Bioethics Discussion Blog: Patient Modesty: Volume 24

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Friday, September 25, 2009

Patient Modesty: Volume 24





The discussion continues by my visitors with their personal experiences and understandings about the issue of patient modesty. However, the discussion also continues to develop mechanisms of how to change the medical system and permit patient expression of their concerns but also the system acting in the patient's favor on them. ..Maurice.

Graphic: An old illustration of a religious scroll but modified by me with ArtRage and Picasa 3.


NOTICE: AS OF TODAY OCTOBER 11, 2009 "PATIENT MODESTY: VOLUME 24" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 25.

139 Comments:

At Friday, September 25, 2009 7:22:00 PM, Blogger Maurice Bernstein, M.D. said...

Alan wrote the following for Volume 23 after I had already closed it down for further comments. ..Maurice.

Hex you wrote my thoughts exactly. Every time we go to a new provider or facility we fill out a new intake form, not once have I ever seen one that asked, whether it be a yes not, 1-5 scale rating, or even a few lines of is there anything we can do to make your experience more comfortable or less stressful. Give the patient the chance to say so upfront. In addition to what Hex said it does something else, it gives the patient permission to bring the subject up, as you stated Dr. Bernstein, providers assume implied consent....patient assume provider resistance or at best, assume providers will assume we are abnormal for bringing this up......also, the key to open communication is trust, when you ask me about something I think you don't care about, that is important to me....your take a large step that way....you have told me how I FEEL matters, I have moved from the rash, or the kidney, or the prostate to the person....you have transcended the physical to the person....when else does the provider ever ask about how I feel...and not mean aches and pains......the simple act of allowing us to make this known on a form means so much more. To me, as Hex stated, its so obvious....but obviously its not, providers focused on the physical perhaps really do look over what we think is so obvious...sort of the empourer has no clothes in reverse. When I fill out the form and say I have a strong preference for same gender providers, when I have an proceedure and a male is available...all you have to do is schedule accordingly....is that really so hard, so disruptive? There is another thing that is so simple I related how a nurse at my PCP asked me IF a female NP in training could observe my physical, on my vasectomy my PCP did it himself, a friends brought in a nurse he knew...all he had to do was ask either on the intake or verbally...if noted on his chart he would have thought to ask....as far as incentive, call, write, e-mai facilities even when you don't need to go there..ask about will the be able to accomodate...etc. if they say no, tell them you were just checking ahead for facilities that can and will...follow up with a letter to the money guys....plant the seed...thats incentive....alan

 
At Friday, September 25, 2009 8:55:00 PM, Blogger MER said...

I offer a few small revisions to Hexanchus's suggestion. And I've made it look like a form. I can see patients handing in a form like this at the receptionist's desk requesting it be read and placed in his file -- and suggesting the office use this form on all patients.


We understand and respect that each individual has his or her own comfort level with respect to privacy and modesty. Please answer the following questions to help us understand your preferences and help us make your visit with us as positive an experience as possible for everyone involved.

1. For non intimate exams or procedures, do you have a preference for the gender of your physician or other caregivers?
_____Male
_____Female
_____Don't Care

2. For intimate exams or procedures, do you have a preference for the gender of your physician, nurses, assistants, or other caregivers?
_____Male
_____Female
_____Don't Care

3. For your comfort, you may request a chaperon be present during any examination or procedure, especially intimate ones requiring any significant degree of exposure. Do you prefer to have a chaperon present during exams?
_____Yes
_____No


4. If yes, do you have a preference as to gender of the chaperon?
_____Male
_____Female

If you have any other specific concerns regarding privacy or modesty, we encourage you to bring them up with your provider at the beginning of your visit, or write them down below.

 
At Saturday, September 26, 2009 9:25:00 AM, Anonymous Anonymous said...

The urologist was sat in the room waiting to see me as part of a list. She assumed it was ok to stay in the room, at no point did she even gesture towards asking me if i minded. The Urologist simply carried on as though nothing had happened once she had left. When I saw him the previous time, it was alone. The nurse was new and i was last on the list, she had self evidently imposed herself on maybe as many as 10 men before me who had said nothing, just had to tolerate her present while they discussed very embarrassing, personal issues, which are hard enough to discuss in even a male to male one to one environment. She should be ashamed of herself. BTW, I am in the UK.

 
At Saturday, September 26, 2009 9:25:00 AM, Anonymous jw said...

Oh and, jw and JW are too different people.

 
At Saturday, September 26, 2009 10:47:00 AM, Blogger Maurice Bernstein, M.D. said...

Perhaps, one of the "jw's" should change their pseudonym initials. ..Maurice.

 
At Saturday, September 26, 2009 11:25:00 AM, Blogger swf said...

PT:
"5)One in 6 americans engage in
privacy protected behaviors such
as avoiding the doctor to seek
care."

Can you reference where this came from? I would like to get a breakdown of stats (age, gender, etc.) and what determines privacy for these people.

 
At Saturday, September 26, 2009 4:17:00 PM, Anonymous Anonymous said...

Excellent suggestion Hexanchus and thank you Dr. B for taking it seriously.

jw - great job! Exactly what I would do.

DG

 
At Saturday, September 26, 2009 8:01:00 PM, Anonymous Anonymous said...

To SWF


www.rense.com/general10/priv.htm

This is just one study where 1 in 6 americans have concerns
about their privacy in general
and mostly involves electronic
data. It does not give a breakdown
on gender,only states that these
would be patients have privacy
protected behaviors as I mentioned
in a previous post. I will provide the statistics on males who don't
seek care for physical privacy
concerns.


PT

 
At Saturday, September 26, 2009 8:31:00 PM, Anonymous Anonymous said...

I think this would be something that we could send to each of our providers and institutions. I think it would also make sense to address the situation frequently occurs for men, my PCP, Urologist, and Dermotologist all employ 100% female staff from the receptionist to the nurses & techs. While it would be good to have the slots to list preference for males, to plant that seed, I think there would need to make preferences known when same gender is not possible. My preference in these cases is, I do not want a nurse present for intimate procedures unless absolutely nesecary. While to patients this seems like a no brainer, that isn't the case. We have seen nurses presnt for vasectomies when all they did was hold the patients penis out of the way, something the patient or tape could have done. We have seen opposite gender techs do intimate procedures when same was available...so I think its important to make that clear. I think this also goes to your comment on 23 Dr. Bernstein. While providers may contend consent to exposure is implied when the patient sees a provider....a patient assumes that consent will be reserved for the benefit of the patient, not taken lightly for the convenience of the provider. I go into care knowing exposure may be a needed to have a through exam or complete an procedure...but I would expect that providers would know that it makes patients uncomfortable, and would be very protective of that consent. I personally feel providers take advantage or perhaps abused the "implied consent" which is given trough the need of the patient to place trust in their caregiver(s). I have felt caregivers have betrayed or abused that trust when they compromise my modesty through exposure to the opposite gender not out of nesecity, but for their convenience....that is putting themselves infront of me on the importance scale. Their schedule is more important than my comfort......alan

 
At Saturday, September 26, 2009 8:37:00 PM, Blogger Hexanchus said...

MER,

I like it! Only one thing I would change:
-In retrospect, I'd use the term "no preference" as opposed to "don't care" - it sounds more professional.

 
At Saturday, September 26, 2009 9:26:00 PM, Anonymous Anonymous said...

I recently had two knee surgeries in the State of Utah, my sister had a surgery on each shoulder and my father also had shoulder surgery. Not once was any of our privacy and modesty compromised during any of these surgeries. We all wore shorts throughout, which was recommended by the medical centers and hospital. We all had the best experiences possible.

Could it be that Morman doctors, surgeans and their staff are more intelligent and skilled? Or is it that high morals and modesty are very important to them? They didn't seem to have any problems working around shorts, so why is it so difficult or impossible for other medical staff to do the same?

They also have plenty of male nurses there in case I ever need intimate care done and the female nurses aren't perverts (as far as I know). Are there far more men going into nursing in Utah or is it simply the fact that more male nurses are hired instead of being passed over for women?

It just proves to me that this kind of respect and care is possible, the medical institutions just have to want to do it. They just have to see that sick and injured human beings are more important than money and their personal convenience.

D

 
At Saturday, September 26, 2009 11:17:00 PM, Blogger MER said...

"D" has brought up an interesting point. That point is -- in some places patient modesty is a priority and is working. There seems to be no double standard in these places. I would think for cultural reasons, Utah would be one place due to aspects of the Morman religion.
Social scientists and sociologists use a research method known as Positive Deviance. I'm describing it specifically for what we're talking about, but it's used in all kinds of areas
1. Look into the center of the institution you want to change. In our case, we're talking about clinics and hospitals. Study what they're doing and how they do it, specifically in areas of patient modesty.
2. Find areas where the problem should exist but doesn't. In this case, the problem of attention to patient modesty may exist in areas where conservative and/or religious values dominate, as in Utah.
3. Go to places like Utah or hospitals that seem to respect patient modesty, places where the problem should exist but doesn't and find out specifically why. What exactly are they doing? How are they doing it? "D" already mentioned specific behaviors he noticed like the availability of male nurses, allowing underwear during surgery, etc.
This is the kind of research that needs to be done. Unfortunately, the medical community seems uninterested in this issue. Perhaps we could get some sociologists to take this on, or psychologists.
By the way, this method was used to solve the Guinea worm disease that devastated West Asian and sub-Saharan villagers. It was led by man named Hopkins. His team looked at the maps, found out where the disease was most common -- but noticed all these little places on the map where it wasn't happening. First they went to places hit by the disease and studied how people lived. Then, they went to those places where the disease didn't exist and studied what people were doing differently there. The basic solution was relatively simple, involving improved collection of drinking water. It's an interesting story.
Maybe certain hospitals and/certain states will become known for their attention to patient modesty. The big word in health care reform today is "competition," especially in regard to insurance companies. But "competition" involves hospitals and clinics. Maybe when the system sees Utah hospitals being flooded by patients because they know their modesty will be respected, the system will start to "get it."

 
At Sunday, September 27, 2009 10:44:00 PM, Anonymous Anonymous said...

High tech hospital equipment
----------------------------------
Godfrey Hounsfield Invented
Allan Cormack CAT SCANNER
awarded nobel
prizes.
----------------------------------
Raymond Damadian Invented MRI
----------------------------------
Ton Brown Invented
Ian Donald Ultrasound
-----------------------------------
Wilhelm rontgen x-RAYS
-----------------------------------
Anthony leeuwenhock Microscope
Gordon Gould electron microscope
-----------------------------------
Guglielmo marconi wireless comm
Alexander bell telephone
-----------------------------------
Albert Einstein Photoelectric
effect,among
other nobel
prizes in
general and
special rel.
-----------------------------------
Without these men we wouldn't
have modern day hospitals.Yet,even men and women should be equally treated as patients and be given the same respect and considerations. Catholic healthcare
west has a sister hospital located
in Gilbert Arizona called Mercy Gilbert medical center 480-728-7253
They have created a womans only
imaging center that is marketed and flyers mailed to female nurses,ma'a and cna,s.

Don't let wait times and unconfortable environments prevent
you from scheduling your mammogram.

Designated registration and waiting areas for womens services
only.Gilbert medical center has
obtained all the female names from
the arizona state nursing boards
so they can send flyers to these
potential female patients.
Seems with this marketing tool
sexism is further ingrained. Do
you think CHW has any interest in
building such a facility for men?


PT

 
At Monday, September 28, 2009 12:03:00 PM, Blogger MER said...

PT -- You need to be really careful about some of your statements and generalizations. I called Mercy Gilbert Imaging Center and got the facts. They have male techs in all areas except one -- know what that area is? Mammongraphy. So -- ironically, it would be a woman who would have a difficult time getting a mammongram with a female tech at Mercy Gilbert. I talked to the people there and the assured me that men would have no problem getting the privacy they wanted.

In the last few days I've made over a dozen calls to clinics and hospitals in my area -- urologists, imaging and radiology centers, etc. Didn't do dermatologists recently, but made some calls to them a while back.

I only found one clinic that didn't have at least one male tech or med asst. -- and they said they had one who left and are looking for another -- but at this time they didn't have one. All others were able to accommodate males.

Now, granted -- these places don't advertise this, and they may not ask for preference when a man calls. But the service is available and these places are sensitive to this issue.

Granted also, that these conditions may be local, regional or statewide, or relegated to a certain hospital or clinic system. There may be areas where this kind of choice isn't available. But I surmise that accommodation is much more available than men think, and that, ironically, there are many places were men get better accommodation than women.

I believe that this male modesty issue isn't so much about the double standard and not being accommodated. It's more about men not speaking up and making their preferences known -- or men not really shopping around to find a place that will accommodate them.

Conclusion -A major effort should be made to educate and inform men that they do have choices. Many men are completely oblivious to this issue until they come face to face with it. Even then, they are not willing to speak up and take a stand. The system appears in willing to work with men much more often than we think. It's up to men to take advantage of this rather than just going along for the ride and then complaining later.

 
At Monday, September 28, 2009 12:21:00 PM, Blogger Maurice Bernstein, M.D. said...

MER, first I want to thank you (I am sure on behalf of other visitors here)on your energetic and valuable resource investigations. I am sure it is much appreciated.

Secondly, MER could you clarify these sentences in the first paragraph "They have male techs in all areas except one -- know what that area is? Mammongraphy. So -- ironically, it would be a woman who would have a difficult time getting a mammongram with a female tech at Mercy Gilbert"?

