Nursing and sexual abuse history

[leekaye]

I was severely physically and sexually abused for 12 years by several immediate family members. After years of therapy, I've gone on to a great life with a wonderful husband and kids and, until recently, was very excited about overcoming my learned helplessness and finding my self esteem as I began to achieve my dream of becoming a nurse.

After two years of hard work through A&P, Bio, Micro, Chem and advanced math, I finally start clinicals in August. I'm embarrassed to admit, however, that I'm beginning to fear some care necessary for male patients. Watching scrotal dressings brings up feelings of nausea. The idea of giving a sentient male patient a bed bath makes me anxious. Stories of nurses being hit while dealing with drugged out patients worry me. And while I understand there's no intent, stories about male Alzheimer patients groping or striking their nurses frighten me. I'm not sure if I'm going to be able to do what my job requires without dredging up a lot of terrible memories.

I discussed this with a therapist and put a lot of careful thought into it before I started school and felt confident I would be fine. As the reality nears, however, and I continue to hear horror stories from nursing friends, I'm thinking I was overconfident.

Have any abuse survivors been able to overcome this?

[minnymi]

I have however, in my job, never been hit, touched inappropriately, or done any intimate procedures on a male patient (besides assisting with washes obviously, but you encourage the patients to wash where they can themselves, such as privates) without another nursing being present. In fact, some facilities have rules where another nurse has to be present to do intimate procedures due to potential allegations.

When you start doing practical experience, none of what you will do will be alone.

this may be the case where you are, but i doubt that it's typical. i have given many baths and inserted many catheters alone. i stated previously that i doubt the OP will have an issue while giving care, but to say "none of what you will do will be alone" could be very misleading. in fact, there have been times where trying to find someone to help was like trying to find a needle in a haystack.

[BonnieSc]

I feel for you. My history isn't nearly so tough, but I had some of the same concerns.

I don't think I've ever been groped, but I have been flirted with a lot, occasionally in ways that made me uncomfortable (felt trapped with patient, felt like it was interfering with my work). Luckily my managers have been sympathetic to this and actually have taken a harder stance on patient flirtation than we staff nurses have--they consider this all inappropriate sexual harassment and have been open to talking to the patient about it, making a care plan agreement (a behavior contract, basically), and switching nurses if the patient is fixated on one particular nurse, on young nurses, etc.

As for intimate procedures, I quickly found, as other posters have mentioned, that the processes are so nonsexual they didn't really bother me. I hope you will find this true, too. I didn't imagine there would ever be a time when I would feel comfortable doing a male catheter and it was one of the main things that ever made me hesitant about becoming a nurse. But it turned out to be a complete non-issue once I was in there with an actual patient who needed a catheter.

This may not be an issue for you at all--I hope not--but what's been harder for me is instances where I feel like I'm inflicting harm on someone else. If I'm not careful I can start to feel uncomfortable, like I'm a perpetrator--which is TOTALLY ridiculous, but I think it's an understandable response. Doing a cath on an elderly lady with dementia who clearly does not want to be cathed is heartbreaking for me. I do try to have help in situations like that because having another staff member in there keeps me grounded. I can even debrief with that person a little if I need to, without revealing any details about myself. "I really hate doing that to people." "I know, poor thing, but she'll feel better eventually." It helps.

For that reason, I can see why there might actually be some things to consider before going into peds. In that field you have to do a LOT of things that are against the patient's will, and that can be uncomfortable--for me, anyway. Also, peds nurses are certain to take care of patients who have survived sexual and other physical abuse. This may be something you feel a calling to do, or it may be too sad/difficult.

Finally... once I had to take care of a patient from a forensic mental hospital who had abused multiple children. I was able to keep it together to be his nurse by focusing on the tasks at hand, but almost broke down when giving report. I think it's something we can all do, just focus on the patient and the patients' needs, but it isn't always easy.

One more suggestion on a possible field for you. I did two years on a post-surgical floor that had a lot of gynecological surgery patients--hysterectomies and such, and also mastectomies. Having male patients isn't an issue for me, but I do like taking care of women when they are at their most vulnerable--I feel like I have a lot to offer, and connect with these patients well. I love seeing how strong women are, and seeing dozens upon dozens of really good, caring husbands was really good for me. Women's Surgical might be something for you to consider.

[DizzyLizzyNurse]

Hmm, i am not sure what you mean by this comment.

most patients that require this much care are usually old and confused one or the other or both. When ever I have had to place a foley/straight cath a younger male pt or female pt or anyone who is not in and out of the hospital and used to it , he/she is moslty mortified, not comming on to you, groping you etc. I can't remember any pt ever groping me. The people who swing at you are usually dementia or tbi patients. or super high on pcp, meth maybe. but for the most part pts on drugs tend to be too out of it. You will never avoid any of these patients do not even bring it up or ask for a request.If they are that out of control they will have prn meds for it or maybe even restraints. It is possible that being a nurse will bring back a lot of bad memories, we are exposed to a lot of different things .

