Pt.'s partner asked to have intercourse with a stoma !

[NurseLoveJoy88, ASN, RN]

Last night we had an ostomy nurse lecture us and she told us this story: One day she had a pt. who undergone an ARP ( rectum taken out and orifice sutured shut), and she proceeded to tell the man's partner that they will no longer be able to have intercourse rectally. The homosexual couple was distraught, and then the pts. partner asked if he could have intercourse with the man's stoma.:banghead::banghead:When she first told us this it just went over my head, then it settled in and we were all like... ewww. My question is as a nurse how do you handle situations like these. I know its not good to make faces and especially not to judge, but if a pt.s partner asked me, I honestly wouldn't know what to say. I know I'll show respect and empathy, but I'll be lost for words.

[April, RN, BSN, RN]

I've heard of similar stories as well.

I'm not sure I would be able to hide the shock on my face if I were asked that question, but I guess I would just say something to the effect of sex via the stoma could endanger the life of the patient and that they should refrain from that. Yikes.

[birdgardner]

There have been other threads here mentioning something of the kind - like "grossest thing you have ever seen" which included a stoma with an STD. And questions about the wililngness of the patient - when the healthy partner seems concerned foremost about sex, no matter what the genders are, is there abuse?

If the reason for the resection was rectal cancer (possibly caused by HPV) then there is a problem with re-introducing that no matter what other issues there are.

Are we really called to be empathetic for every outre behaviour, or is a just-the-facts approach acceptable?

[Blee O'Myacin, BSN, RN]

So was there a point to her story other than shock value? When you think about it, it is a perfectly reasonable question that this person had. A non-medical person might think that a stoma has sphincter control and can be substituted in that way. At least he asked first and didn't do anything that could possibly endanger his partner's health.

[netglow, ASN, RN]

:imbar

[Flare, ASN, BSN]

There was a color commentary on this in another post which was helpful for me as I was curious as to how one arrives at that notion (All I could think of was the potential for perforation - medical mind to the end over here..). Blee O'Myacin has a good point that non medical people may need to have the opportunity seized for teaching that it is not an orafice that can be used for this purpose and that doing so could cause very serious complications.

When I was in college I took an extra elective as a class for human sexuality and practices. I did this so I could have a professional level of comfort when discussing things like this with patients. It really helped me be able to keep a straight face and not look shocked when faces with certain questions or discussions over the years.

And though we covered a whole lot of different thing in class - I have to admit that I can still be inwardly shocked with some of the things i've come across.

[NurseLoveJoy88, ASN, RN]

So was there a point to her story other than shock value? When you think about it it is a perfectly reasonable question that this person had. A non-medical person might think that a stoma has sphincter control and can be substituted in that way. At least he asked first and didn't do anything that could possibly endanger his partner's health.[/quote']

We all asked her what was the point of her story and she said " To look at all of our shocked faces" :omy:

Then she said that she wanted us to know and understand how a colostomy can have a impact on pts. sex lives.

[Batman24]

We all asked her what was the point of her story and she said " To look at all of our shocked faces" :omy:

Then she said that she wanted us to know and understand how a colostomy can have a impact on pts. sex lives.

That's horrible. What a terrible way to teach you. She should have made you aware that non-medical people facing this condition might have questions in regards to their sex life and how you should answer them truthfully and with compassion. She didn't need to share this story to get her point across.

[Batman24]

So was there a point to her story other than shock value? When you think about it it is a perfectly reasonable question that this person had. A non-medical person might think that a stoma has sphincter control and can be substituted in that way. At least he asked first and didn't do anything that could possibly endanger his partner's health.[/quote']

I couldn't agree more.

[labcat01, BSN, RN]

The thought would have never occurred to me and I'd have been shocked if a pt. asked me. This is why I read All Nurses- so I can be shocked at the computer and not suprised too much in my daily practice :)

[leslie :-D]

That's horrible. What a terrible way to teach you. She should have made you aware that non-medical people facing this condition might have questions in regards to their sex life and how you should answer them truthfully and with compassion. She didn't need to share this story to get her point across.

ah, i dunno bat.

sometimes these type stories can have benefit.

i think it could be construed as preparatory to the bizarre situations we can/will face in real life nsg.

heh.

i can see a new nurse being confronted with this very situation and screaming at the end of the day, "WHY DIDN'T ANYONE WARN ME ????"

i think i would pass this question onto the doc.:)

leslie

[chicookie, BSN, RN]

O_O That would have been my face if asked that question. But you know I never EVER thought someone would think of something like that. Especially after seeing what comes out of it, would you really put your part in there with all the liquid stuff that comes out of it?