Students performing intimate procedures
6-Apr-2009 9:49 pm
A debate that is on-going on the RCN discussion zone is in regards to student nurses performing intimate procedures with patients. This is specifically in regards to male students performing female catheterisation. The reason for me posting across is because I want to see what the views of nurses on these forums are. Also I want to identify what nurses think about students being observed whilst performing these intimate procedures.
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26-Jun-2009 2:49 pm
I was working on a ward, and it came as a shock for me when a patient said he'd rather not have a female bathe him. It led me to think.
It's all about the patient and how comfortable they feel I guess. On my last placement we had two male nurses, and all the old women loved them. Very few refused help with intimate personal care because they were male. I suppose it's because when they were a nurse, they were sexless. They weren't men, in the same way that we weren't female, we took on the gender of 'nurse' and the professionalism and duties that entails, and if done correctly, patients as a general rule accepted that and had no problem with gender.
11-Aug-2009 12:23 pm
I think that no matter what the gender of the individual performing the proceedure the patient is going to feel uncomfortable and more than likely embarrassed because of the nature of the proceedure. Catheterisation is an intimate proceedure and i feel that whether its a male or a female performing the proceedure its not going to be the most desirable situation. I think its more an issue of someone else seeing your 'private bits' rather than the gender of the individual. I know that if it were me in the situation it wouldnt matter if it were a male or female performing the proceedure I would still be uncomfortable and embarrassed regardless. However is does depend on the individual some people havent an issue with female staff performing the proceedure but they do with male staff and vice versa but i think for the most people actually having and intimate proceedure is the problem.
14-Aug-2009 11:00 pm
Firstly, what is the university’s policy on this? Secondly, is the male student nurse competent to perform this procedure? Thirdly, has the patient given informed consent? Does the patient have the capacity to decide? Regarding observation, I prefer the term supervision – everything a student nurse does should be supervised in some way. I qualified over 40 years ago and this question has cropped up regularly over the years; I find it disappointing that nurses seem unable to know what is right for them and their patient in these circumstances. It isn’t rocket science!
9-Jan-2010 10:06 am
Well its quite true that the tihng that matters the most is patient to feel confortable during his stay at the health services. On the other hand I can't understand why would women be so worried for having a male nurse performing catheterisation on them, since, I could bet, most have been checked by a male ginaecologist.
I think that if there is a chance to get a female nurse to execute this procedures, in case patient shows to be uncomfortable, it would be better to get one to do it, but if it's not possible it is important that the male nurse explains the patient that he isn't there looking at her in a sexual way, but in a clinical one.
11-Feb-2010 4:04 am
I believe that nursing students should do all that they can within the rules and guidence of their university. Students, of either gender, should get involved with catheterising patients as it is something they will do when they qualify. Many female nurses go on a course for male catheterisation and perform this procedure on as many men as they do women. I found out recently that a clooeague of mine had never catheterised anyone in 3 years of training and 3 years of practice simply because he thought he was not allowed.
I agree with others that it is about how comfortable the patient is. i have also experienced female patients prefering male nurse to cathterise them
4-May-2010 8:56 am
..i think, it doesn't matter if the nurse performing the female catheterization is a male it's up to the patient if she wants the male nurse to perform catheterization. It is our responsibility as nurses to make sure that our patient is comfortable. Proper communication of the nurse to the patient must be observed and it is a must to ask permission to the patient before performing any kind of procedure.
4-May-2010 9:02 am
In my opinion, student nurses are mostly trained to be fully equiped in taking care to his or her patient. When it comes to this situation, they should not only be equiped by knowledge and skills but also ATTITUDE is the most essential of all. It is part of the nurse students training to apply the moral ethics to their patient. On the other hand, it is part of their duty to respect and provide their patient's right to decide whether they are willing to do such procedure with a male nurse. Thus, the nurse should also be responsible of his limitations. Nurses are being trained to help people enhance wellness and be cure for illness therefore, we should be working on our purpose. Catherization is part of thir training thus, it is mandatory to perform this by both male or female gender.
3-Oct-2010 4:31 pm
Let us not forget....the same holds true for female nurses performing these intimate procedures on male patients....men can be every bit as modest and uncomfortable as a female patient. Their chances of getting same gender care for their comfort are far worse due the overwhelming gender imbalance in nursing, 95% female to 5% male caregivers. In this discussion we are focusing on males performing intimate care on females...thus the focus is on ASKING them ahead of time before performing such a task so their comfort level with privacy is respected. My point is it’s even more of a concern for men as our profession is almost completely dominated by females. Some men are EXTREAMLY embarrassed to have these procedures done by opposite gender caregivers. We need to do the same for these male patients and ASK them their preference prior to the procedure, let's accommodate them also. If there's not enough male staff to make the same accommodations for men, then I believe that is gender discrimination. Several studies are going on as to why men don't take better care of their health. It’s believed this is one of the issues. Men are humiliated and embarrassed by opposite gender care forced on them. Women have specialty clinics to avoid embarrassment, as in GYN and Breast health; they never have to see a man. Men don't have this option, let’s treat them with the same dignity and respect as we currently treat our female patients and just maybe we can improve on our men's health and help them to live a longer life. Let's attract that estimated 35-40% of men that refuse to seek medical care because of modesty concerns. Men can't even get same gender care at a urology clinic the entire front desk is female, and any assistants helping the doctor with procedures will be female. Imaging in hospitals as in sonograms of men's prostates and testicals are done almost exclusively by female technicians. My point is to open our eyes up to the gender disparity that also exists for our male patients, lets make them feel comfortable so their not embarrassed and humiliated, maybe we can attract them into taking better care of their health which will also attract healthcare dollars. Let's treat BOTH genders with the same dignity and respect they deserve. I agree we should be competent to do intimate procedures on both genders, but it's the naked person (the patient) in the encounter that should be ASKED what their preference is prior to the procedure.
