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?

@DogsSausages

So what's the alternative if there are no female staff available and the patient cannot wait for someone to be drafted in or finish what they are doing.

If it were me I'd likely refuse the treatment.

@DogsSausages

So what's the alternative if there are no female staff available and the patient cannot wait for someone to be drafted in or finish what they are doing.

And perhaps the NHS should be taking steps to make sure that this isn't actually an issue?

I think there are many reasons why there is a shortage of health staff, not just nurses and doctors, it's not just down to the NHS to fix, however much money there is it wont suddenly make hundreds of staff available. Everyone has the right to refuse treatment but there are situations when a patient is very unwell and wonder if it would be in their best interests to wait for something like a catheter if the female nurse is away for an hour. How do you feel about male patients not wanting personal care from a female or male nurse, no one seems to talk about that so much.

So what's the alternative if there are no female staff available and the patient cannot wait for someone to be drafted in or finish what they are doing

There is no alternative. Not infrequently, requests for staff of a particular gender cannot be accommodated. The NHS is obliged to provide patients with qualified and competent staff, but not to accommodate preferences for staff gender.

Patient preferences over staff doesn't stop at gender either. I've had a patient express dissatisfaction at having a pregnant staff member (me). Colleagues have had patients refuse them due to their ethnicity.

How do you feel about male patients not wanting personal care from a female or male nurse, no one seems to talk about that so much

I feel like they should be able to ask for a male HCP if that's what they want to.

However I don't think it's entirely the same scenario or are that they are as vulnerable as women when women receive care from a male HCP.

The vast vast majority of violent/sexual crimes are committed by men. So it's not really much of a worry for a man receiving care from a female HCP, is it.

The NHS is obliged to provide patients with qualified and competent staff, but not to accommodate preferences for staff gender.

You mean sex. I'm not interested in the 'gender' of a HCP but their biological sex.

And that may be the case but I as a patient also am not obliged to have to receive care from a medical professional I don't want treating me and would also have the right to refuse. Whether that's in my best interests or not is irrelevant- that's my choice.

I think it’s unreasonable to expect female nurses only on any ward, but absolutely not unreasonable at all for your aunt to request a female nurse and for that to be respected.

I agree. I’ve experienced verbal abuse and lack of consent from female hcps in gynae and obstetrics when I was pregnant with my first and during labour so I’m always a bit wary. Saying that, the times I have had a male in gynae or obstetrics there has always been another female present.

@Thatsmydaughterinthewater

YABU to expect that the onus should be on the hospital to elicit consent for a male nurse to provide nursing care. It was reasonably foreseeable that your relative would be cared for by male staff so if she was really uncomfortable with that she could have told them in admission.

Someone needs to read their professional code.

Treat people as individuals and uphold their dignity
To achieve this, you must:
1.1 treat people with kindness, respect and compassion
1.3 avoid making assumptions and recognise diversity and
individual choice

4.2 make sure that you get properly informed consent and
document it before carrying out any action

Your code is very clear and your attitude is in breach. It is for the nurse or other healthcare professional to seek fully informed consent for every intervention. So, yes. this healthcare worker and every healthcare worker should ask before providing any care or treatment.

If the nurses on your wards are not seeking proper consent, trying to offer a same sex professional to provide care and are not explaining this to patients nor offering a chaperone, they are not only in breach of their code of practice but generally of their trust policy. It is a disciplinary offence. See examples of policies below. As a nurse, you should hang your head in shame at your comments. You and every other nurse, are required to put the patient' needs first.

www.surreyandsussex.nhs.uk/wp-content/uploads/2014/11/Intimate-Care-policy.pdf

www.whittington.nhs.uk/document.ashx?id=479

www.whittington.nhs.uk/document.ashx?id=479

Strawberry Absolutely, patients have the right to refuse care, as long as they have the capacity to do so. They also have the right to go to another hospital, where it may be possible to accommodate their request.

I have only ever seen this angst about gender versus sex on this forum. When some requests a female doctor, they have not quizzed me about my biological sex versus my gender.

@PanamaPattie

When my aunt was admitted to hospital, she was dropped off at the hospital door by her daughter because she had to go into the ward on her own. My aunt does not have a mobile phone and had to rely on the nursing team to pass messages to and from the family - hence her fear of complaining - she was afraid she wouldn’t get any messages. My aunt was operating on and was in the care of a female gynaecological oncologist. At every pre op appointment my aunt was seen by a female member of staff. It never occurred to us or my aunt that there would be male HCP working on a gynae ward. The family did not feel the need to advocate for her because we and my aunt assumed there would be a female team. We didn’t find out about the male member of staff until my aunt came home and was crying as she told her daughter about the catheter and shower.

@PanamaPattie

Your update is still quite unreasonable,especially assuming that going to hospital for gynae procedure will warrant female-only care.
Your aunt was probably helped by male porters,her ward/opearting theater- cleaned by a male. Anaesthesiologist could be a male,theater nurse could be a male.What if a female consultant had an emergency and your aunt was operated on by male doctor?

I have only ever seen this angst about gender versus sex on this forum. When some requests a female doctor, they have not quizzed me about my biological sex versus my gender.

I don't really think it's 'angst' to want the correct terms to be used or to believe that biological sex is what counts- lots of us don't even believe in 'gender' and think it's a social construct.

Believe it or not I've never 'quizzed' a HCP about their biological sex either. I've never had to- it's always 100% obvious.

