Sex and healthcare....

A light smack on the bottom or some suggestive comments while washing – that happens from time to time. But what happens when it extends to sexual gratification? Nurses in the Netherlands prefer not to talk about it. But some do what’s asked of them by the patient.
“’If you don’t do it, you’re not suited to this job,’ he said. I asked which days he didn’t need it. But he wanted it seven days a week. Right, I just couldn’t work there.”

Helping hand

The 24-year-old nurse, Michelle Bergmans, was hired through a recruitment agency by a man with a muscular disease. He paid the women who came to care for him daily from a specially-allocated home healthcare budget. Michelle was to be one of his carers.
The other nurses demonstrated how they gave the man a “helping hand” during his shower. “Then I was supposed to do it myself the next day”: Michelle was stunned and shocked. She asked the man why he simply didn’t pay a prostitute to relieve him. “That was too expensive for him. What’s more, he’d have to wear a condom, he said.”
Michelle Bergmans refused to work for the man. “Everyone’s free to make his own choice, but I don’t consider it professional.”
She mailed her trade union, NU ’91, which published details on their website. An open discussion with other nurses and with her mentor ensued. She also went to report it at the police, but all they did was to issue the man a warning. In parliament, MPs questioned the health minister.
“We noticed that there was considerable interest in this subject,” explains union chairperson Monique Kempff. “In one case, a nurse on night duty had to insert a catheter into a patient who was unable to urinate himself. The man was watching a porn movie and asked the nurse if she would sexually gratify him,” Ms Kempff read from the reactions on the website. “It doesn’t just happen in hospitals, but also while administering home care to the elderly and the disabled, as well as in psychiatric institutions. And it isn’t just men who ask for it, women do too,” Ms Kempff explains, summarising the reactions.
“The reactions on the site weren’t just about sex, more concerned with establishing boundaries, actually. People want to talk about professional distance. Where do you draw the line in health care?” The union wants a clearer definition of the professional code drawn up. “We even got a lot of support from abroad because we brought this subject into the open,” says Ms Kempff. “Sexual activities are perhaps a desirable part of home care, but they’re not a fundamental part of the package. We’re saying that we’re drawing a line here.”
Ad Poppelaars, a representative for a council for the chronically ill and handicapped, throws the cat in among the canaries.
“Chronically ill patients and the disabled are also people. People with sexual needs. They can’t just go to a café or a club to find a partner. Often the only person they have physical contact with is the nurse. Of course, nurses didn’t join their profession to sexually gratify the sick and the handicapped, that’s not their job. At the same time, we know it happens sometimes. So, don’t point the finger at the nurses who do it, or encourage a prescriptive approach the way the union does,” he pleads.

Sex carers

How then? The union’s chairperson says that, as a nurse, you should try to create a safe environment where the patient feels he can talk about the subject. “Then you can say to the patient: I recognise your need, let me arrange something for you, but I won’t do it myself,” Ms Kempff suggests.
Flekszorg is an organisation set up to provide sexual services for those in care. Dozens of sex carers visit the clients – “heroes” in the eyes of Ad Poppelaars. “But unfortunately, most of the chronically ill and disabled can’t afford their services.” A real solution for the problem doesn’t exist, he claims.
The clear guidelines sought by the union are not yet in sight – the subject is bound to continue to stir up a heated response in the healthcare sector for the foreseeable future.