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Patient Modesty: Volume 32
We continue on with a multi-faceted discussion regarding patient modesty. Is there any one facet in these previous 31 volumes which hasn't as yet been covered? It seems to me that virtually everything has been discussed except perhaps the role of the government, both state and federal and politics in the distresses expressed here by my visitors. Particularly interesting would be whether anyone who is involved in the United States healthcare reform is considering patient modesty and gender selection issues as part of that reform. Any thoughts on that? ..Maurice.
Graphic: The Donkey and Elephant political cartoon by Thomas Nast (1840-1902) American editorial cartoonist with text applied by me using Picasa3.
NOTICE: AS OF TODAY MARCH 24, 2010 "PATIENT MODESTY: VOLUME 32" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON
VOLUME 33
135 Comments:
Well lets see Maurice,federal prisons employing female guards,
female non-medical observers during
military induction physicals.
I'd say the government has their
hands dirty in all this mess!
PT
The New York State Nursing Association's position statement on informed consent. Specifically, look at # 5. Seems pretty clear to me as it applies to the reasonable requests for modesty or same gender care.
MER
http://www.nysna.org/practice/positions/position18_04.htm
My best guess as an American and a patient would be that the government is giving little if any consideration to things that are truly important to patients (aka health care consumers), because that's how the government has worked in the past. Sure, they might very well pay lip service to these matters, but action is less forthcoming. Does anyone really think the government is going to step in and change the gender ratios in places like nursing and/or medical schools? That would be about the only way to give every possible patient the type of care provider they want. To me that would be an unacceptable level of interference in individual choices. (Not on the part of patients, but on the part of people who are choosing their careers.) And even if something like this did come to pass, I'm sure that in a given location there wouldn't always be the right ration, so you'd have to travel if you're that concerned with the gender(s) of your practitioners.
Bureaucracies are, by their nature, behemoths that function by usually keeping things at status quo. Too much change upsets the beast and makes it even less effective. Perhaps what patients and their advocates need to focus on is not overhauling the entire system, but working at a more "grass roots" level, one provider, one institution, one health care system at a time. Not as drastic as a government overhaul, but more likely to have lasting results.
And no matter what happens in health care reform, you're never going to please everybody.
Wouldn't it be just fascinating to learn the medical gender preferences (for certain exams and procedures) for the President and his family; his White House staff; members of Congress and their families, etc.? I'm sure a certain percentage prefer same gender care, and I'm also convinced that they'd have absolutely no problem getting it -- no questions asked.
Of course, we'll never learn this information. This info comes under HPAA regulations, no doubt.
But when one starts talking about what "government" will and will not do with medical care preferences, what's cost effective, what might require affirmative action or quotas, etc., one must consider the special treatment available to upper-level government officials and their families. Some may claim they don't "take advantage" of the system -- but the fact is, and they can't deny it, the options and special considerations are available to them whether they avail themselves of it or not.
MER
MER
Thanks for sharing this interesting find with us.
5)Each patient has a right to
freedom from the imposition of another's belief or judgemental
attitudes.
Many nurses are unaware that asking their patient on a date
or showing a sexual interest is
a violation of the nurse practice
act,and I certainly don't believe they've ever read the article on informed consent.
Furthermore,I do believe in these instances that knowledge is power and certainly have known
that it is unethical and innapropriate for anyone in healthcare to argue with a patient
on how or what their care should be
and delivered by whom.
However,these instances of informed consent are asking written
permission just prior to a procedure,usually invasive. Such as
a biopsy or surgery.
In Arizona,verbal abuse,sexual
abuse and boundary violations are
grounds for license revocation.
Specifically,abuse means a misuse of power or betrayal of trust,respect or intimacy by a nurse that would most likely cause
physical,mental,emotional or financial harm to the patient.
Each state has its own rules
and jargon and how it applies to
patient privacy or its percieved implication to privacy.
PT
"Does anyone really think the government is going to step in and change the gender ratios in places like nursing and/or medical schools?"