This happened to me recently, but for a different reason. I had a severely alcoholic mother who was very neglectful who died last year. Recently I took care of my first DT pt. It really shook me up to see him like that. It kept making me think of my mother. I had to try to focus on what I had to do with him as a patient. Focusing on tasks like another poster said.

I have worked LTC with alzheimer's patients (and patients who were just bored). I had some attempt to be sexual with me. The Alzheimer's pts I just kind of brushed off but the guys who knew what they were doing where something else. I had to learn to be very to the point and stand up for myself. It was actually very empowering. I've never been sexually abused, but I was a bit of a doormat and having the stand up for myself made me grow as a person. You never know, even if it does happen to you, it might be empowering to say to the pt in a firm voice, "That is very inappropriate. When you are ready to stop acting that way, I will be back to help you. Otherwise I am going to take care of my next pt." And then leave. You can also practice with your therapist what you would say and do in such an event.

[leekaye]

My very first day of nursing school and the instructor told us to watch out for "dirty old men who want you to play with their memberes" which launched the STNA's in the class to telling horror stories! When I said, "It doesn't happen that often, though, right?" they shook their heads and said it happens so often they've lost count! My first day and I'm already questioning what I was thinking.

[wish_me_luck, BSN, RN]

OP, I have to be honest with you. You may want to rule out neuro. The reason being because it is not unheard of/uncommon for a patient with a head injury to masturbate (and also hit on you; I am not saying everyone who hits on staff has a head injury but it happens more with head injury). Also, since it is the brain on a neuro floor that has injury/illness, it is not uncommon for psych manifestations to occur.

[leekaye]

I think I would be ok with a neuro or dementia patient, because they aren't really aware of what they're doing. It's the ones who should know better that look at you like a thing that can be used and manipulated. The instructor said you'll get men of all ages on Med-Surg who will ask you to pay extra care to their member during bedbaths or try to shove your face down into their crotch, and she said it happens ALL. THE. TIME. Seriously?!

[GadgetRN71, ASN, RN]

My very first day of nursing school and the instructor told us to watch out for "dirty old men who want you to play with their memberes" which launched the STNA's in the class to telling horror stories! When I said, "It doesn't happen that often, though, right?" they shook their heads and said it happens so often they've lost count! My first day and I'm already questioning what I was thinking.

This is unfortunate.. While I think there's nothing wrong with preparing a student for realities of nursing, I feel this instructor was unprofessional for saying this.

It does happen, but not every day.

[Vinniesguy]

I have no idea which area of nursing these STNA's are working in if there are dirty old men wanting them to play with theire memberes so often they've lost count. In my 24 years of nursing I have never EVER heard of anything like that. Ok, so I'm a guy and it's going to happen to me but I've met many female nurses and worked in many places - the worst I've ever known of is some old guy smacking a nurses bottom as she's walked past.

As for shoving your face down onto their crotch? No way. Did surgical orthopaedics for years - your instructor is a liar.

[BonnieSc]

I agree. Your instructor is exaggerating or reads into situations things that are not there. If you are okay with the Alzheimer's and neuro patients being sexual occasionally because they can't really help it, you're going to be fine. Men flirt with me sometimes and a couple have done more direct sexual harassment but NEVER have I experienced, or heard about first-hand, anyone doing anything like trying to shove your face in his crotch. NEVER.

Many nurses love to exaggerate, especially about things like this. Take heart, and take such stories with a grain--or a spoonful--of salt.

[LVN2RNMom, ASN, BSN, LVN]

I too have been sexually abused but I have only experienced flirting by my patients. On one occasion an older gentleman patient did try to grope me but I was fast to move. I didn't take it personally as he is older & he wasn't being perverted. We as adults know the difference. In my opinion, it sounds as if you still have issues to deal with. No one can say you will never deal with an abusive patient. Patients aren't always in their right minds and things happen. No one deserves to be abused but being a nurse, you are dealing with people. Many of which aren't in their right mind (whether under the influence or physiologically) and things happen yet most things tend to be unintentional. Good luck & I wish you the best.

[leekaye]

Thank you, everyone, for the encouragement. I'm a bit more relaxed today. She also told horror stories about violent patients and the worst possible stories about the homeless. She told us today that she worked in a prison and a psych hospital so that may explain why her examples were more extreme. Still, I don't think it was wise on her part to share such stories on the very first day.

[LVN2RNMom, ASN, BSN, LVN]

I work in a psych facility & aside from flirting, the only thing to worry about is getting hit or hurt. Within 3 months I got socked in the jaw. He didn't hurt me (no bleeding or bruising) but this happens a lot in nursing. You have to be aware of your surroundings at all times, don't argue with patients & keep your private space. It doesn't matter where you work, getting hit or hurt is a very realistic occurrance. Truthfully this type of abuse is more common than sexual abuse. At least this is my experience & opinion.