Nursing: Single Sex Wards Essay Example

patient (Savage 1987). In mental health cases, it can be challenging for patients to share deeply personal information unless the environment is conducive.

Therefore, it is the nurse's responsibility to make sure that the patient is satisfied with their key worker and is given privacy to comfortably share personal information. This philosophy is also emphasized by Edwards (1998), who believes that patients should always feel comfortable and never embarrassed during any interaction. Nurses are trained to view patients as individuals rather than just illnesses.

Is the suggestion here that the nurse's professional image is now less safeguarded and more emotionally involved? This, in addition to the endorsement of the nursing process that cultivates a stronger connection between nurse and patient, adds to the perplexity surrounding nurses' identity and role, especially for male nurses. It is essential to thoroughly analyze the relationships established between nurses and patients as they significantly influence the standard of patient care.

By establishing these relationships, nurses are able to effectively assess patients' needs and provide more precise care. All approaches in psychiatry concur that delivering this kind of care will enhance nurses' comprehension of the patient's illness (Heron 1993). Mental health nursing encompasses both planned therapeutic interventions and informal supportive discussions between nurses and patients that do not necessitate specialized training. These interactions share a common feature.

According to Rogers, Pilgrim, and Lacey (1993), communication is the exchange of verbal or nonverbal information between two or more individuals. Effective communication skills are crucial for nurses when interacting with patients as it ensures their safety and well-being. We will delve deeper into this topic later on. Supportive interventions often involve expressing genuine concern for a patient's

well-being through both verbal means, such as saying "I want to help, I understand," and nonverbal means, like holding their hand.

According to the author, the male nurse must grasp how the patient perceives him, as this is crucial for their safety. This comprehension can be attained through exploring the idea of socialization. Throughout this process, both genders are taught that women should offer care and nurture, while men should act as protectors (Edwards 1998).

The text suggests that the perception of male nurses has shifted from an acceptable social role to an unacceptable professional role. The author agrees with this perspective, as their own beliefs about male nurses were challenged. The author recognizes the influence of societal teachings and personal experiences on one's beliefs, some of which may be subconscious. This realization prompts the author to acknowledge and appropriately question these beliefs. The author ponders how deeply ingrained beliefs about male nurses may affect the general patient population. Furthermore, professional socialization further complicates matters for male nurses, as they are taught to maintain objectivity and efficiency in their care, potentially reinforcing a less nurturing image for male nurses. This approach would align with societal values, but contradicts the encouragement of compassionate gestures such as hand-holding during invasive procedures. The author wonders how patients interpret and respond to a male nurse's display of care and kindness. Are these gestures perceived negatively or sexually due to societal norms regarding masculinity, or are they seen as genuine concern for the patient's well-being, similar to how female nurses are regarded? The author expresses difficulty in finding the right balance in addressing these issues.Firstly, the nurse must engage in self-reflection regarding

their own practice. This critical incident took place during my initial branch placement on a ward that caters to women with acute mental health issues.

A 63-year-old woman expressed concerns about experiencing auditory hallucinations. I scheduled a follow-up appointment to explore this further, but advised her to try and relax in the meantime. Upon entering her room, she was visibly upset and tearful, expressing fear and requesting my presence for reassurance. Sympathizing with her distress, I agreed and positioned myself beside her. However, after approximately 5 minutes elapsed, a staff nurse urgently summoned me from outside the door. The nurse informed me that I had unintentionally exposed myself to potential danger.

If I had been accused of abuse, I would have felt uncertain about how to defend myself. It left me feeling confused about the proper way to address the situation. I reflected deeply on what actions I should have taken and why I hadn't recognized this issue earlier. Additionally, I contemplated the appropriate measures for handling similar incidents in the future. These inquiries burdened me, and seeking answers from my colleagues and consulting the trust policy proved challenging. One major concern brought up by this incident was the interaction between male nurses and female patients.

Harrison (1992) states that trust and confidence in the nurse are essential for a successful Nurse-Patient relationship. The nurse must be attentive to patients' emotions, provide care and assistance, and respect their privacy, dignity, and autonomy. Bignall (1999) emphasizes that these attributes cannot be disregarded.

Bignall (1999) highlights this by suggesting that if a chaperone were proposed in a certain situation, the patient might question the nurse's trust by asking, "Why do you

need a chaperone? Don't you trust me?" This could potentially make the patient feel uneasy and hinder their ability to express genuine emotions.

