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Patient Modesty: Volume 28
We continue on with a discussion about physicians, nurses and others in the healthcare system ignoring some patients’ modesty concerns and the need for a gender selection option offered to patients who wish to have their say in who examines and treats them. ..Maurice.
Graphic: Photograph from the
Faculty of Nursing Science, Assumption University of Thailand and modified by me with Picasa3. If this was a real man and not a manikin in the photograph, some visitors to these Patient Modesty threads would find such a gathering rather disturbing.
NOTICE: AS OF TODAY DECEMBER 13, 2009 "PATIENT MODESTY: VOLUME 28 WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON
VOLUME 29.
128 Comments:
Horne,
It's great to have you here. I'm all for male nurses. It's just a shame you are in the OB ward instead of other areas of the hospital or at a Urology clinic where many men would really appreciate having you as a caregiver. There aren't nearly enough of you to go around.
That being said, it really shouldn't be any different for you to work in an OB ward than a female nurse working anywhere around naked male patients. I really disagree with female nurses and aides (it's much worse for aides) being entitled with the liberties they have around naked men, but at the risk of sounding sexist I'm glad that you are able to stick your foot into "no man's land". It's only fair. But again, I would much rather have you in helping me than hanging out with the ladies. No disrespect meant to you and your job though.
I couldn't bring myself to read your "female-reporters-in-the-locker-room" link. It's such a difficult subject for me to comprehend that reading about it always infuriates me.
Thanks a lot for your post. I hope you continue posting.
GR
Anonymous,
I think many people feel the same way you do but are too "politically correct" to speak their minds, even on an anonymous blog. I feel the same as you. I'm getting tired of the medical system's lack of ethics when it comes to modesty, dignity and morality. When will they start thinking of us as people and not objects. I'm a human with a mind and emotions, not just a random penis. Medical patients shouldn't be one quick stop on an assembly line. We shouldn't be considered an obsticle that the workers have to get out of their way before they can go home, or to lunch, or to go flirt with the cute doctor down the hall. Our bodies actually mean something to us.
We'll always be thought of as empty headed bodies sent to the repair shop, so all we can do is stick up for ourselves and those we care about.
Anonymous #2
Dr. Bernstein,
What an interesting photograph. The photograph would be disturbing especially to a patient who had been in a similar situation except that the gown was removed and the patient examined in the presence of all those people, conscience and very aware of his nakedness.
Most people would consider that situation humiliating and degrading especially if the patient consented to the exam but the medical community left out that his gown would be completely removed. Not only was he "left in the dark", he might not have consented if he were properly informed. It positions the question of whether the patient really gave informed consent if that one detail weren't disclosed.
And..if the information wasn't disclosed, why wasn't it. , why Could it be that cooperation might not be granted? Absolutely!
Now let's look at psychological trauma. You cannot be traumatized unless it happens unexpectedly.
Some might feel that my comments are far fetched. They are not and sometimes the circumstances described above are done for malicious reasons (NYT article breast cancer patient).
You could say that by not giving all the information to the patient and leaving that patient outraged and humiliated that the patient might be traumatized. This would erode patient cooperation from teaching hospitals based on their prior experience and create a hostile environment if this kind of behavior happens in "bulk".
Also, what responsibility does the medical community have for behaviors that are damaging?
marjorie Starr
'Also, what responsibility does the medical community have for behaviors that are damaging?'
Marjorie they dont seem to have any. We keep telling and telling and tellng them how they are hurting and damaging us and all they do is tell us not to come back. Any other company that offered a service that hurt so many people would have to do something about it but not the medical. They just say I have a piece of paper that says I can do what I want and so what if we:..
Ruin your marriage
Damage your life
Shatter your spirtual plans that you dont know can be fixed
Or Just really ruin your whole life.
If someone told me I was doing so much damage and causing so much pain I would want to stop. That is the moral and human reaction of caring people. But they just say so what and go home to lives that are not ruined and marriages where someone didnt break their vows for them and whole souls that are still on their religious path. What kind of people treat others like that? What kind of people just smile and laugh at the wreckege they cause because THEY get to go home safe and happy?
Any one who really wants to help others does not hurt them and not care. And keep saying they have the right to do it instead of just stopping.
Anon 438
PART 1-
An Anonymous visitor sent the following posting to me this morning: "I want to post a very contraversial link to a video showing female medical students practicing on a body. I won't blame you if you decide not to post it, but it has a lot to do with the disrespect of patients." Well, no I don't want to post the link provided or a link to the original site where the video was first published. Why? Because at neither site there was any discussion of the ethical significance of the behavior of the individuals in the video and indeed at the site provided by Anonymous there actually was a pornographic commentary and in both sites there was pornographic or voyeur material. Thus, it was the sites themselves that I rejected. Now as to the video itself without supportive and constructive educative commentary was inappropriate in the context in which it was filmed: that is what seems to be a medical school anatomy lab with the students starting their work. Now what one sees is a few seconds worth of giggling girl students touching a yet uncut male cadaver on the abdomen and chest, picking at a few public hairs and a minor flick or two of the penis and fiddling with the cadaver’s hands.
Now, if this was really filmed in a medical school anatomy lab, as it does appear, with real medical students then what is observed should be understood in context before jumping to conclusions which will be attempted to be extended to issues described on these patient modesty threads. It appears with the cadaver unopened, that these students are just starting their adventure in the anatomy lab, occurring usually almost the first day of medical school. (Continued in Part 2) ..Maurice.
PART 2-
Medical students are fresh out of the under-graduate college environment and life and are really unaware of all they are going to face as they begin the four years of medical school and practice. Most, if not all, have never in their lives seen a fully naked dead person..let alone fully naked alive strangers. They have never had the potential full control over a human body. They also are aware that this was, perhaps a short time ago, a living, breathing, thinking person as the students are now. As you can imagine many if not most of the medical students are a bit to very nervous about what is about to happen (looking at and beginning to cut on their human cadaver). Some are so upset that they may even suffer a vaso-vagal reaction and faint. Most survive without syncope but may start out with a nervous, childish and inappropriate behavior such as seen in the video to help them feel that they are in control and the dead body is not controlling them. Students are instructed before they first enter the anatomy lab and during the initial hours by the proctors the importance of treating their cadaver with dignity and respect that all humans, dead or alive, deserve. After those first hours and as the dissections develop and become more and more complicated and detailed with much to learn and understand there is no further “playing around” with the body and students end up with great respect and appreciation of what their cadaver as a human person contributed to their knowledge.
The point is, that irrespective of what goes on during the first hour or so, this has nothing to do with how a student or the physician behaves later with their interaction with the living. None of this was mentioned in the sites. So, in conclusion, I would say to Anonymous that the video "has NOTHING to do with the disrespect of patients.” ..Maurice.
An article I recommend to readers here:
"A relational approach to autonomy in health care" by S Sherwin in the book Readings inHealth Care Ethics, 2000.
It's heavily into feminist theory, but that's not a negative thing. It will show you that feminist theory can be used for both genders and can back the privacy and modesty rights of men, too. You can read the article on google at:
http://books.google.com/books?hl=en&lr=&id=cmKQ7gt7R7YC&oi=fnd&pg=PA69&dq=%22Sherwin%22+%22A+relational+approach+to+autonomy+in+health+care%22+&ots=rmolGArDd6&sig=cUOWPeIV49FOIQkWWj8Vtmru9k0#v=onepage&q=%22Sherwin%22%20%22A%20relational%20approach%20to%20autonomy%20in%20health%20care%22&f=false
Marjorie said
"Most cases of cross-gender care
are ok except for those who have
endured sexual abuse."
I don't see the logic in that
statement marjorie. In most cases
of medical sexual assault that
have been proven in court,patient
and provider were usually cross gender.
Historically,men in healthcare
were and have been considered
perverts by the female medical
community as well as the general
female populace. It is written and
suggested by many female patients
who prefer a female gyn commenting
that male gyns are creepy,
especially the older ones.
That all male nurses must be
perverts as well as all male
medical radiographers as you see
no male mammographers and virtually
no male nurses in L&D. I certainly
could go on and on giving examples
of this subject,yet you see numerous examples of female nurses,
cna's and female physicians acting
unprofessional and yes,being perverts.
Every instance of a patient's
genitals being taken with a cell
phone camera were either a female
nurse,pa or cna as evidenced by
links on the web(some of these can
be seen on Dr Shermans site). By the way,that technically in just about every state is a felony or misdemeanor and falls under voyeurism when an electronic recording device is used. A
misdemeanor is enough of a charge
to have your nursing license
revoked.
If that is not enough of a
privacy violation,familiarize
yourself with comments being made
on facebook and myspace by nurses
regarding personel comments about
their patients. Currently,its a
big problem right now.
Yet,when male patients request
same provider in intimate procedures,we're scoffed at.
PT
Dr. Bernstein,
With all due respect, your comments regarding "no disrespect in the video" are simply delusional. How can you, running this blog, listening to all of us, and noting the behavior in the beginning of the mentioned video, simply dismiss the noted behavior of the students with an excuse of nervousness. You are rationalizing the behavior, and excusing it. This position is exactly why nothing has been done to correct the issues discussed on this blog. It is the same position taken when patients file a complaint.
Why in the medical setting is sexual abuse and defiling human beings justified?
The same analogy mentioned previously, if someone is shot by friendly fire is that person not wounded? Is that dead cadaver not defiled because the students were nervous? Someone still pulled at his public hair and flicked his penis, did they not?
Please explain. Thank you.
marjorie starr
Dr Berntein
Just as a hypothetical for my
argument that you made an emergency
room visit.Your complaints are
nausea,vomiting and RUQ pain that
has persisted for a day now.
The emergency room physician
determines that there is an increase in enzymes,negative murphy's sign but positive charcot's triad. The general surgeon is notified and you are
transferred to the OR for emergency
surgery for removal of your gall
bladder.
You have good insurance and
no underlying medical conditions
and as such should recover well.
Several days later while
recovering in the hospital you
are approached by risk management,
hospital administration and your
surgeon. Your are informed that
while being prepped in the OR the
scrub tech or circulating nurse
took a cell phone pic of you while
nude and posted the pic on facebook. Your visitors appologize
but assure you a full investigation
is under way.
What has been committed is a
sex crime against you,yet the
hospital for fear of embarrassment
does not report it to the police
as required in the first 24 hours.
How would you feel? You don't
know as this was simply a hypothetical scenario. Yet examples
such as this do happen. For example
the teenage female cna's in Albert
Lea Minn who sexually assaulted
and abused one of the 75 y/o male
residents. If a 75 y/o male was
fair game who else do you think
is susceptable in our healthcare system.
PT
Here is a clickable link to MER's resource:
link
Those visitors who supply a URL for a resource site should, particularly if lengthy, create a link using the opening bracket < followed by a href followed then with the URL with quotation marks at the beginning and end of the URL and then followed with > closing bracket. This is then followed with the linking word or expression and immediately followed by < bracket and then /a and then a closing bracket >
Note: the characters written in italics in this post including the forward slash are the characters to be included in the HTML code.
I had a most difficult time parsing this posting to prevent getting an HTML error and being unable to publish this. ..Maurice.
Marjorie, trust me..first year med students starting out in anatomy lab are like little kids behaving in very inappropriate ways but behavior which doesn't persist and is NOT related to their behavior to patients later in their training nor in their later practice. I admit, I haven't read any research studies comparing student responses at the anatomy table with later professional behavior but you really have to know what is going on with these students starting anatomy and starting medical school to understand the disrespectful initial behavior of some. ..Maurice.
Dr. Bernstein,
What I took issue with is that you stated that medical students are taught BEFORE going into the lab that respect is important. Then they treat the deceased in a degrading way. You then justify it with the excuse of nervousness. What would the instructor do or say to those students? And...how can you consider the behavior not disrespectful and...how do you know whether a particular student continues this outrageous behavior.
The family of this cadaver was probably proud to know that their family member was contributing to science. What would they if they knew what happened in the lab and what would they say about the mainstream medical mindset of rationalization and excuses.
