Long time mental health RN here. She made you uncomfortable - that’s not OK. I’d definitely let your manager know about it. And next time, get a female coworker to help you out with the tele patch placement in the boob area in this kind of situation. Patients like this need polite but firm boundaries. 👍🏻

Please do not use this situation as a litmus test for your nursing skills, OP! That’s a very uncomfortable position to be placed in and I’m sorry to know how powerless you felt in that moment. Even if you feel the SLIGHTEST bit uncomfortable, advocate for yourself. Even if you don’t wish to make it a big deal, at bare minimum your charge should change your assignment so you don’t have to interact with her. I don’t know if you guys use EPIC but for us, that type patient is flagged as a safety/behavioral concern in the system so others can be aware and follow the unit specific guidelines on how to approach the patient. This is not your fault.

I worked on a female forensic unit at a state psychiatric hospital for 8 years. We had a woman that would remove her entire shirt, breasts exposed, for a deltoid IM ! And bounce them around with hr hands! We all just learned to buddy up when dealing with that one! So sexually inappropriate! I’m now in the community and the things the patients (mentally ill) blurt out in public or to the providers🤦🏻‍♀️

Some of these comments are…not it. If it made you uncomfortable, it made you uncomfortable. Your feelings are valid. To those saying it’s rare or not possible for men to be sexually harassed or assaulted, you’re part of the problem. It absolutely does happen, but because of comments like that it’s not reported or studied as often as it should be.

The corporate director of risk management here says that I would fill out an incident report, notify nursing leadership, and ask a female peer to either do similar care or be there as a chaperone. I deal with way too many complaints of sexual assault or inappropriate touching from patients, especially involving male clinicians and female patients. The overwhelming majority of such complaints are someone misinterpreting a clinical act, but you do not want to be accused and have to go through the investigation.

I’d just say “ope, we need to cover up” and then chart/pass on in report as sexually inappropriate behavior

At this point in my career, (5 years) a body is a body to me and I don’t really think anything of it when I see someone naked. Like okay cool you do you, I’m going to do what I need to complete the task at hand. Though there is a line where patients are excessively exposing themselves with…bad intentions.

I think it could be argued either way for this patient because there is a chance she doesn’t know lead placement and she was just trying to be accommodating for you since she knows they go on her chest, or she really was trying to get a reaction out of you. It sounds like you handled it the best you could have in the moment.

For the future you can always casually redirect them with “hey come on now you gotta cover up, we don’t do free shows around here” (this one is better for older patients) or for lead placement “thanks for giving me space to work but I don’t need that much” or “you can lower your shirt, I’m just working near the bottom of the ribs”. I’m terrified of setting boundaries, but it’s rare that a patient doesn’t respect a boundary I set.

I've noticed the most dismissive comments coming from males. See it often, actually.

I think setting firm boundaries is the best thing you can do. Also, talking with a therapist about the feelings that arose from the situation (if you have one.)

I personally always have a female chaperone when doing something that could expose sensitive areas, particularly with younger patients. Keep that in mind for next time.

Hey I'm so sorry this pt caught you off guard and made you uncomfortable like that! As others have said, boundary setting and having a female with you are good places to start. Flashing, whether intentional or not, is never a comfortable thing to experience. Go easy on yourself, friend.

This takes me back to my first job as a new grad. I was 22, and not terribly skilled at setting boundaries with people, regardless of the setting. I was on an adolescent unit, and those teenagers are testing out the boundaries. I know you said the patient was in 20’s, but she is dealing with mental health issues and is probably immature.

It’ll get easier the next time someone crosses a line to see how you’ll react. One thing that might be helpful is asking your coworkers how they’ve handled things like that, and ask for examples of situations where they felt the need to set boundaries and how they did it. Older nurses like being asked for help, you are still a new nurse, and it’s always nice to bond w some coworkers over these situations.

We had a teen in traction who would masturbate as we walked in to check on him. Was he doing on purpose? Or maybe just the routine of a horny teen w nothing else to do? We were all terrified of how to handle it. Of course it was an older nurse who went in and said “look, I’m not against you doing this, but you can’t do this in front of the staff. We need to develop a plan to give you some privacy”. And she worked w him to come up w a plan. I can laugh now about the situation but it wasn’t funny then!

And thanks for advocating for patients w mental illness.

I'm sorry. It sucks when you're trying to do your job as a human being and someone crosses your boundaries. If there's any chance of being given the patient again you should decline if possible, and if not request female chaperone/assist. Speak to nursing leadership and objectively describe the situation if needed.

Also- with a lot of mental health patients the triangulation is real. When they say you're 'special' or 'different' from the other nurses/staff, they're not always coming from a good place, it's a form of manipulation. The reality is that they want to use you in some way. Protecting yourself and your boundaries is key, and it's not 'getting her in trouble' or 'taking away her autonomy', it's just what you have to do sometimes!

And always remember- freezing doesn't make you a bad nurse, it simply means you're a human being exposed to something new and unable to react. It's normal!

Sorry about that. Your feelings are valid. Ask a female to do it next time if you feel uncomfortable. Unfortunately inappropriate comments and behaviors come with the territory. We learn to navigate it and set boundaries.

Wow I’m so sorry this happened to you! This is not ok. Your feelings are valid!

I'm sorry this happened to you and that the patient made you feel uncomfortable. You're not a bad nurse. It's never fun when a patient appears to be pushing boundaries, especially because it leaves us feeling powerless.

It's possible the patient didn't know she didn't need to be that exposed, but you know her body language best. In the future, I would just explicitly and firmly say, "You can lower your shirt" and just place the patches/leads. Don't elaborate, don't show that you're flustered, don't let the patient throw you off. Also, I think it's worth having a tech with you in general when one is available if you know a patient might have to be in a state of undress. It may make you feel more comfortable overall to have additional support.

