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.

I would refuse the shower and either be dirty, or find it in me to do it myself. If you mean in general, depends what it is. A dr with chaperone ok ish, an operation where there are always a few people I'm fine. But personal stuff, well I opted out of cervical smears for a reason

Am I correct in that only women can become IDVAs? Or has that changed? I've tried to google and have looked at a few job adverts which specify female IDVAs but I'm not sure if this is standard (it obviously should be).

@Sweetpeasaremadeforbees

Yes I keep meaning to read 'Invisible women'. I wonder whether some of the vitamin/mineral RDAs are based on men's requirements. When you get your blood test results are the normal ranges based on your sex or are they the same for men and women? We know that women and girls require higher levels of iron because of periods so surely the threshold for deficiency in women should be higher?

Yes indeed! Certainly for iron it's ridiculous, the range is based on mens needs not menstruating women, not women having blood loss after birth! Women start shedding hair when ferritin drops to around 70. Yet you will often be told ferritin is good if you are a third through the range. I x 2 whatever RDA are. I'm now with a private doctor to help me get to OPTIMAL levels of what I need.

When you combine the fact some ranges are based on what is optimal for men (who have higher levels of certain hormones that boost the effectiveness of certain vits) then add the fact that you can be barely meeting the middle or scraping the bottom of that range and be told all is good just because you're not totally outside it, it's no wonder women can end up ill.

Womens bodies are designed to nurture a child and give birth. It needs a lot of energy to do this, having optimal- not just adequate vitamins and minerals is often dismissed.

Don't get me started on peri-menopause. Poor thirty something plus woman has brain fog, achy muscles, trouble sleeping, poor memory, and feels miserable.

Progesterone will rarely even come into the GPs mind let alone treating it. As long as you have periods you don't need hormonal help. Woman will very likely be offered ADs if she keeps saying she feels rubbish but 'everything is good'

Cue that same woman developing the 'Medically Unexplained Symptoms'. Autoimmune illness is around the corner.

Yep. ignorance about womens health is rife at a basic level. It's deliberate misogyny in my eyes. Because it's not difficult.

There is male midwives, male doctors, male nurses I really don't see the difference. I bet that a male doctor operated on her!

@20viona

There is male midwives, male doctors, male nurses I really don't see the difference. I bet that a male doctor operated on her!

I am staggered that someone cannot fathom how another person might differentiate between male and female care.

Take it in it's simplest form... a 90 year old spinster, virgin and deeply modest. Could you understand why she might not want to be intimately cared for by a man?

If you can imagine that. You can then imagine a lady who'd had bad experiences with men, and harboured a fear... and why she might not want a man.

If you can imagine that, you can imagine a younger woman, we isn't confident in herself when she's in the company of a men, particularly strangers, and definitely not one who has to administer intimate care.

And if you can imagine that - you should be able to imagine any woman, for any reason, not being comfortable with a man.

@20viona

There is male midwives, male doctors, male nurses I really don't see the difference. I bet that a male doctor operated on her!

You have lost the bet. The surgeon was female.

Big discussion on Twitter about this today (catheters in particular), including some discussion of the conflict between the rights of HCPs who have transitioned and the rights of patients to give informed consent:

twitter.com/FeministRCN/status/1410308173261586442

@VerticalHorizon very well put.

[quote StrawberryLipstickStateOfMind]@VerticalHorizon very well put. [/quote]
Would have been better without so many errors!

Not bad for a bloke though!

@VerticalHorizon

The Society of Radiographers tried to get the TUC to support a campaign to allow men to conduct mammographies.

I wasn't aware that they weren't allowed to.

That makes absolutely no sense. Why can a man (highly qualified, chaperoned) not screen a woman's breasts, but a man can wash and do very intimate offices for a woman who may be elderly, confused, vulnerable?

It's the responsibility of the HCP to ensure that they have the patient's consent, including whether they are happy to be cared for by a nurse of the opposite sex. Never mind, 'she should have asked' - she should have been asked, and in such a way that she felt comfortable saying no if she did not want a male nurse.

Actually this is interesting. Because how do you ensure that you're asking in a way that ensures someone is comfortable saying no?

Obviously in this instance OP's aunt was uncomfortable. But we don't actually know if she was asked. If the nurse in question asked if he could help her to shower or remove her catheter and she acquiesced. Then that is consent given.

Obviously women (and people in general) can be anywhere on a scale between those that are feisty and assertive and those that are timid or have spent their lives being oppressed and find it easier just to agree and cope with the consequences. But in most circumstances a HCP - male or otherwise - has no way of knowing where on that scale the patient lies. So if they are asked, and they say yes they carry on.

Obviously you'd hope that had the aunt been crying or shaking with fear or otherwise clearly distressed he would have stopped and ensured that she was OK. But if she just let him get on with his job and complained to her niece later - how was he to know that her consent wasn't comfortably given?

Clearly what was needed in this case was for the aunt to be asked on admission (or another suitable time) for her preferences in terms of care and caregivers. But whether there is enough time or enough staff to feasibly do that is another matter.

As it stands the male nurse in question hasn't (as far as we know) done anything wrong, hopefully he doesn't want to intimidate or upset his patients. And now the OP knows she can advocate for her aunt and hopefully make sure she's not put in this position again.

