Thursday, November 10, 2005

Foley Catheterization, Genitals, and Social Rules

Before we can dress, administer, or insert anything in the hospital, we must pass a clinical checkoff. Today I had a practical examination in Foley catheterization. (For those of you who don't know what that is, it's where you insert a tube into the bladder. Through the urethra. Yowza.)

The labs are filled with these pathetic looking dummies students can use to practice everything on. I say pathetic because they look worse than many of the vegetative patients I've seen in the hospitals; their plastic bodies have interchangeable parts for just about every ailment possible. You can even swap out genitals, which amuses me to no end, so today I inserted a Foley tube into a somewhat disturbing labia mold. Disturbing because the urethra was very exaggerated for easy learning, which is NOT the case in the real world. (Where the hell is the hole?)

I'm not someone who balks at nudity. (As a 96 year old woman once said to me, "If you have something I've never seen before I WANNA SEE IT.")
But I'm also not someone who thinks you can totally objectify something like this. For example: sometimes when inserting Foleys in males you can first inject this numbing gel inside the urethra. Only problem is this: you have to hold it there for five minutes. My instructor said "I've never done the gel thing, probably because I'm not one for small talk". Honestly, what do you say to someone while you hold on and wait for the stuff to kick in?

It always amazes me how willing people are to get naked for you once you wear a hospital uniform. I've had a good number of patients sofar this semester, and not a one objected to me lifting their shirts to listen to their chest, or helping them put on clean undies and a gown. Of course, they have no reason to worry about me seeing them naked; I am a professional. I'm going to see a million before I'm done. But what is it that makes them trust me with their body more than they would any other stranger? Surely it isn't the purple uniform... though I'm certain they'd be more uneasy if I was there wearing jeans and a tee-shirt.

We build up the most interesting environmental associations. Being in a certain setting, playing a certain role, and wearing a certain costume makes all the social rules change. Sometimes the roles can be de-humanizing (people expect super-human responses to their problems, especially from doctors). When someone fails while playing their role, we are disillusioned and disappointed with the role (profession!) as a whole, and not just the offending individual.

This is why I try very hard not to laugh at the plastic genitals of the practice dummies when I'm in the lab, less I undermine my professionalism. But another part of me sees that professionalism is a function of context. Objective detachment is a function of one's role. And though nursing is arguably something that becomes ingrained in one's very identity... I AM still a student.

So. Between you and me, I am seriously considering turning all the "parts" upside down one day. Just to see if anyone notices. I have the serious suspicion the instructors would find it hilarious. For all the roleplay, nurses aren't as stuffy as people think. So long as no one is watching. ^_~

37 Comments:

Hi Heather,

Great blog so far. Very "informative" , my wife is a nurse, so i can relate.

Soon I'm going back to school to become an X-ray Tech, and I am documenting my experiences as i go thru the process. my blog is

http://azx-raytechstudent.blogspot.com/

I put a link to your blog on mine because I thought yours was pertanent to mine. I hope thats ok. Let me know if you would like to remove it. Anyway, keep up the good work, and hang in there with school.

Dustin

By Blogger ArizonaDB, at Friday, November 11, 2005 at 11:20:00 AM PST  

Much thanks. I'll link you as well. Good luck in your studies! ^_^

By Blogger esunasoul, at Friday, November 11, 2005 at 11:24:00 AM PST  

wow i loved this post. I too am a nursing student and i found myself feeling proud that i shared this great profession with a person liek you. Your certainly seem to have a good head on your shoulders.

By Blogger daydream believer, at Monday, November 14, 2005 at 9:58:00 AM PST  

Once, years ago, a young female student nurse had to hold my penis while the gel stuff took affect. The instructor had to handle some other matters during the few (but it seemed like more) minutes. She was obviously uncomfortable (I gather that this was her first time chtheterizating a male) so my thought was: how do you have small talk with a woman holding your penis?

Fortunately a severe snow storm approaching, so I asked here if she would be able to leave before the storm hit. That started a discussion about how she would be leaving the hospital before the storm and could get around the college campus with no trouble. The discussion then turned to cross country skiing, an interest of hers and mine. Eventually we both had forgotten she was holding my penis and the other nurse had to step in and interrupt the discussion.

