FORT WORTH, Texas — Nurses have a professional, clinical and ethical responsibility to discuss and address their patient’s sexual health issues, according to Iris Zink, MSN, RN, ANP-BC, a member of the board of directors and past president of the Rheumatology Nurses Society.
“Sexual problems are frequent in many clinical conditions but are not a routine part of diagnostic workup,” Zink told attendees at the Rheumatology Nurses Society Annual Conference. “Patients will not bring this up with you — it’s very infrequent that a patient will bring this up — but as nurses, we are treating the entire patient. I hear nurses say they don't know how to talk to their patients about sex, but I say, ‘You all have kids, you have had sex — you can talk about sex.’”
According to Zink, multiple disease states — rheumatologic or otherwise — can affect sexual health, including arthritis, psoriasis, systemic lupus erythematosus, depression, Sjogren’s syndrome, cancer and more.
Figure 1. Health care professionals, including nurses, have a professional, clinical and ethical responsibility to discuss and address their patient’s sexual health issues, according to Iris Zink.
Patients with neuropathies and issues with peripheral circulation will commonly experience sexual health issues, Zink said. Such issues can even help alert nurses and providers to any underlying conditions, such as Sjogren’s syndrome or lupus.
“Many of our patients have neuropathies — caused by a lot of diseases — and if you are not having peripheral circulation, ask yourself ‘What is peripheral?’ Your clitoris is peripheral,” Zink said. “So, my patients could have Sjogren’s, or lupus, or rheumatoid arthritis, or a bad back, or whatever — they may have a much more difficult time getting to orgasm. This has come up with my patients, so, do not forget about that. Circulation is important.”
Further, patient concerns regarding sexual health can range from their ability to satisfy their partner, to pain during sex, to communication barriers and anxiety.
Zink added that nurses can help the patients communicate with their partners to improve their sexual health. According to Zink, partners discussing sexual issues with each other should “start with the word ‘I,’” and use phrases such as “I have noticed,” “I like it when,” “I would really like to try” and “I heard a study where people.” She added that partners should “talk with their clothes on first.”
Nurses, providers and their practices also have a responsibility to provide a welcoming and safe space for their transgender patients. This includes using the patient’s preferred pronoun, Zink said.
“This has been a struggle for me because I am old,” she said. “I have two transgender patients and I am certain that I am screwing up how I talk to them. However, we have to make these people feel welcome in our practices. I have had patients call us up and say they are gay, or lesbian or transgender, and ask ‘Is that going to upset you? Because I don’t want to come to your office and have a bad experience.’ So that means asking people how they want to be addressed and using the proper pronoun.” – by Jason Laday
Zink I. Let’s talk about sex: Bringing up intimacy with your patients. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 8-11, 2018; Fort Worth, Texas.
Disclosure: Zink reports speaking fees from AbbVie, BMS, Cresendo and Horizon, as well as consulting fees from Pfizer.