Saturday, December 17, 2005

From the *duh* files...

Nurses face sexual harrassment

Really? You don't say. Grunt Doc, DB's Medical Rants, and Code: The Web Socket have all taken stabs at this; Alwin at C:TWS has a particularly funny experience to recount.

I regularly get sexually harrassed at work by patients; whether it's sweetie or honey pie, or let me fix you up with my son, or even (once) a man trying to pull me into the bed with him for a kiss. It comes with the territory when you're working with brain-injured people. When you're missing part of your frontal lobes, or they've been otherwise damaged, you're not going to have the same control and pay the same attention to social norms that other people do. At any road, it happens at least twice a month.

It also happens to the female residents and doctors. There have been times when I've had to knock on a patient's door and say something like, "Doctor X, there's an urgent phone call for you at the desk" in order to get Doctor X away from the patient who's *sure* that her nephew's business partner's son, who sells used cars in Atlanta, is just the man for her.

The worst is when you're standing over a patient, assisting a (male) doctor with a procedure, when the patient pipes up with "Don't you think Doctor Y is cute?" My answer from the start has always been a puzzled look and "When?"

I have some theories as to why this happens so often. First, it's because some of our patients are brain-damaged. There's not much you can do about that, really. Second, a lot of patients (especially the older gentlemen) seem to think that when one social norm goes away (like I'm wiping your ass for the fortieth time today), the others go away too, and they can say or do whatever they want acceptably. This misconception also explains the amazingly bigoted stuff I hear from patients on a weekly basis.

And, finally, let's face it: a lot of patients grew up in the 1930's through 1950's, a time when nurses were seen as passive, accomodating helpmates. The popular image of the Sexy Nurse hasn't died yet (Google "Head Nurse" sometime and see what you come up with, oi!), but it was infinitely more popular in the days of Cherry Ames and her ilk. (And yes, I know WWII was a different matter, but it was statistically a blip.)

So you've got brain damage, combined with a lack of societal norms, combined with the idea that nurses will do, I mean any*thing* for another person.

The funny thing is this: our facility spends hours and hours teaching young interns how to avoid sexual harrassment by nurses.

I'll wait until you're done laughing.

They don't brief the female residents on how to handle dirty old men or nosy old women. They don't brief the male residents on how to deflect the sorts of questions that make men blush and stammer. And they're certainly not briefing *either group* on how not to make yourself look like an idiot by intimating that certain female colleages get more OR time because they have pretty hair (yes, I heard that one two weeks ago. From a *female* PA, who lost pretty much all the professional respect I had for her).

The point here is that nurses can't win. On the one hand we're being exposed to lecherous weirdos and weirdettes, while on the other, our future colleagues are getting the idea that we're rapacious, predatory, sex-crazed fiends. Our female MD colleagues don't have much more luck. And pity the poor male nurse, who's automatically seen as prissy, if not outright gay. (And anybody who assumes all male nurses are gay is the sort of person who's going to have a problem with gay guys. I guarantee.)

So, okay, what do we do about it?

Well, first of all, nurses' training programs and doctors' training programs can be realistic about the problem. Where I work, there are a lot of young nurses and a whole lot of young residents. Yes, sometimes they do end up dating, but the problem isn't so widespread that it causes problems in the professional arena. So we could probably drop the insistence to the interns that it's the nurses they'll have problems with and save some time and trouble there.

Second, hospitals and other facilities need to be realistic about the problem. The first line of defense is the nurse's own reaction, true, but if the behavior continues, she or he needs to be certain that there will be somebody to back her or him up in her refusal to countenance the behavior. If your charge nurse or nurse-manager falls down on the job, you're left to "solve" the problem on your own, which usually means either getting somebody to go into the room with you every time, or foisting the assignment off on another nurse. Raising conciousness rarely works in such a short period of time.

Finally, families need to be realistic about the problem. Yep, you heard me: I said "families". I've had patients' family members egg the patient on as they were harrassing me or another nurse. That kind of thing usually stops as soon as I get my mouth open. But the point remains that a lot of people seem to think it's cute that Grampa's a tit-grabber or that Papa is a bigot.

It's a weird job we do, nursing. I'm just glad that nobody's tried to get me up against a wall--yet--or done anything really violent. Yet.


HypnoKitten said...

Great post!

I really don't recall any instance where I've been 'sexually harrassed', but then again, I'm relatively new. Sometimes guys will tell me I'm pretty and so nice and jokingly ask if I'm single, but I think that's just their own nervousness and insecurity when it comes to having intimate contact and conversations. I've never been offended by flirting, but I don't encourage it. I'd certainly rather be flirted with than have them in a pissy and demanding mood, but then again, I've never been groped yet. I suppose once that happens, my attitudes will change considerably.

Also - I'd like you to try my new winter drink. A big mug of hot milk with two spoonfuls of dark brown sugar and two quick shakes of salt. It's yummy, and so nice on a freezing cold night.

Glad you're feeling better! :)

Anonymous said...

I did my medical residency in the early '80s and found it"amusing" that we women were routinely called in to stand by while a male resident did an intimate exam on a female patient. No one stood around to protect *my* virtue when I did intimate exams on patients of either gender. In that state, at that time, female nurses were not expected to place foley catheters in male patients. That job fell to the doctor, regardless of the gender. I never felt more neuter.

I didn't get too much sexual harassment from the patients. I looked young (was mistaken for a candy-striper my first month of internship), so it was less of an issue. You had the occasional patient who stood at attention during the exam. As you mentioned, it is more common with the folk whose CNS is not quite up to snuff. I would generally ignore the elephant in the parlour & it would usually go away.

I did have one old creepy guy in my early practice. He kept talking about running away to Hawaii with me & I kept turning him down & reorienting him. He was miffed when one day I came in sporting an engagement ring. He would come in sporadically after that. One day, I realized that I had not checked his prostate in some time. Furthermore, I was *NOT* about to have him drop his drawers under any pretext. Realizing that this was not good medical practice, I had him switched to another doc - male - in the group.

It has gotten better in later years. I suspect that it may be in part because I am unlikely to be still mistaken for a candy-striper. I suspect that it is still difficult for young women, regardless if she's a nurse or MD. A bit of gravitas helps, but it takes a few years & gray hairs to pull it off.


Anonymous said...

ps - forgot to say that I'm glad your tum is better. The stomach bug swept around here about a month ago. No fun. Keep with the juices & resist the urge to advance the diet too quickly.


Michelle said...

As a neuroscience nurse I must say you hit the nail on the head (get it...head). A lot of times we give the excuse of the tumor or stroke making them act that way. I always wonder if that is really what is going on. At least I can make excuses for the patients, not the family members who think nurses "are so sweet and cute". Yuck. Nursing really is a weird job.