twahls65

Why such hatred towards me all I was doing was asking for was simple advice but if I can't find that here I guess I will have to look elsewhere to further my training and look for friendship and fellowship where I won't be constantly judged. I thought this was a friendly forum where I could ask questions I guess not.

I am having trouble with my young patients both boys and girls open up to me about such sensitive subjects especially about there genital health if any fellow np have any tips or suggestions to get my patients to open up and feel comfortable talking to me about such subjects I would greatly appreciate it.

as part of the yearly well child checkup begining when the patient is 12 or 13 I try and set aside some time with just the patient without the parent in the room so If there is anything the patient wants to discuss without there parent there they can feel free to open up with me. Sometimes that is easier said than done. I find it more difficult for girls to open up and ask questions they feel embarrassed talking to me since I am a male nurse practioner but I try and calm there nerves and let them know whatever they tell me does not go beyond the exam room. If anybody has any other tips or suggestions for me to try and help me with talking with adolescent girls and how you approach talking about such sensitive topics with them I would appreciate it. Thank you

Sorry I am asking so many questions I am just comparing what we do at our pediatric practice to other pediatric offices with well child checkups. What i try and do is keep the patient as comfortable as possible during the checkup and just remove clothing as needed. I have found girls more shy to talk about there development with me even with a parent in the room during the exam when I do ask about puberty and there periods.

Do you have your patients undress for their yearly checkup or do you keep them dressed and just do the checkup over there clothes and just move clothes as needed?

Even though not necessarily part of a genital exam in older adolescent girls as they develope as part of the yearly checkup do you perform a breast exam on the female patient or just ask her about her development?

For older adolescent girls once they do reach puberty and get there periods do you do a little more compressive exam other than looking at there Tanner stage and just pulling out the waistban of the patients underwear? Do you try and counsel them and ask if they have any questions or concerns about there development or there periods? Do you actually look at there lady parts and pelvic area?

Please dont get me wrong i am very sympathetic towards any of my patients that i see being either male or female. I just find it hard being a male nurse working with children and giving them instructions ( i misworded my saying earlier when i said i give them directions ment to say instructions please forgive me?) I trully do watch how i word things to my patients when i am talking with them especially my female patients knowing i am a male nurse and they may take what i am saying to them the wrong way. I also realize i have to wait for responses to my posts and it wont be instant response back please forgive me in that aspect as well.

I am sorry if my topics are not interesting to comment on by fellow nurses i was hoping to connect with fellow nurses and start a conversation about these topics and see how othee nurses deal with difficult patients and the cloth vs paper gown issue in different parts of the country.

Thank you for your response it was appriciated i would also like to hear from other nurses experience with cloth vs paper gowns and how they handle that situation. I am also dealing with difficult patients especially with adolescent girls not wanting to follow my directions when i give them with me being a male nurse they dont want to have there weight andheight taken when i ask them to step onto the scale or when i ask them to give a urine sample and especially when i ask them to undress and put the gown on during there annual wellness checkup then i have to hear it from the physician as to why the patient isnt changed and ready for there checkup when the physician enters the exam room. How do you handle difficult patients like that any tips or suggestions are much appriciated thank you

I work in a pediatric office and want to find out from other nurses who work in pediatric offices if you have your patients change into a gown when they come into the office for their yearly checkup or they stay clothed for their checkup? If you do have them change do you use the disposable tissue gowns or cloth gowns for the patients? We use cloth gowns but its getting expensive to have to send them to get laundred and returned to us. We are trying to get the physicians to switch to the tissue disposable gowns. What are your experiences with cloth vs disposable tissue gowns for your patients?

Just a question does your hospital use mainly bedadine for lady partsl prep in a patient who is getting ready to deliver lady partslly or do you use soap and water to prep the patient. The hospital i work at uses mainly bedadine for the patient prep who is getting ready to deliver bedadine is widely used in our labor and delivery area's any feed back is greatly appriciated

I know its possible for them to get lumps but i didnt know if it was appropriate for a pediatrician to check there breasts during a routine physical.

I don't find it odd that the patients have to undress i know that is a nescescity so the dr's could do a physical what i do find strange is asking an adolescent female to undress and to also take her bra off so the dr could do a breast exam as part of there checkup. Is it really necesary for a dr to do a breast exam on an adolescent female during a routine physical?? I know how uncomfortable the patient could be with taking her bra off or am i really overracting to the whole thing???