She has probably gone on to do many such procedures in the last decade. As for me, it is the only time I have ever discussed skiing with a strange woman holding my penis.

By Anonymous Anonymous, at Monday, January 2, 2006 at 6:50:00 PM PST  

Wonderful story Heather! I am also a nursing student - 1st year - second semester. So, I look forward to reading more of your blog and hope to be able to share some similar experiences! Thanks for sharing.

By Anonymous Anonymous, at Wednesday, January 4, 2006 at 5:23:00 PM PST  

To anonymous...
I will always be grateful that there men like you would be concerned about a nursing student in uncomfortable situations. I am retired, but in my years in nursing I have seen, held, inspected, washed, and bandaged about every part there is, and a penis is no more significant than an ear. There are some (only a few, I think) men who would make the most at such a situation and enjoy the discomfort of the nurse. So I thank you for being the way you were.

When I was a student nurse in 1960 "nice girls" in nursing school would never have seen a penis until we first saw them in nursing training. My first time was when I had to help strip and clean off a young accident victim--not badly hurt but bloodied up "down there". It was a small town so of course I knew him, from high school. I tried to be nonchalant and hide my embarrassment but I am sure he must have seen that I was uncomfortable.

I don’t remember exactly what he said but, even though I know he was in pain he did try to make me feel more comfortable about the situation. Not much later we came to know each other socially and I even dated him a few times while he was in college. He never brought up the time I cleaned his penis, but did let me know he was grateful for the care while he was injured.

In a small town where everybody knows everybody, there are some men who would enjoy a nursing students discomfort, but fortunately there are many others who would not.
Mary

By Anonymous Anonymous, at Friday, January 27, 2006 at 3:41:00 AM PST  

Hi Heather I am enjoying your blog makes me smile and laugh, I finished my stdies last July and am 5 months into my new graduate programme. Keep up the blogging.
I have a blog also
novice2expert.blogspot.com

By Blogger novice2expert, at Saturday, January 28, 2006 at 6:24:00 AM PST  

I'm a nursing student, and my fiance' has a hard time dealing with the fact that I will have to catheterize male patients. How to husbands of nurses handle the fact that their wives will be handling other mens genitalia?

By Anonymous Mel, at Friday, June 6, 2008 at 8:38:00 AM PDT  

Jealous men cannot be made un-jealous by reasoning. There is nothing you can do about his issues. Just do your job, don't talk about it with him, and remember that it isn't a big deal. Because it isn't.

By Blogger esunasoul, at Saturday, June 7, 2008 at 10:17:00 AM PDT  

I think you and any other nurse that think they have the right to see and touch naked men are bloody PERVERTS and if you tried to see or touch my private parts I would definately make you sorry you did!

I appreciate any help I get from a female nurse as long as your eyes and hands stay off my privates. But if you tried to see or touch me intimately you would be sorry.

FILTHY PERVERTS!!!

By Anonymous Anonymous, at Tuesday, December 16, 2008 at 2:17:00 AM PST  

I agree with the last guy. I would cut my own throat before letting a female nurse see or touch my penis. You have NO right to touch me and I will make sure every nurse knows that. PERVERTS!!!

By Anonymous Anonymous, at Tuesday, February 17, 2009 at 12:13:00 PM PST  

Thank, god, last two guys said it right. Its believeable that anyone would think that was ok, for a female to put a cath in a male patient adn come home to a husband. SICKENING, if you cant see the logic of that ur just a hippy idiot.

By Anonymous Anonymous, at Wednesday, March 3, 2010 at 1:14:00 PM PST  

It's hard to know when someone is trolling a blog or if they genuinely feel the way they do. In either case: let me clarify my opinion from the original post now that I have some years of experience behind my belt.

It IS, in fact, totally possible to objectify the bodies one cares for. After seeing thousands of genitals, they are no longer the mysterious thing that society's dress code tries to disguise them to be. A few might think such desensitization to the sacredness of the "private part" is somehow inherently wrong, as if social mores were absolutes in all contexts, but this simply isn't true. If by losing my inability to giggle about penises and vaginas helps me to be a better caregiver, then such objectification is, in fact, the superior moral choice. To simplify: in this particular circumstance, seeing the things s/he sees prepares the nurse to be a better person rather than a worse one. To shyly turn away from serving your patient's best interests would be the perversion.