The Patient Bill of Rights was compiled due to the sad unethical behavior in our medical institutions. It addresses dignity and respect and issues of informed consent. The medical community has decided to ignore all and bully their way. What's even more outrageous is that these acts are committed upon the sick and the vulnerable, cause catastrophic erosion of trust causing patients to avoid heatlhcare at all cost. What does that say about out health system?
Imagine this...I know a physician who was a rape victim. She recently told me that she can't wait until she sees me and always asks about the work. She told me I give her hope. that I get it. Then in the next sentence she asked me not to mention her in my book! Not one doctor who I've spoken to will openly acknowledge the problem or do anything about it. They all acknowledge it off the record including the physical harm of subjecting the previously traumatized to retraumatisation. All of the medical community is responsible for the behavior. When is somebody going to "step up to the plate"?
marjorie starr
Can anyone in the medical field explain to me why they must be so secretive about exactly what happens to a patient when they are unconscious? Why is it difficult or impossible to find out ahead of time who will be prepping them for surgery and who will watch? Who specifically will be in the OR and what exactly happens post op and who will be doing and seeing it? Why are patients and their families always kept in the dark about all of that? Why does a patient's wishes and morality not matter in the least to medical staff?
Also, why does it seem that the surgeans have no power whatsoever over their support staff? Like "I know I said that wouldn't happen but I didn't make that decision, the Circ nurse did." Why is it always THEIR idea of morality and ethics that matters, not the patients. Even when the patient was perfectly clear about it from the beginning.
Is it because they have trade secrets that nobody but the staff at that hospital can know about?
1st Anon
Horne,
You bring up the question should lesbian nurses be in the labor ward? When I first came to this blog I thought I didn't want a male gyno because it was a sexual thing. But I realize it's not that at all. It's a respect thing. A respect for my gender. So I don't care if my nurse is a lesbian and I know lots of other women wouldn't either. In fact I think I would prefer them because I think nobody is going to be more respectful of women than lesbians. Now there's no doubt that many men respect women, but I don't know which ones do in a professional setting. Are they just "acting" professional and respectful but in their minds they're thinking "another neurotic silly woman" or something along those lines. They could be, I don't know.
I just read a book written by an older male gynecologist and he describes his medical training and it reveals a huge disrespect for women in "the old days". E.g. he was taught that a lot of women's complaints are just psychological.
I don't have a problem with your right to be in a labor ward, but I wouldn't want you in mine. And even though you say "the patient doesn't say anything... nobody cares" we'll I'm sure some do but we're too embarrassed to say something. Maybe you should ask the patient first and see what the response is, I would be interested. Anyway the problem I have with male nurses in L&D is that I wouldn't want you telling your buddies about all the gory details of my birth at the pub after work. Maybe the female nurses talk about it too but they probably will be giving birth themselves one day or already have, so I would expect that they would be a little less disrespectful about it. BTW I had a male nurse when my 7 year old daughter was in hospital and he was the nicest one I met.
NP
I don't know a lot about these things, but it seems to me that ethics and morality are something that someone is born with or learns early in life. If medical students like to dink around with a cadaver's penis and pubic hair and giggle and make jokes about it, can they really change? If they have that much disrespect and contempt at the beginning can they really mature or do they just learn to cover it up better?
I wonder how many people have suffered and/or died because doctors, nurses and hospitals have refused to respect their modesty and dignity. Do they even care to think about it? Is it unreasonable for a patient to demand only same-gender care when they're naked? Does that demand excuse a doctor from the Hippocratic Oath and justify his or her refusal to treat the patient?
How many people have died because of the pride of a medical "professional"?
Been reading the posts on the previous volumes so didn't do much posting for a while. But I spoke to one of my relatives who is very orthodox about his experience with modesty issues.
He went for a medical exam required before buying an insurance policy. He was escorted to a nearby hospital by an insurance agent and then proceeded for the exam while the agent waited in the lounge. For the ECG, they had to shave the hair on his chest at specific places to fit probes as his chest hair is dense. He refused the female nurse being orthodox and asked for a male nurse or orderly. The nurse said she would get his from another floor but returned saying that the orderly was busy and he would have to take her. He flatly refused. They continued with the ECG which then gave a faulty result making him ineligible for the insurance. He told the agent what happened and told him he could take the policy and shove it.
The agent took him back to his office, introduced him to the manager and they assured him another medical exam according to his convenience. He got what he wanted a couple of days later. I think I read a post by PT which said the issues of modesty could be taken up by the insurance company rather than the doctor. PT, have you also been able to do this?
------SKI
Another thought on Dr. B's comments on the medical video...
The fact that this video seems real and the fact that the video appeared on a porn site just solidifies the thin line between what happens in hospitals and perversion.
Dr Bernstein was quite cross with me on a post written by me on Blog 27 regarding sexual assault during hospitalization. Most of the problems in healthcare/sexual assault are the variety that PT speaks about, what I spoke about with Mom and what happened to me. However, my assault had a verified sexual component that added to the humiliation of the patient, the perversion of the staff, irrevocable mistrust of the system.
Most patents like me aren't afraid of an all out sexual assault. It is the perverted degradation that a public shaving and other "standard of care practices" such as group observations of unclothed patients (without their consent) that create a dark experience for those victimized. One that a patient will never accept and one that the medical community wants to keep in dark; both the experience and the isolation of patients.
It is the way these experiences are handled that creates the damage to the vulnerable patient psyche and the most volatile recipe for ptsd
marjorie starr bjmd
PT
Regarding your quote from my post "most cases of same gender care are okay". Please let me clarify.
Most patient experiences with cross gender care are okay. You are correct in that most cases of inappropriate care (one on one) are cross gendered. I should clarify that some of the degrading treatment is performed by same gender care (female nurse, female patient) in the presence of males in the ER or OR; sometimes with students observing creates the power differential, patient vulnerability and a perverted scene if not handled delicately.
marjorie starr
Marjorie,if a proctor saw a student "playing around" with a cadaver, the student would be readily reminded about the need for human dignity and respect. Also "playing around" is not the reason students are in the anatomy lab.
Although I have never seen my first and second year students in the anatomy lab during their first day, when I have them in my Introduction to Clinical Medicine course, none has ever shown lack of respect for their patients.. in fact, as I have previously mentioned here, sometimes they are extra-sensitive and concerned what the patient might think of them. As I said, if there is any "playing around" in the anatomy lab, this is a first day behavior and there is no evidence beyond. ..Maurice.
Doctor: I hesitate to write this. I'm so tired to seeing the medical profession attacked as a whole when it's a few who deserve the criticism. But I must comment about the resent discussion regarding unethical actions in the anatomy lab. I do understand what you're saying, and I don't disagree completely. People should be able to identify with how we all sometimes do or say stupid things when we're nervous. But as I've said before, the stakes are so much higher in medicine. With great knowledge and power comes great responsibility.
I've dealt with teenagers in my various careers. But, in this case, we're not talking about teenagers. We're talking about adults who have done their undergrad work and are now in medical school. They've made an adult decision to become doctors. At what point, precisely, in one's journey does one become a professional? Do these students go to sleep one night as a student and wake up the next day as a professional? Professionalization is a process. They must start behaving like a professional all throughout their training, because we "train" to become professionals. It doesn't just happen.
I don't understand why all this hasn't been thoroughly discussed with the students before the lab sessions begin-- I mean thoroughly discussed. Not in theory. But in reality.
Part 2
Here's a sample speech to be given before entering the lab:
"Today we going to dissect human bodies in the anatomy lab. We've talked about the respect we must show these bodies, these human beings who have donated themselves to science. You may be nervous about dealing with a naked dead body. That's natural. But you've got to learn to deal with this as part of your profession -- with live naked bodies, too. In the lab, no snide comments, disrespect, fooling around will be tolerated. No adolescent sniggling, no jokes -- nothing that even hits at any disrespect. Now, in a few moments, we're going into the lab. If you don't think you can handle this, you can stay outside and see me later. We'll talk about you perhaps taking this class or internship next semester. But if I see anyone whose nervousness slips into disrespect, you'll be asked to leave.
I mean, Doctor, we're talking about adults, 23-24 years old. Medicine must have a no tolerance policy in areas like this. People do change, and I'm willing to forgive if people change. But to some degree I agree with the poster who said that by that age, if they don't get it, some may never get it. And unless these ethical standards are strictly enforced at this stage, some may see their actions as just part of the dark humor culture that is permitted. Live patients become "just bodies," too, and these attitudes can slide down that slippery slope.
Having said all that -- I'm encouraged that doctors like you are teaching ethics to students. But once you decide to become a doctor, professionalization isn't something that happens when you get your license -- it's a conscious decision you make as part of your everyday behavior.
First of all, I want to elaborate a bit more on why I decided not to include a link to the anatomy lab video. I already noted that the sites showing the video were non-contributory to the dignity and respect issue and were, in fact, pornographic or voyeur sites. However even more importantly was the video itself. Whoever took the video was more in violation of dignity, respect and privacy than any of the students and certainly so if the video was taken for non-educational distribution and WITHOUT the prior permission of the deceased or his family. It is the one who took the video that I am more worried about than the students seen there.
Again, some may argue that the person taking the video was doing a public service by showing what might be going on in a medical school anatomy lab. But I would argue, filming this video for sexual fun or profit but without the intent of presenting and explaining the context in which it was taken was reprehensible. I can defend the students' action, as I already have, but I cannot defend the taking of the video. And don't come back and say I am encouraging the hiding of inappropriate behavior. If this video had been taken with the needed permissions and with an explanation of the emotional status of students starting out in med school and first looking at their human cadaver then I would have a more accepting opinion of taking the video.
MER, as I said, I have not been with my first or second year students at the beginning of their anatomy experience and I haven't heard what the professor or proctors say to them before entry to the lab but I know what I was told over 50 years ago and I know from my talking with students how they felt and also from my literature reading.
Nevertheless, since this issue has been brought up, I will discuss disrespectful behavior in the anatomy lab and how they were counseled with my second year students who I meet again after their Thanksgiving break on Thursday and let you know their experiences and remembrances.
..Maurice.
SKI
There are sections within insurance companies that handle privacy complaints made by their
members(members being the insured).
You have to wade through the
bureaucracy and yes you can get
results as I've seen it happen,
although the process is a little
different and varying from insurer
to insurer.Should you decide to submit a complaint to your insurer
make some phone calls first. Find out who in the organization handles
complaints and then be persistant
with the complaint.
Marjorie
I'm sure you'll agree with
me that once you've been burned
that's it. We are the examples
that everyone should learn from
and my experience is simply this,
don't allow yourself to be put
in those situations.
PT
MER
I'd like to comment on an earlier post you made regarding
male patients being given an older
female nurse so as to reduce the
level of embarrassment or the
possibility of arousal that might
exist with a younger nurse.
Realize of course I'm most
certainly aware that this is in
various literature you have came
upon as I've seen it as well.
First I have to say the
assumption is just absolute stupid
in their thought process. You'd
think if they took the time to
wade through this process it would
be easier to find a male nurse to
perform the procedure.
Fact is the older nurses are
from an era where patient satisfaction scores did not exist
as neither did hippa,the dying
patients bill of rights and advance directives.
They are from a time when a
steel spoon was used to reduce
those errant erections and lack of neuro checks are what the cat scan is for today.The younger nurses are
now so ever eager to discuss patient issues on facebook and
cell phone cameras are available at a moments notice to capture
those precious moments. You lose
either way.
PT
To get a better understanding of the work of the medical school anatomy lab manager and the attitude of the students about their teaching cadavers go to this link. I have a thread on this topic at this link
..Maurice.
After repeated telephone calls to the regional office of the LDS Church, I received no answer or voice-mail. Calling headquarters in Salt City, I was put in contact with a family services director who gave me the name of a Mormon psychiatrist in my region. This doctor coordinators a social group with other Mormon professionals. I made contact with the psychiatrist, with us talking briefly. He promised to get back to me, but it never happened. When something like this happens to me, I'm not disappointed or frustrated, but sense that it is the Spirit's doing. I am to remain with my earlier Jewish contacts, rather than expand my list of names. Anonymous, this is where you may want to begin. Please refrain from all talk which could be construed as antagonist with Medical World. Just let the receptionist know that you are different, sincere and that you seek their help with accommodation with patient modesty. I believe that a chain of events will be set in motion, to make it come to pass. This is the second sermonette. - REV. FRED (Oops! I failed to sign my previous post, although my name was in the copy! I tell my congregation that I am sleep-walking with my eyes open!)