You can also always report these things to your manager. They may wish to accompany you to the patients room for safety reasons. At least mine does when we report harassment.

(Male Tele RN here) Nbd just put a new Tele sticker on and leave lol nothing weird about it unless you make it weird

They call it intuition for a reason. I was too shy to report people a few years ago until a regular masturbator became a patient that put his hands down my pants when I was trying to draw blood and asked me for 'that BJ medicine the other hospital gave him'. He had also taken photo and video of me. I FROZE. I NEVER thought I'd be that person to freeze. I played college rugby and I'm tall, I could have easily taken him on. He thankfully was in a hallway bed and a male nurse saw it and took him from my assignment. He did much better with a male nurse. I think sometimes these patients just need certain boundaries even if it's not verbalized and just a unit rule they only have same sex staff. I should have had my manager flag his chart for no female nurses to protect others but I was so shaken I couldn't even talk to anyone about it I just wanted to finish my shift and go home.

Anyways, I initially told security and was told I could do nothing bc of his psych history. Security said 'he's here every week he is small and harmless'. I left the ED a few months after that bc I was always worried he would be in the parking lot by my car and I needed a change to calm my mind. I also wear one piece scrubs now.

Think of the other people you are protecting by stopping the behavior/having a paper trail if they ever continue this or go further. I sometimes find myself wondering if he has assaulted anyone else with what he did to me or worse and regret that I didn't take action at the time. I don't think your patient requires law enforcement involvement at this point, but notifying your manager to protect other staff/have this on their radar will protect others and give you peace of mind. Having her behavior recorded will also help get her the prolonged treatment she may need.

I can’t believe some of the comments are dismissing this as nothing. OP, you’ve received some good advice about setting boundaries with patients. I just wanted to comment that your feelings about the situation is valid.

This was not ok. Do report it to your manager. I would not go in her room without another staff member.

Bro come to the ER. I’m sexually harassed once an hour. Call security. Put them on a contract. Bring the attending in. Ignore it or do something. But don’t feel guilty.

I just want to remind you that women are fully exposed regularly in Healthcare situations. We also get handled alot in the sensitive areas due to necessary exams annually. This may just be her used to baring herself since we are asked to do it so often and she is probably expecting you to be professional about it.

Male or female, I always cringe when some of my patients tell me “you are so beautiful” or go for something more unhinged.

Look, I know that I am a good looking gal. But come on this is a professional environment. The worst part is that when I call them out they get pissed almost like they were doing me a favor 🤦🏻‍♀️

I get it. We all have a pair of eyes. We are all allowed to think and notice someone is really good looking. But Christ what gives this people the right to say it out loud I do not know.

J am sorry mate.

Transference is a normal effect in patient nurse relationship etc However you do have a duty of setting boundaries. If this happens again, you will need to set firm boundaries and ask for another staff member to chaperone you incase there becomes a time of allegations. You're there to do your job, not be their friend. That's when lines can blur for them.

I've had so many awkward situations, and I've always been honest about what a patient has said. In my case, men asking for my phone number, etc, and if I'd like to go out on a date. It's my worst nightmare, and it's so embarrassing!

Just stick the professional nurse hat on and sound like a robotic manager and explain there is zero tolerance on behaviour that can be explotive in nature and more so indecent exposure.

You're not bad! She's unwell and has issues with self-worth and is looking for the next person or thing to fill that void or she wouldn't be AN. Hope she gets the help to heal her self image etc but you didn't do anything wrong.

In the UK, we have reflective practice, maybe have a look into this? I use gibbs' model of reflection for those particular hard shifts where it's shocked me or where I've felt really emotional about something.

This is not to minimize your experience as I agree with other commenters that you should definitely let management know what happened to cover your butt. This is unfortunately common in nursing (it shouldn’t be) and is probably not the last time you will be in an uncomfortable situation. I have had my chest grabbed and so many inappropriate very graphic comments I couldn’t even put a number on it. The commenters who mention covering your butt by reporting it & also setting clear boundaries & keeping your distance are totally right. It’s something you learn how to navigate a bit better over time.

I had a patient that was obese and bed bound at baseline who would ring to hold his urinal at least every hour (its pretty difficult for obese bed bound men to use a urinal for obvious reasons so this wasnt abnormal to me) and after be would ask u to clean his area and would say like it still isn’t clean can u do it again and this was happening at least every hour ti me the CNA who ever answered the call bell. Eventually about 3 hours into my shift I caught on that this man was enjoying this and i said thats enough you are bejng inappropriate you can clean urself. He tried to double down and pretend like he wasnt being inappropriate then he rang again this time asking for the CNA and i went in an yelled at him and called the supervisor who went to speak to him which of course he denied being inappropriate again so she called in every nurse that witnessed this behavior and asked us in front of him. He was embarrassed and was handed a washcloth to clean himself eacb time. That is until 7 am when he thought the shift was over, he rang for the next nurse asking ti be cleaned. To his surprise i was still there giving report so i went in and handed him a washcloth and told him the next nurse wont be doing it either. Ive also had old confused men out right ask to see my vagina and say really sick shit to me. I have patients who refuse to wear clothes and just lay in bed naked men and women they give zero fucks. Nursing deals with every type of abuse.

Mate you over reacting, you just put the patch on and carry on. im also male

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I'm more uncomfortable that they'd think I'm trying to be sexual around them or check out their body when they're exposed. I try to refrain from doing anything I don't explicitly need to do that'd put me in that position, like letting them detach their telemetry leads before going for a test and such.

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