That being said, it is NEVER acceptable for any healthcare professional to perform a procedure the patient feels would violate him or her in any way. If a man requests a male nurse insert his Foley catheter instead, I would certainly make every effort to accommodate those wishes. When I assist a bed-bound patient in bathing, I always ask "Would you like to bathe your private areas, or would it be easier for you if I did it?" 99% of the time the patient doesn't care. But practicing sensitivity separates good nurses from excellent ones.

Those of you who feel extremely defensive of your penises, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like prostate exams! We women learn to get over much of our shyness earlier in life because of pap smears and childbirth. Men certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Urethral Resection of the Prostate (Google it) because of that choice, well, what's the point?

A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather her laugh, blush, and turn away? Or would you feel better if she treated it as business as usual?

By Blogger esunasoul, at Wednesday, March 3, 2010 at 4:03:00 PM PST  

I must say, I support the comments of the male posters saying they do not want any female nurse near their privates - and I'm female.

The medical industry (for various reasons, and not all of them 'for our own good'!!) seems to take delight in demanding to view, test, and violate female AND male private parts while blithely saying, 'Get over it, its necessary, and if you feel like you're being violated or raped, you're wrong and that's stupid'. No understanding, no sympathy, no care towards how we feel at all.

I've seen and heard a lot of the happenings in the medical industry over the years, and I am very wary of doctors and their tests and demands - many of which are not needed and often not actually healthy either!

Go and read Dr Joel Sherman's blog on the dignity of patients and their right to privacy. Most doctors and nurses (particulary in America!) have no idea of what patient privacy, dignity and rights are. Sadly, nor do they care to know...

By Blogger Fiona, at Monday, January 17, 2011 at 2:04:00 AM PST  

Good discussion. I would just like to
challenge a statement made by one poster:
"We women learn to get over much of our shyness earlier in life because of pap smears and childbirth."

If that's the case, then why are most medical students studying OB-GYN females, and why is it not uncommon for men to be discouraged from going into that area? And why do the majority of younger women today prefer female gynecologists?
I don't think many women "get over" their shyness. They just didn't have a choice in the past. Now that they have a choice they're demonstrating their preferences. Frankly, the same goes for many men. When and if they ever get a choice, they'll show their preference. Don't confuse compliance, especially from a vulnerable, anxious patient -- don't confuse their surface willingness to go along with the program -- with acceptance.
That said, many other points made on this thread are interesting and well-taken.
Doug Capra

By Blogger Doug Capra, at Sunday, March 13, 2011 at 11:55:00 AM PDT  

Those of you who feel extremely defensive of your vagina, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like a trans-vaginal ultrasound exam by a male mammogram technician assisted by a male chaperone! We men learn to get over much of our shyness through forced opposite gender intimate care in hospitals and clinics. Women certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Vaginal hysterectomy (Google it) because of that choice, well, what's the point?

A day is coming, ladies, when a male nurse will see your vagina. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather him laugh, blush, and turn away? Or would you feel better if he treated it as business as usual?

Seeing as how Feminists want equal rights, I think its only fair we have equal rights with an even mix of male and female Mammographers to serve in our breast health clinics, and all O.B./.GYN areas. Seeing as how men have no choice when it comes to Urology as far as all same gender care, its only fair we do the same for females when it comes to breast health, and GYN issues. Let's see how comfortable you ladies are exposing yourselves to opposite gender intimate care at every step of the health care system as it now is for men. You’ve been catered too and spoiled for years with “all female breast health and GYN clinics. You don’t have to expose yourselves to men in intimate care situations but expect men to do it and not feel embarrassed. It’s about the patient ladies, not you the care giver. That was an extremely rude and unprofessional statement. Oh and by the way, did I mention the patient has the right ‘By law’ to not be exposed to opposite gender care against his or her will. So for the patient you’re wrong they do have a choice, if they don’t want to be exposed to opposite gender intimate care, it’s their right, courts have already ruled on this.