Probably not. But one thing the government can do (which we have discussed before) is make grants and scholarships appear less gender biased.
This applies to private organizations as well. Three fundraisers happened in my area last weekend, and all three were scholarships specifically for girls who would enroll in UNR's nursing/med program. Just three fundraisers can benefit 21 girls, and combined with the millenium scholarship will have a greater advantage.
I have no problem with scholarships for females in theory, as long as there is an equal effort for males. We can see how this type of bias leads to the current ratio of female to male caregivers.
On a side note, I saw von Hagens’ Body World when it was in LA in 2005 and it was indeed fascinating. I know the human bodies donated were of their own free will but the overwhelming majority of them were male bodies. On the Body Worlds’ website in the FAQ section is “Why are there not more women plastinates in the exhibits?”
Answer: Sensitive to perceived community concerns, Dr. von Hagens did not want to appear voyeuristic in revealing too many female bodies. Further, he sees himself in the tradition of Renaissance anatomists, whose works traditionally included far more masculine than feminine bodies, since all but the reproductive systems are essentially the same. The musculature of male bodies is generally more pronounced and illustrates more aspects of the muscle system. The organs on display come primarily from the female body donors. However, since opening the exhibits, Dr. von Hagens has received numerous requests from women visitors to see more examples of female anatomy. Based on this, Dr. von Hagens has already added and will add more female plastinates to future exhibits.
There’s that double standard again. Female bodies must be kept from view, male bodies hey no problem.
http://www.bodyworlds.com/en/exhibitions/questions_answers.html?edit#13
Jean
The government has done something about these issues. When the Civil Rights Act of 1964 came to be there is a Title VII exception for consumer privacy and a bona fide job qualification acknowledging that in some positions where bodily privacy was important it is perfectly ok to hire same gender as in the bathroom example below.
It is the medical industry who trampled all over it and decided to put an employess right to work ahead of patient privacy.
Note...a bathroom attendant would have full expectation of being the same gender as client's who use that bathroom. However, in healthcare let's have a young man bathe and humiliate a 80 yr old woman or...the other way around.
gd
Today, I had my appointment with a new urologist, possessive of a private practice, affiliated with a major city hospital. His website advertizes: "Because many urological conditions are accompanied by social discomfort or embarrassment, he emphasizes sensitivity and discretion when dealing with all his patients' concerns...This commitment means we work harder and smarter than our competitors." Folks, I want you to know, this man makes good his claims. Permitting me to discuss my spiritual consecration to celibacy, past trauma experienced with female staff when I had an inguinal hernia operation and a mammogram, and if in need of possible exams, tests, surgery or care, involving my genitals, of my insistence on same gender providers; without any reluctance, the doctor assured me that all office procedures with men, are performed by him, with no woman present. Stating that he had no control over the nurses' scheduling in the hospital, he agreed to be my advocate with this issue, should the need arise. Next, I pushed the question, that on my prescription, I would desire for him to write that the patient seeks same gender providers, he affirmed that he would do this for me. (His "John Henry" on the order, would inform the hospital, that modesty has been discussed between doctor and patient, increasing the likelihood of accommodation.) Several months ago, I had seen one of this urologist's competitors, part of a nationally recognized team, and the doctor dismissed my discussion of modesty. Be assured, he will never see me again. When recruiting a healthcare professional, always remember "more things are wrought by prayer that this world has dreamed of."-REV.FRED
Great to hear Rev Fred. I hope you recommend him to every man you know.
Could it be possible? A Urologist with no double standards?
Rev.FRED
Women don't need a script with
same gender provider notice when
seeking a mammogram,its a guarantee.
Therefore why should we? I can
only imagine the facial expression
of some medical secretary when she
looks over the script. My bet is
that she notifies her supervisor
and comments "Is this a joke or
what." I'm sure the ordering
physician would get a phone call
for clarification.
