# Gynecology, and Obstatrics



## G-Man222 (Nov 28, 2009)

I'm on personal leave until tomorrow. but gong over some course work while waiting for tomorrow.

Currently getting into female hygiene, and female genital care, and nursing assistants role in female genital care in the gynecological setting, and working Obstetrics.

And a scenario has come up. and I have no clue how to answer it, I've gone through the laws and ethics again, and gone over techniques, but anyways, here it goes:

You're assigned to provide gynocological care to a pregnant female suffering from a yeast infection, as well as remove a catheter, and insert a newer, more sterilized one. the patient has a phobia of physical contact, is mentally unstable, and is suffering from withdrawls. Suddenly, a green vaginal discharge occurs.

The patient is incapable of performing activities of daily living.

How do you proceed?



Personally, I haven't gotten into mental health all that much (it's not emphasized that much).

In regards to military medical, do you gentleman (and ladies, for those few who're on the board) ever work with things like the above"?

What about in NREMT-B?

And in regards to the above scenario, any aid as to how someone on the CNA level could proceed? I know how the catheters supposed to be done, as well as a yeast infection is supposed to be treated, but how should a "priority list" so to speak look like?


Mental issues?

I know how to work individual issues, but never done multiple issues at once.


----------



## Muppet (Nov 28, 2009)

I got to say this is weird but working as a C.N.A. you have obligations to report to a nurse or M.D. I do not know of any C.N.A.'s that do what you are stating has to be done. This is coming from my wife, whom is a OBGYN tech and a nurse friend of mine. The role of an EMT-B does not allow you to place foleys, if that is what you are saying. My answer to this would be to find a female of a higher skill level, R.N. and report to your supervisor. Thats all I have. Maybe the more experienced medical personnel on here can help you. I would not touch that pt. with a 10 ft. pole.

F.M.


----------



## G-Man222 (Nov 28, 2009)

Firemedic said:


> I got to say this is weird but working as a C.N.A. you have obligations to report to a nurse or M.D. I do not know of any C.N.A.'s that do what you are stating has to be done. This is coming from my wife, whom is a OBGYN tech and a nurse friend of mine. The role of an EMT-B does not allow you to place foleys, if that is what you are saying. My answer to this would be to find a female of a higher skill level, R.N. and report to your supervisor. Thats all I have. Maybe the more experienced medical personnel on here can help you. I would not touch that pt. with a 10 ft. pole.
> 
> F.M.


 
I was thinking the same.

But, according to the skillsets of the CNA, any/everything but sterile technique, is the CNAs job. 

Genital healthcare, fi the patient is unable to do it themselves, falls under the CNA to provide, regardless of pt gender, or illness, as long as propper PPE is worn, and as long as it falls under the job description, and training certifications of the CNA. And follows state laws on treatment.

Which that said, is why this scenario has me a bit stunned as to how prioritization of what needs to be done first is supposed to work. 

If this was ever an actual scenario, I'd pray to God the woman would be getting a c-section.


In the healthcare setting of a Nursing Team. this kind of scenario already has the treatments that are needed, vaginal hygiene, new catheter. 

Observation to Report: Green Discharge.

But working the above with a patient who has impairments. idk how that works.


----------



## txpj007 (Dec 3, 2009)

G-man...

judging from your posts, curiosity and more importantly your line of work. i think this forum would be better suited for your questions. http://www.ultimatenurse.com/forum/f122/

the name of this forum is combat medicine...not clinical medicine.  yes combat medics do practice clinical medicine but in the realm your looking for i'd recommend the above link.


----------



## Ajax (Dec 3, 2009)

Dude.....what are you studying to be?

If it's an ethics question, get a female nurse to be in the room while you do the exam. That's a CYA move.  Still not entirely sure what the ethical dilemna is, or why you'd be changing a foley as an EMT.

BTW, just got your note.  Yes, I am sure there is no dive team.


----------



## AWP (Dec 3, 2009)

Advice given, thread is outside of the parameters of the subforum, send hate mail.


----------