By Blogger lefteddie, at Monday, March 14, 2011 at 8:16:00 PM PDT  

Perhaps the most telling in exposing the selfish nature of the nursing ‘game’ is this..
“Those of you who feel extremely defensive of your penises, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like prostate exams! We women learn to get over much of our shyness earlier in life because of pap smears and childbirth. Men certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Urethral Resection of the Prostate (Google it) because of that choice, well, what's the point?

A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather her laugh, blush, and turn away? Or would you feel better if she treated it as business as usual? “


This is not caring treatment. This is a threat to all men that something terribly humiliating will happen to them , likely beyond their control, and there is not a damn thing they can do about it. Yes, I see how noble that is….

If men feel” defensive of your penises” then that is their right. If men have social, ethical or moral views of their naked bodies, then that is again their right. If men (and women!)” will have many more opportunities to be in "vulnerable" circumstances” then that is a tragedy, not an opportunity for threatening exploitation.
Your point is really to give up now, stop fighting those with inevitable control.
Bullying, threatening and coercing people into submission, in or out of a facility, is a disgusting practice. I can only hope that you are either one year smarter than your last post, or we are all one year stronger.

By Blogger Suzy Furno-Maricle, at Wednesday, March 16, 2011 at 3:04:00 PM PDT  

My previous comment was poorly considered. I definitely remember posting it in the heat of the moment.

Let me provide some context: my inbox had just been flooded with some extremely personal comments that I chose not to approve and publish here. I review each comment that comes through this site and allow nearly everything, even if the comments make negative assumptions about me personally, because I am a sincere advocate of the larger privacy debate. (This particular poster was just being an irritating, relentless troll.)

It is never acceptable for a medical professional to perform a procedure or exam on you that you are uncomfortable with. Period.

Personally, I believe refusing to submit to screening exams that could detect cancer in it's early stages is a bad decision. Just like I think smoking and eating too much junk is a bad decision. My job is to give people the knowledge they need for an informed choice. When I educate them, I will not bully or coerce them. And then, whatever they decide, I will support them decision 100%. You are free to do with your body as you will, whether by refusing an invasive test, smoking, or eating too much sugar. (Everyone has at least ONE unhealthy habit, right? Who should get to choose what's most dangerous? Who says yours is stupider than mine?)

My greatest aspiration is to be my patient's advocate and ally. It would be impossible for me to forget patient privacy and autonomy. Especially considering the commentary this entry continues to generate years later. I have asserted that genitals are "no big deal" in the past. But I was only speaking for myself. I of course realize they can still be a big deal for patients.

Some of you have been hurt by nurses and doctors in the past. While I am not perfect, I hope to never be one of those. I encourage you all to continue speaking up for patient rights. With healthcare being simultaneously better and worse all the time, the patients deserve every ally they can find.

By Blogger esunasoul, at Wednesday, March 16, 2011 at 7:01:00 PM PDT  

Hello Nurse Heather;
Why is it when a female nurse does a Foley Catheterizing on a male patient, he is most usually presumed, categorized, pigeonholed as a pervert. I mean really just how many men get off on having a tube shoved down a man's urethra. The mere thought of this is scary and no doubt painful. As a Asexual/Heterosexual man once gang-raped and tortured at gunpoint the life-long aftermath has placed numerous unwanted fears especially considering the details of torture I was subjected to. I'm not homophobic...but I am Androphobic as result of my horrid gang-rape.
And of course any man who is raped is prejudged in a bias way as always gay. So if a man request a female nurse in a hospital if catheterizing is ordered, will the female nurse always prejudge first?
Given today's sexually pervasive society no doubt a female nurse will question this aspect.

Chris F.

By Blogger centurionguard57, at Friday, March 25, 2011 at 7:47:00 PM PDT  

Hello Nurse Heather;
Why is it when a female nurse does a Foley Catheterizing on a male patient, he is most usually presumed, categorized, pigeonholed as a pervert. I mean really just how many men get off on having a tube shoved down a man's urethra. The mere thought of this is scary and no doubt painful. As a Asexual/Heterosexual man once gang-raped and tortured at gunpoint the life-long aftermath has placed numerous unwanted fears especially considering the details of torture I was subjected to. I'm not homophobic...but I am Androphobic as result of my horrid gang-rape.
And of course any man who is raped is prejudged in a bias way as always gay. So if a man request a female nurse in a hospital if catheterizing is ordered, will the female nurse always prejudge first?
Given today's sexually pervasive society no doubt a female nurse will question this aspect.