As a medical student we were given a stern lecture before working with cadavers. It wasn't taken lightly by anyone. We knew people had given us a tremendous gift by donating their body to science. I have never seen anyone act in a disrespectful manner in a lab. It wouldn't have been tolerated nor should it be. We never lost sight of the fact that is was through the generosity of patients both alive and deceased that we were able to learn so much. Nice article, Dr. Bernstein. I believe this is the view most who work with cadavers actually hold.
Dr. Lisa
I wish every anatomy lab at every medical school was like the one at Boston University. Unfortunately, as indicated in the Slate magazine link, in the late 1800s and early 1900s this was not the case at many schools.
http://www.slate.com/id/2216761/pagenum/all/#p2
anon
PT says: Marjorie
I'm sure you'll agree with
me that once you've been burned
that's it. We are the examples
that everyone should learn from
and my experience is simply this,
don't allow yourself to be put
in those situations.
-------
PT, This is why I'm fighting. Why should I and others like me have to avoid healthcare to get what we need? Aren't our feelings the result of being mistreated? That's the only way not to be put in this situation.
Once my presentation is complete, it will be difficult for the medical community to ignore it's contents. So many times during writing and research my quest reminds me of the journey from slave trade to civil rights with our current climate of no tolerance for degrading behaviors from society that hurt people.
It is appalling that this issue of modesty, patient rights, dignity and "to do no harm" has absolutely no clout in the medical arena. It was also interesting to hear the doctor's explanation,and justified behaviors regarding the anatomy lab. Somehow, Dr. B. doesn't get it!
It seems short sighted to me that the disconnect between the anatomy lab and cruel, degrading treatment in healthcare is somehow isolated and apart from the systemic problems discussed here. It is common, hidden and poses to ask Dr. B why this blog is important to him and why if this issue is important that absolutely nothing is being done inside the system.
Soon, I will be leaving here and starting my own blog that with help from bloggers will create a place of safety, hope and action.
My experience was so outrageous that when it happened I vowed to do something about it fearless of consequences to myself because this issue is bigger than me. I found it exceptionally funny that I'm willing to expose myself in ways that are more intimate, more vulnerable to combat exposure that was intolerable for me. The difference is that I'm doing it of my own free will to handle a problem that effects us all as human beings with feelings, rights and beliefs I'm doing it to end the right of entitlement where there is none. I'm doing it to balance the power differential in healthcare and to remind every medical professional that we pay the bills and we don't have to take what they are "dishing out"--even if it means an early end to a life. Some things ARE worth dying for. What better cause than your dignity and autonomy?
marjorie starr3723
Anon, thank you very much for the Slate link. Some of the photographs are atrocious, yet I think (unless, at the time,also involving racial factors) they represented the same novelty and emotional distress that current students face as they first enter medical school, the medical profession and its stresses and their to many the first physical contact with the deceased.
I think that this turn of discussion specifically to an apparent early medical education issue regarding dignity and respect of the dead and with reference to these same qualities of behavior in the context of patient modesty of the living is appropriate. I also thank Dr. Lisa for her comments about her experience. I wonder what she thinks of my possible explanation of any early misbehavior by medical students in their anatomy labs. ..Maurice.
About the issue of male nurses/techs being discriminated against while hiring, is there a public forum where they can register their complaint and get support from consumer groups? Suppose they are made aware of their rights when they are in nursing/tech school and allowed to discuss their opportunities on a separate forum specific to them where male patients also can join in, would it help in decreasing their being shunted out by clinics/hospitals? In that way their progress can be tracked and if they do get blocked, help in some way can be provided through interested members of the public.
Anything on this?
-------SKI
"However even more importantly was the video itself. Whoever took the video was more in violation of dignity, respect and privacy than any of the students and certainly so if the video was taken for non-educational distribution and WITHOUT the prior permission of the deceased or his family. It is the one who took the video that I am more worried about than the students seen there."
They don't just let people into the lab to hang out do they? The person that shot the video had to have been a med student as well. So the only person there that was worse and more disrespectful than the female med students was another med student. It's just the beginning of a career of taking illegal videos like PT has written about. Do you think that person is going to lose their love of taking illegal and incredibly disrespectful videos the day he or she receive their medical degree?
Anonymous #2
I agree with PT. Instead of locating an older, unattractive female nurse to handle naked male patients, why not just locate a male nurse?
SLO
Anonymous, you stated on the November 27 post, that you would welcome counsel from Rev.Fred. I have several recommendations, to assist you, to become proactive with possible future intimate exams and care. Recognizing that both Orthodox Jews and Mormons have modesty traditions for men and women, I contacte their regional organizations. Calling the United Jewish Federation, I shared my need with the receptionist, who put me in touch with Mrs. R., Director of Family Services. Mrs.R. supplied me with the names of three Orthodox specialists whom she imagined would be sensitive to this issue. Since I had a short-lived respiratory condition in the past, I made an appointment with the pulmonologist. Informing Dr.W. I had no current health problem, I needed to talk with him about patient modesty. As the vice-president of a major hospital, Dr.W. gave me the names of several general practitioneres and specialists with strong faith commitments, whom he believed would attempt to accommodate my expectations. Dr.W. stated that he personally regarded that the population had low morals, and that modesty is not a concern with most patients. "Reverend, you are definitely in the minority," he said. Dr. stressed that I must be upfront from the very beginning and let the provider know of this concern. Dr. W. related his knowledge that a Hasidic rabbi had a hernia operation at a nearby hospital, and that the staff bent over backwards to safeguard his modesty. Also, Dr.W. reiterated the Patient Bill of Rights, and for me not to be afraid to refuse exams/procedures/care. Not charging me for the consultion,I sent Dr. a thank you note, and donations in his honor to Hadassah--the Jewish equivalent to the Salvation Army, and the Hebrew School he attended as a youth. I sent a letter to Mrs.R. telling her of my meeting with the Dr., along with an offering to the United Jewish Federation. I disclose my benevolence, not to pat myself on the back (this is a contradiction of Maimonides' Ladder of Charity), but for instruction. If modesty is a concern for us, and we have to fight for us, and we find allies who are nice to us with the achievement of our goals, then it is in order to tangibly let them know of our gratitude. Since gathering this info in the late summer, I will meet with a Jewish PCP in three weeks to discuss his role as an advocate for me. I hope this helps.-REV.FRED (This is the first part of two posts. I somehow goofed with the prior sending of this communication.)
The following comment was from Marjorie this morning but because of a glitch with blogger.com, I could only publish the comment by copy and paste. ..Maurice.
It may be time to note the psycho social failings of the medical industry. While medicine is in the 21st century, patients are treated as specimens. Can you imagine the opposition to the Patient Bill of Rights? It's amazing that it got passed. Little else has happened.
Let's talk about common practice in our teaching hospitals. It is still common practice to gain permission from the patient and then put them on naked public display without their explicit permission for such conduct. It is still common to have sales people and other unauthorized people in the operating room. It is still common to restrain and strip patients in the ER with a public audience. It is still common practice to walk in on patients either without knocking or waiting for a response from a knock.
Patients are still being lied to regarding their informed consent. There is still no regard for patient dignity.
While things are improving, there is still the practice of humiliating medical and nursing students during their training who just learn how to become abusers in practice.
There are still deviants who gravitate to medicine because of patient vulnerability. There is still no accountability or responsibility from the medical profession to get rid of these "bad apples". The only time this happens is when the patient makes a scene. And...the worst of all, just like the abuses of the Catholic Church that have been covered up for years, there are still deviant physicians in practice who are violating patients every day.
I had the experience of being subjected to a deviant pediatrician. When I wrote to him telling him his behavior was inappropriate, outrageous, he wrote me a letter telling me he wasn't a pervert. I never said he was; he did. Now he's still practicing in the United States after being disciplined. Would you like your daughter to be a patient of his? Would you like your wife subjected to sexual innuendo during visits with your child?
So, Dr. Bernstein and Dr. Lisa what do say about this? Why does this behavior fit the moral compass of those we are supposed to hold in high regard? Maybe that's why (the victimized) don't. We don't have any basis for trust. Why should we? Dr. B, you wrote to me in a post, "trust me". Why would I? Trust has to be earned. Your position with regard to the anatomy lab and that no disrespect occurred are the opposite of mine. Please understand, you are part of the problem.
I commend your efforts on the blog, however, you must start looking at this as if you were the patient and not as a brainwashed medical professional (as they all are). You, too, will be a patient some day and I hope sincerely, that you will be treated better than we.
marjorie starr 3723
Has everyone here sat in on a few meetings involving men and women who have been physically or sexually assulted/abused? If not, you really should. It would help to understand what is REALLY meant when the terms "entitlement" and "power" and "giving up the rights to your body" are used. Now, you think that you can imagine these feelings, but you can not really imagine the anger, resentment, fear, and absolute feeling of lack of control. Emotions that literaly take your breath away. I would challenge anyone to leave not feeling that their heart has been changed in some way...
Often these people do not care if you are a doctor, lawyer, or Indian Chief. You are just a person as they are, trying to take their body away from them.
I think the medical profession needs some help and (perhaps) guidance in the insight of understanding that even though they feel their job should entitle them to full exposure and access to all bodies, not all bodies consider that their right to make that decision for them.
It is the assumption to thier bodies, the lack of power and control over their own rights, that cause such anger that we see here. This is often mistaken for modesty that can be mitigated, as opposed to entitlement which can not.
The reason why I bring this up, is that more and more people who have not suffered abuse are saying they feel the same way: It should not be the choice of somebody else that they lose the power of control and choice of their own bodies. And really, once a 'caregiver' decides to go to school, they are assuming their right to everyone's body is their choice, not ours.
I would also caution 'caregivers' that the interpretation of this is to assume they are all being called perverts and immoral beings. That is harsh and not often true, though it may be true that they are considered assuming, uncaring, and entitled.
I can see how it would be easy to be offended and tell patients to go seek help somewhere else, or even better...avoid care. But wouldn't the better attitude be how can we improve the approach of care and help everyone with these issues? After all, alot of people are just one intimate care situation away from feeling abused.
swf, I am providing an active forum for the discussion and suggestions to be presented. Now it is up to you guys and gals to change "attitude" and work to "improve the approach of care and help everyone with these issues." ..Maurice.
Yes...and Thank you Dr.B.!
It takes a long time to reach caregivers and facilities, often one at a time. Hopefully more will come to your site to acquaint themselves with this topic as you have.
Here's a interesting blog run by an ER nurse. This particular URL will take you to a little essay called "buff tuesdays." Read the reader comments after the essay. This all demonstrates many things:
-- The sensitivity of an ER staff about nudity, and/or
-- Their lack of sensitivity about nudity, and/or
-- Their dark humor, and/or
-- all of the above.
It's an interesting blog, although I don't always agree with his point of view -- as a patient. But it does give you great insight into the minds of those who work in an ER.
http://www.impactednurse.com/?p=255
SKI
You can find literature on
the web about male nurses voicing
their concerns about experiences
with job discrimination. Visit the
site ultimatenurse under general
threads and a male nurse moderator
Aaron has a thread about his
experience.
On the site seannurse has
several examples of discrimination
regarding male nurses as well as
allnurses under male nursing.
Keep into perspective a number
of issues in that its not just
about male nurses,but male
mammographers,male ma's and yes
even male physicians. At a large
university here in the southwest
a male gyn physician was pushed
out from practice in the student health services.
He was an older gyn and a female administrator told him that
young female students want young
male gyn's,go figure. The older
gyn physician sued in court for
discrimination and won.
My question would be do you
think this female administrator
had asked these young women if
gender had mattered to them?
PT
SWF,
What a beautifully articulated post.
