Demystifying sexual connotations: A model for facilitating the teaching of intimate care to nursing students in South Africa

Abstract

Intimate care comprises physical touch that involves inspection of, and physical contact with body parts, which can cause embarrassment to the patient and the nurse. [1] It is further described as task-orientated touch to areas of the patient's body that might create feelings of discomfort, anxiety and fear or might be misinterpreted as having a sexual purpose. [2] Patients seek physical or psychological care at healthcare institutions. Nurses provide care that meets the needs of the patient, and these needs may require a nurse to be physically and psychologically close to a patient. This closeness could include exposure of private body parts, touching of the naked body and sharing of intimate information with a total stranger. When providing physical care, touch is necessary and an essential and intrinsic part of a caring profession, [3] as it facilitates communication between the nurse and the patient. The interactions between a nurse and a patient are classified as intimate because they cross the patient's physical and psychological private zones. [4] During intimate care, a nurse and a patient need to establish a relationship in a confined space, where a patient has to allow a stranger to access his/her body's most intimate parts and, in turn, the nurse has to see and touch a body that is not theirs. [5] Touching the patient's body may initiate feelings of discomfort, [3] because the care involves parts of the body that need to be touched. There is reluctance in using the concept 'intimate care' in the nursing profession. This is based on the assumption that establishing an intimate care relationship with a patient is a violation of the personal and professional ethical boundaries between nurse and patient. [6] However, in the execution of their duties, nursing students are expected to touch areas of a patient's body that are considered private and emotionally sensitive. Many nurses are young, inexperienced with regard to social maturity and responsibility, and may struggle to take on the professional responsibility of providing intimate care to diverse patients, who are strangers to them. [7] Professional intimate care responsibility is entrusted to students, and they are expected to excel at it. However, little is known about how nurses learn, rehearse and incorporate appropriate touch strategies, and there is no model for the use of intimate care/touch in a non-sexual context. [1,2] Nursing students also receive limited instruction in this regard from nursing education institutions (NEIs). [8] Young nurses are rudely awakened to the reality of intimate care work once they are placed in the clinical area. At the onset of training, they do not necessarily understand the degree to which nursing care includes intimate care and the discomfort they may experience in such situations. [7] To add to the complexity of this issue, South Africa (SA) is challenged with increased gender-based violence against women and children. [9] Within this context, men and women choose caring careers, such as nursing. The patriarch...

Journey less travelled: Female nursing students’ experiences in providing intimate care in two nursing education institutions in Gauteng province, South Africa

“…The provision of intimate care transforms private and personal activities into a social process shaped by complex beliefs, behaviours, attitudes and cultures (Thompson et al 2021 ). The nurse comes into contact with a patient’s body, and the patient allows a nurse to touch his or her body (Shakwane & Mokoboto-Zwane 2020a ). Touch cannot be avoided when caring for the patient’s body and often it includes exposing a patient’s sensitive body parts.…”

“…When providing intimate care to female patients, the majority of participants experienced refusal of care and discomfort because of the age difference. Nursing students are novices in age, social maturity and responsibility (Crossan & Mathew 2013 ), and age is pivotal in accepting and rejecting intimate care (Shakwane & Mokoboto-Zwane 2020a ). Some female patients refused intimate care because the participants were young.…”

“…Nursing students enter the nursing profession with their socialisation, values and beliefs about touch and intimacy; such practices are generally private and happen within the safe space of a family (Mainey et al 2018 ). South African nursing students are from diverse communities, so nurse educators are challenged to facilitate methods of intimate care that are culturally and religiously acceptable (Shakwane & Mokoboto-Zwane 2020a ). Providing intimate care can be stressful for nursing students; touching patients’ private body parts may evoke feelings of distress and apprehension (Mainey et al 2018 ).…”

Degendering Male Nursing Students’ Intimate Care Provision: A South African Perspective

“…A theory-generative study was conducted, with multiple phases published elsewhere [10,18,20] this manuscript presents descriptive phenomenological experiences of male nursing students in providing intimate care to diverse patients. A phenomenological study focuses on the conscious experiences of the participants and gains meaning from a phenomenon [21].…”

“…O'Lynn and Krautsheid [9] expanded the definition of intimate care as task-oriented touch to areas of patients' bodies that might produce discomfort, anxiety and fear or be misinterpreted as having a sexual purpose. It also involves physical and psychological closeness between a nurse and a patient; a nurse touches a stranger, and a patient allows a nurse to touch their body [10]. The areas of the body that are touched during intimate care provision include genitalia, buttocks, perineum, inner thigh, lower abdomen and breasts [11].…”