Chris F.

By Blogger centurionguard57, at Friday, March 25, 2011 at 7:50:00 PM PDT  

Chris F:
I think this is an interesting point.
I have often read the mentality of "you take what you get" in the medical arena. A female patient is conditioned to believe that intimate care from a male nurse is 'natural', and should not have a problem with it. A male patient is conditioned to believe that intimate care from a female nurse is 'natural' and should not have a problem with it either. The point is that the power and control is in their court: accept care/ resign yourself to whoever's care/we don't think you should make it an issue. You are a 'good patient' if you accept your emabarrassing circumstances with no questions. No one should question their ethical motives.

However: if you prefer opposite gender care: even request it, YOUR motives will become suspect. They will say this raises red flags, and often you will be watched as a deviant patient.
The hypocracy is clear. Accept opposite gender care and the humiliation and power control that goes with it, but certainly do not prefer it! If you do....they lose their edge.

swf

By Blogger Suzy Furno-Maricle, at Wednesday, March 30, 2011 at 3:19:00 PM PDT  

Heather:
I appreciate the fact that you re-thought your earlier post. It shows that you have given some thought to the patient's dilema on the subject, and are perhaps one of the few who do. Brava to you for your honest communication.
I believe what we lack is that ability to communicate honestly with each other. Indignity certainly runs high when people feel they are not understood on this subject, and defenses can quickly flare.
Modesty is the new 'genre' of patient care, as more come forward to express their concerns. It is a sub-culture of sorts,that is gaining it's voice as a true healthcare crisis and ethical dilema.
Thanx for the continuation of this subject, allowing people to question the theory of modesty in medicine.
I do have a (respectful)question that I would like to ask "off-blog". My e-mail is
boshemian2@aol.com
If you would care to answer, just 'e' me O.K.
Thanx again
suzy

By Blogger Suzy Furno-Maricle, at Tuesday, April 5, 2011 at 10:17:00 AM PDT  

Now what happens if a male or femaile ends up with the same sex nurse, but yet they would prefer opposite. Is that a law? Like me for example. I'm a male and would preferrably rather have a female touch my genitals vs a male any day vs a male touching my cohones. For one I'm not gay and two just thinking about it makes you wanna go yuck. I'm saying I'd be more calm and comfortable if a female did it vs a male. I wouldn't be embarrased about it, so why should they. If they was uncomfortable. I'd be like well you wanna hook up, maybe give them a little laugh. lol! But no jk on that. But yeah I'd do my best to make them comfortable.

By Blogger redneck7890, at Saturday, May 28, 2011 at 4:03:00 AM PDT  

Nice. I start classes tomorrow, and google "How to get through nursing school" and have been wonderfully distracted for a few minutes. I'll be back...

By Blogger Chris, at Monday, August 15, 2011 at 1:47:00 PM PDT  

This comment has been removed by a blog administrator.

By Blogger CAPEMAN1, at Wednesday, December 21, 2011 at 2:34:00 AM PST  

This comment has been removed by a blog administrator.

By Blogger CAPEMAN1, at Wednesday, December 21, 2011 at 10:03:00 AM PST  

Chris:

I see your post has been removed, but I would encourage you to join us at
http://afpmgoals.blogspot.com
to share ideas about how we can change the system to provide dignified and respectful care for everyone. Since all patients are different, we would like your views on what needs you would have to be considered respectful care.

Heather...you are welcome to post yout thoughts and ideas as well.

By Blogger Suzy Furno-Maricle, at Friday, December 23, 2011 at 12:54:00 PM PST  

after reading post's on allnurses.com..and other threads on nurses taking pics of men with their phones and passing them around... ...is just terrifying to me.Nurse's want to be treated like professionals and most fight for that right.I would like to hear from nurses that this is not done and nobody is walking around with their iphone do this..I read so much on the internet about abuse....no regard for mens modesty in the ER etc...

By Blogger CAPEMAN1, at Sunday, December 25, 2011 at 8:52:00 AM PST  

Sorry CAPEMAN, I did not realize I had deleted your previous two comments. I probably hit the wrong button on my phone's screen. I get a lot of strange and often inflammatory comments to this blog, and don't always take time to read them carefully, as they are overwhelmingly troll-like of late. Apologies.