I have a feeling you were trying to express a different relationship than what you actually wrote. ..Maurice.

 
At Monday, September 28, 2009 12:36:00 PM, Blogger MER said...

Besides the typo, I think it came out as I intended. Mercy Gilbert said at that time they didn't have a female tech to do breast exam imaging for women. Only male techs. That's what I found ironic. We're complaining the double standard and here at a Women's Imaging Center, women couldn't get a female tech for a breast exam.
Is that what you meant?

 
At Monday, September 28, 2009 2:08:00 PM, Blogger Hexanchus said...

MER,

I had the same question as Dr. Bernstein, and I'm still a bit confused....

You originally stated they had male techs in every area except mammography, and subsequently that they had only male techs to do mammography and no females. From your followup post I can only assume (and yes I know the dangers of that) that you originally meant to say they had female techs in every area except mammography.

Completely agree with you that people need to check out the facts before jumping to conclusions based on assumptions.

Interesting that they didn't have female staff to do mammograms - that seems highly unusual. Women should have the same right to same gender technicians as men if that is their preference.

 
At Monday, September 28, 2009 3:14:00 PM, Blogger swf said...

This comment has been removed by the author.

 
At Monday, September 28, 2009 3:20:00 PM, Anonymous Anonymous said...

MER, are you saying that male techs are everywhere and mammography is all male, or that the only place there is male techs is mammography?

Also, I think PT's point is that generally there is little effort to accommodate either men's health or modesty, a position I find accurate despite his choice of example.
--rsl

 
At Monday, September 28, 2009 4:05:00 PM, Anonymous Anonymous said...

Mer

What they have and what they tell you are two very different
things. I have a home in Gilbert Arizona and I checked this facility out myself.
I have the flyer they mailed
to potential female patients, I
don't just post stuff without looking into it. I used to work
for Catholic healthcare west,I
know how male patients are treated
firsthand.
Furthermore would you like to
know just how many male mammo techs
there are in the U.S.? I'll give
you the breakdown state by state.
Don't believe everything these
facilities tell you on the phone,its what they want you to
believe. Do you think you are the
first male to call this facility?



PT

 
At Monday, September 28, 2009 4:07:00 PM, Blogger swf said...

Thank you for the information Dr. Bernstein.

 
At Monday, September 28, 2009 4:24:00 PM, Anonymous Anonymous said...

In the state of Arizona to perform mammography you must hold
an ARRT Licence and a certificate
from the MRTBE. Additionally,you
must have considerable mammo experience to be employed. In
the state of Arizona there are
(0) male mammographers employed.
I'll be happy to give you a
state by state breakdown on this
data. By the way, should anyone not
believe me or that I'm generalizing
you can call the Medical Technology
board of examiners located at
4814 S. 40th Street,Phoenix Arizona
602-255-4845,and as always have a
nice day.


PT

 
At Monday, September 28, 2009 5:05:00 PM, Blogger MER said...

I can see now I wasn't clear. What I meant was that this imaging center had male techs available in every area. In mammography,they only had male techs. No females. No doubt most of their techs were female, except in mammography. But men could be sure to make an appointment to get a male tech.
Of course I'm not suggesting that mammography is all male everywhere. But it was at that place at this time. And it may be at some others -- just as urology and dermatologist med assts. may be all female at other places.
Instead of making generalizations, we need to do the research. Why not have everyone on this blog make a dozen calls or so in your area and ask questions and report back to us. Undoubtedly we'll find differences.
I'll tell you something else, too. In making those phone calls, I talked with many female receptionists. I didn't run into one receptionist who sniggered, or seemed surprised or acted offended that I was checking on this. They seemed quite aware that this was an issue. Ironically, I did find one reception who seemed upset. This was at the clinic that said they couldn't accommodate men. She seemed upset that she couldn't accommodate me and would lose a patient. She kept assuring me that they were looking hard for a male medical assist. Having said that, a while back while making phone calls to dermatologists, I did find one female receptionist who seemed really shocked that I was even asking these questions. Of course, I learned that she worked in a clinic with all female medical assistants.
I also recently called a clinic that advertises not only Women's Health and Children's Health -- but also Men's Health. Most clinics leave out Men's Health. I thanked them. They seemed surprised and gratified that a man actually called to thank them.
In all my research I try to follow the facts to the truth. If the truth upsets me, then so be it. I'm not saying I've found the "truth" to this issue -- but in my region, the facts suggest to me that men will be accommodated if they become more proactive about their health and make it clear they'll find a clinic or hospital that will accommodate them.
I must say that I think the health care system is shooting itself in the foot by not facing this issue up front and advertising that they accommodate patients for gender choice. Many are staffing to do it. So they know it's an issue. Why not use it as a marketing ploy.
When I called these clinics, I asked why they didn't advertise that they can accommodate. This is when I got the deer in the headlights response. Advertise? Why? I told them that instead of calling around to several clinics, patients like myself might just call you first to make an appointment if we clearly knew their policies in this regard. Silence on the other end of the phone line. I could hear the cogs turning. Maybe they'll begin to get it.

 
At Monday, September 28, 2009 6:58:00 PM, Blogger MER said...

PT wrote: "Don't believe everything these facilities tell you on the phone,its what they want you to believe. Do you think you are the first male to call this facility?"

Sorry, PT. I just can't believe the implications of your statement. You're saying these place will simply lie to you? I can tell you the exact telephone number,date and time I called to at the hospital you mentioned. So we could probably track down who I spoke with. Do you think these place will risk simply being dishonest like that?
I'm not even going to say that it would never happen. But that kind of behavior catches up with you pretty quickly. If what you say is true, our health care system is in much more trouble than I ever imagined. Some of the places I called locally willingly gave me a breakdown of the gender of their staff. They're going to lie to me so I make an appointment and then I find out they're not telling the truth? Sorry, I just don't believe that's in their best interest either financially or ethically to do that -- and they know that.

 
At Tuesday, September 29, 2009 8:24:00 AM, Anonymous Anonymous said...

I went in for a colonoscopy requesting same gender only explaining why it was important to me. The doctor assured me there would be no problem.

On the day of the procedure a male nurse walked into the room. I was still awake and threw him out. Next, the doctor handed me forms as they were knocking me out. I didn't have the wherewithall not to sign.

When I awoke, remembering that I'd signed something I made a request to receive a copy of the papers. After three weeks and no copy I called the hospital. The doctor called me back trying to understand why I needed the papers. I explained why and spent twenty minutes telling her off. They reluctantly sent them. After spending lots of time arranging the procedure in a way that was tolerable for me, unknowingly I signed consent for students to watch and for the videotaping of the procedure.

That was the last time you'll see me in a hospital!

As a medical sexual assault survivor, I can't think of a way to further erode trust.
marjorie starr

 
At Tuesday, September 29, 2009 11:21:00 AM, Blogger MER said...

Marjorie -- What happened to you was unethical and probably illegal. Did you report this to the proper authorities and file formal complaints? As patients, we can't let this happen, then not become aggressive in complaining and then later claim that complaining makes no difference. We need to fight these battles in a public forum if necessary.

 
At Tuesday, September 29, 2009 11:53:00 AM, Blogger Hexanchus said...

Marjorie,

I'm sorry for your experience - things like this simply should not occur.

If you were asked to sign forms after being given medications that could in any way affect your judgment then the consent was in all likelihood not legally obtained. If you were being rushed in any way to sign, not given time to read the forms completely, or not told the purpose of the forms, then consent was in all likelihood not legally obtained.

How long ago did this occur? You may still have recourse, although how much depends on how much time has elapsed since the incident.

At the very minimum, I would suggest:
1. Write a letter to the CEO of the facility with the nature of your complaint. Include a chronological outline of what occurred from your initial conversation with the doctor, assurances that were given, subsequent violations of those assurances, etc. Insist that the incident be investigated and that they keep you apprised. Tell them that you feel your consent for the students/videotaping was given under duress and not valid - demand that the original tape and any copies be destroyed and that you are notified when that has completed. The letter needs to be calm, factual and business like, but firm as well. End it with something like "It is my sincere hope that upon receipt of this letter your facility will do the right thing and honor my requests, as my only other option will be to seek legal redress. I look forward to your prompt response." Make it look like something written on the advice of counsel.

2. Send copies of the letter to JCAHO and whatever governmental agency licenses these facilities in your state. Your letter should include a "cc:" list so the CEO knows you are sending this to the others.
3. File a written ethical complaint with your state BOM against the physician for failure to obtain informed consent.

If you have any contacts in the media, talk to them. See if there's an investigative reporter that might be interested in doing a piece on how the medical industry preys upon sexual assault victims and others, subjecting them to completely unnecessary emotional stress for their own purposes that have absolutely no direct benefit to the patient.

As MER said in one of his recent posts, we need to stand up and complain when these things occur. If we don't, then things will never change......

 
At Tuesday, September 29, 2009 1:11:00 PM, Blogger swf said...

Marjorie:

I've re-read some of your posts involving PTSD, and requests to send information involving incidences of inappropriate medical situations.
Is your group advocating for separate legislation (a sort of 'special circumstances' bill) for those suffering PTSD or advocating for everyone to have the right to choose the gender of a caregiver?

 
At Tuesday, September 29, 2009 3:54:00 PM, Anonymous Anonymous said...

Men get breast cancer too,an
unrecognized problem in our society
today. Yes, men need mammograms as
well and one can only imagine what
it might be like for a man to have
to get a mammogram. You arrive at
a clinic with only women there
in the waiting rooms. Imagine the
stares you'd recieve.
Nonverbal stares such as "whats
he doing here,is he undergoing a
sex change or something." Why would
a man be here in our mammo clinic.
Not that the women would have too
much to be concerned about as far
as male mammographers are concerned
as they are about as rare as a unicorn at a hookah convention.


PT

 
At Tuesday, September 29, 2009 4:48:00 PM, Anonymous Anonymous said...

I have had similar experiences as MER, I took it upon myself to call several local hospital and asked if I could have male techs for various urological procedure/tests. The results were mixed, but I live in a rural area and the hospitals are smaller. Those that said they could I thanked and told them I would keep them in mind when/if it came time to get one. For those who only had female staff I thanked them and told them I was going to look for a facility that could accomodate, they were respectful and seemed to understand. That said, I think we would be going to far to say the issue is viewed the same by the medical community. In our area a local hospital opened a women's imaging center to go with their women's health center. The billboard copy "Because Women Have special needs" Women caring for Women.......I also contacted 3 different hospitals regarding their websites asking about the fact that they adverstised women's health clinics, had tabs for womens health, etc....yet if I typed mens health in the search box....nothing...I recieved no response. I make it a point to research before I need a facility, it does a couple things, plants that seed and lets me know before I need them where I want to go. I also make a point of telling those that can accomodate...I will recomend them to my friends....postive reinforcement helps....alan

 
At Tuesday, September 29, 2009 6:15:00 PM, Blogger MER said...

I'd like to see other men on this blog report on their areas as alan and I have. I've checked into some Women's Health Centers. Some have all female staff. Some do have male doctors. Few if any have male nurses or med techs. I'm not saying there is not a double standard regarding men and women's health and intimate care. It's out there. But there's accommodation out there for men, too -- more than we may think.
By the way, let's not let that Mens and Families Health bill get forgotten. Apparently the bill has been brought up for several years and can never get out of committee in the House. I've written to my Senators and Congressmen. I hope we'll all do that.

 
At Wednesday, September 30, 2009 5:38:00 AM, Anonymous Anonymous said...

swf,

Thanks for commenting. After doing seven years of research on the subject and getting nowhere with privacy and dignity, I decided to take a different route.

Several things have occurred. First, studies are now showing that psychological sexual torture has ramifications that are worse than physical. The first item on sexual torture is bodily exposure. Many circumstances in hospitalization with a different backdrop could be considered psychologically the same as torture. It is in the literature that victims of torture outside healthcare have a difficult time with medical care and it's time that the psycho social aspects be examined instead of the patients. Second, Senator Patty Murray (Washington State) introduced a bill supporting female veterans of sexual abuse in combat with specicial provisions for healthcare recognizing that trauma survivors and women (only because the statistics are higher) need special provisions.

So, I decided it's a start as ptsd is recognized as a disability. Forcing opposite gender care on someone who has this disabillity as a result of sexual assault is not only retraumatizing but another assault if the care is forced.

Modesty is a huge issue and I believe everyone has a right to same gender care if they need it. I suppose I'm more objectionable to cruel and degrading treatmetn in healthcare that often accompanies modesty issue . Statistics on medical sexual abuse are on the rise and we see the ramifications in elder care abuse, abuse of the disabled, in our mental health institutions and penal system. It is a systemic problem. All of this abuse centers on public stripping which is a modesty issue.

I welcome anyone to join me or Misty who has an organization promoting modesty in healthcare without these other issues.

Things are starting to change. Title VII recognizes and supports gender discrimination in employment when privacy of the patient is at stake, therefore less male nurses in ob/gyn, mammography suites, etc.
Men need to start exercising their rights by refusing female nurses for intimate care. This will cause hospitals to hire more male nurses.

My experience has shown me as a previous victim of medical sexual abuse, is that what's worse than the offenses is the medical industry's denial that only retards healing on the part of the patient and secondly, that doctors will lie to you, remove your autonomy just to get the job done further eroding trust. The worst of it is that there is no support system for this at any sexual assault center anywhere. I wonder what lobby did that?