Despite the patient's agreement to have a chaperone, they might still experience discomfort and embarrassment when discussing information in front of another person. According to literature (Rogers, Pilgrim, & Lacey 1993), patients value nurses who demonstrate respect and concern for their well-being. Therefore, it is essential for nurses to prioritize the safety of their patients. Instead of solely focusing on personal protection, an alternative method could involve asking the patient if they would like someone to accompany them by saying "Would you like someone to be with us?" If the response is positive, then the issue can be resolved immediately or revisited later.

It is the nurse's duty to record and inform other staff members if the patient refuses a chaperone. This indicates that the nurse should consistently offer a chaperone, but not enforce one. Some argue that having someone else present could disrupt personal interaction or upset patients. According to Bignall (1999), women appreciate being offered a chaperone but may be reluctant to request one. Bignall also stresses that patients have the right to make informed decisions and preserve their autonomy in any interaction.

The importance of offering a chaperone, regardless of their sex, should be emphasized. It is recommended that a chaperone always be offered as part of good practice. However, staff on the ward argued that this is impractical due to the shortage of nurses. To address this issue, it is recommended to document the offer of a chaperone to protect oneself legally. The nurse-patient relationship involves communication through both verbal and

non-verbal means, and this communication should be skillfully utilized.

For instance, if a patient's behavior is worrying, the nurse should assess this behavior by limiting physical contact, avoiding unnecessary eye contact, and adjusting their tone of voice accordingly. In simpler terms, they should remain neutral (Edwards 1998). Non-verbal cues are hard to manage. They provide significant information to the other person, so nurses must be conscious of them. If controlling these cues is not feasible, the best action might be to remove oneself from the situation.

The nurse's self-awareness is crucial for effectiveness. Touch is a significant non-verbal communication tool for nurses, and it should be a compassionate response to a patient's situation, based on empathy and genuine care for them as an individual (Savage 1987). Expressive touch is not obligatory as part of a task, and mental health nurses utilize this type of touch more frequently than any other (Edwards 1998). As a naturally tactile person, I faced challenges with this form of communication and needed to understand the boundaries associated with it.

According to Savage (1987), the crucial factors in determining the significance of touch are the person being touched, the type of touch used, and the overall contexts. She also highlights that touch safety is influenced by the patient's illness. In addition, concerns are raised by Webb (1994) regarding the care provided to patients with a history of sexual abuse. It is emphasized that touching can be easily misunderstood in such cases, highlighting the importance for male nurses to be more attentive to appropriate touch. One approach to assist nurses in achieving this goal is actively listening to patients' experiences within their nurse-patient relationship.

Research

suggests that sexual abuse is prevalent in mental health nursing, with studies indicating a high occurrence of such incidents. For instance, Nibert et al (1989) found that 38% of inpatients reported being victims of sexual assault. It was observed that women were more vulnerable to experiencing this form of harassment. These findings raise concerns regarding the employment and effectiveness of male nurses in all-female environments. Additionally, Feinemann (1998) acknowledges an increase in sexual assaults; however, these issues have not been consistently addressed.

According to the American Psychiatric association (2001), it expels around 12 members each year for various forms of patient abuse, primarily sexual. Additionally, Bakers (2000) report on behalf of 'Mind' reveals that when sexual harassment takes place, the patient is often not believed. In some instances, staff suggested that an attractive patient should be more cautious. It is our responsibility to ensure the protection of these patients, so how can male nurses safeguard female patients from abuse?

Despite the introduction of single sexed wards, the issue still persists within the nurse patient relationship. Mental health nursing involves deeply personal and occasionally intimate interactions. This can result in mutual sexual attraction between the nurse and patient. Therefore, male nurses must acknowledge and address these natural and common feelings within the confines of this professional relationship, despite their taboo nature.

The nurse-patient relationship can result in patients being sexually, emotionally, or financially exploited by nurses due to a power imbalance. Nurses must comprehend how patients perceive them and adapt their behavior accordingly. Unfortunately, this aspect is often overlooked during training. Although we are taught about the importance of addressing patient's sexual needs, there is no guidance on handling

situations where patients make advances towards us.

Freud (1914) cited in (Corby 1998) has long recognized that an erotic component can emerge in the nurse-patient relationship via transference and counter transference. However, this attraction is not directed towards the nurse as a person, but rather towards their professional role. Despite the awareness of this issue, nurses often resort to insinuations and feigned sexual appeal as a means to influence patient compliance (Webb 1994). As an example, a nurse might say "come on do it just for me".