To answer your concern that you "would like to hear from nurses that this is not done and nobody is walking around with their iphone do this."
I can tell you that any nurse caught taking such photos would be fired. It is a violation of the nursing code of ethics, the opposite of what is taught in nursing school, and would be completely unacceptable to any nursing professional. Has it happened in the history of nursing? Probably, because there are always a few terrible people in every profession screwing things up for the rest of us. But I would personally report anyone I witnessed doing something that to the hospital as well as the state board. They would not deserve their license.

While I have sincere respect for patient privacy issues, I would be pleased if further discussions move toward an advocacy site such as Suzy's. The comment section of an ancient blog post really isn't the place to tackle such questions, and would love to point you toward a place where constructive discussion is ongoing. I intend to close commentary on this post at some point in the future. Yours are the only few readable messages in an unending flood of perverse baiting.

By Blogger esunasoul, at Sunday, December 25, 2011 at 6:11:00 PM PST  

thanks for posting my comment.where is the site you mentioned? never heard of it.Kinda off the subject...also I read that the foley catheterization is painful to men...mostly not really needed. .when needed is used for to long,and used for nurses convenience.. I refer to a white paper from a hospital in Chicago study....something like 40% plus infection rate..I would refuse one if I were able to

By Blogger CAPEMAN1, at Tuesday, December 27, 2011 at 1:29:00 PM PST  

Capeman:

http://afpmgoals.blogspot.com

We are working on a web site to help patients change protocals about what is perceived as respectful care.

Thank you heather. Your insight would be welcome as well. It's been a few years...we have all learned a thing or two about respectful communication. Perhaps you would brave our waters as well.

By Blogger Suzy Furno-Maricle, at Wednesday, December 28, 2011 at 4:12:00 PM PST  

dear heather,

if nothing else, this barrage of comments is educational, no? lots of people, lots of intense feelings re bodies. as a recipient of much healthcare of late, i'm far into the category of patients who appreciate humanity in my caregivers; i am most assuredly not shy about my body.

when i was in college, i chanced into a job as a "medical assistant" (meaningless title; zero training.) all the other ma's were women from the trailer park next door; because they were required to wear white (as pseudo-nurses) they in turn insisted that i wear white too. my mom sent up to a box of lab coats from when my dad had been in med school... they had red embroidered caduceuses and the name of prestigious medical school on the shoulder... suddenly i became a junior doctor. pretty soccer moms would say to me, should i take my clothes off now?

i had a whole lot of curiosity re naked bodies and very little interest in professional ethics. still, a system of social rules became necessary, if only because i am an obvious blusher. i learned to detach -- it was the only way i could get the job done.

memorably, i was doing an ekg on a young woman with an admirable chest; small talk revealed that she knew my wife and that she was an ekg technician at a local hospital. essentially, i was nailed to a cross three ways: i had to pretend her breasts were just so much meaningless adipose tissue, and that any lapse of etiquette on my part wouldn't be reported straight to my better half, and that i was somehow going to fool an ekg specialist that i knew what i was doing.

By Blogger orionoir, at Wednesday, February 29, 2012 at 6:58:00 AM PST  

Been a nurse for almost 30 yrs and worked just about every aspect you could think of. the majority of my patients turned out to be female and all but a few had reservations because i was a male. if you're professional in your approach and respectful of their vulnerability there is no problem. unlike many female nurses, males can't discuss female patients like they do. the amount of inappropriate comments regarding the patients 'physique' and their attempts to see it were astounding. naturally, the better looking the male the more the looking and discussion. i actually had some men confide in me what some nurses did to them that they felt were un professional; and they were. as for foley, exams, dressings, etc.; with men the opening is pretty well defined for you. for women, the opening can be located close to the clitoris or further inward into the introitus. checking it out first always made things easier for everyone. we also never had numbing gel to use for males or females. warning them about the burn and being gentle always helped. as for holding the penis until the gel took effect; i find that totally unnecessarry. once inserted it can be placed lying down on the sterile drape until insertion is ready to be done. the desire to hold a man's penis has nothing to do with the process until insertion is necessary. i would never leave my finger in a woman's introitus just to mark the meatus. ascultation of the chest/back/abd can be done under the clothing to protect the patient's dignity. if your training didn't include that then your school and instructors are professional. bottom line, treat the patient with the same dignity that you'd want yourself to be treated, or your wife/husband, sister/brother, son/daughter, parents. i hoped this help some on here, especially students.