Marjorie Starr
PT,
Please read my question. Is there a support body to help these male nurses/techs/MAs etc with legal aid? If they have to fight their own battles, its going to be tough. I have read all about the discrimination that male healthcare providers face. Since you are looking to change things legally, this seems to be a form of affirmative action similar to what females got 20 years back. There were posts about people writing to legislators about encouraging more males to become nurses. Do these people also provide legal support?
-----SKI
I found a paper "A qualitative study of sexual harassment of female doctors by patients" published in Social Science & Medicine, Volume 45, Issue 5, Sept 1997 pp 669-676. Since this is copyright material that I have access to in my university, I don't know if it can be posted here (even then how would you attach a .pdf file?). A few comments about this.
Some of the actions are clear cases of harassment as the patients have attempted to touch/grab/insult the doctor. But others are a little vague and the paper puts them in neutral light. A patient who refuses a gown may be unnecessarily exposing himself making the doctor feel awkward. Numerous posts on this blog and others state how awkward the gown makes patients feel and that they should have the right to refuse it. Spontaneous erections are described at two parts in different lights. In the fist part it is seen as sexual activity though it is quite obvious that an erection may result from awkwardness or touch. The discussions however describe them as normal physiological reactions but the frequency is what makes it harassment. Again how is frequency of an erection under control?
The paper almost justifies a nurse being present. The gender of the nurse is not specified but in most cases the paper reports how one or even two female nurses have been present. But the paper reports about how some female doctors have transferred the case to a male colleague. This transfer is definitely better than a female nurse chaperone.
The paper is incredibly vague in the results and cases in terms of the modesty discussions on this blog. What is worrying is that it is published in a fairly reputed journal.
------SKI
SKI
Everyone has a right to work. There are shortages of nurses everywhere. What's needed, however, is a merging of a patient's privacy right and the employees right to work.
It is possible to create a system that does both. It's been said before and it's only a theory if half of the population is female and half male and a hospital employed fifty percent of each gender to fill their nursing needs then everyone would have a right to work and patient needs could be met.
Male nurses could be employed in all departments of the hospital however, the percentage of what gender goes where would have to be dictated by the privacy needs of the patients.
You cannot force patients to expose themselves in front of members of the opposite sex against their will.
If this issue of opposite gender care is huge throughout the general population, then nurses will be dispensed in accordance. Patients in the general areas such as general surgery, ICU, ER would have a choice. Specialty areas may be more segregated. However, if the gender needs are generated by patient need, the hospitals can prove it and will, thereby restricting different genders in different areas. The same policies might prevail in other gender driven exams and tests, however, because not everyone has an issue with gender of clinician, then every area should be able to employ both sexes.
This would alleviate disgruntled patients. Together with special protocols for sexual abuse/assault victims would create a wonderful environment for workers and patients.
marjorie starr 3723
Thanks for your comments rev. fred. I'm a Mormon and I like what you're doing for your congragation. I'm not really sure what exactly the heads of my religion say about medical modesty but my own personal morals and those of my family are to stay away from opposite gender medical nudity. It might be difficult to get a solid answer from our leaders because they try not to say things that might be considered politically incorrect by the public (in the most part). But the feeling I got growing up in the church was to stick to our own gender in those situations.
All through my cub scout and boy scout years (sponsered by my church) I don't ever remember seeing any other scouts undressed, (which I thought was good). But scout troops outside my church always talked about skinny-dipping and changing and showering in front of each other, so I think we were pretty sheltered and nudity of any kind was really frowned on. When we had physicals for camp we were always one-on-one with our male doctor and I never saw a woman around. Same with church sports.
So I think that in not so many words we were taught that it's OK to see a male doctor for whatever reason (because we were boys) but being naked in front of any woman wasn't right. That's what marriage is for.
Morm
Mer: Interesting link, and it certainly reflects a thoughtful side that we do not often hear stated in the medical arena. (Although a friend read it and gathered he was just making fun of patients.) I guess that is why this blog has run so long, we all see intentions differently!
An aside:
"I agree with PT. Instead of locating an older, unattractive female nurse to handle naked male patients, why not just locate a male nurse?"
I agree with SLO here, and....not to be rude but I would certainly hate to be considered that 'older less attractive' nurse whose life's mission was not to give men erections. I don't think my ego could take being considered the resident troll, and I would be begging for more male nurses so people would stop coming to me asking for 'ugly' help.
Doctor: Did you ever look into whether your hospital has a written policy regarding caregiver gender choice for patients? Or, if not, there is any inclination to consider one? Did you present those samples I posted to those who make these kinds of decisions?
SKI, nobody has previously written here about the seductive patient, only about perverted physicians. Nevertheless, the seductive patient is a real logistic and emotional and professional hazard for the unaware physician, male or female. We teach this subject to medical students along with their need to respect patient modesty and avoid their own unprofessional behaviors that might be interpreted as sexual.
The seductive patient: logistic- what is the appropriate way to deal with this patient's medical conditions if the patient's seductive behavior continues without medically abandoning the patient. Emotional-it is emotionally distressing and distracting to the physician. Professional-the physician needs to be cautious about responses to the patient's actions that it doesn't itself become unprofessional and simply encourage further seductive or sexual behavior.
So when those on these threads continue to write about physician sexual perverts.. remember there are patients out there who themselves, for various reasons, attempt to take control or pleasure out of the doctor-patient relationship by initiating their own sexual seductive acts. In conclusion, I must say that both such physicians and patients are outliers, in the extreme minority. ..Maurice.
MER, the answer to your question is "not as yet". I have been recently fully engaged with the COO regarding an ethical policy issue that I don't want to add another and distracting issue. I have your request on my menu and I will shortly attend to it. ..Maurice.
Am I the only one to notice the double standard of complaints coming from some of the male posters on this thread? On the one hand they claim the right to same sex providers, not those female nurse "perverts" (PT). Then on the other hand condemn hospitals for allowing female patients the right to deny the attendance of male nurses/techs in intimate situations... to the point of advising those rejected male nurses to sue the hospital for discrimination (SKI).
So, in the "ideal" world male patients would have the right to chose the gender of their caretakers, and male caretakers would have the right to sue for discrimination if hospitals facilitate female patients requesting the same choice.
Did I get this right?
Yes SW How disrespectful and humliating to treat a fellow coworker like that. I would get angry if people kept coming to me because I was the ugliest person they could find. Disgusting to not just find oppisite gender and get it over with. Too many games and not mature and profesional at all.
offanon
"Lady Patient said"
No I don't think you got it
right.
" On the one hand they claim the right to same sex provider."
Female patients already have this
option in L&D,mammograpy and just
about every outpatient surgery
center to name a few.
Everyone has a choice as to who
delivers healthcare to them.
" So in the ideal world male patients would have the right to
choose the gender of their caretakers."
In the ideal world we wouldn't have to ask now would we?
Medical institutions treat male
patients like they are in prison,
which by the way female prison
guards according to the justice
department have a higher incidence
of commiting rape than male prison
guards.
Female prisoners in New York
carry a no frisk search card. Wow,
what a novel concept. Why don't male prisoners get one of those?
Keep in mind there are more male
prison guards than female prison
guards,yet 94% of nurses are female. Perhaps most women need to
walk in the shoes of a male patient
before making these kinds of comments.
PT
SKI
I don't know of such legal support,I'm not a male nurse
and never worked as such.
On the subject of the seductive
patient. This is a byproduct of
cross gender care is it not? Fact
is more female patients have claimed unprofessional behavior
from male physicians,only because
in the past there were more male physicians than female physicians.What if a male patient claimed unprofessional behavior from a female physician? Would there be legal services for the male patient to the extent that female patients would recieve?
I've reviewed medical boards
across the country over the last
number of years and I have seen
female physicians being reprimanded
for having affairs with their male
patients and as such the numbers are increasing.
On one notable case not only did a female physician have a personal relationship with a patient,she managed to get him
overdosed from oxycontin causing
his untimely death.
PT
"Did I get this right?
Lady Patient: No. You didn't get it right. Most on this blog, from my reading, are in favor of patient choice -- both male and female patient choice. But, as PT stated, although a significant number of caregivers understand this problem, many don't address it -- and because of the gender imbalance in the nursing, cna, med tech area, men often don't have a choice. And unknowing men (new and unfamiliar with hospital culture) are just not offered the choice.
The further issue is this: It's not a question of forcing male nurses on females in OB-GYN. The issue is allowing the OB-GYN patient the choice. In some areas, male nurses are discourage or prevented from even asking the female patients if they would allow a male nurse to work with them. They end up sitting around on their ob-GYN rotations doing nothing. That's what we're talking about. In other areas, male nurses find it counter-productive to even do intimate procedures on females because they must have another nurse or cna as a chaperone. There arguments are, why not just let the other nurse or chaperone do the procedure? Why have two of us? Are all men considered suspected perverts? Is that why I must have a chaperone and female nurses don't?
Furthermore, there are cases of male doctors being discouraged from even considering OB-GYN as a profession.To some females, OB-GYN is a female occupation and male doctors have don't belong there. Currently, females largely outnumber males in OB-GYN training.
That's the kind of discrimination we're talking about. In hospital culture, gender neutral generally means that female nurses can deal with men in the most intimate manner as a regular part of their job. And although it's recognized that this should be the case with male nurses working with female patients -- that's not how it works in reality.
So, no -- you're way off. If there's anyone on this blog who condemns hospitals for allowing female patients the right to deny the attendance of male nurses/techs in intimate situations -- I disavow myself from them and their opinions. But I do condemn hospitals who won't even allow male nurse into OB-GYN areas to ask the patients if they would allow a male nurse. And that does happen.
Most of us are for patient choice -- male and female choice. We're for gender equity. Real gender equity. Gender equity that doesn't translate as women's rights, but gender equity that goes both ways.
PT and Dr. B,
The reason why I cited the paper was that it makes assumptions that are simply untrue. The refusal of a gown makes a patient seductive. The occurrence of an erection or repeated ones makes the patient seductive. The presence of one or more female nurses is OK. And all this published in an international journal. Even the paper cites that these patients are in the extreme minority but by simple law of probability it almost assumed that every female doctor will one day encounter such a patient.
Lady,
No I am not suggesting that women should have their rights taken away. I suggest everyone should have the same rights to gender choices. The main problem is the badly skewed ratio in nursing. Also, I found another paper 'The Glass Escalator: Hidden Advantages for Men in the "Female" Professions' published in Social Problems, Vol. 39, No. 3 (Aug., 1992), pp. 253-267. I found it on this link:
Paper
It talks about how the few male nurses are pushed up the ladder to admin positions or ER/OR due to their gender. Also, it states that they are preferred for catheterizing male patients though people on this blog that its not true. I wonder if this glass escalator will disappear if the number of males in nursing increases.
-----SKI
Those visitors here that would like to read a bit more on the seductive patient, I have a thread on that subject from August 2007 with, as of this writing, 22 comments. ..Maurice.
I don't remember reading a single post that suggests that women shouldn't have an option. But most of the time women don't need to make a choice because their modesty is usually respected from the beginning. If they prefer a male nurse I don't think they would automatically be considered perverts like male patients are in the very rare occasions that they are given a male nurse and request a female.
RRRRRRRR
A man with a name tag and a short white lab coat walks into
a waiting room full of women and
calls out some name. The woman
responds and the man says,I'm
George and I'll be doing your
mammogram today.Imagine the looks
and stares let alone gasps that
would be seen and heard. What would
the women do?
Now George is a fictional
person as male mammographers
don't exist,at least in about
every state licensing boards I've
looked at. If George were a real
person he would have the credentials RT after his name and
he would be licensed by the ARRT
and the state board of medical
examiners in which he worked.
He would have attended a college
for 3-years or 5 years for a
diploma in radiologic technology
and afterwards recieved additional
training in mammography. He would
have underdone a background check
and passed a comprehensive test
by the ARRT. Then take additional
testing before being awarded a
diploma in mammo with the initials
RT and (M) after his name meaning
certification in radiology and
M for mammo certification.