Legislating for the disabled is a start for improvement across the board. Once humiliation is recognized for the psycholgicial damage it can do, provisions will be made in healthcare to lessen the risk of trauma to patients, thus the modesty issues. Would you believe that the disability rights organization in my state refused to legislate this issue because they felt the medical community would have strong opposition????

My book will probably be published wtihin the year. While my personal story is part of it, this is really about the medical industry and how they are promoting harm due to the emotion humiliation and what it does to the psyche. We're all blogging on this subject and I haven't heard anyone talk about their feelings of humiliation or degradation based on the way they are treated. This is what is at the crux of this and other modesty blogs.

Many standard of care practices are extremely humiliating when members of the opposite sex are present. Once a research project on the psycho social aspects of medical care that are damaging is completed, things will have to change just as they would take a bad drug off the market. The industry is causing harm to patients, eroding trust, evoking avoidance and in those previously victimized (one in 6 women, one in 33 men) causing a deterioration of mental health from retraumatization.

Anyone wishing to work with me please e mail at: marjoriestar3723@yahoo.com

swf, I hope I've answered your query.

 
At Wednesday, September 30, 2009 5:45:00 AM, Anonymous Anonymous said...

Thanks everyone. While the colonoscopy experience was traumatizing, the original incident involved sexual deviance of a pediatriciation, cruel, public and degrading treatment by staff as a punishment.

while I'm a writer/researcher I'm also a victim. I couldn't report the colonoscopy incident; too traumatized. However, while the legal statute might have run out, you can rest assured I will be taking on the governing body of this major hospital citing the violations and publicly repremanding the doctor who is responsible. This incident has also caused a deterioration of my health by avoidance of all healthcare. Just recently, I started with a new doc, and hopefully things will improve.

 
At Wednesday, September 30, 2009 7:45:00 AM, Anonymous Anonymous said...

I really don't understand why they don't just assume men don't want their scrotums scanned by one or more females. It seems like common sense to me. How can they be so inconsiderate and cruel?

 
At Wednesday, September 30, 2009 7:56:00 AM, Blogger Maurice Bernstein, M.D. said...

Again my mantra:

Those visitors who want to remain anonymous should nevertheless end their comment with some consistent pseudonym or initials. This is important in order to provide readers a reference to who wrote what and to maintain continuity in the discussions. Thank you. ..Maurice.

 
At Wednesday, September 30, 2009 7:57:00 AM, Anonymous Anonymous said...

"Sorry, I just don't believe that's in their best interest either financially or ethically to do that -- and they know that."

Since when does ethics mean anything to clinics like that? Especially the receptionists. I can see them lying about some things just to get you there because they know most people will go along with it anyway and won't walk out on them, especially if they've already made their co-pay.

Which brings up a question I've always had:
If you give all your insurance information at admittance as well as your co-pay, get set up in an exam room just to find out that an opposite gender nurse, tech, aide or whatever will have to be involved with your naked exam or procedure, how likely is it you'll be able to object and walk out without being charged for the visit?

SLO

 
At Wednesday, September 30, 2009 8:04:00 AM, Anonymous Anonymous said...

Marjorie's experience surprises me. I can see that happening very often to male patients but not female. In my experience females usually get what they ask for while men are usually ignored, lied to, laughed at, deceived and ridiculed for having the nerve to request anything.

 
At Wednesday, September 30, 2009 8:05:00 AM, Blogger Maurice Bernstein, M.D. said...

SLO, ah! that's the difference between a doctor behaving simply as a business man and a doctor behaving as what a doctor should be behaving-- a humanistic and caring physician. ..Maurice.

 
At Wednesday, September 30, 2009 8:08:00 AM, Blogger amr said...

Marjorie,

Before you do what Hexanchus suggests - which I totally agree with, the fact that you signed a form that allows them to have observers and take video, doesn't mean that either of those things actually occurred. Both of these provisos are standard for almost any institution whether or not they actually have observers or video. It is put in there to cover their butts, just in case. For a colonoscopy, pictures of your colon are routinely taken as part of documentation of the procedure. I do not believe video of the actual procedure is routinely taken. As a part of your medical legal record, there is a form that is filled out and in your official hospital record that states who was in the treatment room. The anesthesiologist is responsible for filling it out along with the circulating nurse. If it was filled out properly, you will know if in fact students observed. If they covered it up, which could have happened, then it might become a harder issue to deal with. Also, writing a letter to your doctor asking him what occurred could also be helpful. Depending upon how long ago this was however, he might not have a recollection of your case, so you might ask him for any notes he has to back up any of his assertions.

Having you sign these forms the way it happened is all too common. However, actually finding out what happened before drawing your guns I think is the first step.

Also, next time you need to go into a hospital setting, make it clear that you want to look at and sign any and all releases before hand. And find out if they allow you to cross out stuff you do not want. If they don't you can find another institution hopefully that will. At several docs office and for my colonoscopy, I explicitly crossed this stuff out and noted it to the nurse and had her sign that she read the changes.

Also, tell your next doc about this experience you had as a part of your request to read and sign the release docs before hand.

Hope this helps,

amr

 
At Wednesday, September 30, 2009 9:02:00 AM, Anonymous Anonymous said...

I just talked to my parents here in Utah and told them about the problems that men have getting female Ultrasound techs for testicular Ultrasounds and I couldn't convince them that it actually happens. It seems that it isn't done around here and I imagine it's because the medical institutions know that their patients would never allow it. Apparently when patients speak up it does make a difference, along with the fact that many or most administrators have the same high morals that the majority of the Mormons have.

D

 
At Wednesday, September 30, 2009 9:05:00 AM, Anonymous Anonymous said...

Thanks amr but there won't be a next time. I don't care what the cause or consequences I would avoid going; even if it meant life or death. Once your autonomy and dignity are taken there is nothing left. Another negative experience would result in devastating consequences.

My feeling are not from ptsd. They are from refusing to be abused. Subjecting me to opposite gender care is abuse and I have no intention in entering a system that only promotes erosion of trust and refuses to monitor themselves.
marjorie starr

 
At Wednesday, September 30, 2009 9:25:00 AM, Anonymous Anonymous said...

Marjorie,
Do you know if any students actually observed or if videos were actually taken during your colonoscopy? Did you ask your doctor or nurse and do you think they would tell you the truth? Your doctor didn't sound very honest to begin with.

SLO

 
At Wednesday, September 30, 2009 9:46:00 AM, Blogger MER said...

"We're all blogging on this subject and I haven't heard anyone talk about their feelings of humiliation or degradation based on the way they are treated."

Marjorie: I agree with much of what you say, but I can't understand what you write above. Dr. Bernstein's 23 volumes and all Dr. Sherman's threads are full of people talking about these experience. And many threads on these two blogs give links to many other stories on the web.
Have you read Art Stump's book "My Angels Are Come?" If you haven't, you need to. His book is perhaps one of the best fully explained, contextual stories about humiliation in a medical situation.
The stories are out there. Find them.

 
At Wednesday, September 30, 2009 10:59:00 AM, Anonymous Anonymous said...

MER referenced the Men's Health Act, by coincidence I had just checked in on it. The bill would establish an office of men's health under the Dept. of Health similar to the office of Women and family health. The bill was presented in the 106th, 7th, 8th, 9th, and 110th congress and never got out of committee. Senator Henry Waxman D-Ca is the head of the House Committee on Energy and Commerce which have this bill. There are a ton of bills pending in the committee, very few target men's health issues. The bill notes men lead 9 out of the top ten causes of death, 1 in 2 men vs 1 in 3 women will be diagnosed with cancer, the life expectancy gap increased from 1 year in 1920 to 5.2 in 2005. Yet the bill can't get consideration. The bill or lack there of not only highlights the apparent lack of concern for mens health, but also sheds a little light as to why men's modesty may recieve lower consideration. Folks, especially men and the women who care about them....if you don't contact your rep and express outrage about this, you might as well accept part of the responsiblity. AT a time when health care is in the forefront...for this to be happening is very telling. Not only will this office give an additional outlet to address male modesty....it could save your life, but only if you are willing to stand up and make yourself heard......you can see if your rep is on the committee at govtrack.us...even if they aren't demand they contact those that are....alan

 
At Wednesday, September 30, 2009 4:51:00 PM, Anonymous Anonymous said...

I have talked to men that dont want male intimant care. They admit its homophobic. That seems funny because that would admit it was a sexual experince and female nurses dont want to admit that either and say its not. You cant have it both ways.
eoe

 
At Wednesday, September 30, 2009 5:32:00 PM, Blogger Maurice Bernstein, M.D. said...

eoe, I think (though I may be mistaken) this has been the first time in the 24 volumes that the issue regarding homophobia on the part of male patients has been brought up. And as long as we are discussing (as we all have) all aspects of patient modesty, I think this is an intellectual and possibly practical topic to include. The question is what is in the mind of those men who would feel more comfortable with and prefer a female nurse over a male nurse. And, of course, this then may relate to the overall issue of sexual interest or fear in both genders of patients. And if such a non-heterosexual view is prevalent, how that might affect interest in institutions providing further male nurses in patient care. ..Maurice.

 
At Wednesday, September 30, 2009 6:02:00 PM, Anonymous Anonymous said...

New car dealers use the old bait
and switch method. They advertise
a particular vehicle in the paper,
however,once you arrive at the dealership the excuse is always the
same. "Oh,we sold all of those or
would you rather look at this vehicle".
Medical facilities use the same
technique with male patients. I
believe it is productive as Alan
mentioned in that it is a valid
point to call around and plant
that seed of thought. Certainly,
when you call and ask about choices
in the presence of certain genders
they are most always caught off
guard without an immediate response
as silence ensues, particularily
when male patients are involved.
The economy is in a tremoundous
slump as healthcare dollars are
thin and competition is high for
new patients. What a great
opportunity for facilities to
capatalize on only if they could
see it. With the vast majority of
hospital managers being female that
wall is thick and old,but it can crumble and crumble fast.
Few job opportunities are available for nurses as I've heard
one female nurse say that she has
applied at over 70 facilities
without success. Certainly few
medical receptionists are going
to risk their job by telling you
the truth about their ability to
accomodate male patients. No one
really wants to turn away a patient
as I know they have been instructed
not to,irregardless of their ability to accomodate.
Approximately 10 years ago one
hospital in the valley had a policy
that you could re-apply for a position after 90 days if you were fired! You believe that,not anymore. In reality, if fairness
applied and discrimination didn't
exist why would men have to call
around at all! After all do you
think women call to see if there
is a male mammographer at there
chosen mammo clinic or worse will
males watch their gyno exam at
their chosen female gynocologists,
not.


PT

 
At Wednesday, September 30, 2009 11:21:00 PM, Blogger MER said...

PT wrote: "Certainly,when you call and ask about choices in the presence of certain genders they are most always caught off guard without an immediate response as silence ensues, particularily when male patients are involved."

PT -- "Certainly?" My experience has been very different, and I've made dozens of calls. I don't find receptionists generally to be caught off guard. I find most of them open to answering and/or discussing this issue with me.I only found one clinic where the office staff seemed caught off guard. Later, when I talked with the doctor, told me directly that didn't allow his office staff to discuss issues like this. He said that if that made patients go away, the so be it. This doctor ran a very profitable clinic and didn't really need more business. But that was only only one case.

You also write: "Certainly few
medical receptionists are going
to risk their job by telling you
the truth about their ability to
accomodate male patients."

I would think the exact opposite to be true -- that is, they'd be risking their job if the continually, systematically, as a matter of policy, lied to males who called and asked about this. That would be risking their job and their integrity. Remember, it's one thing to just show up and be caught off guard. But the kind of man who would call ahead of time and ask seems to me to be the kind of man who wouldn't be afraid to complain and cause trouble. receptionist who lied to these men on a regular basis wouldn't last long, no would a clinic that behaved this way on a regular basis. Patients aren't stupid. Word spreads.
I'm not saying there's no double standard. In an ideal world men wouldn't have to call to ask about this. But my experience has demonstrated to me that, when they do call, men are most likely to be treaded with respect and taken seriously. And, the odds are that they will find a place that can accommodate them.
In cases where this doesn't happen, when men aren't treated with respectfully and seriously, they need to make a huge issue of it to those who own the clinic and professional boards who license these people.

 
At Thursday, October 01, 2009 10:41:00 AM, Blogger swf said...

PT:
"In reality, if fairness
applied and discrimination didn't
exist why would men have to call
around at all! After all do you
think women call to see if there
is a male mammographer at there
chosen mammo clinic or worse will
males watch their gyno exam at
their chosen female gynocologists,
not."

I do see the point you are making regarding same gender care for everyone, and I do believe it is trickier for men. But, women need more than just mammograms and gyns.
We do call around for things just as men do. And just like men, we don't want to go if we can't get what we need.
The good thing about women like us is that while advocating for themselves, they advocate for their family also. Alot of us are on your side. I'm not sure if you see that.

 
At Thursday, October 01, 2009 3:14:00 PM, Anonymous Anonymous said...

PT
Female patients have the same problem especially when dealing with the operating room or a procedure that requires multiple people.

Here's what Title VII says...basically that you cannot discriminate based on gender, race or religious affiliation when it comes to employing workers. There is an exception, however, based on privacy for example in a ladies room for an attendant's job or...in healthcare. That's why you see higher employment for one gender or the other in healthcare. However, the practice is not dictated from the medical industry but rather from the patients who refuse treatment that dictates their hiring practices. Eventually, it becomes an inherent cultural issue.