Being a male nurse, I find this practice completely unacceptable as it can be easily mistaken for genuine sexual attraction and can be seen as an abuse of power. According to Webb (1994), conflicts arising from these issues can disrupt the therapeutic relationship, highlighting the importance of effective communication with both the patient and colleagues. As Savage (1987) points out, sexual attraction can and does exist in the nurse-patient relationship, even becoming mutual at times. This becomes problematic when performing basic tasks like taking a pulse, as these situations can become highly charged with sexual undertones.

If a nurse or patient is attracted to each other, it is seen as abnormal and can affect the care given. Nurses typically handle this by trying to avoid the patient or acting indifferent towards them (Savage 1987). To ensure both the patient's and my safety, it is vital to approach this issue as a nursing concern rather than a personal one. The nurse should stress that these individual sessions are strictly for clinical purposes and not an invitation for sexual involvement. Whitley (1978) supports this perspective.

However, unless male nurses receive support from their

colleagues and adopt an open attitude towards what can be considered as part of human nature, these issues will always remain personal. It is essential for male nurses to acknowledge this reality both internally and among their coworkers. Unfortunately, many nurses avoid doing so due to concerns about professional conduct. If nurses were to recognize and address this issue openly within the team, it could lead to more effective solutions. Professional and user recommendations highlight the importance of creating women-only spaces to ensure safety, dignity, and privacy (Baker 2000).

Single-sex wards have been implemented to address the issue, but this does not address the problem of male staff abusers. Perkins & Repper (1998) argue that it is important to consider factors such as race, ethnicity, age, and class. They emphasize the importance of culturally sensitive mental health services that include separate areas for women who would typically prefer some separation from men. Given that the ward often has Asian patients, male nurses must respect and adhere to cultural norms regarding male-female relationships.

Whether touch should be used, whether a male should be the key-worker in this instance, etc., the RCN (1994) recommends that nurses should listen to and accept as legitimate the experiences and needs of women who use the services. This will make them more empathic, a concept that is at the heart of nursing. The patient has the right to every consideration of privacy during their stay, and the nurse must ensure confidentiality. However, this poses a dilemma: how can you ensure privacy when the advice is to talk in a more public place or have a chaperone?

Privacy allows the patient or nurse to be

sexually expressive, raising questions about whether the nurse should offer privacy for one-on-one interactions at all. Privacy enables conversations with the named nurse that others cannot hear, which benefits patients with mental health problems. It seems that pressing for increased patient privacy is not in the nurse's interest.

Recommendations for practice for assuring protection for both nurse and patient include:

1. Familiarize yourself with your job description, including its limitations and expectations.
2. Stay alert and focused at all times.
3. Record observations objectively, timely, accurately, and completely. Document any concerns regarding a patient's behavior to protect yourself from accusations.
4. Inform your colleagues about these concerns and discuss ways of addressing them.
5. Maintain a professional rapport with the patient throughout your relationship.
6. Conduct assessments that cover key issues such as the presence of a history of abuse, relationship needs, and personal preferences for a male or female key worker.

7. The needs of vulnerable women and the risks they face are recognized and dealt with.
8. The established policy and protocols for staff working with vulnerable patients of the opposite gender are identified. These matters are included in the trust-wide policy, which states that any staff conducting physical examinations must be of the same gender or have a chaperone present. Nonetheless, this policy is not always adhered to, raising concerns about potential hidden agendas and issues regarding communication and transparency. These unanswered questions may be brought up in a tribunal or court proceedings, and it is the responsibility of nurses to address them with evidence. The main findings of this paper emphasize the importance of better education on the subject of sexual attraction between

nurses and patients, which can be discussed in academic or professional environments. It is vital for male nurses to be self-aware, while also placing greater emphasis on appropriate non-verbal communication, especially touch.

It is necessary for trust policies to explicitly address issues regarding sexual attraction or abuse. If the profession fails to acknowledge the significance of taking a more transparent approach towards this matter, individual trusts should consider having a dedicated counselor available within the hospital for nurses to consult about this specific issue. This is because it is unlikely for it to be effectively addressed during supervision sessions. Additionally, it suggests that healthcare providers should regularly offer chaperones and whatever approach a ward decides to implement, it must be consistently applied.

Recognizing and questioning societal values ingrained since childhood is necessary for male nurses. This helps them become more skilled, capable, and protected individuals. It may be tempting to see oneself as the victim in these situations, but the true victims are the clients who have experienced abuse. Therefore, addressing this issue by raising awareness and acknowledging that nurses are professionals and human beings is essential.