A process that could take any
where from 5 to 8 years. But George
and males like him don't exist in
mammography. But Sally does exist,
as she is a medical assistant that
went to a trade school or class
for 5 months for medical assistant
training. She is not required to
undergo a background check nor
take a comprehensive exam. In fact,
Sally just got a job at a Urologists office and next week
she will be inserting foley
catheters and all kinds of intimate
exams involving male patients.
Now Sally is a true professional
and when she calls out some male
patients name at the Urologists
office there won't be stares and
gasps cause Sally is 19 and a true professional.
PT
There are many reasons that contribute to each person's psyche as to why one or the other gender is preferred for intimate care. What decides these matters are our experiences, both positive or negative and previous traumas.
I have read on this blog and others that women don't have a problem having their gender needs met. This is absolutely not the case when it comes to surgery, tests that require many participants, or the ER, ICU experiences.
Every time I've requested same gender care it's been an uphill battle, mistakes are made justifying the mistrust that comes with anyone who has ever been abused in a medical setting. Who are these people? They are just like the others...strangers.
marjorie starr
PT,
You have earlier posted that you believe the way to change the medical system is through legal means (correct me if my interpretation of your posts is wrong). From the posts of MER and others, another approach is proposed and that of communication. I'll just give my outsider (outsider since I don't live in the US) opinion.
Communication is an excellent and smooth approach to deal with the problem. But how many men will really communicate effectively, politely and firmly in those embarrassing situations? My guess just 10-15%. The rest will either suffer silently or become rude and abusive creating further trouble. To educate the general population about their rights to dignity in healthcare will be a long drawn out process but can be made effective if included in school curriculums.
The legal option is to be exercised with care as it may push the medical community against a wall. But then again like PT said who are the "professionals" that are objectionable? Medical assistants, CNAs, and to some extent nurses who attend part time courses. Would it be effective and least disruptive to use legal options at them? One way is to force legislation on the manner in which they are trained and required to be certified. Another way is to provide support to male nurses to be recruited particularly in departments like urology and ED. Another is to force legislation in the manner in which nurses/techs/MAs etc are recruited. They should be done by a panel and not just by some female admin who will just recruit whom she sees fit.
The following example is like comparing apples and oranges and maybe even inappropriate in which case I apologize in advance. But it just is to illustrate the approach.
When a predator attacks a herd of buffaloes, whom does it target? The lead bull? The adult strong males and females? No it doesn't. It attacks the weak, the young, the lame. When you are dealing with a system with a wide range of individuals in power, it would be advisable to not attack the ones in high positions as this will lead to a long and expensive battle. Instead hack away at the flanks.
----SKI
I have nothing against male doctors, but I greatly prefer female doctors, actually I enjoy it. And I would swear that most female doctors I have ever encountered enjoy examining me too, especially my genitals, whereas male doctors I sense often feel uncomfortable about it themselves.
I don't think this is complicated. I do think it is normal, human sexual nature. No more, no less.
Al
PT,
An interesting point regarding your descriptions about SallY and George. It reflect what we already know.
George is more qualified than Sally. Your comments, though, reflected the behavior of the patients.
George's female patients were uncomfortable with his gender. Sally's patients either were not, noting a male perspective or men have culturally accepted the female tech without objection.
It like the chicken and the egg--which came first?
No doubt with the civil rights act, men were probably hired in the beginning and after rejection and loss of business, the title VII exception emerged.
There is no gender selection in a hospital when a male nurse is assigned a female patient or the other way around. We, are supposed to accept whomever is assigned.
Again, when men reject "Sally" that's the only time you might see change?
marjorie starr
marjorie,
I've never had a negative experience (or any experience) with a woman nurse handling my genitals, but it doesn't take prior sexual abuse for me to know I don't ever want it to happen. Does my lack of experience mean nobody should take me serious when I request (demand) a male?
PT, great example of reality.
RRRRRRRR
I hate hearing people say "I had to strip for the nurse", "I had to let her stay in the room. I had no choice". You almost always have a choice! Don't let them push you around! Doctors hardly ever NEED help. YOU are the client. YOU are paying them. It's YOUR body.
PT hit the nail on the head.
Majorie, most posters here feel that women don't have a problem having MOST of their gender needs met just not ALL of their gender needs. The problem of widespread, routine modesty violation remains primarily a male one. Flip the scenario and imagine that men's modesty was mostly protected; females, on the other hand, had to suffer such indignities as 30-something women submitting to pubic ministrations by 19-year-old males who may have been flipping burgers 6 months ago. That's what men contend with.
Further, prior sexual trauma should not be a necessary criterion for the prevention of modesty abuse any more than religion should. Harping on trauma actually weakens the general cause of patient modesty because, like religion, it seeks to protect a specific class rather than everybody.
--rsl
RRRRR-
My last post says that there are many reasons for gender preferences including experiences. Nobody said you had to be abused to have your needs met.
Secondly, woman are subjected to such care in nursing homes where the gender of the cna's is sometimes male. These patients don't always have the ability to communicate their needs and are nontheless traumatized by their experiences.
I'm not harping on trauma. As a matter of fact, not having your modesty needs met is a CAUSE of trauma and would not want that to be the case. Any action against someone's will is a violation.
What I'm saying is that (and I've said this before many times) that if they can't look at the general population and give them what they need, it is abusive to force the already traumatized just emphasizing the need for same gender care.
Everyone has a right to have their privacy needs met. I don't think there's any disagreement there.
As for the term harping...if you had been victimized "harping" is the least of it and you have been offensive in use of the term. Nobody is complaining about you "harping' on your privacy needs; don't dare classify mine as being any less important. And, for the record, this modesty issue is not one that effects everyone. Some people simply don't care.
marjorie starr3723
Marjorie said
"George's female patients were
uncomfortable with his gender.Sally's patients either were
not,noting a male perspective or
have men culturaly accepted the
female tech without objection."
How do you know they accepted
the female tech? Its exactly the
response I expected in that just
because men don't verbally object
certainly dosen't mean the situation is accepted.
I was being sarcastic of course
about the female ma at the urologists office being a true professional. We all know better!
PT
--rsl:
"Harping on trauma actually weakens the general cause of patient modesty because, like religion, it seeks to protect a specific class rather than everybody."
Let's say that Majorie's book happens to be an eye-opener for the medical community and they acknowledge medical abuse is a problem.....
which leads to the legislation she has spoken about...
which leads to fixing the abuses they have now admitted they have created....
which is partly caused by opposite gender intimate care...
which opens the door to same gender intimate care....
Wouldn't we have the same goals just from different advocate approaches?
We advocate where we see the need, and thankfully there are lots of people seeing lots of needs. And while I'm sure we can all sympathise with every persons need for choice and for many different reasons, each person's advocacy path helps the other.
rsl
A very high percentage of the sexually assaulted/abused develop Post Traumatic Stress Disorder. When humiliation is the source of the trauma it is almost impossible to heal.
It is a debilitating condition and the only mental condition that develops from someone's experience. It is a recognized disability.
Your intolerance to my posts is not only personally offensive as I've said before, your comments are based on ignorance of the problem and that's the reason I'm making a second post about these issues.
Post Traumatic Stress Disorder has many symptoms and the condition has movement in that symptoms can get better or worse. Retraumatization occurs when previous victims find themselves in similar conditions to their original experience. Retraumatization deteriorates mental health.
One of the main problems of the condition is avoidance of any environment that reminds them of the original trauma.
This can mean that obtaining healthcare is impossible with the current culture. Giving the disabled their privacy rights is more important than the general population; they have a disability.
That's like telling someone who can't walk that to obtain healthcare they must walk up the same ramp the general population uses. Please, have some compassion and understand that everyone's privacy needs are inclusive and watch your language. You are not only offending me, you are offending a large segment of the population that has no voice. Your use of the term "harping" is invalidating to those who have experienced horrors.
marjorie starr
swf, as I see it, the medical establishment will do as little as they can get away with to address the problem, and lawmakers will legislate as narrowly as possible. A similar situation arose with cross-gender strip-search (CGSS) in prisons. When a clash occurred between prisoner privacy and the right to work--esp. in CGSS--feminists were able to exempt female inmates, citing the possibility of prior sexual trauma--the "abuse excuse"--while keeping the far more common modesty infringement of male inmates firmly in place (maybe even expanded).
I have little doubt that organized medicine, narrowly defining trauma, would codify protections for women--lauding their own "sensitivity"--while further pressing "gender neutral" indignities on male patients. They make themselves look good while letting the far larger issue fester. And a silent majority of men continue to avoid care until it's an emergency.
Addressing a small part of the problem does not provide a toe-hold for us, merely an escape hatch for them.
--rsl
Lets all "get along" personally, one writer to another, despite differences in opinion. That is the way the common goals eventually can be articulated and reached.
I talked to my group of second year medical students Thursday regarding what I had thought I observed on that anatomy lab video and my response on this list to explain the behavior. The consensus was that they had not themselves witnessed such or any physical disrespect to the human cadaver and indicated that they were given a proper lecture prior to the anatomy lab so that the students understood the significance of applying respect and dignity for the person they were to use in their anatomy studies. They also disagreed with the theory that what inappropriate activity, if it did occur, during the first day in anatomy is a predictor of the professional behavior in the future. In my own experience, after 23 years or so of observing first and second year medical students, I have never observed or was told about behavior of my students which was disrespectful to the student's patient. ..Maurice.
rsl,
Again, it's not the abuse excuse. There are real problems with your attitude.
This determination by the prison system supports the damage done to women. This is not a whim or a made up issue. It's almost that you're angry that men have not been abuse to the same degree to get their privacy rights met. They should be met, however, on general principle.
This does not mean, however, that your privacy issues are none the less valid. It's only, that not giving the previously abused the exception, does more damage (noted on my post above) than it might to the general population.
It is important that you know we are really on the same side. You see, part of my work is calling for a research study on the psycho social aspects of medical care that are damaging to mental health. It's important to note that I was once like you and everyone else not previously traumatized. It was an issue in the hospital that caused the damage and got me thinking about the general practices in healthcare that are really human rights abuses.
You see, if someone has privacy issues and doesn't want to be exposed in front of the opposite sex that force either by intent or the patient feeling they have no choice is a violation of that person. This is a fundamental cause of traumatic stress and will "color" future medical treatment or lack of it.
Results of that study, together with humiliation studies and work published on psychological torture, would help everyone get their needs met.
marjorie starr
Maurice: I agree with you and your medical students. Video's showing behavior like the one described are rare -- though they tend to be the kind of sensational stuff that's posted on the web. All you need is a few of those to indicate to some people that this behavior is the norm. We need to be very careful that we don't regard this rare stuff as the status quo. .
To Marjorie: I agree with you and applaud what you're doing. My concern is this: A significant number of people who have been traumatized sexually or otherwise never go public, or even tell their closest friends our spouses. Especially men. Several volumes back I quoted a study of male sexual abuse which indicated a statistic of 1 in 6 men have been sexually abused. I would suggest that an even larger percent of men (as compared with women) will not say anything about their abuse. It's a cultural and a gender thing. It shows weakness. And our culture does not so readily accept male confessions like that. A while back I was talking with a male sexual abuse counselor. He said he was surprised at how little sexual abuse seems to affect some men later in life. I asked whether these men really talk about it. He said they didn't. Because they didn't seem to have the need to talk, he was assuming they were coming along fine. I challenged that assumption, and he agreed that it's difficult to talk with some men about this. They just won't talk. He agreed that the fact that people don't talk about it doesn't necessarily they have come to grips with it. That could be true. But not necessarily.
A patient who has been sexually abused and who has been silent about it, shouldn't have to declare that event in order to get the specific gender care they require. Their silence may actually be part of their personal therapy and that should be respected.
Mer: I agree with you that one should not have to declare their reasons for wanting same gender intimate care. I said on an earlier post that it would be difficult to explain this in every medical scenerio, and respect should dictate that one should get the care they deserve regardless. Many people do not ever speak of past abuses and I agree that part of the healing is the privacy it takes to do this. For some. the least amount of people who know about it is better, otherwise it seems quite public, and you do not want to 're-live' abuses. While some people need to talk about it to get over the anger, some need to keep it private to avoid further humiliation.