People need to speak to someone on the phone when they make their appointments, get their name, state your need and then, when it's not met...you walk. They'll feel it in their pcoketbook and things will change.

The homophobic issue with men makes all of this a little more complicated, but nevertheless just as valid.

Please know that as a woman I support you and your inherent right to have your privacy protected. However, even though you may perceive that it's easier for women, it's not all that easy at all.

We need to work together to genderize medicine. It's the perfect solution; will instill hiring massive amounts of male nurses, increase medical procedures (that many people avoid), and have happier outcomes for everyone.

What about an online petition to be submitted to congress? Does anyone know if these are legally valid?
Margorie Starr

 
At Thursday, October 01, 2009 5:14:00 PM, Anonymous Anonymous said...

TO EOE

You said

" I've talked to men who don't want male intimate care. They think
its homophobic."

If all male nurses are homosexual
as implicated,then why does the
female nursing industry work so
hard to keep them out of Labor and
Delivery?

Furthermore,whats the difference
for a male patient if its the male
nurse or the male physician. Its
called the power of suggestion.

I've never been to nursing school,however,I've read many many
comments about male nurses who say
that every attempt was made to
discourage their progress. Fact of
the matter is in all the years I've
worked in healthcare I've only seen
two male nurses who might have been
homosexual.
I've never ever seen male nurses work in endoscopy either as
I'm sure for the same reasons you don't and won't see male mammo
techs.
Male nurses have been branded
in our society with this homosexual
stigma and whose fault is it. Is it
gradual comments made by female
nurses in an already female dominated industry trying to hold
their ground.
There is an old saying that
you can't write about war unless you've been to war. Many behaviors
have long been forgotten and unfortunately those are the lessons
this generation won't learn from.

Frankly Mer, patients are
lied to every day. Do you really
think that some receptionist who
a week ago sold flowers knows about
staffing or perhaps is going to be truthful with you.

www.scienceboard.net/community/
perspectives.129.html

Take a look at this site
about patients being lied to. Fact
is patients being lied to is one
of the chief complaints patients
have.


SWF, with nursing at 94% as
female please,enlighten me!



PT

 
At Thursday, October 01, 2009 6:48:00 PM, Blogger MER said...

That's a good article, PT, and does back up your point to some degree. 've not experienced being lied to, but I make it clear to my caregivers that I'm the kind of guy that wants to know everything -- the truth. Don't lie to me, and don't even equivocate. When I talk with receptionists, I get their name and I note the time. God help the receptionist that tells an outright lie to me. Hasn't happened yet, to me. Too bad it does happen to some people.
But as patients we cannot stand for this kind of behavior. We must fight back.

 
At Thursday, October 01, 2009 6:56:00 PM, Anonymous Anonymous said...

There are male mommo techs out there. I believe it was MER who posted about that just this week. There are two male techs in mammo where I work. There are also males in L&D there and have been for some time. Not all males are disciminated against in these areas.

And of course many receptionists are honest when you call about same gender care. Yes, they do know about staffing. They work in the office and are surely aware if there are male nurses or techs available. I called several urologists in the area and all but one told me there were no males nurses or techs on staff. The one that told me there was one I knew was being honest because I know someone who goes to that office for care. None of them were shocked or rude about my request.

I took it a step further and asked if I could have a private exam. In one office the recpetionist assured me I could and in the other offices I was passed on to a manager in back. All said an exam could be done privately but if a procedure was needed they wouldn't be able to accomodate. Three of the four suggested trying to have the procedure done in the hospital where I possibly could be better accomodated. These people were helpful and kind as well.

Men not wanting care by other men isn't uncommon. While the whole gay scenario in that situation rubs me the entirely wrong way some men do feel that way and it needs to be respected as much as the men who would prefer same gender care. It's their feeling and right or wrong they are entitled to them.

 
At Thursday, October 01, 2009 6:58:00 PM, Blogger swf said...

PT:

"SWF, with nursing at 94% as
female please,enlighten me!"

What is the question?

 
At Thursday, October 01, 2009 8:01:00 PM, Blogger Maurice Bernstein, M.D. said...

There are still postings by Anonymous with no identifying pseudonyms including the worthy comment at 6:56pm today. Please remember, whoever wrote that one and other recent Anonymous comments identify yourself with a consistent pseudonym or some initials so the discussion can be directed to individual views. ..Maurice.

 
At Thursday, October 01, 2009 10:20:00 PM, Anonymous Anonymous said...

Well,tell me which state you live
in and I'll tell you how many male
mammo techs there are. I already know the answer though.



PT

 
At Thursday, October 01, 2009 11:37:00 PM, Blogger MER said...

This whole issue of males who prefer female nurses is interesting. I know some men who have that preference. Their reason? The sexual aspect of a gay male handling their privates. Gay men are attracted to men. But then, so are hetrosexual female nurses.

As another poster pointed out earlier -- many have no problem accepting or at least understanding why a male wouldn't want a gay male to care for him intimately, even though we don't necessarily believe that most male nurses are gay. And even if they are, that's not to say that they're not professional in this regard -- as would be a female nurse working on a man.

These homophobic men (if that's what they are) seems to be understood in hospitals. Many nurse I've talked with have mentioned this -- men who just won't let male nurses touch them. Note we're talking from patient's perception, not from the nurses perception. And that's I think doctors and nurses sometimes forget -- the patient's point of view.

So -- why don't people more readily accept that a male patient might, from his perception, have uncomfortable sexual feelings with a female nurse? Regardless of how the nurse sees the situation, it may have sexual connotations for the male patient, especially if he is fearful of getting an erection. Doesn't that make sense?

Just because a doctor or nurse, through practice and experience and routine, has been able over the years control these natural feelings -- why do they think a patient, who has not had the years of experience, is able to completely separate the sexual feelings associated with genital manipulation or exposure from what that doctor or nurse sees simply as necessary medical care?
I think this is an area where the medical profession and patients sometimes just don't understand each other. Can a patient feel sexual stimulation even if it's not intended? Of course. Can a patient feel humiliation even if it's not intended. Certainly.
This an issue that is never discussed, especially between caregivers and patients.

 
At Friday, October 02, 2009 12:09:00 AM, Anonymous Anonymous said...

I'm Sam and I was the 6:56 comment.

 
At Friday, October 02, 2009 2:48:00 AM, Anonymous Anonymous said...

eoe,

Who's opinion matters most (concerning whether it's a sexual experience or not), the naked person having having their private parts gawked at and fondled or the clothed person doing the gawking and fondling? We've read many experiences about nurses, etc who complain about patients being too modest and say it's "no big deal, I'm a professional", but when SHE is the naked and volnerable patient it's completely different and she DEMANDS to have it the way she chooses (usually same gender and at a different institution).

Just like in the judicial system, it matters what the VICTIM of a sexual assault believes, not the perpetrator of the crime. Many will say though that it's different because nurses, aides, etc are ENTITLED by law to gawk at and fondle private parts whether the patients (or victims) give their permission or not because most went to school for at least a few weeks and have a piece of paper to prove it. Others say your permission is implied because you voluntarily (in many cases) went to see a doctor, which of course is an open invitation for anyone of either gender wearing scrubs to see and do whatever they want to your naked body. Same thing when you're TAKEN in for an emergency. It's great that there's someone to take care of you in an emergency but for every person that actually help you there are many others that just watch and your modesty and dignity means nothing to any of them. Again, it's THEIR opinion that matters to them (concerning whether it's sexual or "proper"), not yours. So they say. Well it should be the patient's (or victim's) opinion that matters since it's happening to them and they're the one who's paying for it and experiencing it. A nurse's opinion on whether it's sexual or not shouldn't matter if she's not the naked person experiencing it. When will the medical world realize that (or admit it)?

GL

 
At Friday, October 02, 2009 2:55:00 AM, Anonymous Anonymous said...

There is something we can all do to reach awareness. Whenever I hear that a research study or free screening is being done of an intimate nature I call whomever's running it and say that I may be interested depending on he gender of the examiner to protect my privacy.

Next I ask if they would like to have a vast increase in participation and advise that if the examiner were the same gender as the patient (based on statistics that are available)there would be a vast improvement.

Most of the time the doctor gets on the phone. They are of course, unhappy with me and I refuse to cooperate. However, if lots of people did this, their morale would suffer because the perception would be more a lack of cooperation than a focus on how many did cooperate.

This is a mindset shift that we all need to implement together with walking out when we are told one thing and surprised with the wrong gender in the exam room. This can also be done as a perspective mother shopping for a hospital to deliver her baby citing that they would or would not come to that hospital based on their policies.

Also, when doing this it's important that administration or patient advicacy is called, not to interfere with the busy nursing staff

I've been thinking of going one step further by calling hospitals and asking them if they would like to see positive reviews based on advertising that they will go above and beyond making patient dignity a locus of pracitce by advertising openly a same gender care policy in labor and delivery or other areas where they are already doing this. At the current time it's kept quiet unless a patient asks for it. This would create a mindshift almost implying that other hospitals who don't have this policy or are silent, are somehow deficient and changing the implied mindset by being gender sensitive that there's something immoral about it.
Marjorie Starr

 
At Friday, October 02, 2009 3:05:00 AM, Anonymous Anonymous said...

"I don't find receptionists generally to be caught off guard. I find most of them open to answering and/or discussing this issue with me."

Of course they're not caught off guard. They know they'll receive calls like that and have a well organized speech to repeat to you, whether it's true or not. When they pretend to be shocked, whether on the phone or in person it's either because they had a sudden brain fart and can't remember how to begin their rehearsed speech or they're not sure if the doctor or nurse changed it.

SLO

 
At Friday, October 02, 2009 3:13:00 AM, Anonymous Anonymous said...

"Alot of us are on your side. I'm not sure if you see that."

Many of us do see that swf and appreciate women like you. Also the fact that you know it is much easier and more common for women to be easily accomodated without arguments, strange looks and bad attitudes. Particulatly when you speak up.

SLO

 
At Friday, October 02, 2009 3:26:00 AM, Anonymous Anonymous said...

"There are two male techs in mammo where I work. There are also males in L&D there and have been for some time. Not all males are disciminated against in these areas."

But I'll bet if a woman requests not to have a male involved her request is well respected and no backlash, funny looks or complaints from staff occur, unlike men.


Marjorie said,
"There is an exception, however, based on privacy for example in a ladies room for an attendant's job..."

You got that right. In a "LADIES" room. Mens rooms are very different in that women are perfectly welcome there (apparently). But that's a different discussion.

 
At Friday, October 02, 2009 4:26:00 AM, Anonymous Anonymous said...

Marjorie,

I read a few comments you made on another site and another person who critisized what you wrote. You wrote that you used to watch young men at a boys home get their induction physicals completely naked. You weren't even required for the examination except to take notes. Someone critisized you saying you are a hypocrite because you would never allow something like that to happen to you, even in a medical setting. He/she had a valid point.

Have you changed your opinion since then or do you feel justified to do what you did while feeling the way you do about yourself? Did your bad personal experience happen AFTER you had that disrespectful job? Did you think that if you didn't do it then some other women would, or do you think boys don't deserve the same respect that you DEMAND for yourself?

ME

 
At Friday, October 02, 2009 8:10:00 AM, Blogger swf said...

I almost want to write a disclaimer before I post on this subject.....

The men I have spoken with do not seem to care about the issue of whether or not the male nurse is gay. It is about how they themselves are perceived ( or how they perceive themselves) after allowing a male to touch their genitals.
It seems that'real men' only allow women to do this, medical or not.
AGAIN..not saying I agree. I think 'real men' stand up for what they believe, whatever it may be. But as Mer pointed out before, society has almost pushed men to the wall on these masculine issues.

SLO:
Thank you.

 
At Friday, October 02, 2009 10:52:00 AM, Blogger MER said...

SLO wrote: "Of course they're not caught off guard. They know they'll receive calls like that and have a well organized speech to repeat to you, whether it's true or not"

I don't see that as a problem when it happens. It's easy to demolish these "well-organized" speeches with logic and reason. Anyone who has been reading these threads for a while should have a suitcase full of arguments to use in cases like this. These "well-organized" are designed to end communication, as are expressions like "We're all professionals here." Don't forget that. Frankly, I enjoy debate, and people who don't use their heads, don't use critical thinking skills -- but come at me with "well-organized" speeches full of cliches -- they're in real trouble. Their arguments are easy to disassemble.

Marjorie wrote: " At the current time it's kept quiet unless a patient asks for it." I, too, don't understand why hospitals don't advertise the availability of same gender care if they're doing it already. I can understand hospitals that are unable to accommodate not advertising. That makes sense. I'm in touch with a two hospitals now that do offer accommodation but don't advertise. I'm trying to find out why they don't. I think we should encourage hospitals to think this issue through and to see that it is in their bgest interests, both financially and ethically, to communicate openly about patient modesty.

 
At Friday, October 02, 2009 1:20:00 PM, Anonymous Anonymous said...

ME

You must have me confused with someone else. I am a writer/researcher patient advocate presenting information regarding the right for same gender care to whomever needs it. When privacy and dignity didn't seem to get the message across, I escalated the situation to victims of abuse who have post traumatic stress disorder. This is considered a disability and currently is recognized in a bill by Senator Patty Murray asking for special provisions for female vets who have been victimized.

Please go to the other blog and re-read. You are mistaken.
Marjorie Starr

 
At Friday, October 02, 2009 5:58:00 PM, Anonymous Anonymous said...