By Blogger analyst216, at Friday, February 1, 2013 at 10:14:00 PM PST  

Been a nurse for almost 30 yrs and worked just about every aspect you could think of. the majority of my patients turned out to be female and all but a few had reservations because i was a male. if you're professional in your approach and respectful of their vulnerability there is no problem. unlike many female nurses, males can't discuss female patients like they do. the amount of inappropriate comments regarding the patients 'physique' and their attempts to see it were astounding. naturally, the better looking the male the more the looking and discussion. i actually had some men confide in me what some nurses did to them that they felt were un professional; and they were. as for foley, exams, dressings, etc.; with men the opening is pretty well defined for you. for women, the opening can be located close to the clitoris or further inward into the introitus. checking it out first always made things easier for everyone. we also never had numbing gel to use for males or females. warning them about the burn and being gentle always helped. as for holding the penis until the gel took effect; i find that totally unnecessarry. once inserted it can be placed lying down on the sterile drape until insertion is ready to be done. the desire to hold a man's penis has nothing to do with the process until insertion is necessary. i would never leave my finger in a woman's introitus just to mark the meatus. ascultation of the chest/back/abd can be done under the clothing to protect the patient's dignity. if your training didn't include that then your school and instructors are professional. bottom line, treat the patient with the same dignity that you'd want yourself to be treated, or your wife/husband, sister/brother, son/daughter, parents. i hoped this help some on here, especially students.

By Blogger analyst216, at Friday, February 1, 2013 at 10:26:00 PM PST  

I'm 63/male. Prob. 90% of my pts were fem. My exper. ranges from medical-surgical to ER/ICU/CCU/ psych/L/D, CCTransp./Dialysis/ etc. as a staff rn or supvsr.
Besides the obvious notice of their immediate condition of health I also immediately noticed their state of exposure which I also immediately add'd for dignity. In many yrs of exper. the % of disregard for that exceeded the consideration of the pt's dignity. It's merely a lift of a sheet/blanket cloth/drape. My rule was also that drapes were drawn/doors closed/ only nec. personnel present. This can be achieved if at least one person is cognizant of the rt of the pt to have their dignity maintained.
For pts, the system seems to have conditioned them to be naked almost through the entire exam. I have palpated breasts/examined vulvas and cervixes/put in a multitude of caths in females as well as radium implants in one lady's cervix. In delivering babies I had to insert fingers to check the effacement. I always included the men and explained everything to them. None ever felt threatened and were very thankful for my care. One time the niece of a former pt saw me working at a hosp. while she was a pt. She asked me if I remembered him and I did, indeed remember 'Al'. She requested that I be reassigned as her RN and she mentioned me to the other three women in her ward and they, too, asked for me to be assigned to them. Besides being flattered, having four patients in one location made my job very easy.
I've also had pts of different nationalities/religions.
Ultimately, it's YOUR attitude of respect/consideration/knowledge/ experience/genuine compassion that makes a difference in how the pt perceives you. Of all the male pts, only four preferred a female and that was perfectly fine with me. If my presence would've made them uncomfortable then their care would be compromised because it's not just the physical care we have to give, but, the emotional and psychological care as well.
I haven't practiced for seven years because my service -connected disability had slowly gotten worse with age. With new medication I've been able to do much more in the last few years except the limitations from my cardiac issues but even that is getting better. I've actually thought about going back part-time because I truly miss the pts and helping them reach their max. level of wellness.
I became very close to many of my patients and their families because they weren't just pts but fellow human beings. So anyone who is a nurse and truly loves their profession without considering it a 'job' I commend you and know that your pts are in good hands. During 2010 and 2011 I had multiple heart procedures and my nurses and nursing assistants were incredible. Someone was with me constantly in spite of being a general cardiac unit. Their care gave me hope that there are caregivers who truly are special angels (male/female).
I've also had some doctors and NPs that also shared that same kind of professionalism and compassion. Though fewer then nurses, it was greatly appreciated as a patient.
In spite of being Jewish, I got most of my training at a catholic univ. The first teachers, nuns, were emphatic that it's our responsibility as nurses to advocate for the patient. I guess I can blame them for the type of care I gave to my patients and at the same time thank them for the blessings of having the opportunity to take care of them.
Ironically, several I took care of were also veterans from WWII and were instrumental in liberating Nazi death camps where many of my relatives perished. I felt, as they did, that it was the hand of G-d that brought us together to help them in their dying days to give them and their loved ones peace and comfort. That's one example of why we as caregivers need to treat ALL of our pts with the same dignity and respect we would want for ourselves and family. You never know how our lives intersect in the circle of life!

