26 Jul, 12 | by BMJ Group
Fiona Pathiraja’s blog “Who are chaperones really for?” set me thinking about my own practice and how nurses react to similar circumstances.
I am a general medical nurse with 35 years of experience. Intimate care of both men and women is central to a nurse’s daily work.
We need to carry out personal care in such a way that the individual’s privacy and dignity is protected. You could call this “setting the scene.” Introducing yourself, explaining what you are going to do in a professional manner, and ensuring privacy, go a long way to avoiding any “misunderstandings.”
Nursing staff do not routinely request chaperones. In my career I don’t recall ever asking somebody to chaperone me. And yet, when I read Fiona Pathiraja’s blog my immediate reaction was, “Fiona should have a chaperone for these procedures, every time.” I have never blinked an eye when requested to provide a chaperone for a medic in my daily work. But I know if a nurse asked me to chaperone her I’d probably think “For goodness sake, just get on with it.”
Well, I would be very wrong. Healthcare professionals must be very aware of the minefield they enter on a daily basis. Allegations of a varying nature are made every day, causing immense stress. False allegations can be avoided by simply making sure you have a chaperone, and of course the desultory sexual innuendo which previously was made so casually will be less forthcoming.
We don’t always have the time to provide a chaperone. There is certainly a cost implication which trusts should be considering. Nursing culture must change and be proactive for nurses’ own protection and that of the patients in ensuring that chaperones are provided every time it is thought to be necessary.
And, spare a thought for lone workers. I have recently been working in industry. One nurse mans a department for 12 hours at night in the middle of a plant of 3,000 men. Chaperone? It’s a foreign word.
The environment we work in and peoples’ preconceptions of nurses can influence behaviour. It is part of our job to undress people, wash every part of their body, feed them, make sure they are able to pass urine and have their bowels open, make them comfortable in bed and on occasion carry out procedures of an intimate nature. Normal working hours do not prevail. Much nursing care goes on through the night.
Nurses get plenty of good press, but there is a whiff of a suggestion in the tabloids at times that we are good time girls rather than hard working professionals doing a difficult job.
And when you least expect it somebody will make a gesture or a request that isn’t quite right. “Nurse I can’t get my pencil in this bottle,” or “When you’ve finished over there come and tuck me in.” Many sexually provocative statements are pretty light hearted and can be dealt with quickly with no offence. But every so often, suddenly, you are in a situation that isn’t right. I remember being pulled onto a bed and kissed all over by a previously charming gentleman. He was strong and I was a bit freaked out. Luckily my colleagues heard the shout for help and I was rescued. This man had gone hypoglyceamic and had no idea what he was doing.
Sometimes people are not aware of what they’re doing, due to confusion or illness. Some are sexual predators who need to be treated with caution, and in the middle are those who feel able to behave in a sexually provocative way. Snide comments, unreasonable requests which when challenged are hurriedly explained away to appear reasonable and making the nurses question themselves. Women can be as predatory as men, male nurses are as vulnerable as female.
It may be surprising to some that age has never been a barrier to either giving it out, or nurses being on the receiving end of inappropriate sexual behaviour. I am in my 50s and am in receipt of as many remarks and suggestions as I was in my 30s.
Becoming comfortable with naked bodies and other people’s bodily functions can take some time. Sexual innuendo is, at any time, insulting to us all, and we need to ensure we protect everybody, especially members of the team with less experience.
Alison Spurrier is a nurse. She has been practising in the NHS for 25 years.