So what's the alternative if there are no female staff available and the patient cannot wait for someone to be drafted in or finish what they are doing.

Patient in cardiac arrest or hemorrhaging might require a opposite sex professional to intervene - although in those situations there is usually more than one person present, so a chaperone.

A catheter removal is not usually an emergency. Having a shower is not usually an emergency. Its quite simple; "we only have Bert around at the moment, but Sally will be working later and you could have a shower after lunch, if you are happier with a woman helping you". " Your catheter needs to come out today and I can sense you might prefer a woman to do that - I'll ask matron when she's on the ward, if you don't want me to do it".

Most men having male procedures will be cared for by a female nurse. If she’s not comfortable she can ask to change. In my honest experience, my male consultant was much kinder and more gentle than the female one who I felt treated me very roughly.

It was your aunts right to request a female nurse and if she had she would have been given one

But do I think we shouldn't allow male nurses to work on gynecology wards? Of course we should. A nurse is a nurse.

Such a good point by Lemonroses. A lot of the time it's not emergency care- it's very basic things that can wait if a patient prefers.

I wonder how many male hcp deepdown hope they dont get asked to carry out personal care

I agree there @DogsSausages- although they know it could be an element of the job?

@m0therofdragons

Most men having male procedures will be cared for by a female nurse. If she’s not comfortable she can ask to change. In my honest experience, my male consultant was much kinder and more gentle than the female one who I felt treated me very roughly.

Yes, but we don't reasonably anticipate or fear her doing anything untoward (I'm male).

Again, nobody's denying a man can do a great job and be extremely respectful. The issue is that a woman can simply not want a man for other perfectly valid reasons, which are nothing to do with his ability or manner.

In the simplest of cases, it might just be simple modesty. In the worst, it may be a genuine fear.
I suspect most nurses, male or female, would accept it's perfectly legitimate to want a same sex nurse, however, the NHS as an operation may well be less concerned.

Your aunt was probably helped by male porters,her ward/opearting theater- cleaned by a male. Anaesthesiologist could be a male,theater nurse could be a male.What if a female consultant had an emergency and your aunt was operated on by male doctor?

Unless the hospital porters also routinely wash people’s anuses, I fail to see how any of this is relevant.

I'm not talking about what might be reasonable or unreasonable to expect today. I'm well aware that nurses and HCA today work on whatever ward regardless of sex.

I'm suggesting we should change this.

Redeploying HCAs would be the easiest first step and would make the most difference. It's a non-specialist role and involves very intimate care such as washing, dressing and toileting.

Many posters who think OP is being unreasonable are partially basing their opinion on 'yeah well, lots of men would prefer a male HCP but they don't get the choice either'

What is stopping NHS trusts from moving male HCAs to male wards and moving female HCAs to female wards? Wouldn't that be better for everybody?

I am not saying that male nurses are not capable of doing an excellent job. My view is why would they work on a female gynaecology ward where it’s possible that not every women will be happy to be cared for by them. Why work on a ward where your best efforts may not be appreciated? Perhaps they have no choice - I don’t know how the NHS rota their staff these days. Wouldn’t a male nurse need a chaperone to protect themselves and their reputation? Wouldn’t this double the staff needed?

I would imagine there are significantly more female HCA's than male.
Given this, it should be feasible to provision enough female HCA's to cover female patients, or at the very least, activities that require intimate health care, whilst the remainder of joint female and male HCA's can cover the men.

Perhaps there are more complexities, indeed there almost certainly are, but on the face of it, it's workable.

Patient preferences over staff doesn't stop at gender either. I've had a patient express dissatisfaction at having a pregnant staff member (me). Colleagues have had patients refuse them due to their ethnicity.

Do you think these things are the same?

Do you think we should just have mixed sex everything? Hospital wards / bays, public toilets, changing rooms, homeless shelters, refuges, prisons etc.?

Do you think equality means just treating everyone the same? The equality act would be a helluva lot shorter if that's what it meant.

No. Just no. I am a nurse and if my male colleagues had to do that for every female patient who required basic nursing care they would never get anything done. Totally impractical.

Is it that much different to explaining what you're about to do and asking for consent which surely should be done anyway?

@DogsSausages

The male care workers and nurses I know don’t dread it in the slightest. It’s an incredibly routine, everyday part of their job. If they dreaded being asked to do it then they’d be spending their whole working lives with a sense of dread!

One aspect people tend not to think about however is that when it comes to GPs, the less often they deal with a specific issue the more deskilled and unconfident they become in it. DH as a doctor has always suggested I see a female doctor for breast exams or cervical/vaginal issues, purely because the male GPs do them less frequently so tend to be more cautious, less confident, and quicker to refer when a more experienced female doctor would recognise something wasn’t a problem more decisively. I’m only speaking for myself here (no patient owes it to do something they’re uncomfortable with as a learning tool, nor would any doctor want that) but I’m very happy to be seen by anyone for any issue and make it clear I welcome students watching or having a go (for example carrying out a pelvic exam while being assessed by the consultant). It’s in our interests as patients for clinicians not to become deskilled and they do need to be able to learn so as someone who is happy with that I’m pleased to contribute.

As it stands my last cervical check was a female doctor, who said afterwards ‘was that okay? Uncomfortable? I haven’t done one for a while so worried I was out of practice!’ 🤣