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A nna,1 a new Latina nurse, prepared for what was next on her shift: she had to go change a catheter for Alan, a young white man. As she gathered her materials, Anna thought about how uncomfortable she had felt the first time she changed a catheter as a nursing student. She marveled about how it did not bother her anymore , but it did sometimes still make her nervous. “When did that change?” she wondered. Anna considered the various ways she could act with her patient during the procedure. When she first asked her mentor, Jason, about this, he suggested she could try not talking as a symbolic way of showing her respect for her patient’s privacy. However, Anna knew that talking could serve to help keep her patient’s mind on something else. From talks with senior nurses, she was beginning to understand that establishing some intimate connection with her patients was necessary for them to feel safe and to feel better, and it seemed to help patients trust her and the hospital. She did not want to seem “uncaring” like her colleague, Joyce, another new nurse, who avoided intimacy with her patients whenever possible. At the same time, she admitted she did not quite understand how to be professional and intimate at the same time. What if Alan does something she is not prepared for? What if he becomes aroused? What if he feels violated? What if he does not like Chicanas? Should she involve Maura, his wife? Would that make him more or less comfortable with the situation? Introduction Fantasies and Realities in Nursing Care 2 IntroductIon Inserting Alan’s catheter went well. As she performed the procedure, Anna asked Alan personal questions and shared some information about herself . They discovered that they were both army brats as children and could relate to each other on this personal level. Alan seemed fine when she was finished. He breathed a sigh of relief and thanked Anna. She asked if there was anything else she could do. Maura said, “Um, no Anna, we think you are great. We were just wondering when we would see Alan’s nurse—you know, the one in charge of his care. We have some questions about his diagnosis, his procedures, and when he might see the doctor.” Anna half-smiled and said a little hesitantly, “I am your nurse” and pointed to her badge. Both Alan and Maura appeared embarrassed. Alan looked away, and Maura blushed. At the same time that Maura started apologizing for their mistake, Anna said, “I can get you another nurse if that would make you more comfortable.” “Oh no, that isn’t necessary,” Maura said. “We just didn’t realize . . .” she trailed off. Anna was embarrassed and worried, but she put those feelings aside and reasserted professionalism. She offered to sign Maura up for the hospital’s patient advocacy program, PAL. She explained Alan’s plan for the day. She promised to tell them both when they could expect Alan’s physician. Although Anna knew she had handled herself well, she left the room feeling frazzled. Did she do something to make Alan and Maura think she was not their nurse? Perhaps she should have brought in her clipboard? Maybe she should wear her name tag in a more prominent place? Then again, she knew she had introduced herself to them that morning as their nurse. Her name was on the board in their room, indicating she was the RN. How could they not know? Anna was assigned Alan the next day, and unfortunately, things took a turn for the worse. Alan’s illness had progressed, and he was feeling significant pain. When Anna went to check on him, she found a very worried-looking Maura and a very frustrated Alan. Alan cried out that he needed his medication . Anna gently explained that he was not due for his medication for another two hours. Alan was furious. He told her that she was so nice yesterday; he just thought she would care for him when he needed it. He started yelling at Anna, cursing at her, using racist and sexist slurs, and saying derogatory things like “Why don’t you go back to where you came from?” Anna was shocked. Feelings of humiliation and anger poured over her. When she left the room, Alan called out, asking for a “real” nurse. Anna was especially embarrassed because Alan’s room was right next to the nurses’ station...

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