22-Nov-2010 9:14 am
But in my point of view if some one have problems serving the patients then he or she should not be kept in this job. This is a job where your word and service can cure patients. They should have to see the patients only as a patient whether male or female patient.
30-Nov-2010 9:25 am
In RCN you have to study 2 years of associated degree and 4 years of bachelor's Science degree so this is the advance course of nursing but i don't know how can i get certified in LPN and what is the course duration?
26-Jul-2011 11:49 pm
Aren't the majority on gynecologists male anyway?? all mine have been!!!
30-Jul-2011 1:21 am
This is an issue that really annoys me. Gender should not be an issue when it comes to giving care.
With regard to the student part of the question, then as long as the appropriate competencies and supervision requirements are met, then there should not be a problem. Student Nurses are there to learn procedures after all, and the supervision part of that is necessary. We are shown, we practice, and we are assessed. That is how we are trained. We all possess the necessary communication skills to ask permission and keep the patients dignity.
With regard to the gender, I have come across so much sexism within Nursing it is unreal.
Women perform procedures like this on men without any questions, yet when a man performs the same procedure on a woman, suddenly there is an issue?
Why aren't female Nurses chaperoned when performing procedures on male patients?
For the patients, why are many women so vocally against being treated by male Nurses? We are there to give care and perform clinical procedures, what does it matter if I am a man or a woman who is performing those tasks as long as they are done? They are in YOUR best interests as a patient after all.
The problem with what Trudy says above, is that when patients wishes are respected, male Nurses can go through their training being DENIED training and practice opportunities and that DOES lead to competency issues later. I remember myself being denied the chance to practice female catheterisation many times, because we were respecting the patients wishes, yet my female colleagues NEVER had that problem practicing on men. I am not saying patient wishes should not be respected, but we cannot allow this situation to continue either.
17-Aug-2011 5:08 pm
Bottom line, the patient has the final say when it comes to who see's him or her when an intimate procedure is involved, if the patient wants same gender care because THEY ARE UNCOMFORTABLE, thats their right. Its not only women that are uncomfortable, men are also. Most men don't speak up, they just go with the flow, then feel betrayed and humiliated after the procedure. More men need to speak up about their wishes, there are probably just as many modest males as there females. The problem is the deck is stacked against men with the majority of nurses being female. Still, its about the patient and their comfort, not about you. If they want same gender intimate care, they want same gender intimate care PERIOD. Both men and women need to be able to do these procedures but the patient has the final say who see's them naked.
17-Aug-2011 11:52 pm
In my personal experience, I've only witnessed one elderly female patient refusing intimate care by a male nurse - as is her right. However, I've never known a male patient refuse to be catheterised by a female nurse. Surely they must feel embarrased too?
My university doesn't specify what we can and cannot do, it is down to the mentor and patient to decide. Ultimately, it all comes down to patient choice.
I would not be offended if a male patient asked for a male member of staff to provide intimate care. However, many must not feel able to ask due to lack of a male presence on a lot of wards.
20-Aug-2011 5:46 pm
Maybe that is YOUR experience, I’ve been in healthcare for many years and I personally want same gender care for all of my intimate procedures. Women are accommodated everyday with same gender care in America. In the approximately 3200 hospitals in America almost all of them have women’s clinics that provide same gender care for breast health (mammograms) and GYN issues. It never even enters a woman’s mind that a man would be present during her mammogram. Where are these same clinics for Men for their comfort and to protect those that have modesty issues? There aren’t any. If a man goes to a urology clinic, the entire front desk is staffed by women asking him what the nature of his visit is. Just what a man wants, to discuss his ED with six women present to listen. If after seeing the Male Urologist (if that’s what the man chose) if a procedure is needed in 95% of the clinics he will be assisted by a female RN or MA. And people wonder why men don’t take better care of their health. If men were catered to like women are at Breast health and GYN clinics, I think you’d see that estimated 35-40% of men that now avoid health care take better care of their health. Gender is and issue, it always will be. But it seems like our society only caters to the women in our society, men are and afterthought. And Laura, I personally know MANY men avoiding healthcare for this exact reason, they don’t want to go into a system staffed almost entirely by women to be humiliated by opposite gender intimate care. Almost all sonographers in America are female, scrub nurses that scrub the naked patient are almost entirely female, where does that leave a modest male, he usually avoids care. In America we have BFOQ laws written for this exact purpose, the courts have ruled that where title V11 privacy laws stop is at our genitals. The laws clearly state that a patient has a legal right to not be viewed or handled by an opposite gender care giver against his or her will. Laura, try asking men BEFORE you perform an intimate procedure if they have a preference, I think you will find out you will all of a sudden encounter more than ONE patient that says they would welcome it. Men usually won’t complain and just go along with the flow, then feel humiliated and betrayed after the fact. Then avoid healthcare from then on in the future.
4-Nov-2013 8:07 am
Instructors should explain to students how the procedures will be performed, making certain that students are not placed in situations that violate their privacy or sense of propriety. The confidentiality, consequences, and appropriate management of a diagnostic finding should also be discussed.