By Blogger analyst216, at Saturday, April 13, 2013 at 1:12:00 PM PDT  

It's interesting to see my comment come back to me after almost a year. As such, I took the opportunity to read the comments made once again.

I've been a patient many times over my almost 64 years and the care included male and females, doctors, nurses, assistants. Only once did I experience an uncomfortable moment. After my first heart procedure I was in my room and the male nurse was cathing me. He had the curtain drawn but the door was open. Suddenly, two women (one for sure was a nurse) came in to do something with my IV, all while I was totally exposed. The embarrassing part was that the nurse was someone I knew as a former client. So, I had to lie there having this guy try to get the foley in while she and the other lady were doing their thing.

If she were professional, she would have asked permission to come around the other side of the curtain and given me an opportunity to ask her to wait. That didn't happen and once she saw me it was too late to do anything to ameliorate the discomfort. I resigned myself to the event. She never came back to my room after that and therefore never made an attempt to at least apologize for coming in during the procedure. And, yes, she's seen other penis' and maybe doesn't think about them other than a body part on a stranger, but, it was MY penis and I knew her from business.

The female NP's, PA's and MD's that I have seen over the years have all been EXTREMELY professional, kind, compassionate, with tenderness and caring. They have addressed every part of my body depending on the situation and never left me feeling vulnerable; save one arrogant MD. And, being honest, when it comes to examining genitalia; I'd rather have a woman. Having been injured in that region a number of times their incredible gentleness is much appreciated compared to the gruff approach by the men who have checked me.

Being a male in nursing I have encountered a significant amount of discrimination both in school and by female peers. Some even tried to influence female patients against having me care for them. To the credit of those few patients, they stood up for me! So when more women began entering advanced roles in nursing and especially in medicine, I had a strong empathy for them and we often shared our stories of abuse.

I'm friends with a number of former female caregivers and we see each other now and again. We hug, joke, whine, share personal stuff, etc. We've come to love each other as colleagues and friends. As of this date, the demographics has changed so much where I receive most of my care that I'm almost totally cared for by females. G-d help the male doctor that puts these folks down in front of me. He'll get a piece of my mind for sure!

By Blogger analyst216, at Saturday, November 16, 2013 at 9:10:00 AM PST  

Heather Hello,
I am been in nursing care for 40 years. Over the time I have seen a lot of patient nudity and have done many, many catheterizations on both men and women. I started when I was a Navy Corpsman. We watched a video in school, and during the clinical watched an RN do one, and explained it while she was doing it. We got to do the next one, with the RN watching us. We had to explain it while we were doing it. Permission was obtained prior for me to do it. I prefer being trained on a live person, as all urethras and penises are not the same. There are variations. Female catheterization on a female can be tough, as their urethras tend to hide. I was told to use a flashlight and betadine and look between the clitoris and the vagina, and bingo it is there. That is true and not true. On older women, the urethras tend to be in weird places. A bright light held by another nurse or CNA helps a lot. With men. some of us can have a false urethra and the real "peehole" is underneath the head of the penis. I have seen this a few times. Also the prostate can be rather large and hard to penetrate. That is when you use a coude' catheter and placing it on ice in its sterile container actually helps the insertion.
Fro some reason, some of the female nurses are hesitant to catheterize a female, and some of them asked me to do it, as I always had success.
Remember, informed consent: explain what you are going to do, and ask "May I touch you to do this procedure?"
Thanks, Gary, RN,MSthe

By Blogger Cryptoreformer, at Monday, May 5, 2014 at 4:24:00 PM PDT  

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