Who establishes the rules

[quizzical]

I am completely new to this forum. Maybe a lot of you would think I don't belong here. I actually am currently studying to be a Medical Assistant but might eventually go on to become an RN.

However in the Medical Assisting program I am in, there were several nurses who needed to learn phlebotamy , and there was even one doctor from Russia who's Russian MD was somehow insufficient for the US and was studying to be an MA or phlebotamist.

I would have some stories to tell about my Medical Assistant training but I

just want to begin by saying that I was taught quite a bit about medical ethics and it left me with a lot more questions than I ever had. Of course my experience as a patient (whenever I had to go to a doctor or the hospital) already had left me with a lot of questions that my enrolling in Medical Assisting training hardly answered.

There is a "closed" forum on this site about how nurses ought to deal with female patients when applying EKG leads on them. At MA training I was taught that it is appropriate to touch the female's breast using the back of the hand because this is considered less intrusive and if you use your palm it can be considered "groping" thus sexual harassment or assault.

(By the way, I was also told that the same technique would apply when you are dealing with a man who has gynecomastia ; and this is not mentioned much).

What I wonder about is who established such a rule and had it become a "universal" technique to be taught to all nurses, or medical assistants or EKG technicians, ( etc)?

Anyone know?

This will be my first question on this forum. I will probably have more of different kinds.

[NanaPoo]

Funny.

I spent a very brief time teaching MA courses at a for-profit "college" until I realized admin was requiring me to pass students who were cheating and failing. I refused to send "healthcare providers" out into the world who were unknowledgeable and incapable. The concept was frightening and the idea that I was contributing to that horrified me.

But, I digress. In the EKG lab that I taught, the textbook suggested the back of the hand method and I thought, "that's the first I've heard of that but, hey, it works." I also added on that the students should inform the patient of their intent. These are just general manners and not made up by a board of physicians who makes the end-all-be-all rules for patient care. My clinical instructors always made the point that we not call our patients endearing names like "honey" or "baby" so I've always passed this along in my own teaching. The patients are not in fact my "honey" or "baby." When I've been a patient I don't really like being called pet names, either.

[brownbook]

Golly gee wiz....I have never heard of any of this, never used the back of my hand! No one has ever complained, and with all the emphasis on patient surveys I would think I would have heard of any complaints?

Of course I use privacy, consider the patients modesty, etc. with any procedure. I just don't see it as being a big issue...that is until some patient does complain, then I'm sure we will get a memo...maybe a "use the back of the hand"memo?

A friend was complaining about her "former" dermatologists when he did an annual cancer/mole screen. He was constantly asking her...."Is it okay if I check here....is it okay if I check here......is it okay if I check here...." drove her crazy!

[nurseprnRN, BSN, RN]

I have this agreement with my GYN, bless him. If she sees him every year, she can remind him at the beginning of the visit that nothing is off limits and just to proceed. If she says this in the presence of the inevitable attendant witness, they can both just get on with it. :)

[roser13, ASN, RN]

Hi all.

I am the one who created this post. I have yet to fully learn how to utilize this forum.

I appreciate the replies but none really answers the question, who made the "back of the hand" rule?

It seems to be taught to every medical worker who will have to deal with the matter. Therefore, some "medical authority" must have thought it up and made it a standard to teach to all students of EKG or Medical Assisting ( etc). Was it the American Medical Association? ( It seems that they are very politically powerful and can make rules for a lot of medical personnel to follow).

Thanks to anyone who can provide info. Maybe some of you can ask a teacher or professor whom had taught it to you.

It's not a rule. No one "made" it. And trust me, the AMA does not make rules, nor does it give a fig about EKG or MA classes. Or nursing classes/practice, for that matter.

This was mentioned previously, but may need to be emphasized: becoming an MA does not "lead" to either a career in nursing or the field of medicine. I sincerely hope that you are not attending (and paying for) a for-profit program that promises that the field of medicine will open up to you upon graduation.

[caliotter3]

Interesting that this thread appears around the same time as the sex shop thread.

[Catzilla]

I just lift the breast by the nipple. The most minimal touching I can think of!

[JBudd, MSN]

I just lift the breast by the nipple. The most minimal touching I can think of!

ow.....

It is just a technique that some of us use to be "less invasive", can't be accused of grabbing when your fingers are pointing in the other direction. It is also shown in at least one physical assessment book that I know of, with a slide showing using a gloved hand to move male genitalia aside.

[jayc1157]

first obtain consent, then have the patient remove the least amount of clothing and then ask them to assist you or use the back of your hand to lift the breast out of the way.

[CT Pixie, BSN, RN]

I was taught the back of the hand lift in my LPN (graduated in 2008) and RN schooling (graduted in 2013). And I'm in my mid 40. I do remember seeing and hearing about the back of the hand lift prior to my formal nursing education.

[nurseprnRN, BSN, RN]

The back-of-the-hand lift also leaves those fingers free in the field.

Still wondering about the troll thing. Sex shop thread? Where's that?

[BuckyBadgerRN, ASN, RN]

Why does it matter? My DH is a police officer, it is standard procedure to use the back of the hand when "frisking" a female detainee. THAT was most certainly brought about by the litigatious nature of America. Maybe its the same thing in this instance.

Hi all.

I am the one who created this post. I have yet to fully learn how to utilize this forum.

I appreciate the replies but none really answers the question, who made the "back of the hand" rule?

It seems to be taught to every medical worker who will have to deal with the matter. Therefore, some "medical authority" must have thought it up and made it a standard to teach to all students of EKG or Medical Assisting ( etc). Was it the American Medical Association? ( It seems that they are very politically powerful and can make rules for a lot of medical personnel to follow).

Thanks to anyone who can provide info. Maybe some of you can ask a teacher or professor whom had taught it to you.

[blondy2061h, MSN, RN]

Trying to move breast tissue with the back of the hand will usually make it take longer and make it more awkward than if you say, "I need to place some EKG leads under your breast to get an accurate reading, is it okay if I lift your breast for a second?" and then do it in whatever manner is quickest.