Marjorie: I hope you will let us know when your blog is active. There is certainly enough need for advocacy in all areas if this discussion.
--rsl: Our goal in advocacy is exactly that....to take men's needs as seriously as women's. I believe it can be done, but it is certainly a slow process.
MER, SWF Thank you for your comments.
It is interesting that I walked around for twenty four years with these issues and didn't know I had them until I got sick and needed the healthcare system. This poses the reality that there may be many people walking around with the avoidance aspect of ptsd and they don't even know it!
The reason I'm so public is that I don't have a history of sexual abuse in my personal life. The only place that I was abused was in the hospital when I was paralyzed from epidural block and arms restrained (standard of care) prior to a C section. It's because of the absurdity of my situation that causes me to stand on my soapbox and shout from the rooftops about what happened to me. Why should I feel shame? I did nothing wrong.
It is also imperative to note that my need to get what I need now is stonger than my not wanting to disclose my history. It is interesting to note that on my last mammography visit when I refused to wear a hospital gown and was grilled by the tech that I finally blurted out why I didn't want to wear the gown, followed by complaints to the facility (where they changed their rules). It's one thing to spout my observations and views and quite another to be literally forced in telling my story that was re-traumatizing for me. At the time I was a patient, not an advocate and there was no reason for me to share my experience.
Now to address Mer's concerns. You are absolutely correct. One should not have to disclose anything. Our privacy rights are already ours. It's the medical profession who decided that we have none. That's why the patient bill of rights was created and that's why the profession still tries to ignore them.
I've often wondered if someone wore a medic alert bracelet that said, "Sexual assault victim, do not disrobe" treatment refused, you will not be paid" mentally competent (and a phone # to a therapist confirming same).
They would have to look at the bracelet, they were advised that they would not be paid and the threat of legal action against the facility would loom over their heads. Quite a commotion I might imagine.
Now let's talk about those unfortunate who suffer from terrible domestic abuse. They shouldn't have to disclose anything. It would not be difficult to register requirements based on the will of the patient and not on their previous history.
Competent people have the right to refuse treatment
marjorie starr
A previous post from someone asked why the medical field keeps people in the dark and doesn't tell people about what will happen and who will do what in the OR etc.
Fact is - in THEIR EYES-
1. They have been trained to do these things so therefore it is their job and therefore it is okay.
2. Most people don't speak up so therefore it MUST be okay.
3. You're sedated in the OR so therefore you don't know - so it is okay.
4. It is normal protocol and procedure so therefore it is acceptable by people so therefore it is okay.
So.. why tell anybody anthing? People are there for a service so therefore it is okay.
Bottom line... for them it is okay.
JW
"Now let's talk about those unfortunate who suffer from terrible domestic abuse. They shouldn't have to disclose anything. It would not be difficult to register requirements based on the will of the patient and not on their previous history."
Marjorie: I'm not exactly clear on this. If they choose not to disclose prior abuse, how would it be easy to register requirements based on the will of the patient?
Would you not have to disclose some sort of statement on prior abuse?
I have been trying to find out exactly how a patient is prepped before surgery but it is proving difficult. Even if the patient is conscious (as I was for my c section) a sheet goes up so she cannot see what is happening. Of course I know I was catheterized but apart from that I do not know what else occurred. My husband was allowed to be with me when they administered the epidural but could not be with me until after I was prepped. What could be so bad that he is not allowed to be with me during this time and I am not allowed to see either?
NP
SWF,
What I was trying to express is that one should not be required to divulge any sensitive information (especially of the ilk that would be considered traumatic to the patient). Additionally, there is still a huge stigma against any kind of mental condition. That's an entirely other issue that must be dealt with as well.
Therefore, what I was trying to express is that the will of the patient is what should prevail regarding privacy matters. It is already law. The problem is that the medical industry chooses to ignore it.
While some may not have a problem vocalizing their needs, others do. This should not preclude every patient (both male and female) from having their privacy needs met.
marjorie starr
NP - That's been my question too. All I know is I'm supposed to accept a teenage female aide stripping me naked, shaving me all over (fondling), scrubbing the area for surgery (more fondling), maybe even inserting a catheter (very active fondling). I have no idea who will be observing any part of the pre op.
This small amount of information I got from hours of internet research and not from my surgean or nurse. They refuse to talk in detail about any of it and will promise me nothing. It's all a secret that apparently we simple folk can't comprehend.
I'm canceling the surgery. Good luck getting any answers NP. It's too bad we can't meet at the same hospital. I'll trade you all my women for all your men. Maybe then they could get it right.
SLP
NP -- The surgical prep for a C-Section is an abdominal prep plus the inner thighs and vagina. This is a solution scrubbed on the skin in circular strokes starting at the incisional site outward. It is from the nipple line down to top portion of the thighs from table side to table side. It includes swabs for cleaning inside the vagina. Male or female circulating nurses do this task (a non-sterile job).
Observers or spouses aren't welcome during this time evidently as I guess they feel the patient is too exposed or it is less than respectful... who knows?
This prepping procedure is the same for other surgeries. Seems this part of surgical procedures is never discussed ahead of time with a patient UNLESS the patient asks. Female nurses most times do this intimate prep on male patients without the patient's knowledge or approval.
For a non-seasoned or novice patient, they don't have a clue to ask!
JW
NP, I think it's easier for them if they have the sheet up - they somehow think you'll be less embarrassed and I guess less likely to cause a fuss. Your husband might cause a fuss too if he wasn't happy about the exposure or who might be in the room.
I told my female obstetrician that I wanted a closed suite until I'd been prepped. Once I was covered, I didn't care. The same rule applied at the end. I have a thing about control in medical settings after an upsetting incident with a family doctor many years ago. I don't want men involved in my medical care. When you lose trust, it's hard to get it back. I have seen male doctors for non-invasive, general things, but control the consult very closely. I've just found the anxiety it causes me seeing a male doctor for anything, is just not worth it. It was a struggle initially, but now we have female doctors working in most areas. I make it clear what I can and can't cope with and just cancel if my wishes can't be guaranteed.
Many of us have issues for a reason. I don't think it matters whether there is a reason or you're a modest person, we should all be accommodated or have a choice anyway.
Annie Y
We should all be accommodated. What I've been trying to say and skirting the issue is that while we all have rights, patients who demonstrate avoidance behavior and s more medical harm from the stress these issues cause have a medical necessity to same gender care in addition to patient rights.
marjorie starr
We can only change things individually with fighting each medical person at a time and we will NEVER change the whole group. Why? Because the medical people know it is wrong, they know we are embarassed, they know it messes us up. They know it causes divorces, they know it causes suicides, they know it causes more abuses and you see here by doctors they don't care what happens to us after. They don't care. I think they enjoy it. So much power to ruin lives, how fun! They have had these "special" priviledges to our bodies for so long that they don't WANT to give them up. They want the controll and power, or else they would be regular people just like us and off the special pedestal of owning us like slaves, or fondling us whenver they feel like it.
If they cared they would change. That is that. How many times do we have to be told here that scociety says it's o.k. and our body doesn't belong to us before we get it and realize they really want to win and we are being strung along like silly children? Try and change it, they laugh. Good luck trying is what they mean.
We say we care and they say no you don't. We say no and they say so what. We say this isn't right and they say they don't care. Are we getting the message yet??? They want controll of our bodies and that is it.
Don't bother. They don't care!!
offanon
It should be required that all nurses go to marriage counciling so they can see how they ruin our lives, break our morals, leave us feeling cheated on, and destroy our marriages.
Matty G.
Having posted several times in past here, I can say that the only sure way to avoid all the issues of cross gender care that one may feel, is to be open and up front about it at the very outset.
I have had a colonoscopy which was delivered by a male doctor and 2 MALE nurses (as opposed to the usual 2 female nurses. I was so glad I insisted as i was conscious throughout.
I have also been unfortunate enough to require a urodynamics procedure, again by being quite forceful, this was conducted by 2 male doctors (the "usual" team being a female doctor and female nurse).
I now routinely make it abundantly clear that I will not tolerate any females present while I am naked. When faced with my totally uncompromising stance, medical staff have gone for the course of least resistance and given in. In the past I was always expected to give in.... NOT ANY MORE.
Matty G: Maybe nurses dont take marriage seriously since they are willing to ruin so many and also cheat on their own husbands everyday. Dont count on your idea even mattering to them.
Good luck though and sorry about your marriage.
offanon
It's one thing to want, even insist upon same gender care. I support a patient's right to choose that.
It's quite another thing to attack a whole class of people -- nurses, male and/or female. Lately there's been a lot of that on this blog. I want to make it clear that I divorce myself completely from that point of view. I consider it sexist, bigoted, stereotyping and not worthy of serious discussion. I also think it harmful to any credible activism that may change medical attitudes in this area.
Its interesting to note from my
experience in healthcare that over
the years patients opinions never
mattered up until the last 3 years
or so. Patient care surveys didn't
exist before 2000. Even today most
hospitals only survey every 4th
patient.
If you want your opinions heard
write,ask for a survey if you don't
get one. Make concerns known even
if you were accomodated.For many
facilities it is a competition for
healthcare dollars from the federal government regarding medicare and welfare medical services,with pending healthcare
reform looming in the background.
You see only now how many facilities are concerned about your care based on federal money, the impetus is dollars.Now is the time to make change and make your
complaints known.
PT
Another interesting discussion over at allnurses on the double standard facing male nurses. *Kelly*
http://allnurses.com/general-nursing-discussion/managing-perceptions-male-143419.html
The reason I want female doctors and nurses is because I am straight. No straight man would want to be seen and touched by another man. That is just sick!
Al
"We can only change things individually".
I don't see why this is a negative thing. Isn't that really what most people have been saying on this blog? No matter how many groups, surveys, or letters there are, it is not designed to replace each person advocating for their own needs and choices.
gve is a great example. His needs were met because he spoke up, and opened the door for others who feel the same.
MER,
You wrote:
"It's one thing to want, even insist upon same gender care. I support a patient's right to choose that.
It's quite another thing to attack a whole class of people -- nurses, male and/or female. Lately there's been a lot of that on this blog. I want to make it clear that I divorce myself completely from that point of view. I consider it sexist, bigoted, stereotyping and not worthy of serious discussion. I also think it harmful to any credible activism that may change medical attitudes in this area."
My sentiments exactly.
The reason I want female doctors and nurses is because I am straight. No straight man would want to be seen and touched by another man. That is just sick!
Al -- Correct me if I'm wrong in my assumptions. Because you talk about "no straight man," you've attached homosexual connotations to this entire point of view. So -- a male nurse could elicit homosexual feelings or fears -- because gay men are attracted to other men.
Well -- straight female nurses are attracted to males -- so, using your reasoning -- this to could elicit sexual feelings.
You're free to hold your opinions. But when say "no straight man" would do this or that, feel this or that, you're jumping to irrational conclusions and stereotyping. You're essentially establishing yourself as the standard for how everyone else should feel. Are you somehow a representative man who stands for what everyone else should believe or feel?
Al,
so you change in the female changing room at swimming pools, after sport etc?
Or are yo gay enough to change in front of other men?
Well here we go again!
When did we stop being civil?
My story from another blog was;
"My husband reluctantly allowed a female nurse to perform intimate care on him. I could not get over his letting her or her believing it was her right to fondle my husband like that.
We are no longer intimate. If we stay together remains to be seen.
Someone needs to stop letting them ruin our morals and marriages!
I hope it can change before others suffer and it is not too late like me.
Matty G"
Mer: I don't find my story sexist, bigoted, or stereotyping. It is what happened and the heartbreak of my life. Many marrieages suffer this same way, and some education needs to happen. No woman should ever assume being intimate with another person's husband doesn't ruin a lfe, no matter who you are.
No one can say I am wrong to feel the way I feel.
gve,
Both of your comments are excellent. Great job doing what you did to get the respect you deserve and keeping your morals intact. Your second comment was almost word for word what I was going to write after reading that other negative comment.
GR
Matty G, I would like to know what is the definition of "intimate care". I have been performing intimate care on both genders all my professional life as part of my profession as a physician. In a way, I would feel shaken if patients and their families looked at me as having performed some sexual act that would disrupt a marriage.