I am a new RN working in a pediatricians office and i have noticed that the pediatricians here require all of our patients to discloth for all checkups and physicals and we give them gowns to put on to cover up. For our adolescent patients our Dr's also require our female patients to take there bra's off so they could do a breast exam on them. My questions are is it really required to have a child and adolescent discloth for physicals or can the Dr's do there physicals with the patient clothed? Is it also necessary to do a breast exam on a adolescent female during a routine physical? I don't know if i should say something to the Dr's about that or am i overracting about it. I love working with kids and at the office i am working at

Thank you everybody for your responses, I am still looking for more advice on talking with the main Pediatrician on how he does physicals with toddlers and adolescents. I am the only male nurse in my practice with 2 other female nurses. I feel kinda weird and uncomfortable telling the parents or the patients that they have to undress their child to their underpants/bra for the childs physical. We do give the child a gown to put on but alot of them are still apprehensive on undressing but they end up doing it. For female patients i do tell them that the Dr. would be doing a breast exam on the older alolescents and they have to take their bra off. For the older male patients i do let them know that the Dr. would be doing a testicular exam thats why they have to undress. I still feel weird telling them these things. how do i get over my embarrassment with talking to pediatric patients. I am looking for more stories on how other pediatric offices do toddler/adolsecent physicals in their office. I am defenetly going to talk to the main pediatrician on my feelings on how things are being run in the office. I do really like my job and the people around me we are a good team i just dont want to ruin it by opening my mouth and saying something.

bumping up for more responses hopefully

Thank you for your responses, let me clarify a few things i live in NY and the law states here in NY that children have to have a physical when then enter kindergarten, first grade, third grade, seventh graqde and then again in tenth grade. Our physicians in our group require that we tell all of our female patients during their seventh and tenth grade physicals to take their bra's off as well when they undress. My question is, is it really appropriate and nescessary for the girls have their breasts examined during their seventh grade physical or are the physicians going over board with the breast exams on the adolescent patient at that age? I have read about Tanner Stages and understand how that works and would along with doing a breast exam looking at the females lady partss for maturity age be nescessary or just asking the female patient about her periods and if they are regular or not is appropriate? I hope I am not going over board with this. Any suggestions and comments would be greatly appriciated.

I am a new nurse working in a pediatric office and got a few questions I hope you all can answer for me. I have noticed when we have our patients come in for physicals, for our adolescent patients the physician wants us to tell the patient to undress to thier underpants and for the female patients to take off their bra so the physician can check their boobs for development. we provide them with a gown. Is it nescessary for the physician to check the female patients boobs at this stage of development? I know it is nescessarry for the physician to check a males genitalia for development would the physician need to check the females genitalia as well or just ask the patient about her periods making sure there are not any problems developing. I would think this would make the patients uncomfortable. I just don't know if I should talk to the physician about this since i am new to the pediatric nursing field. Any responses would be appriciated.

thank you for those that have responded to my question, i am still looking for other nurses experince dealing with pediatrics and adolescents in the office setting. My main duties in the office are to call the patient to the back and do their height,weight, vision check and also ask them to give a urine sample. Then i escort them to the exam room and do their bp. While i wait for them to give their urine sample i go to the exam room and pull a paper gown from the exam table drawer and have that laying on the table when the patient comes in. Is this basically what it is like at other pediatric practices for the nurses their? Or do the nurses do other things at the office as well when you are dealing with a patient? Any more responses would be appriciated. I thank you in advance for your responses.

bumping up this post to hopefully get more responses. I thank you to those that have all ready commented and i appriciate it very much. I am still looking for more peoples opinion and experience since i am a new nursing student.

bumping up to get some more responses, please help me with these questions. I cant get a straight answer from the office where i work, so i am asking for help on here so if anybody could help me out it would be appriciated.

Thank you so much for your responses, i dont understand what the advantages and the disadvantages of weighing a baby with their diaper on or off? if someone could explain that to me please i would be greatly appriciated. you mentioned that you work in a peds office do u usually get a new nursing student in the office who wants to study office based medicine? Do the girls act all embarrassed when you tell them that they have to undress to their underwear and bra's and to put on a gown? When you give them a gown is it one of those basic hosital exam gowns that is cloth or is it one of those blue paper gowns? I know in the office where i am a student we have animal print gowns to give to the kids when they have to undress. Do u usually have the parent step out of the room for a minute while the child is undressing or does the parent stay in the room with the child? I hope i am not going overboard with these questions, i just cant get a straight answer at the office where i work. i hope to get some good responses and i thank you for your help.

Thank you all for your responses the reason I fear asking the physician or other better trained nurses there is I dont want them to think i am questioning them with what they are doing with their patients. Since i am just starting out in the field i like what i do i just dont want to loose my job for questioning them. Would it be appropriate for an older adolescent who is 15 or 16 and entering the 10th grade to get a breast exam? or is that still unappropriate action on the physcians part? I do know when the physician is doing physicals on older boys they do testicular exam and the physician does ask the girls about their menstral periods. I have learned this part so far. All this sounds ok to me but other people disagree i would just like to know should I fear loosing my job over asking the physician these questions. The people in the office are very nice and i dont want to loose the job i have. I hope you dont think i am going overboard with this thread. i would just like the right answers.

thank you for your response it is very appriciated. i think you misread my post a little at our office since i live in new york state the law states that a child needs to have a school physical before they enter the 7th & 10th grades. the physician in my office does a breast exam on females entering the 7th grade which is a 12 or 13 year old not on a 7 year old. Do other pediatricians do this at other pediatric offices? Do the parents have a problem with their daughter having a breast exam at this age or is it normal? We do give the child a gown to cover themselves with. Since i am just new to the student nurse's field i dont know if this was appropriate or not? I know for boys that the physician checks the boys testicles just did not know if a breast exam was proper at this age. I thank you for your response and hope to learn more as i continue learning. If other people can help it would be appriciated.