From The Rainbow Machine: Tales from a Neurolinguist’s Journal by Andrew T. Austin.
The meaning of an intimate experience cannot be read from the physical action alone. A procedure can be routine to the professional and deeply awkward to the person receiving it. An interaction described as humiliating can be unwanted in one setting and deliberately sought in another. Context, choice, expectations and the relationship between the people involved alter what is happening.
My memories of nursing contain many examples of that gap between the outside description and the experience from within. They also contain reminders that age and distance change the way we interpret our own history. It is easier to sound measured about a workplace after we no longer have to return for the next shift.
A colleague’s change of career
Sarah is a pseudonym for someone I knew during my student days. After qualifying and becoming dissatisfied with her job, she chose a very different occupation: working as a dominatrix. The name protects her identity, and there is no need to add identifying details to make the point of the story.
What interested me was the contrast with nursing. As she described her work, clients paid for a particular kind of verbal humiliation without physical contact. It was an arranged interaction that they sought. Meanwhile, hospital work could involve extensive physical intimacy that patients would never have chosen for its own sake.
A description of the occupations might make one appear respectable and the other transgressive. That description does not tell us how exposed, embarrassed or in control a person feels within either encounter. The professional label and the person’s subjective experience are different kinds of information.
The comparison is about context and consent, not a claim that every encounter within either occupation is safe or beneficial. The fact that somebody seeks an experience does not remove the need for boundaries. Equally, the fact that a procedure has a clinical purpose does not make the patient’s discomfort unimportant.
Leaving the hospital with a scene
I stopped working clinically in hospital around 2000. For some years afterwards I used my nursing qualification in occupational health, advising companies about matters such as sickness absence and workplace health. Leaving the hospital itself, however, was less dignified than this orderly career description suggests.
I was unhappy with a situation and made a scene. I removed my name badge, threw it on a desk and announced that I was leaving and would never return. Looking back, I find the performance childish and embarrassing. At the time, the feelings behind it were intense.
My recollection of the workplace includes severe staffing pressure, demanding work and the knowledge that mistakes could have serious consequences. It felt impossible to meet expectations with the resources available, while criticism still followed when the work fell short. These are memories of the environments I worked in, not a description of every hospital or of current staffing arrangements.
The relationships inside such a workplace can become intense too. People share experiences that are hard to translate into an ordinary conversation at home. A well-meant question about whether the day was pleasant may seem to belong to a different world from the shift someone has just completed.
Inside and outside perspectives
Hospital work is one example of an occupation with an insider and outsider divide. Emergency services, the military and other demanding workplaces can create similar difficulties of translation. The person outside may care very much while still having little idea what the work actually involves.
Distance has helped me see aspects of my nursing years more generously. I am no longer in the same emotional frame, facing the same workload or preparing to return tomorrow. That difference should make me cautious about attributing all of my changed perspective to wisdom. A changed environment is part of the explanation.
When somebody describes a difficult job, an outside observer can mistake their own distance for superior judgement. It is useful to ask what the observer is no longer required to experience. Being able to talk calmly about a situation is different from having to live within it.
The assumptions attached to a male nurse
People occasionally asked whether being a male nurse attracted negative assumptions. My experience was largely that people outside the hospital expressed respect or said they could not imagine doing the work themselves. I did not routinely receive the kind of direct hostility that the question seemed to anticipate.
Inside the hospital, a different awkwardness occurred. When I approached an older female patient to do my job, a relative would sometimes make a fuss about a nice young man arriving for her. Occasionally a colleague did it too. An ordinary care interaction acquired a sexualised or teasing meaning that I had not introduced.
I used to imagine the genders reversed and wonder how the same performance would be received. The comparison exposed a cultural assumption: that one form of teasing was harmless or complimentary while another would be recognised as inappropriate. I am describing what I encountered, not claiming that women working in care never experience sexualised remarks.
The patient’s perspective also matters. A joke directed at a member of staff can alter the atmosphere for the person receiving care. People should not have to laugh along in order to preserve a comfortable relationship with those responsible for helping them.
Preferences are not obvious from stereotypes
Another surprise concerned intimate procedures. I do not recall a female patient objecting to my involvement simply because I was a man. I do remember male patients asking for a male nurse when one was available. Their preference was more common in my experience than I had expected.
That recollection does not establish a rule about what men or women prefer. It demonstrates why the preference needs to be asked about rather than inferred. My own idea of what would feel more comfortable did not reliably predict another person’s answer.
Familiarity, age, embarrassment, previous experience and the nature of the task may all be relevant to a person’s preference. There is no need to invent an explanation for them. Listening to what the person requests is more useful than fitting them into a theory about their gender.
An ordinary action becomes an embarrassing moment
One particularly awkward memory comes from preparing a patient for an angiography procedure. Part of the preparation then involved shaving the groin area. The patient was about my age, which made the situation feel uncomfortably easy to imagine from his position.
As I worked, the razor became clogged. Without thinking through the setting, I blew on it to clear the hair. I looked up and met his eyes. Neither of us said anything. We continued as though the moment had not happened.
The story is a recollection of an old practice, not procedural guidance. Its interest is the sudden collision of routine and intimacy. To the staff member, a small action can feel automatic until the other person’s presence becomes newly apparent. The patient has been present throughout.
Dignity requires that awareness before an embarrassing moment forces it upon us. Explain what is needed, allow questions, notice discomfort and give the person room to state a preference. A task can be familiar to the practitioner while remaining unfamiliar, vulnerable and intensely personal to somebody else.