AIBU to expect female only nurses on a gynae ward?

[PanamaPattie]

My vulnerable elderly aunt has recently had an hysterectomy for ovarian cancer. During a telephone call, she became very upset because she had her catheter taken out and was helped to shower by a male nurse. She didn't feel that she could complain as she was afraid of repercussions.

Am I being unreasonable to expect female only care on a gynae ward - considering the intimate and invasive nature of care?

@Cheshirewife

Why should a hospital change their staffing based solely on your views?

If I need treatment, I genuinely couldn't care less about the sex or gender of the clinician.

Good for you? Can you not see how some women might be uncomfortable with a man assisting them in the shower? I'll give a hint, it's nothing to do with them thinking that man personally is a deviant.

If a patient feels unable to say no then they have not given valid consent. The onus is on the HCP to ensure they have valid consent.

If a patient does not indicate a 'no' verbally or non-verbally (shaking their head, for instance) but goes on to let the HCP proceed with the care (getting out of bed to walk with HCP to shower room as an example), this is deemed implied consent and is valid.

It wouldn't bother me so you are unreasonable to say they should all be female however it is not unreasonable to request a female nurse for intimate duties so I suggest you do that and all will be well

I feel uncomfortable, exposed, generally vulnerable. There is no logic behind this. It’s just how I feel

In a world where foetuses are aborted for being female and violence against women is so overwhelmingly a male crime its completely rational to feel a degree of fear and caution when exposed to an unknown male which is why chaperones are supposed to be provided.

If a patient does not indicate a 'no' verbally or non-verbally (shaking their head, for instance) but goes on to let the HCP proceed with the care (getting out of bed to walk with HCP to shower room as an example), this is deemed implied consent and is valid

Deemed by whom? The consent needs to be given explicitly and not in a situation of vulnerability. It should be part of the checking in system and in an atmosphere where the patient is free to decide, not at the point where a male HCP/HCA comes to take a vulnerable and fearful patient off to the shower.

I cannot get over the number of posters saying "I'm ok Jack" or claiming its somehow "not fair" and that women's needs must again be surprised so that they can be nice to mens wants.

Patients over the last year have had delayed treatment, limited treatment and most of all no visitors to advocate for them in person. Apparently though their needs don't matter and we shouldn't expect better from our NHS?

Actually shocked at this thread and the results of the poll. And this is a site of predominantly women and mothers.

YANBU at all OP. Intimate care by another female should be a right for all women should they wish it.

As for the argument about lesbians, so stupid. Lesbians aren't known to be predators. Men are.

@gorngss

Actually shocked at this thread and the results of the poll. And this is a site of predominantly women and mothers.

YANBU at all OP. Intimate care by another female should be a right for all women should they wish it.

As for the argument about lesbians, so stupid. Lesbians aren't known to be predators. Men are.

Especially as a really high proportion of staff in nursing and HCA roles are women, it's not demanding something hugely unobtainable.

YABU. There's intimate care on all wards. You can always say if you would prefer a female to assist you, where I work this would always be accommodated.

Intimate care by another female should be a right for all women should they wish it.

But she didn't express her wishes.

Deemed by whom? The consent needs to be given explicitly and not in a situation of vulnerability. It should be part of the checking in system and in an atmosphere where the patient is free to decide, not at the point where a male HCP/HCA comes to take a vulnerable and fearful patient off to the shower.

Deemed by law. Implied consent is a real thing. Best practice would be to get verbal consent in terms of personal care though but not everyone talks.

www.cqc.org.uk/sites/default/files/documents/rp_poc1b_100476_20110331_v1_00_sn_consent_updated_for_publication.pdf

It's really important for preferences to be expressed at start of stay or before any procedure or care. But again the onus isn't on the HCP if the patient can clearly see and hear that the carer is the opposite sex.

HCP’s are well aware that patients will not always speak out for a number of reasons and this should be taken into consideration

They are also aware that many patients will feel very vulnerable

It’d an essential part of the role to be respectful around boundaries as much as the treatment allows for this (I’m well aware some seem to lack empathy)

@shivawn

YABU. There's intimate care on all wards. You can always say if you would prefer a female to assist you, where I work this would always be accommodated.

Intimate care by another female should be a right for all women should they wish it.

But she didn't express her wishes.

Do you not see how someone who may feel unable to communicate this confidently in this situation?

I think for so long the medical profession was populated mainly by males, women have become conditioned to accepting gynaecological exams and obstetric care by male practitioners. Conversely, nursing and midwifery care has traditionally been performed by female caregivers. I think this is why many women are prepared to accept (or are resigned to) receiving intimate medical attention from a male doctor, but dislike the idea of intimate care provision from a male nurse. However, since women have now entered the medical profession in large numbers, I don't see why it isn't standard for gynaecological medical care to be administered by females.

In my early twenties I had to have some sort of scan on my heart. I was naked from the waist up; my chest was slathered with some sort of gel and in addition to the person checking my heart, there were two male medical students in the room observing the procedure. These students were both male and about my age. Both were perfectly professional, but it was still a really uncomfortable experience! I never sunbathe topless, and am just not comfortable in those sorts of situations.

I'm sorry that some male nurses are sad and uncomfortable at the thought that they wouldn't be welcome at the side of a woman in a vulnerable state. However, I'm sure that good male nurses would completely why a patient might have that mindset.

Btw, I agreed to the medical students watching me because back when I was 20, I didn't want to seem 'rude'.

Today I am older and more assertive.

Especially as a really high proportion of staff in nursing and HCA roles are women, it's not demanding something hugely unobtainable.