I suppose the question is who ensures that vulnerable people without family receive the care they prefer? And what happens if all of the patients request a female or male nurse. At some point presumably there is a duty of care to ensure people are bathed, or that catheters are changed in a timely fashion.... what happens when staffing doesn't allow for this to be done?

Breast screening is quite a brutal procedure. There's a lot of pushing and shoving and squashing of a woman's breasts and it could very easily feel like assault if a man was doing that to you.

All these arguments about how a male HCP is supposed to know whether their female patient consents or not are just further arguments for female only care.

I would be very upset if this happened to me so YANBU. The exact same thing happened to a friend of mine two years ago, she repeatedly asked for a female nurse but was simply told that she did not have the choice.

Why can a man (highly qualified, chaperoned) not screen a woman's breasts, but a man can wash and do very intimate offices for a woman who may be elderly, confused, vulnerable?

Have you had a mammogram? Quite extensive manipulation, squeezing, pulling, pushing and poking of breasts would leave plenty of scope for concern. It would also place a chaperone at risk of excessive exposure. Much better not to have men. There’s no need.

Same with women being bathed by male healthcare staff. There’s very rarely a need. 80% of nursing staff are women. It would be much easier not to have men providing intimate nursing care. Cheaper than chaperoning, less risk for both parties and less concerns about discomfort not being identified.

Obviously in this instance OP's aunt was uncomfortable. But we don't actually know if she was asked. If the nurse in question asked if he could help her to shower or remove her catheter and she acquiesced. Then that is consent given.

No, that is not consent that meets requirements of any trust or any professional body. Unless the options were explained, any risks or benefits made clear and alternatives offered then it is not consent. It is acquiescence, as you point out. Very different to consent.

Clearly what was needed in this case was for the aunt to be asked on admission (or another suitable time) for her preferences in terms of care and caregivers. But whether there is enough time or enough staff to feasibly do that is another matter.

There is a professional requirement to do exactly this at every point care or treatment is provided. Especially if it involves undressing or intimate care. Staffing challenges do not reduce the requirement for obtaining proper consent.

At some point presumably there is a duty of care to ensure people are bathed, or that catheters are changed in a timely fashion.... what happens when staffing doesn't allow for this to be done?

The duty of care is to offer assistance to wash. People have an absolute right to refuse. It is rarely the case that a women would specifically request to be showered by a strange man. It is rarely the case that staffing totals provide more male nurses than female (except perhaps in psychiatry, emergency department and theatres).

I find it quite bizarre and concerning that women excuse this appalling lack of proper care for an elderly, vulnerable women. Even more worrying that some of those making excuses claim to be nurses.

Another NHS professional here.

Any patient, male or female, has the right to request a nurse or HCSW of the same sex as themselves. But I think it's unreasonable to just expect it.
Personally, I almost always ask if a male patient is comfortable with me doing certain procedures or assisting with personal care. I say 'almost always ' because sometimes we don't have any male staff on ward. If that is the case I always inform the patient that we only have female staff that day.
Unfortunately not all nurses or HCSW do ask and just assume the patient has implied consent by not objecting. It takes less than a minute to ask the question.

@LemonRoses

I find it quite bizarre and concerning that women excuse this appalling lack of proper care for an elderly, vulnerable women. Even more worrying that some of those making excuses claim to be nurses.

I’m my experience people who work in the NHS are all consumed by it and don’t appreciate that patients don’t know the ins and outs of their job or what they can or can’t ask for.

I had to make a complaint when I had DD, I was in hospital and one of the midwives said “I’m just going to examine you” then did a sweep without telling me, and when I screamed in pain she got annoyed with me and said something along the lines of well of course it’s going to hurt, what did you think was going to happen? And I had to point out that it was my first baby, first time in hospital, how would I know what she’s going to do unless she tells me?

I was catheterised by a male doctor . He took the opportunity to sexually assault me - he was rubbing local anaesthetic in to me in the wrong areas, for too long . The female medical student with him shoved him out of the way and took over .

I know most men wouldn’t do this but some would and due to my experience I wouldn’t let a male nurse near me, unless a woman was with him .

I also had an experience of being scanned shortly after being given morphine; I was drowsy, female doctor was doing a trans vagina scan - I dozed off, came round to a man holding the wand thing and scanning me (still internally) He didn’t even introduce himself to me . Gynaecology care is fucking horrendous .

Have you had a mammogram? Quite extensive manipulation, squeezing, pulling, pushing and poking of breasts would leave plenty of scope for concern. It would also place a chaperone at risk of excessive exposure. Much better not to have men. There’s no need

Yes exactly. There is no reason for men to be doing mammograms other than the sensitivities of men.

Patients should be asked on admission, preferably by someone of the same sex, how they feel about intimate care and procedures before the situation arises.

What low standards we have come to expect when people describing themselves as as professionals in the NHS take a view of "be grateful for what is there and shut up" and imply women are bigots for wanting their privacy, dignity and sex based rights respected.

What low standards we have come to expect when people describing themselves as as professionals in the NHS take a view of "be grateful for what is there and shut up" and imply women are bigots for wanting their privacy, dignity and sex based rights respected.

Very well said.