I have no argument for the need to change the medical system's view of patient modesty and need for gender selection as experienced by some patients, but I disagree to look at the modesty issue as representing some malicious sexual actions on the part of the healthcare provider. That view is unreal and unacceptable. ..Maurice.
Matty G - if your husband allowed a male to perform "intimate care" on him wouldn't your husband now be gay and a cheater? Maybe you should have been there to do all his intimate care so someone else didn't have to since you feel so strongly about this.
I often have a difficult time distinguishing between a nurse and a prostitute. At least prostitutes call themselves prostitutes, they don't try to make themselves sound culturally legit by calling themselves nurses or nurse's aides. They also don't put their "customer" to sleep before having their way with them and then keep what they do to them a secret. Men visiting prostitutes have some say in what happens to their bodies and give TRUE informed consent. I'm amazed at what nurses and their assistants can get away with today in our free and civilized world.
Doctor Bernstein:
There are many women who feel the same as I do. I would suggest that if I provided you a list it would be shocking as to the amount.
Just let me say that there is a bond in marriage, rights to each others body that no one else is supposed to have. That is what keeps a marriage private, or even sacred if you will.
Most marriages find it unacceptable if someone from the opposite gender took those privacy rights away. That is a big reason for divorce, is it not?
Most nurses are women, and for those that care about gender, are always taking priviledges that just do not belong to them with other women's husbands. It breaks intimate bonds and ruins relationships when a woman assumes these rights with anothers husband. I can't really say it any clearer. I guess I would respectfully ask you if you are married, and if so, how would your wife feel if you stripped for a female nieghbor and allowed her to fondle you? Broken I would guess. Just as I do.
I know nurses want to be considered an exception to all marriage vows, but they simply are not any more special or sacred than the rest of us. Women are women, no matter who you are.
**I did note however that it would bother you if people felt that way about you, which gives me hope for other marriages. But let me also say that I have read your posts, and you don't force intimate care on anyone, so chances are no one does feel that way about a respectful care provider such as yourself.
My suggeation may have sounded silly to some, but I was serious. Maybe if nurses saw first hand what a ruined marriage is like and how if feels to be the one who destroyed it.
Nurses may want to deny all of this to other people,friends, and family, but it doesn't make it not so just because they get to walk away and not care. It just means they want to hide the truth, and go on happy despite what they have done.
I hope you can see what I am saying in your heart, and not be angry with those who feel this way.
Everyone's sadness matters, doesn't it? Matty G.
To Matty G.
I'm not challenging your feelings or your story. Your feelings are valid and so is your story. I'm just saying that people who stereotype a whole profession, a whole gender, are not using rational argument. Saying that all female nurses (or male nurses) have ulterior motives or are uncaring is not logical and is, in fact, stereotyping -- and, not true. But I strongly support your right to get the kind of care that makes you and your husband most comfortable and fits into your value system.
Anon: Your question was not designed to be answered, it was designed to ridicule. Therefore you really don't care about my answer, do you? What you care about is whether everyone thinks the turn-about was clever, not valid.
I did write a rather legnthy explanation about how I feel regarding Dr. Bernstein's post early this a.m. as yet unposted.
I'll wait and see if that will suffice. As for being there, I left for 10 minutes. That is my guilt to bear I well imagine.
**Mer: I see we don't agree, but at least you acknowledged my right to my own feelings. For that I thank you.
Regarding "Saying that all female nurses (or male nurses) have ulterior motives or are uncaring is not logical and is, in fact, stereotyping -- and, not true."
If they cared about ruining lives they would stop. Is that not logical? If you told me I was hurting people by my actions, I would stop. Wouldn't you if I said the same to you? One would assume that to be a logical conclusion.
Matty G.
Matty G. is expressing a feeling that I am sure some women feel after learning a female has handled their husband's genitals in the name of medical care. It isn't an assumption, Dr. B., that the 'worker' has an expressed or hidden agenda regarding sexual intent. It is the knowledge of the spouse that another person of the opposite sex has viewed and handled their spouse. Many men feel extremely upset with this issue and do not want their wife going to a male gyn/ob doctor. There is a group - "how husbands feel" that discuss this and how much it has damaged relationships. This works both ways in a relationship. I wonder do these 'nurses' that do intimate care in the OR and other areas realize that this actually causes a great deal of pain and damage to people? Maybe they should be told so! The image of the opposite sex doing such things to one's spouse can be or is very upsetting to some people.
JW
You're funny AL,real funny.
But tell me this,in your view
where do men in trench coats who
enjoy flashing fit into the scheme
of things.
PT
Mattie G,
Here is the dictionary definition of "fondle":
fon·dle (fndl)
v. fon·dled, fon·dling, fon·dles
v.tr.
1. To handle, stroke, or caress lovingly. See Synonyms at caress.
To show fondness or affection by caressing.
Now if any healthcare provider (physician, nurse or other) is handling lovingly, stroking lovingly or caressing lovingly, that person should be immediately fired and they should be subjected to the other penalties associated with sexual battery.
If the behavior of "fondling" is what is in the general public's mind whenever a physician or others in healthcare perform pelvic or male genitalia exams or procedures, we might as well throw out the profession of medicine and nursing and have the wife, husband or lover be responsible for the diagnosis and therapy of their mate.
I must say that the concept of fondling as a mainstay and universal and not an extreme outlier behavior during diagnosis and treatment is ridiculous! ..Maurice.
I agree that the word "fondle" isn't the way to describe 100% of what nurses and aides do to patients. Quite often a man's penis is treated like the stick shift of an old truck that the driver has a hard time shifting into third. Sometimes women's genitals are treated like an old bowling ball during a plumbers league bowling tournament. But whether it's stroked lovingly or mistreated terribly it's still wrong. Either way people of the opposite gender shouldn't be handling them.
However much the medical profession claims its intimate care is not intended to be sexual, patients still feel the same. Could this be understood in the context of sexuality?
Let us consider different type of people. People "A" are those who consider sex and exposure to anyone of the opposite gender other than their spouse to be betrayal. To them, sex and exposure can be seen as an act of love and trust. So the statements of Mattie G seem along these lines. Whether there was any sexual inclination to the intimate care her husband received, the fact that there was exposure and contact are enough for her to be betrayed.
People "B" say are those who stay loyal within their marriages but may enjoy intimate contact with the opposite sex occasionally. It could also be that even if they are not unfaithful, the thought of sex, exposure or intimate contact may not bother them to the extent of ruining their marriages. They may have not been faithful because they didn't have the opportunity or maybe didn't want the risk of divorce.
People "C" maybe those who neither bother themselves with relationships nor have any issues with sex with absolute strangers. These maybe the ideal patients as far as the medical profession goes they may not complain whoever does whatever to them.
With Mattie G, her feelings should have been made clear before her husband's illness and she should hear about what her husband's needs as far as intimate care is concerned. Its unfortunate if this is happening to many people.
------SKI
Mattie G I agree with you completely.
Dr B,
I know it's been mentioned before but I think there is a huge difference between doctors and nurses/aides. Many reasons, but to begin with is the amount of education doctors get. They completely dedicate their entire life to learning everything they can about the human body. Everything they do and every decision they make could effect their career. Any mistake they make not only effects the life of their patient but also their entire career and reputation. They have to deal with know-it-all nurses every day who constantly second guess them and think they know better. Nurses have MUCH less education and when they make a dumb mistake they can just move on to the next job. They have much less to lose if they get caught acting unethically.
It seems like the more education someone in the medical world has the less they deal with nudity. To give a job as important as intimate care to a young and inexperienced teenager is ridiculous. They have nothing at stake and often don't have or understand ethics. They also lack maturity.
Those are just a couple of reasons but they get the ball rolling. Doctors should have access to whatever they need on the human body to do their job but nurses and aides shouldn't have that same access and "entitlement". A female aide that is given the job of shaving off all of a man's body hair could have been working as a waitress the week before, or even attending high school. It's just ridiculous.
Well Doctor, we have told you the truth of it. We have told you that opposite gender care hurts relationships, and since we are the ones hurt I believe we should know. It can be 'ridiculous!' to you, you certainly have the right to feel as you do. But it does sadden me that that's as far as you will allow yourself to feel about it.
As far as: "we might as well throw out the profession of medicine and nursing and have the wife, husband or lover be responsible for the diagnosis and therapy of their mate." I think the extreme of that you don't really believe. Gender care needs sre different for everyone, and you have suggested respect for that. Just because some reasons behind those needs don't make sense to everyone does not warrent the closing down of medical care.
Matty G.
The problem seems, to me, to be the lack of nuance in caregivers for some medical treatment -- the one size fits all attitude regarding patient intimate care. Now, we as patients need to understand that overall, this is not a bad attitude. It goes to protocol, what works, and best practice. When you learn that something works, you do it that same way over and over again. But that's the mechanical model. That may work to fix a heart or liver, but it won't necessarily work in dealing with a whole human being, body, mind and spirit.
Contributing to this problem is the gender imbalance in nursing, staffing problems, the bottom-line attitude, fear of lawsuits -- and a general culture of secrecy in medicine that I've written about in past posts and cited in credible books. Not all, but I find too many medical professionals to be judgmental regarding patient values, attitudes and feelings. It's just easier to call for a psych consult, to regard the patients attitude as not normal. For some caregivers, normal patient behavior in the hospital should be, as some of them say, for modesty to go out the window. Heard that expression before? This is not normal behavior; in fact, it would be abnormal behavior.
I think this intolerance is partially created by the environment in which some medical professionals work. They want to be more accepting, but they can't. They system won't let them. Their intolerance is a survival strategy, a defense mechanism. I'm not excusing unethical or unprofessional behavior. I'm just trying to understand.
Privacy rights of the individual are just that; rights to that individual and not of the spouse. Medical care is not sexual until the behavior of the clinician (or patient) becomes inappropriate or deviant. This could come in the form of little more than an inappropriate comment when a patient is exposed or outright sexual assault.
Should there be a spouse who is upset that someone of the opposite gender is looking at their spouse, it is up to the patient to create the boundaries. Should the spouse be upset with the other spouse because that wasn't done--too bad
marjorie starr
My neighbor's husband was hospitalized and received intimate care from female nurses and now he hasn't been intimate with her ever since. It's not clear to her what exactly happened but she knows he was very upset that female nurses and their assistants did intimate things to him. Appropriate or innappropriate, whatever happened has now messed up their physical relationship.
Marjorie, I'm really surprised with what you said about rights being for an individual and not of the spouse. My neighbor's husband was clearly unable to create the boundaries on his own for some reason and she regrets not creating those boundaries for him. I thought you fancied yourself a patient advocate but now you say that a patient is on his or her own and the spouse shouldn't get involved or upset?
You say "Medical care is not sexual until the behavior of the clinician (or patient) becomes inappropriate or deviant." Sometimes a patient doesn't realize what's happening and may not see something as being sexual until well after it happens. A good spouse should put a stop to something before it goes too far. Getting mad at your spouse for something that's beyond his or her control doesn't make sense but a spouse should know when the patient isn't thinking clearly. Do you think the spouse should just sit back and allow something to happen that he or she knows will negatively effect the patient? Can you blame Mattie for not wanting to see or touch her husband's privates after they had been a dozen nurse's personal playground for a while?
My neighbor thinks her husband was traumatized by the way the nurses treated him and they most likely didn't do anything illegal. Just insensitive and unethical. I personally think that if I allowed female nurses or assistants to touch me that way or gawk at my naked body I would feel like I was unfaithful. Nudity between the sexes is a privelege that should only be given to the one you love.
LG
I must say that, although I've read about attitudes like those of Matty G. and LG, I don't really understand them. I do agree that spouses should talk with each other about this modesty issue and agree to support each other's values and advocate for each other. But I do agree with Marjorie, that these privacy rights are basically individual. If one spouse feels comfortable with opposite gender intimate care, and the other doesn't feel comfortable with that attitude, the two need to compromise and work something out. But just as I won't challenge Matty G's feelings (they her feelings), spouses need to accept the feelings of each other, too. Again, a main problem seems to be communication. Husbands and wives need to talk about this, express their feelings to each other, and respect those feelings. LG brings up a good point, though. Spouses need to know when to advocate for each other, times when the ill spouse can't seem to communicate his or her feelings to medical staff. That's a valid position. On the other hand, medical staff need to make sure that one spouse isn't being bullied by the other spouse. That can happen, too.