PT I think you took me wrong or Im not as smart as you to write here.
Female nurses say what they do to men is not sexual. but men say they dont want male nurses to touch them in a sexual way. We should admit if it is or not sexual. Thats all, you cant have it both ways. I never said all malenurses are gay.

 
At Saturday, October 03, 2009 7:35:00 AM, Anonymous Anonymous said...

MER,

The reason they don't advertise same gender care is that while hospital administrators see the ethical and moral issues of our privacy, they do not want to change the overall culture in medicine. Advertising same gender care means they've lost.

They have already lost but don't know it yet. while it seems we are on the losing side by lack of accommodation, it is they who see a world that is changing with empowered patients, lack of cooperation, blogs like this one and refusal to accept their position.

Interesting that in researching humiliation studies, it is noted that doctors and nurses don't ultimately want the culture changed. The new inabililty to humiliate with bodily exposure in front of the opposite sex would ultimatey reduce their power. Sad, but true.

Small things...recently I visited my 84 year old aunt in the hospital. She needed a bedpan and a young male nurse came into the room. My reply to him was, "What's wrong with you people? Please get a female nurse". While that seems rude, it hits them where they need to be hit. Here's what it does...Nurses have been trained how to de-sexualize their feelings. In time, I believe most of them are completely almost unaware that their gender is different from the patient; it's a non issue for them.

Stating that you believe there is something wrong with their behavior creates and uncomfortable feeling for them. This will be internalized and they will learn to become uncomfortabe or at least aware that there is another side to their feelings and that unwanted privacy invasions are unacceptable.

What do you think would happen if there was a protocol for us to follow that would psychologically destroy the current culture that the medical schools have spent time building? Our feelings are what's natural in mainstream society, their training is almost like brainwashing. Psychology, can readily be used to reverse their training, thereby creating avoidance in caring for the opposite gender. This together with patient refusal would change the culture!

marjorie starr

 
At Saturday, October 03, 2009 11:39:00 AM, Blogger MER said...

Very well put, Marjorie. I've stated as much over many posts, but you've put it so concisely. I've talked about the connection between prisons and hospitals in terms of getting people naked. I've talked this fetish of nakedness that's used to control people, even humiliate them. I've talked about game playing, in the sociological and psychological sense -- role play scenarios that go on in hospitals. Little games where everyone has a script and everyone knows what's going on but the patient. That's the culture of hospitals. Has been historically and continues to be today.
You right. The game is over and they've lost. They just don't know it yet. Much of it has to do with the patient's view now of medicine as a business, a competitive business. I study the ads that doctors and hospitals put in magazines and newspapers. There'a lot of competition out there and ultimately they'll learn how to compete, and they'll figure out that this modesty issue is a tool they can use to. They haven't discovered that yet.
By the way, this last week I called a half dozen medical businesses that offer in-home caregivers. They include in their ads that these caregivers not only do light housekeeping and other basic tasks but also help with baths and other intimate care. Of the half dozen ads I studied, 4 of them show photos of female caregivers with male patients. I called them on the phone and asked if they had male caregivers. They all said yes. One woman with whom I talked said: "Why, of course" -- as if, why would you ask such a thing. I responded. "They why don't you advertise such, and why does your ad show only one photo, that being a female caregiver working with a male patient?" I got no answer. "Do you have any more questions?" she responded -- and that ended the conversation.
Interesting, isn't it.

 
At Saturday, October 03, 2009 1:27:00 PM, Blogger MER said...

"What do you think would happen if there was a protocol for us to follow that would psychologically destroy the current [medica]}culture..."

Marjorie: There is a protocol that we've talked about and that you've brought up -- that is, standing up to the ground level workers, the intimate caregivers, and then filing written complaints with the CEO's, boards of directors, licensing boards, ethics boards, etc. Create a paper trail. Involve the media with especially egregious violations. The trick is educating patients to do this and, more difficult, giving them the confidence to do it.
I agree with the tactic you mention. I hate to say it, but sometimes people need to be made to feel uncomfortable in order to call attention to a situation they refuse to acknowledge. They may resent it, but, as you say, they are made aware of the situation and probably look at things differently next time.
This is resocialization -- the same kind of resoialization that the medical culture tries to accomplish with its gender neutral stance towards patients.
Great ideas, Marjorie.

 
At Sunday, October 04, 2009 8:16:00 AM, Anonymous Anonymous said...

"She needed a bedpan and a young male nurse came into the room. My reply to him was, "What's wrong with you people? Please get a female nurse". While that seems rude, it hits them where they need to be hit."

Good for you Marjorie. Actually, good for everyone. You're right, you said what had to be said. That's the only way we might be able to get it through their thick heads. Why can't everyone have guts like that?

SLO

 
At Sunday, October 04, 2009 10:19:00 AM, Anonymous Anonymous said...

Thanks for all the support.
Because not everyone has a history of medical sexual abuse I suppose.

I have an absolutely fabulous idea involving a class action suit by patients whose privacy has been violated against their wishes or perhaps from other abuse victims who have mental health deterioration from continued pleas for same gender care that are ignored and eroding their physical and mental health.

How do you all feel about it? Eligability would be on the premise that you asked for same gender care and you were ignored against your wishes. Other cases have been won for individuals.

Let's hear your thoughts. I'm already working on the legal issues. It might not win, but boy would we be starting something!

Interested parties can e mail me at: marjoriestar3723@yahoo.com

 
At Sunday, October 04, 2009 2:08:00 PM, Anonymous Anonymous said...

What you experienced Majorie with the bedpan issue is commonplace. This has gone on for years and years and continues to go on. My mother was in a nursing home and a male attendant showered her! She was livid and was shocked with the event but was told "it was okay". So she reluctantly went along only to tell me after the fact that she would never submit to that again! She was 89! These places and other healthcare facilities do what is best for them with no regard to patient preference or patient feelings. Period the end.
Males are stuck with female attendants and nurse most of the time. I definitely agree with you and others THIS crap needs to change.

JW

 
At Sunday, October 04, 2009 9:47:00 PM, Anonymous Anonymous said...

It was a common practice for female nurses to take a steel spoon or even their hand to slap
the genitals of young male patients for just having an erection. Everyone knows young boys
and men get erections for no particular reason.
On gentleman who goes by the
handle 58Flyer on allnurses stated
that this happened to him and he
became impotent. His thread is EEK,
there is a woman in my room.
I've had military guys in the
early 70's tell me they've seen it
happen.

Here is the site where they admit it!
http://tigerhawk.blogspot.com/2005/
05/nurses-secret-weapon.html

This behavior apparently was taught and occurred in the 60's,
70's and probably into the 80's.
Yet people wonder why some prefer
opposite gender care.


PT

 
At Sunday, October 04, 2009 10:06:00 PM, Anonymous Anonymous said...

As a sidenote its a good idea they didn't have viagra back then. A man
could have been beaten to a bloddy pulp.



PT

 
At Monday, October 05, 2009 6:58:00 AM, Blogger MER said...

Places who do these kinds of things have certain attitudes we need to correct. These include:
-- The schedule is sacred. We set up a scheduled, oblivious to gender that suits our needs and the needs of our employees. Patients values nor patient gender plays any role in our decision making. It's a crap shoot. You get what you get.
-- We don't see ourselves as males of female caregivers. We're just caregivers. Of course, that also means that you the patient shouldn't see yourself as male or female either. The key word in that last sentence is "shouldn't." We're living in la la land. It doesn't matter what "is," we're behaving as we think society should be. And if it isn't that way, we're going to change it. You need to be resocialized.
-- We need to "take turns." We need "variety." Who wants to do just one "thing" all day -- and by the way, you're the "thing."In fairness, another aspect of that attitude is that we all need to do different things so we can all learn how and be prepared to do different procedures. That attitude assumes the patient as an object to practice on. The focus becomes what's in the presumed best interest of the caregiver and the institution.
These attitudes are not those of bad people. The not be sensitive, but most are caring people. The best of them, when challenged, will see their error. Their upper level bosses have little insight into what they do on a daily basis, and only see this issue in terms of the institution needs, or, when they get sick, their personal needs and values.
That's why these kinds of actions need to be confronted as assertively as necessary at the moment they happen. At the very least, the confrontation causes a disruption in the holy "schedule," and that gets the attention of supervisors. Letters and complaints can come later.
If only 10 or 20 percent of patients to whom this happens confront caregivers and write letters -- that's all it will take. We don't need 100 percent. As we've seen in our culture, a very vocal, activist minority fully willing to make this issue public can get the attention of those in power and especially those who focus on the bottom line.

 
At Monday, October 05, 2009 11:49:00 AM, Anonymous Anonymous said...

Mer,

I agree with you. The problem is that when something happens quickly and without warning a kind of shock sets in followed by trauma and the inability to express yourself.

You were right in a previous post when you said that educating the public is key. I'm pondering some very interesting legal and social concepts and am meeting with a Director of Assigned Risk Management at a major city hospital to discuss the positive savings of implementing options for people who are distressed over this issue.

I will let everyone know what happens and what you all can do. Bless the internet for all the possibilities for reform that it holds.
Marjorie Starr

 
At Monday, October 05, 2009 1:05:00 PM, Anonymous Anonymous said...

You are correct PT, I know a woman who was in nursing school in the late 60's. The nursing instructor had been an ARMY nurse and was now teaching in a two year nursing program. She instructed the students to "flick" the base of the penis if an erection occured.
She said that would take care of the problem.

As far as your comment on Viagra, you may have been making a funny but Viagra doesn't just "work" on its own.

JW

 
At Monday, October 05, 2009 3:46:00 PM, Anonymous Anonymous said...

But JW

My point was that some men get
an erection from viagra that lasts
over 4 hours in which case you are
instructed to see your doctor,ie visit the ER. If a nurse who
has been instructed to "take care
of the problem" with a steel spoon
as the plastic kind didn't exist
in the 70's,it could get bloody.


PT

 
At Monday, October 05, 2009 4:19:00 PM, Blogger Joel Sherman said...

In response to Marjorie Starr, we ought to be clear. All patients whenever possible, deserve choice in their care, including the gender of the caregiver. However, most people really don't mind or consider it a secondary consideration. Some prefer it, even female patients.
Opposite gender care is not synonymous with an assault. Look at my gender preferences thread if you want some harder data on what people really do prefer. We're all different.

 
At Monday, October 05, 2009 6:23:00 PM, Anonymous Anonymous said...

Dr. Sherman,

I agree with you. I only said that if someone is forced against their will to be either publicly exposed without consent (as in an operating room while awake), or forced intimate care would be considered a sexual assault if it were against a person's will. We have the right to refuse treatment and many times patient wishes are ignored and excuses given to justify forcing or bullying.

Also, I have no problem with opposite gender care for those who don't mind or for non intimate care. It's only for those who do mind or have a history of abuse that this issue is paramount.
marjorie starr

 
At Monday, October 05, 2009 7:32:00 PM, Blogger Joel Sherman said...

Glad you feel that way Marjorie.
Don't mean to pick a fight, but a quote from you above is:
... recently I visited my 84 year old aunt in the hospital. She needed a bedpan and a young male nurse came into the room. My reply to him was, "What's wrong with you people? Please get a female nurse".

Yes that was rude. Did you know how your aunt felt before you threw the nurse out? I'd have no complaint if you asked your aunt first if she'd prefer a female nurse. It was her decision. You might be surprised. My elderly mother was quite comfortable being taken care of by male CNAs in a convalescent home. You might be surprised. And beyond that, it's common that patients find that a male nurse is just as professional and caring once they get to know them.

 
At Tuesday, October 06, 2009 11:06:00 AM, Blogger MER said...

I think an essential part of this discussion between Marjorie and Dr. Sherman is the idea of presumption. What are we all presuming?
I want to make it clear that I'm not for being rude for rude's sake. I'm for being assertive when necessary, granting that it isn't always necessary to be extremely assertive.

Back to presumption. When I read Marjorie's earlier post, I assumed she knew what he aunt's preferences were. Perhaps I was wrong. But to beg the question, why are we arguing about our assumptions? Why don't we get them on the table?
I know some people disagree with t his -- but I think the burden of "assumptions" falls primarily on the caregivers. It annoys me that the medical culture just assumes that opposite gender care is okay with everybody unless they specifically protest. It would seem to me that plain courtesy should prevail. The caregiver carrying the urinal, ready to give the bed bath, ready to do the foley cath -- they need to be the ones to ask.
Now, I'm not naive. Usually, the system doesn't give them permission to ask. They're just assingned a job and expected to complete it.
Although I don't excuse it, that kind of policy or culture invites rude behavior on the part of patients. It invites the question: "What's wrong with you people?" Unfortunately, the anger is directed at the specific caregiver and should be directed at the obtuse hospital leadership that forces that insensitive kind of approach.
It's about communication. I'ts aboutcaregivers approach patients. The initial contact. To me, and I think to many patients -- that initial contact makes all the differences. If it's done with a sense and attitude of entitlement, gotta-get-the-job done, gender-neutral-game- playing, that's-just-the-way-it is-get-used-to-it, we're-all-professionals-here, seen-one-seen-them-all
-- If the approach is of this type -- I don't feel my dignity as a human being is being respected, and I will respond in a way I judge to be appropriate for the particular situation.