You'd be surprised. I worked overnight in a care home with mainly female residents (18) and 3 staff members (2, of which, were male sent by agency due to staff shortages-females specified but not available). If a resident wanted immediate toileting and help with personal care (and, often, this was required due to incontinence needs), there was no choice but to have the care of a male.

Deemed by law. Implied consent is a real thing. Best practice would be to get verbal consent in terms of personal care though but not everyone talks

Your link is to CQC guidelines. Implied consent is real but it has to be given freely, particularly when removing someone's sex based rights (which removal of access to female intimate care will do).

Additionally CQC from memory advises a chaperone for male on female intimate procedures.

There was no consent "implied" simply because a vulnerable 82 yr old women didn't fight off the male carer. That is victim blaming.

Implied consent is a thing....but, the Commission also requires trusts to ensure staff act in accordance with their own policies. Trust policies invariably require a chaperone for intimate care.

Implied consent is not about simply assuming consent if someone acquiesces to an instruction.

Example of implied consent being, if a HCP says can I just check your blood pressure and the patient rolls up their sleeve voluntarily and holds their arm out.

Example of it not being implied consent being nurse saying, “ I need to take your catheter out. Lie back and draw your legs up and let them flop apart. Might sting for a moment.” That is a directive order, not implied consent. No consent has been sought. There is no suggestion it is optional or there are alternatives.

It's really important for preferences to be expressed at start of stay or before any procedure or care. But again the onus isn't on the HCP if the patient can clearly see and hear that the carer is the opposite sex.

That is entirely incorrect. The onus is always on the practitioner to ensure informed consent is obtained. It is never the requirement that the patient needs to demands their wishes are considered. Preferences isn’t the issue. Legal consent is.

I understand how distressing this was for her because she is elderly. She could have requested a female nurse.

It wouldn't bother me. Nurses and doctors just see us as human beings and nothing more. I had a variety of male and female nurses and doctors when having my DS. I just wanted someone competent and they were.

If a male nurse or carer is not actively seeking consent to provide intimate care and suggesting verbally or by implication that there is no option but to have a lone male carry out the task to someone vulnerable, then there is a safeguarding issue.

That differs from a gynaecologist who will always have a chaperone or assistant to carry out an intimate clinical procedure. It differs in theatres where there is a team - although hospitals should (and do) still try to provide a female theatre team, if requested.

It's weird isn't it that it's usually only same sex nurses we require but don't blink an eye at a man operating on us??

It's weird isn't it that it's usually only same sex nurses we require but don't blink an eye at a man operating on us??

1. some women do ask for female doctors as well as women for intimate care
2. a surgeon isn't with you one on one showering you in the bathroom (potentially whilst you are home alone in the case of home care). They are part of a team of people.

@Twinkie01

It's weird isn't it that it's usually only same sex nurses we require but don't blink an eye at a man operating on us??

That’s about the degree of intimacy.

Nursing is far more intimate than operating on someone. Bathing someone is often done alone, a theatre is full of people. Some people do request female theatre teams. Many certainly request female GPs and gynaecologists.

Having someone rub you all over with a soapy sponge is very different from having, say, a hysteroscopy, where mainly it’s the instruments that touch you.

@gorngss

Actually shocked at this thread and the results of the poll. And this is a site of predominantly women and mothers.

YANBU at all OP. Intimate care by another female should be a right for all women should they wish it.

As for the argument about lesbians, so stupid. Lesbians aren't known to be predators. Men are.

You've completely misunderstood, as have several other posters.

The AIBU wasn't about whether a woman should have the ability to request her personal care be delivered by a woman.

The AIBU was about making sure gynae wards ONLY have female staff working there. As in, staffing a gynae ward entirely and solely with female staff members, as standard.

@Twinkie01

It's weird isn't it that it's usually only same sex nurses we require but don't blink an eye at a man operating on us??

Probably because we aren't awake and so can't feel embarrassed!

In general, I don't think there is much wrong with male nurses providing intimate care - they have seen it all before, after all; however in the case of OP's aunt, I do think they should have taken her feelings into consideration and provided a female nurse. Perhaps the lady is of an age where it was not considered 'right' for men to attend to women in this way.

Honestly it bothers me that so many men are gynaecologists anyway. In my trust all the senior gynaes are men. I refuse to see them now and ask for a woman but i always get someone less senior as a result. Noones ever minded me asking though, ive always been made to feel as if its a totally understandable reasonable request when ive asked female staff to give me female consultants. The only time ive ever been made to feel shit about it was when i was 17 and needing an abortion and when i asked to be examined by a woman, the man said that it wasnt as if a man had never seen down there clearly. I ended up being examined by him. For years after that I didnt make any fuss even if I left feeling shit. Nowadays I ask for a woman. Men are overrepresented in so much of medicine. At least let us have bloody gynae and midwifery. It shouldnt even have to be said IMO. Most women who would be OK with a man doing it would also be OK with a woman doing it and dont have a specific preference for a male gynae. They just put up with it

@MagicSummer

They couldn't take her feelings into consideration because she didn't make them known. If she didn't speak up and request a female then that's a problem. They should have asked consent for the person to carry out her personal care, but if she gave consent they've acted appropriately.

I'm uncomfortable with the idea of mandating all patients over a certain age and of a certain sex only receive healthcare or personal care from a specific sex or gender to be honest. Even the most compassionate nurse, doctor or healthcare worker isn't able to read minds and can't second guess every time they've given consent to carry out a procedure or provide care.