A point that I've made off and on throughout this blog is this:
On either end of the spectrum are the two extremes -- people who completely refuse to be treated intimately by the opposite gender, and people who insist on being treated by the opposite gender. Most patients, I'm convinced, are somewhere in between, and could go either way, depending upon the entire context of the situation, how safe and comfortable we feel, whether we feel our dignity is being respected, how we're initially approached.
I found a recent study in an Australian journal that may indirectly support this position. See below:
"Undermining self-efficacy: the consequence of nurse unfriendliness on client wellbeing"
Collegian: Journal of the Royal College of Nursing Australia, Volume 12, Issue 4, Pages 9-14
R. Geanellos
ABSTRACT
"Although unfriendly nurse behaviours are noted in research findings, no study names these behaviours as such, nor investigates the impact of nurse unfriendliness on clients. Because the present findings reveal the phenomenon of nurse unfriendliness, they allow both the phenomenon and its consequences to be understood. These findings were developed through secondary data analysis of a text where participants discussed their encounters, during hospitalisation/s in 2002-2003, with friendly and unfriendly nurses. Findings reveal nurse unfriendliness is characterised by frostiness, officiousness and apathy. It results in thoughtless and inept nursing and in a hostile environment where clients feel unsafe, unwelcome and unaided. Unfriendly nurses create barriers – they are disrespectful, cheerless, unresponsive and domineering so clients feel belittled, disheartened, unprotected and distressed. When clients are placed in this position, their self-efficacy is undermined. By revealing the consequences of nurse unfriendliness on client wellbeing, findings from this study advance nursing knowledge."
Now, the paradox may be that what the patient perceives as nurse unfriendliness isn't necessarily conscious unfriendliness on the part of the nurse. It may be the nurse trying to distance her/himself, protecting her/himself emotionally, not getting too involved. (By the way, this applies to all medical personal, not just nurses). But we're talking about distinct situations
-- Nurses who may not realize the persona they're projecting.
-- Patients who misinterpret nurse behavior.
-- Really unfriendly nurses who actually demonstrate frostiness, officiousness and apathy.
-- Patients who are just pains in rear end who create a situation where good nurses become unfriendly.
But I think this is one key to this issue. The majority of patients in the middle of the spectrum on this modesty issue, may refuse opposite gender treatment if they perceive the nurse as uncaring and unfriendly.
I haven't been able to find a link to the article. If anyone can find it, please post it. I'd like to read it.
MER, thanks for the abstract. Notice, no sexual behavior innuendos was noted as included in the patients' descriptions. However, with regard to all the sexual behavior innuendos which have been written about on these threads, I really think you really hit upon an explanation when you wrote "patients who misinterpret nurse behavior". I know I am going to get a whole bunch of criticisms on this but it may well be the whole furor here is just about "misinterpretation". But let's discuss that. Most patients I am sure are not aware of the details of the individual healthcare provider's education, licensing and supervision. They are not aware of the psychodynamics of the duties of the occupation (or non-occupational responsibilities) on the thinking and behavior of that individual healthcare provider. They are not aware of the individual personality difference of that provider as compared with other providers. Etc., Etc. Not knowing all of these and more can lead to: "Misinterpretation". ..Maurice.
My comments were based on competent adults whose preferences may not reflect those of the spouse.
While I have been married for many years and do appreciate my husband's support of my issues by reinforcing gender choices for his intimate tests (even though his level of caring is nowhere near mine), It would be overstepping his personal freedoms if he were laying in a hospital bed and didn't mind the opposite gender care even though it wouldn't be my choice. His medical and emotional needs would be met sooner rather than later.
Personal needs are just that. Yes, we should support our spouses (who knows us better?) however, my comments were based on differences between spouses and the patient in need of medical attention should be the one calling the shots on these personal issues if they are capable.
Dr. B, It is in the research that previous victims of abuse/assault misconstrue medical procedures and yes, there is basis of misunderstanding. All the more reason to honor the needs of those patients for patient safety and the safety of the staff.
Everyone knows what "feels good" and they also know when something is wrong. It might be a look or comment or someone feeling justified to intrude on someone's privacy. While there may be no ill intent it depends whether you're the patient being gawked at or the professional daydreaming waiting for a procedure to begin while looking toward the unfortunate patient.
When this happens, followed by sexual comments you can rest assured what the intent. The trouble is that you cannot always tell. Patients are left feeling violated and staff puts itself in a precarious position by being insensitive. Either way, the damage to the patient as I think you are realizing in these posts, is devastating, erodes trust and mental health and the saddest part...most of the time there is no reason for it; just that right of entitlement that is wearing itself out!
marjorie starr
Mer:
What I really appreciate about some of your posts is the fact that you often say "I'm just trying to understand." What often gets lost in the fervor of emotions here is the basics of human thought, differences in our interpretation of what is 'moral', and perhaps emotions in general. I understand that part of that is the nature of a blog, and the lack of real time response, and part is simply the lack of being able to attatch scientific data to purely emotional (and often confusing)responses/opinions.
I often wonder why we do not ask more questions of each other here in efforts to understand the other, if that is our goal.
So along that vein, my question to you would be..
"I must say that, although I've read about attitudes like those of Matty G. and LG, I don't really understand them."
...what it is of this you do not understand?
I ask this because I believe this is a key issue, often expressed but not acknowledged or even accepted by some. Without being too dramatic, it is actually an entire foundation of thought attempting to fit into a modesty niche.
This is not to say I would splinter my advocacy in all different moral and emotional directions. Advocacy goals need to remain simple: the right of choice and options. But understanding the moral movement into these modesty discussions is key to understanding a big segment of the population with 'modesty needs'.
Any way I say this is probably going to come out wrong, but here goes:
Marjorie said:
"It would be overstepping his personal freedoms if he were laying in a hospital bed and didn't mind the opposite gender care even though it wouldn't be my choice."
In an effort to understand those that I have spoken with similar to Matty G. etc., this is how those spouses view what she said:
"It would be overstepping his personal freedoms if he were laying at home in bed and didn't mind opposite gender interaction even though it wouldn't be my choice."
Bad way to run a marriage?
Call it ridiculous, petty, or not making sense in somebody elses eyes, but this is the perfect example of the "women are just women and men are just men" belief.
Doesn't really matter who agrees or disagrees if it is how they feel. This is a hard way to live if spouses do not agree or respect the beliefs of the other when it comes down to the definition of infidelity. Divorce is a result more often than people know.
I would hope people communicate and seriously discuss the importance of these issues with their spouse.
MARJORIE: PLEASE NOTE...this was an example and not a judgement or reflective comment on your marriage. swf
swf -- What I don't understand about points of view like Matty G's is the "trust" factor. I trust my spouse. If my spouse feels comfortable with intimate care from the opposite gender, that's my spouses's decision. We can talk about it, share each other's point of view -- but I respect my spouses autonomy. That's what I don't understand. Although it exists, it's hard for me to understand spouses who have such opposite views to the extent that once spouse will not have intimate relations with the other if he/she feels comfortable with intimate care. It's a matter, to me, of respecting each other, our differences. As long as there's nothing immoral or unethical going on. But, as far as I can determine, Matty G. considers any opposite gender intimate care to be immoral. If that's the case, then I see where Matty's coming from by don't agree with that assessment. But this is a very personal situation, between spouses, and they need to work it out as best they can.
SWF,
Your comments struck me in an amusing way. This is because I've been married 35 years. What makes this marriage work is respecting each other's individuality and supporting each other even when we don't agree. That means he supports my needs and I support his even when our needs conflict each other.
When it comes to individual needs it is important to support that person's belief system and not push your own onto someone, especially when your loved one is in a vulnerable state.
Independence, strength and respect is what makes marriages strong. Knowing when to step in and when not to makes marriage what it is supposed to be--an unconditional bond of putting someone else's needs above your own.
It is my opinion depriving a loved one who is ill of care to their benefit just because the gender of the caregiver isn't your choice is not only selfish but just as damaging and egregeous as the other end of the spectrum--forcing intimate care of opposite gender on someone.
marjorie starr
So marjorie starr you don't care what female nurses and aides do with your husband's penis? If he agreed to be a naked display for a group of female nurses you wouldn't object? Nothing he decides bothers you enough to try to interfere?
NOTICE: AS OF TODAY DECEMBER 13, 2009 "PATIENT MODESTY: VOLUME 28" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 29.
"If they cared they would change. That is that. How many times do we have to be told here that society says it's o.k. and our body doesn't belong to us before we get it."
I wonder if that's what is really behind the oddly large number of folks who claim to prefer/accept gender neutral care. American children are groomed into accepting the "doctors are doctors" professional card from a young age. Clearly the modesty that begins developing in children around three is disrupted by dr.s-probably a great reason for the promiscuity of today. Read up on the "think like a dr." (re pelvic exams) blog-school physicals and genital checks are still going on and the details are far more blood curdling today. (One school even hired a male and female examiner, specifically to force opposite sex genital exams on both groups of children, while opposite sex school staff observed.) Dr.s even speak frequently of "getting children used to it"-isn't this what sexual predators say? The anonymous responses are sad: children rightly feel violated, but others gang up on them to immaturity bait, say it's ok if dr.s/nurses violate them, and again "get used to it." I'd put money on this oddly large acceptance of forced/pressured gender neutrality simply to be nothing more than brainwashing, conformity and political correctness. (Thanks to the sexual revolution, everyone is terrified of having "hang ups.") I can't believe that more isn't going on deep deep down. People from other countries think US & Canadian dr.s are sick perverts for such reasons. I've talked to Australians who've never even heard of genital checks in children and thought pelvic exams had something to do w/checking your hips.
Back to cadaver abuse: Below is a link to just such events. Dr.s in this country are obsessed with genitalia, and of course the corpses were sexually abused. I don't buy the claims of "respect" as anything more than the public face of medicine. I also know horror stories personally from med. students-which I buy more than I do medical PR.
http://www.smh.com.au/news/national/cadaver-abuse-unsw-apologises/2007/02/06/1170524072141.html
LG and Matty-thank you! I wondered if I was the only female who ever felt possessive of her man. Worst is that this issue dare not speak its name. I myself had a relationship ruined for similar reasons B/C I knew that to say I had such feelings of resentment and jealousy would label me, in this country anyway, "crazy." Thus they ate away at me and expressed themselves in destructive ways.
I really can't believe that modern medicine isn't just part of some larger Orwellian drive to eat away at the bonds/privacy of men and women and families.
BRAVE NEW WORLD
After having read the post here I find that most objections are from lack of respect for the patient be they male or female. I personally have been refused treatment, yelled at, chastised, ridiculed, and ask to find a doctor else where for requesting gender preference in my medical treatment. This has been done mainly because I didn't want a female observer in the room. First of all you do not know if the observer is a trained nurse or not, some doctors just use people who apply for a job no training except for what the doctor gives them. Also nurses seem to feel that they are ordained to view the nude body of the patient even upon the objections of the patient. Yes I have made certain requests to have gender specific care, both in doctors offices and in hospitals just to be laughed at for even asking. And I have left doctors offices because I refused to have them present. I do understand the legal issues very well. As for me,a male, I have no preference on the sex of the doctor that treats me. However I object the the observer, nurse, tech, or any stranger off the street being in the exam room while I am being examined. This is a time for the patient to be honest with the doctor and not be restrained in asking questions or giving answers that no one else should hear. Noone has the right granted them by God or the licenseing board to violate the privacy of the patient. When the rights of the patients modesty are taken away they have nothing left, this doesnt mean the patient should not get treatment but the fear of this usually does. I believe that I have the last say in who sees and or touches me, and noone else has a right to just be there to watch or see what is done unless I agree. The training of medical personnel here locally is like 98 to 1 female to male students. It therefore difficult to get gender specific care.
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