 
At Tuesday, October 06, 2009 3:35:00 PM, Anonymous edo deweert said...

hey, there is a perception in canada and perhaps elsewhere in the world that americans are overbearing, pushy, arrogant and riding rough-shod over the feelings of people who do not feel the same way as they do.....imagine the feedback i get on the entry in my blog ealing with that barbaric of all mutilations: circumcision.

yes, of course i wanted you to see "ode to edo", but it should have been me to post the ul....sorry, my fault; i should have just done that right away.

and , no, i do not suggest that one should feel sorry for the caregiver who comes upon a male patient with an erection....i took the perspective that not all erections are "innocent" natural phenomina; there are those quite deliberate, even in the most unsuitable places.

which leads me to ponder the female equivalent: when a male caregiver cares for a female patient presenting swollen, moist labia, should he see that as an invitation, an "innocent" natural phenominum, or what?

and my REAL point was, and always has been: is the docotr's clinic, the medical examining room any different in this respect from the art room?
and yes, maurice, i am back...

 
At Tuesday, October 06, 2009 3:59:00 PM, Blogger Maurice Bernstein, M.D. said...

Welcome back Edo! For those new to these threads, Edo has as a profession being a male nude art model and related to us in a earlier volume his experience and opinions regarding physical modesty. ..Maurice.

 
At Tuesday, October 06, 2009 4:16:00 PM, Anonymous not jw said...

a few weeks ago i related how a female nurse assumed it was ok to stay in the room while i was seeing male urologist. I am male. I decided I could not "let her behaviour go". I rang the hospital. The first response i received was that "most people are happy with that" when I challenged the person as to what evidence she had for her assertion, she was dumbfounded. I pointed out to her that silence should never be deemed as informed consent. Reluctantly, the hospital has agreed to review its policy and has agreed to ask patients in advance if they mind. I wonder how surprised they will be by the responses, after all, "most people are happy...."
Keep on their case, they know what they are doing is wrong, simply pointing it out assertively is all it needs.

 
At Tuesday, October 06, 2009 4:47:00 PM, Anonymous Anonymous said...

But edo

Are you suggesting that its
excusable to strike someone in
that an assault is warranted for
such a physiologic response. How
do you know these cases were
deliberate.
Reverse the roles,should the
male nurse strike the genitals of
that female patient with an object just as female nurses have done so with males? Striking someones
genitals sounds like sexual abuse
to me along with some pyscho-sexual
disorders as well.


PT

 
At Tuesday, October 06, 2009 7:17:00 PM, Anonymous edo deweert said...

i see i am still working with a defective keyboard.....

hiatus..great stuff, did expand on my blog, read a lot of personal experiences of male and female naked models, from which i could not help but (still/again) come to the conclusion that artists, the art establishment, art students continue to be dishonest when they maintain modeling naked/rendering the human body naked is not about sex.
as a reasonably intelligent individual, i also maintain that there is a protocol of common decency and respect that i would expect in the art room, as well as in the examining room.
those of us who have not learned that protocol, or knowingly, or unknowingly, breach it must be corrected.
though i am not certain i should believe every story written on line by art students and models, some incidents would be rather offensive if true such as the female student complaining out loud that the model's hirsuitness prevented her from "seeing his butt"
erections, i discovered, are a central theme of many of these on-line stories.
when i once asked an instructor if students were ever prepared for this and how to deal with it, the answer was a flat-out "no"
most people are not comfortable with nakedness, as it is directly related to sexuality. those, however, who do come in contact with it should have to attend a workshop on dealing with it in a sensitive manner and should also be made to learn ways to check their arousal, should that be an issue.

 
At Tuesday, October 06, 2009 7:18:00 PM, Anonymous Anonymous said...

Apparently my blogs have been edited. I just wanted to say that yes, my aunt was very upset and it was my reaction to her, together with my past experience that wanted to get the message across that the behavior that MER and I were talking about is unacceptable. This right of entitlement. Then, when something happens that shouldn't, instead of putting the burden where it belongs, we are the problem patient.

Until we stand and complain in a way that makes them uncomfortable the culture will never change. Being polite isn't going to get anyone anywhere. Why not give them something to think about?
Marjorie Starr

Who do you they think they are? This culture is degrading and bullying and it hurts people. What do you all think you're doing on here if this wasn't hurting you?

 
At Tuesday, October 06, 2009 9:01:00 PM, Blogger Maurice Bernstein, M.D. said...

For those who haven't read Edo's previous postings, they can be found on Volumes 17 and 18. ..Maurice.

 
At Tuesday, October 06, 2009 11:06:00 PM, Blogger MER said...

"The first response i received was that "most people are happy with that" when I challenged the person as to what evidence she had for her assertion, she was dumbfounded."

Good response. These are the kind of questions we need to ask when presented with bald assertions like the one you received. Medicine is as much a science as it is an art. Medical professionals are men and women of science. They deal with empirical evidence and data every day. Their medical best practices are mostly based on study after study after study. Yet, when it comes to gender preferences, they will often make these statements that have no factual basis. They'll retreat to personal experience as evidence, but that can only go so far. I would hate to have a surgeon cut into me based entirely on personal experience. I would hope he/she would have other kinds of knowledge, too -- knowledge based upon empirical studies and tests.
So, when given responses like -- "Most men don't complain," or "Most men prefer female nurses," we need to toss back the question -- "How do you know that?" or "What evidence do you have, personal experience, to back that up." These are the kinds of skills patients need that can be taught.

 
At Wednesday, October 07, 2009 2:52:00 AM, Anonymous Anonymous said...

Great job not jw and Marjorie Starr. Also, nice post MER.

 
At Wednesday, October 07, 2009 4:48:00 AM, Anonymous Anonymous said...

PT: Viagra does not work on its own. The 4 hour warning advertised is extremely RARE. Doctors will tell you they have never heard of it actually happening to their patients. Basically a non-occurence. I assume advertised as many other side effects are stated with prescription drugs.

JW

 
At Wednesday, October 07, 2009 8:08:00 AM, Blogger swf said...

Mer said:
"The initial contact. To me, and I think to many patients -- that initial contact makes all the differences. If it's done with a sense and attitude of entitlement, gotta-get-the-job done, gender-neutral-game- playing, that's-just-the-way-it is-get-used-to-it, we're-all-professionals-here, seen-one-seen-them-all
-- If the approach is of this type -- I don't feel my dignity as a human being is being respected, and I will respond in a way I judge to be appropriate for the particular situation."
As we have discussed before, this is the attitiude that 'caregivers' have before they even step into the classroom. The automatic sense of entitlement, that these things will be alright with them, therefore it has to be alright with us. In a way they feel we have no choice...they are who we get like it or not. Their decision: not ours.
How many classrooms caution the females going onto this that there will be men who are not OK with them doing certain things? If they do, are they taught to respect that, or learn how to manipulate that? I suspect the issue probably comes up to future male caregivers more often. (From my experience with interviewing)And here is where the double standard starts.
The issue of entitlement has to start at the very beginning. Ask the students why they feel opposite gender intimate care is NOT an issue. Ask before it stops being a question and starts becoming an entitlement.
If we have to address this issue from the middle of the system, then we will. But, if the up and coming caregivers give it thought ahead of time, perhaps they will be better trained to handle requests appropriately.

 
At Wednesday, October 07, 2009 12:13:00 PM, Blogger MER said...

I would suggest that what these caregivers learn in the classroom about the modesty issue is very theoritical and abstract. That's assuming any significant time is spent on it at all. Even if they're taught about embarrassment, they're taught to deal with it, mitigate it, using techniques that probably don't include finding a same gender nurse for the patient. But basically they'r taught that nurses, caregivers are gender neutral. Male nurses deal iwth female patients; female nurses deal with male patients -- in all circumstances. That's not a wrong philosophy -- but I believe they're taught that this is the way it is and should be all the time in all cases. If patients object, that's not the way it should be. Deal with it, but strive for the way it should be. The standard is opposite gender care, especially for men.
I contend that the real practical curriculum for this issue is on the job -- the hidden curriculum. What they then learn in the field dependends on what's going on in the individual hospital or clinc, who's in charge, what their attitude and philsophy is. Much of how these field caregivers behave depends upon how the institution is staffed. They quickly learn the unoffical policies. If male nurses are available, the'll often switch with each other, assuming the administratin doesn't mind. If male nurses are not available, they'll get the job done one way or another. They may not like it, but if they wan to keep their jobs, they do what they're told, either directly or indirectly.
As with many institutions, the medical culture is embedded within a system and the rules and policies are not always openly discussed.
I'll always remember a scene from the movie "A Few Good Men." A marine commander is accused of giving a "Code Red," which is permission to harrass a substandard soldier to get him up to par. Unfortunately, the soldier dies in the hazing incident. During the trial, he tries to claim that there's no such thing as a Code Red because it isn't in the manual. In cross examination, the attorney asked another soldier where he goes to eat every day. The soldier tells him. How do you know where to go to eat? I just know, everyone else goes there. Is it in the manual? The soldier laughs. Of course not, everyone knows where you get your meals.
Just because rules and policies are not visible or in writing, that doeesn't mean the people are not completely clear as to what they are.

 
At Wednesday, October 07, 2009 12:20:00 PM, Anonymous Anonymous said...

Good points swf. I think though that it's not the students. They are trained to be "professional" and taught with focus on training that patient gender is a non issue.

The problem is that the other half of the equation (the patient) is coming from a different point of view.

The culture needs to be changed from the beginning. The good news is that is already is changing. My husband recently had surgery and the surgeon couldn't have been more respectful of his dignity. The nurses on the other hand were not and while in the prep area that was laid out like an ER with nothing but curtain between the bays, my husband was ordered to take everything off and put on a sterile solution. I, was holding the curtain shut and sure enough the nurse began to pull the curtain wide open in front of everyone while he's applying this stuff completely nude. The only thing that kept him from being completelty humiliated was my hand on the curtain. She knew what he was doing and the reason she was coming in was to bring him a paper!

This is exactly the kind of behavior that is unacceptable.
Marjorie Starr

 
At Wednesday, October 07, 2009 4:08:00 PM, Anonymous Anonymous said...

JW


There have been 94 cases reported to the FDA regarding erections lasting over 4 hours
with viagra,cialis and levitra.
We may even start to see more cases as its been found that viagra
is beneficial in the treatment of
copd in that it helps better control pulmonary blood pressure.
Priapism is more commonly seen
in conjunction with penile injection therapy(alternate treatment for ed). My original
point was not in the occurrance
but rather the consequences of an
erection. The consequence of being
assaulted by some nut with a steel
spoon. No I was not being funny but
merely illustrating a point and
sadly some were left impotent by
the consequences for merely having
an erection. Visit the website,
thats not funny either.


PT

 
At Wednesday, October 07, 2009 5:22:00 PM, Anonymous Anonymous said...

I read an article that was dealing with gender preferences in gyn and the age/number of previous intimate exams. There were several ineresting observations, older women who had had numerous exposures were less embarressed and had less preference than younger women who had not had the number of exposures. So one could say they where you down to accept what comes your way....the other thing which was an interesting note, they had 7 questions, and can you guess what the first one was...which is more important to you.....the quality of care or the gender of your provider..........it amazes me how often when providers do questionaires they make the assertion that its an either or proposition which is more important...they plant the seed...which would you rather have...as if they are exclusive of each other. The more one looks into this the more you understand why it is as it is...now the challenge and perhaps the question becomes how do you change it and can we do more than just effect our own experience.....alan

 
At Wednesday, October 07, 2009 6:00:00 PM, Blogger swf said...

While I understand the theoretical process of 'modesty' teaching, I do not believe we should let 'caregivers', or students for that matter, off the hook so easily. Entitlement isn't taught. It is however, reinforced. No one goes into this process with eyes wide shut. Every human being knows of modesty and feelings of the loss of it, therefore they are all well aware of what they are expecting of the public. I in no way accept that they are innocent bystanders in, or byproducts of, a system gone wrong.
'The System' may hold handy excuses and justification for them, but it doesn't take away individual thinking or moral awareness.
Doesn't anyone hold themselves accountable for anything anymore?
Doesn't anyone think for themselves anymore?
All corporations have devious secret cultures. If you become part of that harmful scenario, then you are to blame.
"They made me do it" or "They said I could" is for the very young or the morally weak.

 
At Wednesday, October 07, 2009 6:17:00 PM, Anonymous Anonymous said...

I love the "beaten to a bloddy pulp" joke PT.

Maybe if a male nurse is fiddling around with a female patients genitals and she starts to bleed (menstruation blood) he should poor some hot wax all over her genitals, that should stop the bleeding. Obviously she started bleeding as a disrespectful act just to piss him off.

 
At Wednesday, October 07, 2009 7:13:00 PM, Blogger MER said...

swf -- History has shown us that most human beings take the easy,safe, comfortable way out when they can. When push comes to real shove, they look out for themselves and their families. Those caregivers working in systems where modesty isn't considered a high value or respected, rather than lose their jobs, will figure out a way to work with the system and rationalize their behavior. That's true with most of us. It's the rare individual who challenges the system at great sacrifice to him/herself and families. Those who do this we often call martyrs because of the personal suffering they receive and generally accept.
I'm not excusing anyone. I'm just conveying to you reality as I see it and as I interpret it historically. We're looking at this from the outside. Look at it from the eyes of a young nurse or cna who gets her first job. Or an older caregiver who has a family to support and a mortgage. What would you do? What would any of us do? It's easy to say "challenge the system" or "find a new job." Easier said than done. No excuses. Just a description of the human condition.
We can't depend upon corrupt, faulty, morally bankrupt systems (I'm not suggesting hospitals as a rule deserve these descriptions) to correct themselves from the inside. Did Southern slave owners end slavery on their own? Did whites in power give up that power on their own and transfer it over to blacks? We'll often find great reformers from the inside of corrupt systems that help push things along -- and many of them indeed become martyrs. But generally serious change must be forced. People with power generally don't give it up without a fight.
Side Note -- One reason why we should really admire George Washington. -- Napoleon was shocked when he learned that Washington gave up the Presidency after eight years. Gave it up. Stepped down. Left office. It's foolish to give up power, Napoleon reasoned. Washington set a precedent and established the idea that leadership change is essential in a democratic republic. I just mention Washington to show you how rare it is yet wonderful that we have human beings who will think of their fellow humans and just themselves.

