important thing to me is to get a patient to manage their lives successfully and understand the importance of looking after themselves. Sexual need is secondary

That may well be, but I've run across many clients over the years who, in addition to the valid concerns already mentioned, quit taking their meds and decompensated (repeatedly) because of the sexual side effects of their medications (impotence or loss of libido). That is certainly not a "secondary" concern to those clients. If the treatment team doesn't address their concerns and work with them to come up with a treatment regimen that doesn't destroy their sex lives, they are going to continue to be noncompliant.

While I agree that sexual activity on an acute inpatient psychiatric unit, outside of private, discreet xxxxx, is going to be inapppropriate and problematic, that doesn't mean that clients' sexual issues and concerns aren't an important issue to be assessed and addressed by mental health professionals.

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I just disagree patients sexual needs are simply NOT important when their mental state has deteriorated to the point they do NOT know what they are doing

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