 
At Wednesday, October 07, 2009 8:17:00 PM, Anonymous edo deweert said...

a caregiver striking a patient's genitals?
perhaps she took the "spanking the monkey" a little too literally.....
seriously, there is plenty of evidence that points to Man's preoccupation with assaulting others' sexual parts; they seem the first ones to be targeted in torture cases, and the rape and pillage tales of every generation and culture are innumerable.
...then there is always the matter of proclivities: did the caregiver get sexual gratification from hitting the patient's penis?

there is a weird and in my opinion very unsettling proclivity in the porn industry - bukkake, in which numerous men ejaculate on a woman's face !!!!
gee, i thought i was depraved in my sexual desires, but bukkake?...i don't get it.
it seems so degrading....but then again, in the stuff i have seen of it, the woman seems to clearly enjoy it
then again, if she doesn't at least pretend to enjoy it for the camera, she would probably not ever work again.
heck, what do i know?

 
At Wednesday, October 07, 2009 9:36:00 PM, Blogger swf said...

Mer:
Just have to stand my ground here, but I see you are posting from the heart of where you believe most people stand. And while I do see that some people are like that, I have to question why.
I rarely post anything directly personal, but I was a single Mom for many years. Trust me, I know what it is like to need a job. I have been in their position, and I still knew myself and what I could/would do.
I worked in the Casino arena during those years. Imagine the secret culture for young women there. I stood my ground many many times, tried to change what I could, and found it was respected. Many women started to do the same. I very well could have lost my job for fighting the system, but I didn't.
I consider myself to be neither a martyr or particularly special.
I would imagine that you too, would have rarely gone with the flawed system to keep a job.
My point is, if everyone is weak: if no one stands up for change, then nothing gets done. Yes, you can blame evryone else, or eventually say 'this is wrong'.
I never said it was easy. If it were, everyone would do it and there would never be a need to take a stand. You are right though, many people do take the easy way out. I don't have to respect them for that, just because it is historically human nature.

 
At Thursday, October 08, 2009 5:55:00 AM, Anonymous Anonymous said...

Good for you swf and you too mer. It is women like us that do make change.
I am getting ready to tackle the medical community on the basis of ethics, disability and research. It will be very interesting to see what happens. Additionally, I'm working on patient advocacy and have written my own personal story.

Sometimes this only happens when you feel like it is the only option. In my case, I feel the cause is bigger than me and am willing to expose myself in ways that many others wouldn't.

We need more like us. If you or anyone else out there are interested in real reform, join me and email at: marjoriestar3723@yahoo.com
Marjorie Starr

 
At Thursday, October 08, 2009 7:46:00 AM, Anonymous Anonymous said...

mer and swf I see both your sides. mer says people dont stand up and swf says why not. most people here do and its hard to understand people who dont. But Im not sure weak is the right word maybe hardend?
eoe

 
At Thursday, October 08, 2009 8:14:00 AM, Blogger swf said...

alan:
"now the challenge and perhaps the question becomes how do you change it and can we do more than just effect our own experience....."
I see your point, and I certainly hope so. I believe that concerned and curious patients will seek out a site to help give them options and a voice in their own healthcare. Education appears to be the best way into this system, and the best way to reach people that are not in our direct contact.

 
At Thursday, October 08, 2009 9:21:00 AM, Blogger MER said...

Don't me. I'm not discouraging people from standing up for what they believe. I think that's been clear my past posts. We should and we should encourage it from the inside. I'm just saying that moral reform usually has to be forced. Good forces from the inside are essential, and they are a tremendous help. But it takes more. I'm saying we have to depend upon ourselves, patients. We can't depend upon the medical profession. They'll get it when enough patients complain, not when a few of their own tell them what they should do. I think we're really on the same page.

 
At Thursday, October 08, 2009 10:11:00 AM, Anonymous Anonymous said...

and edo I dont get the bukkake things but are you saying you think femalenurses like humilating or hurting male patients? maybe they just dont care anymore.
eoe

 
At Thursday, October 08, 2009 1:08:00 PM, Anonymous Anonymous said...

It is in the literature that medical professionals who were humiliated during their training will do it to their patients, passed on much like child abuse.

It's not about male or female professionals. It's about that small percentage of professionals who enjoy abusing their power and get a charge out of the ability to humiliate patients.One of the reasons medical professionals don't want to see reform is that loss of the ability to humiliate will lessen their power.

Or...sometimes, just as in the general population, there are sexually abusive employees who gravitate to healthcare because of patient vulnerabilities.

It's unfair to pin who likes humiliating who on one gender or the other.
Marjorie Starr

 
At Thursday, October 08, 2009 2:39:00 PM, Anonymous edo deweert said...

no, what i am getting at is thatamong all populations there are those who want to humiliate, control and submit to a variety of degradations.
and no, just because that is a well-documented fact of life, should we simply accept that and not stand up to it.

i still now, after having been away from this discussion for about four months, have no incidents to report about having had my dignity assaulted by medical personnel....but here's the thing:
documentary on bravo tv about art models, anecdote:
middle-aged female naked model in art class at college.
19-year old student (male) mumbles, though loudly enough to be heard by model:"it smells of piss here"
is it possible that respecting the dignity of our fellow human beings was not very high on the "to-do" list of the parents who raised this kid?
and are we simply assuming those who are going into the medical profession of whatever discipline, do so becase they have this unquenchable thirst to "do good"?
after seven years of posing naked for hundreds upon hundreds of art students, i have come to the inescapable conclusion that it's all about sex...i have said so time and time again.....
i know there are people whose sexual proclivity includes the desire to be peed on, but, does that mean that young man was right in even uttering that sentence?
no, i cannot assume what makes aperson do things within the context of the provision of medical care.
presenting swollen, moist labia is a natural and involuntary phenomenon that mostly occurs during ovulation; erections can often also be involuntary phenomena.my 2 am erection is not necessarily associated with sexual desie - it's a very natural, involuntary phenomenon.
i would be offended as an artist and a naked model if a young female art student would walk out of the studio at the sight of my involuntary erection. i would assume instructors would prepare their students for such an occurrance,......obviously i have misjudged their sense of duty.

and i am well aware of the fact that there lots of us who find the very existence of pornographic material offensive, the most insidious element of it , in my view, is that it portrays women as liking, enjoying and inviting some of the humiliating aspects of it.
in a loving relationship would there be any man who would even entertain the notion of asking his mate if he could ejaculate on her face?

 
At Thursday, October 08, 2009 4:06:00 PM, Anonymous Anonymous said...

To Edo


I really don't see how nude
modeling relates to patient care,
however,should you suddenly get
an erection what would be your
reaction if someone ran up and
hit you with a steel spoon. Would
they have to start the drawing process over since you've moved?


PT

 
At Thursday, October 08, 2009 4:24:00 PM, Blogger Maurice Bernstein, M.D. said...

Does anyone here really believe that there is enough time in the vast majority of interactions during the occupation of attending to patients for the healthcare provider to have the opportunity to consider and carry out words and actions to humiliate or sexually abuse them? Couldn't some of the interpretation of the words and apparent actions be more in the "eyes of the beholder"?

I know what I wrote may raise the hackles of some of the proponents of this concept here but I just wanted to throw the thought out to return this discussion to a more realistic proportionality! (if that is the correct expression to use) ..Maurice.

 
At Thursday, October 08, 2009 4:47:00 PM, Blogger MER said...

An interesting note: In today's paper, if you get or read the Amy Dickinson advice column, you'll read about a woman who resents being called "Mom" by her dentist and the assistant (both women) when she brings her children in for exams. She also resented being called "Mom" by a nurse when she was in labor. She says she finds it "condescending and just lazy."
Here's how Amy Dickinson responds:
"I completely agree with you that this is annoying. Thinking about this, I realized that every technician and worker at my local veterinarian's office somehow manages to address me by name during animal examinations (where they also refer to my pets by their names. If some health care workers can manage this, then why not others? Granted, family practitioners and their staffs are very busy, and their attention is properly focused on the children when they come in for an exam. It is also fair to assume that people don't know if they should address you as "Monica," "Mrs. Smith," "Ms. Smith.," Ms. Your-childhood-surname" or "Dr. Smith."
Okay -- now pay attention to her last two sentences:

"This is why health care professionals should ask you how you would like to be addressed, and then make a note on your or your child's chart. You can help this cause along the next time you encounter it by saying 'Oh, please call me Monica. Usually only my kids call me Mom.'"

A few points:
1. Note again, we're dealing with assumptions and lack of communication on the part of both parties.
2. Note that Amy Dickinson suggests that the patient step up and become more proactive.
3. Finally and most important, note that Amy Dickinson places the
primary responsibility of asking how a patient would like to be addressed upon the medical professional. And she suggests they make a note in the patient's chart. See where I'm going with this?
4. How we wish to be addressed is important. Yet how we wish to be seen and handled undressed is even more important. If we can "assume" that it's a good idea for medical professionals to take the lead in issues how to address their patients, how much more important it is that they should take the lead in modesty issues.
5. What's so hard about providing a form asking patients how they wish to be address -- as well as a question about their privacy and modesty preferences.

 
At Thursday, October 08, 2009 4:53:00 PM, Anonymous Anonymous said...

While it would be a bit naive to say NO provider EVER intentionally humiliated a patient I would think it is a very very rare occurance. However, trying to give providers a carte blanche pass blaming the system is just as off. While it was a stretch, the holocost was the result of soldiers following the norm of the system as was apartide, jim crow, seperate but equal, and all sorts of transgressions. We all have choices, soldiers faced severe discipline if they showed compassion in the concentration camps...do we justify their actions. Granted the severity of the transgression is no where proportional...one also has to say the situation for caregivers is much less daunting....we all have choices and not all transgressions are the result of providers fearing for their jobs. I have related my experience where a male tech was available for my ultrasound...but the female tech did it without so much as asking...there was no negative consequence for doing so, there was just a lack of concern or perhaps recognition due to lack of empathy vs self interest...whatever the reason, I think there is more wilful partcipation in the problem than forced compliance........alan

 
At Thursday, October 08, 2009 5:08:00 PM, Anonymous Anonymous said...

yes

 
At Thursday, October 08, 2009 5:09:00 PM, Anonymous edo deweert said...

maurice,
i do not think anyone in the medical profession sets out to humiliate or sexually abuse a patient, unless, that is that person's proclivity.
i doubt very much a person would get up in the morning, rub his/her hands together and muse: let's see, whome we can humiliate today"

but if there are, these are the ones we must simply throw out of the profession...simplistic??? you bet...we could also -as i understand they used to do in the ussr - re-educate them.

and anon.: in the art studio erections are dealt with in a whole variety of ways, ranging from taking a break to, as one writer of an article i read on the net recently wrote, to asking the model to masturbate.
erections in the artroom, as i have suggested in a previous volume, are viewed by some (young) male models as ways to "pick up chicks"
but if an erection puts even one student ill at ease, i suggest that is sexual harassment.
by extension, an erection in a hospital bed could be construed as sexual harassment, though i hope most medical personell are well-enough informed about human (male) anatomy to realize involuntary erections are quite common.

in this conversation i take the wider view that the art room is not all that different from the examining room and the expectations of those inside them with regards to respecting human decentcy and dignity.
sexual arousal is such a complex matter that location, circumstances and other variables play a major role in creating the "right" atmosphere for them to happen.
we are all people........

 
At Thursday, October 08, 2009 6:17:00 PM, Blogger swf said...

Let's consider Marjorie's story of her husband.
"My husband recently had surgery and the surgeon couldn't have been more respectful of his dignity. The nurses on the other hand were not and while in the prep area that was laid out like an ER with nothing but curtain between the bays, my husband was ordered to take everything off and put on a sterile solution. I, was holding the curtain shut and sure enough the nurse began to pull the curtain wide open in front of everyone while he's applying this stuff completely nude. The only thing that kept him from being completelty humiliated was my hand on the curtain. She knew what he was doing and the reason she was coming in was to bring him a paper!"

Now perhaps she did not (as EDO said) wake up in the morning and plan to humiliate someone today. But, planned or not, if this is her M.O. then who cares if she "plans" it or not? The end result is the same....she humiliates people.

 
At Thursday, October 08, 2009 6:46:00 PM, Anonymous edo deweert said...

and then there is the matter of profiling
the sheer magnitude of this matter prevents me from doing it the full justice it deserves in this post, except for this one question:
is the person who willingly gets naked to earn a few dollars less entitled to respect and dignity than the one who is by necessity naked undergoing medical attention in an examining room?
in this illustrious forum i can hear the chorus, loud and clear: that is a no-brainer!!
the reality??

 
At Thursday, October 08, 2009 7:38:00 PM, Anonymous Anonymous said...

There are absolutely sadistic personnel working in hospitals. Humiliation is used to make patients submissive and to punish when they don't feel the patient is cooperating.

I was sexually abused just prior to giving birth and I would say that there's no other interpretation when the abuser, a pediatrician, came into my room the next day and upon witnessing my attempt at breastfeeding made comments like, "don't think I'm going to kiss your nipples to make them better". His behavior, followed by other comments even more offensive than this one, got him into lots of hot water and eventually fired. Although, he's still practicing. Wouldn't you like your little girl going to him? It's very similar to the abuses of the Catholic Church, swept under the rug and instead of victimizing children they're victimizing people in vulnerable states who thought they were in a trusting, caring enviornment.

This is not as rare as you think it is. Elder care abuse, abuse of the disabled and abuse in mental health institutions is rampant. Such is the case in our hospitals. A Director of Assigned Risk at a major city hospital said that 40% of the lawsuits and complaints are over inappropriate behavior.

There are many articles that talk about this that have been published where incidents occur. So many more are never reported.

NYT wrote an article about a woman who recovering from breast cancer surgery was visited the next day in her room by a doctor and several medical students. He pulled off her blanket and her gown. Laying there horrified and naked his next question to her was, "Have you passed gas yet"?

Another woman miscarried and was screaming from the bathroom. In walked a roomful of medical students and a nurse. She had soiled her gown and in front of everyone just pulled it off.

This is nothing short of cruel and degrading treatment. It happens all the time. Please read up on it; it's there for the finding.
Marjorie Starr

 
At Thursday, October 08, 2009 9:46:00 PM, Anonymous Anonymous said...

I dont think I can read this stuff anymore. it makes me mad and sad and sick. goodluck evryone.
eoe

 
At Thursday, October 08, 2009 9:58:00 PM, Blogger Maurice Bernstein, M.D. said...

I would also wonder whether this onslaught of anecdotal descriptions on this blog are really useful or of further benefit to accomplish the hopefully constructive goals of many of those writing here. ..Maurice.

 
At Friday, October 09, 2009 12:49:00 AM, Anonymous Anonymous said...

And just think, for every negative female anecdote we read there are probably 10-20 bad male anecdotes.

 
At Friday, October 09, 2009 3:56:00 AM, Anonymous Anonymous said...

Please be more specific.
Marjorie Starr

 
At Friday, October 09, 2009 9:36:00 AM, Blogger MER said...

I agree with Dr. Bernstein. I come to this blog to read about and share patient communication strategies -- techniques that will help patients become more civilly assertive in achieving their medical goals. The doctor is working on teaching doctors communication strategies. We can't expect the medical profession to teach patients how to communicate. We need to do that ourselves.

It may mean that both providers and patients need to listen to each other more. I also come here to find credible sources, books, magazines, articles, etc. The anecdotes are interesting. B it's difficult to get into the nuances of any of them, though I do believe most accounts on this blog are true in spirit. But if you go back all 24 volumes, I think we've covered almost all the possible kinds of modesty violations anecdotally. I'm not saying we shouldn't have any more.
If we do anecdotes, I'd like to see an analysis of the interaction. What did everyone do wrong? I mean everyone, patient too. How could the patient have been more proactive? In other words, what kinds of actions can we as patients Dr. Bernsteins and Dr. Shermans are rare. Patients will begin to find more advocates on the inside the more we forcibly interact with the system. The more we communicate our position, the more we write letters, the more we go public -- the more decent insiders will begin to come out of the closet and support us. But we as patients have got to start this process.
Pure venting, complaining, anger -- although perhaps helpful to the poster, are counterproductive to what we're trying to accomplish.

 
At Friday, October 09, 2009 10:08:00 AM, Blogger Maurice Bernstein, M.D. said...

At the current 125 postings on Volume 24, we will be going on shortly to Volume 25. I think going back over all the previous volumes, the issues and basis for the concern of these issues have all been fully described. I suggest that unless there is some new angles or aspects to patient modesty that hasn't been previously explored then these should be documented here,however those writing further comments should look now primarily to and develop ways to remediate the previously presented issues. Let's aim for further constructive discussion. ..Maurice.

 
At Friday, October 09, 2009 10:47:00 AM, Anonymous Anonymous said...

I agree with everything said. As I'm fairly new to these blogs, my mindset was that the more knowledge into different types of violations, the better equipped and prepared we are, even if these things are unpleasant.

Hearing about experiences from others is nothing compared to what some people have endured. Sometimes, at no fault of themselves and sometimes with partial repsonsibility. This is a very complex issue and I commend Drs. Bernstein and Sherman for taking this on.

Based on my experience,research and psychological outcomes of patients, together with the blatant issues that are in the public eye, while communication is key, many times in the hospital setting it falls on deaf ears.

Everyone needs to be accountable and responsible, both patients and doctors. Dr. Aaron Lazare wrote a wonder piece on how far an apology goes.

People cannot always be vocal during hospialization; they are afraid, traumatized and alone. At no time is it more important to have humanity come together forging shared values and respect. The medical community isn't doing it yet as much as it needs to, but they are, I believe, trying.

It is great news that the medical model is changing. It is great news tha paients are speaking their minds.

what isn't great news is that those victimized are not benefitting, they have been ignored and forgotten.
Marjorie Starr

 
At Friday, October 09, 2009 4:47:00 PM, Anonymous Anonymous said...

eoe

Wait,please come back! I have such websites to show you.


PT

 
At Friday, October 09, 2009 5:27:00 PM, Anonymous Anonymous said...

PT

How was that helpful?

 
At Saturday, October 10, 2009 6:26:00 AM, Anonymous Anonymous said...

eoe

It isinteresting that you choose to mock and what's even more interesting that the comment was put through and some valid points were not. Leads me to wonder...

Please think about what upset you so. The reality that is some ways people are so unkind and that sometimes there is ill intent?

No one deserves to be treated disrespectfully on this or any blog. We are all in the same place here with different reasons motivating.
Marjorie Starr

 
At Saturday, October 10, 2009 2:41:00 PM, Anonymous edo deweert said...

maurice, i thought the point of this type of discussion was exactly to extract the anecdotes so the medical profession can examine the issue , address it and find ways to improve.

from my perspective, i am less focused on one item, more on the general and from what i have read and seen in my lifetime is that there are people in every culture, on every continent who seem to have a need to degrade others.
upbringing?? bad experiences??
do some of them go into prefessions that enable them to come in contact with the very individuals they want to hurt??
perhaps (teachers, clergy, medical)
this forum dealing with the latter should tell you there are some in your own profession.
probably finding them is not quite possible at times, until they have struck, butdevising ways to remedy the situation and explore ways to devise a code of conduct (conduct being the operative here, for even if they have propensities, they should still be able to address those)

and there are always two, or more sides to a story....i read the one about the fellow whose wife was quite upset about the way a nurse violated his privacy by pulling open the curtain when he was applying a medical cream.
as an exhibitionist, i would have been delighted to "expose" myself and my wife? well, she is very well awaare of my proclivity...she is amused, for she knows......
we will soon celebrate 46 years.

i do see a tremendous value in this blog, but after having been away from it for only 4 months, it has accomplished little here on line...it must now go to the institutions, to the powers that be.
i also read with a great deal of interest your blog on dying with dignity and its numerous implications.
thank you.

 
At Saturday, October 10, 2009 7:26:00 PM, Blogger MER said...

Over several threads, I've claimed that accommodation is out there if you only ask. Over several threads, allnurses.com has been criticized.

I call your attention to the thread on allnurses that I'll place at the bottom of my post. It's about how much accommodation should be done for religious or cultural reasons. Right now it's 3 pages. The overwhelming opinion is that you should accommodate, that it's about the patient, about patient comfort. It's not about changing how people feel or what they believe. Most of the thread is about racism and sexism. But at on page 3 a discussion begins about requesting same gender care. So far, the response is to accommodate.
So, if some bloggers here are going to claim that the wierd threads on allnurses are representative of all nurses -- you need also to accept my contention, that is -- This thread is representative of what's going on in most hospitals in this country -- accommodation whenever possible.
I'm not saying that complete ignorance of male (and female) modest never happens. It does. I believe most of the anecdotes on this blog. But the main problem as I see it is that men don't ask, and some women don't either.
At the risk of repeating myself over and over again -- it's as much or more about good communication as it is about anything else. Here's the URL to this thread on allnurses.com

http://allnurses.com/general-nursing-discussion/when-draw-line-430154.html

 
At Saturday, October 10, 2009 7:42:00 PM, Anonymous Anonymous said...

Thank you edo. It is difficult to address some subjects.

I feel exactly the same way that you do about the need to move this issue forward. It is interesting that I left an e mail address for those who really want to shake up the system and heard nothing from anyone on this blog.

It confuses me though why this issue is important for you as an exhibitionist. Most of us are screaming about our privacy but you know what?. It's about exposing ourselves against our will, ignoring our privacy and thereby eroding our dignity. Dignity is not eroded if exposure is with pleasure, consent. To each there own and rightfully so.

It also confused me when Maurice welcomed you back with open arms after your departure from the blog when your postings have a clearly erotic nature and it seems that mine are at the very least ignored; at the very most offensive to him. Must be hitting nerves; the right ones.

The truth will prevail on this issue; like it or not out there.
Marjorie Starr

 
At Saturday, October 10, 2009 8:54:00 PM, Blogger Maurice Bernstein, M.D. said...

Marjorie and Edo and others: I want to be clear regarding my view about postings on these volumes. I have felt that throughout these 24 volumes there has been adequate numbers and content of anecdotes presented which should give any reader who reads through the volumes a useful idea of what some of my visitors and other patients are up against in terms of healthcare provider behavior with regard to patient modesty. So, I think that further discussion to be constructive and to attain a goal many of my visitors would like to attain should be now a switch from anecdotes to advice and planning to change the system or mitigate the individual unpleasant experiences.

I think also the this is not primarily a blog dealing specifically with sexuality nor is it also not a pornographic or scatologic blog. Therefore graphic descriptions in these areas are just as unnecessary as the more and more anecdotes themselves.

Presentation of his view, as moderator, hopefully shouldn't diminish interest to continue on the topic of patient physical modesty in the healthcare system and discussing ways to make treatment of patients more fair and humanistic with regard to these concerns. ..Maurice.

 
At Saturday, October 10, 2009 10:08:00 PM, Anonymous Anonymous said...

I suppose as blog moderator you can choose to cut and chop any time you want. It's offensive that you allow some to vent and reprimand others.
It won't be surprising if you delete this posting too. Your comments are biased. Oh...and I'm bored
Marjorie Starr

 
At Saturday, October 10, 2009 11:40:00 PM, Anonymous Anonymous said...

Mer


Regarding allnurses and the comments posted there and as you
may know I'm being realistic,
what some say and do are two very different things. I truly doubt that is representative in the
real world as I've never seen an
accomodation as they mention.
Furthermore the site allnurses
has essentially reinvented itself
earlier this year. I believe the tone has been somewhat changed to
be more politically correct if you
will. The nursing industry is
struggling for credibility which
in my opinion has been lost for
years,they just don't know it.
Until male patients have the same choices and opportunities as
female patients, the entire
nursing industry is biased. As many
of you know the susan g. komen
race for the cure sends fliers out
for donations and participants.
In not one of their fliers do
they ever mention male breast
cancer. Men account for about one
percent of all breast cancers. I
doubt the average female even considers this statistic in that
they view it as an all female problem.


PT

 
At Sunday, October 11, 2009 6:00:00 AM, Anonymous Anonymous said...

My illustrations were to bring to light an uncommon but very real aspect of modesty violations. It came on the heels of anothers' post that it seemed unthinkable that these kinds of violations could exist.

The subject is medical sexual abuse. You and others didn't want to touch it. It is commonly known and discussed in abuses of the elderly, disabled and the mentally ill. Loss of dignity/modesty is huge. Please think about why not.

Many of the issues spoken about have to do with intimate care. Dr. Bernstein, perhaps you can tell us why intimate care couldn't be genderized (for hospital prepping, toiletting, and bathing. I think more people are offended by opposite care in these areas than they are from nurses of opposite sex.

What I can't understand is how the medical industry has been permitted by both patients and our government to treat privacy violations that are built into The Patient Bill of Rights and our Constitution to ignore the law--the ultimate arrogance.

It is my perception that this is possibly too painful a topic for both patients and doctors. Patients don't want to think about it and doctors are humiliated by it.

What do you think is the reason?
Marjorie Starr

 
At Sunday, October 11, 2009 9:21:00 AM, Blogger MER said...

PT -- I'm not saying that male patients are accommodated at all times everywhere. My contention is this: We often seen allnurses referenced on this blog, usually with some very unprofessional comments made on threads. People who post these references are quick to accept these posts as representative of nurses throughout the country. You can't have it both ways. If you accept those as representative, you need also to accept threads like the one I posted as probably representative.
I don't believe any conspiracy of opinion. On the thread I posted you're just reading common sense opinions. It's in a nurses best interest to accommodate. As one poster noted, just a male might not want a female nurse for intimate care -- so too the nurse doesn't really want to treat a patient that doesn't want her. It makes much sense to me.
There's no absolute guarantee. But I still believe that in most situations, males can get accommodated if they speak up.

 
At Sunday, October 11, 2009 10:33:00 AM, Blogger Maurice Bernstein, M.D. said...

NOTICE: AS OF TODAY OCTOBER 11, 2009 "PATIENT MODESTY: VOLUME 24" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 25. ..Maurice.

 

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