PT
I recently went to a hospital for a caudal epidural to help with sciatica pain. The procedure is VERY painful. I have had the procedure before so knew what to expect. The first time was like a "circus" with about 10 people in the room, the vast majority of whom were spectators. The second time involved 3 males and 1 female (a nurse), again more that strictly needed.
This time I wrote on my consent form "no non-essential staff" for the procedure. The specialist carrying out the injection readily agreed to my request and it was conducted by him with one male nurse assisting. Once I knew it was just to be himself and one other (male) nurse, I relaxed completely (even knowing the pain that was bound to ensue).
I will always state my preferences more openly and up front in future now that I have seen how less uncomfortable things can be when one does not have to worry about being embarrassed by females during such an already unpleasant procedure.
To Dr Lisa and other female healthcare workers.
Would you allow men to do EVERYTHING necessary in your healthcare? Please be truthful. Would you allow:
1. 1 or more male nurses to perform, assist or observe ANY type of physical exam? Including breast exam, genital exam or gyno exam?
2. Even if he's there for no reason other than to observe?
3. 1 or more male nurse's aides to give you a pre-op nipple to knee shave? (or observe)
4. 1 or more high school aged boys to bathe you or perform other intimate care?
5. A male nurse or nurse's aide to be alone with you in a room while performing intimate care to you when you're conscious or unconscious?
6. Do any of the above things to your underage daughter?
We know most of these things will probably never happen but what would you accept?
Todd
Todd,
Y0u are absolutely right! Men though have the perception that same gender care is easy for women. When you get into a hospital situation it's not and furthermore, they could care less. It's up to all of us, both men and women to insist on our privacy rights or walk. When they realize who's paying the bills they will have no choice but to respect patient privacy.
gd
Okay -- here's a group we need to support. It's called "Women Against Prostate Cancer." In their "Take Action" link, you'll find this as one of the causes they support:
"Passage of a Bill to create an Office of Men’s Health within the Department of Health and Human Services (HHS); this Office will mirror the fine work of the Office on Women’s Health. You can learn more about how this will impact prostate cancer and take action at: http://menshealthpolicy.com/OMH/index.html"
So -- here we have a group of women who are dedicated to working with men. Check them out. You'll find the group at:
http://www.womenagainstprostatecancer.org/
MER
I admit I haven't read the entire womenagainstprostatecancer site, but the mission statement says in part "Women Against Prostate Cancer (WAPC) is a national organization working to unite the voices and provide support for the millions of WOMEN affected by prostate cancer". It appears to want to help the WOMEN effected by prostate cancer. They care about the women, not the men. Though men are also helped indirectly.
MER, thanks for the link, there is already a wonderful comment by minutemoon about modesty related issues. That website made me wonder about how common breast cancer is to prostate cancer. Here's what I found:
-- Based on rates from 2004-2006, 1 in 8 women will be diagnosed with cancer of the breast during their lifetime. --
-- Based on rates from 2004-2006, 1 in 6 men will be diagnosed with cancer of the prostate during their lifetime. --
Now look at the funding each receives from the US gov: Breast Cancer $572.6M vs Prostate Cancer $285.4M
Chances a woman with breast cancer will receive treatment by an all female staff: 99%. Chances a man with prostate cancer will receive treatment by an all male staff: nil.
Here are the links:
http://seer.cancer.gov/statfacts/html/prost.html
http://seer.cancer.gov/statfacts/html/breast.html
http://www.cancer.gov/cancertopics/factsheet/NCI/research-funding
Jean
To anonymous who wrote: "They care about the women, not the men. Though men are also helped indirectly."
If you want to influence human beings, you've got to deal with what's called perceived self interest -- what's in it for me. Of course -- women are concerned about themselves. But the issue is more about families. Statistics demonstrate that when spouses die, especially those with children, the family suffers. That makes sense. But when husbands die, a significant number of families suffer not just emotional, but financially as well.
So I really think the women are focused on families, and how families and children suffer when husbands die or become sick due to diseases like prostate cancer.
Let's not get too cynical. A certain degree of self interest is just part of being human. And, frankly, if don't care at all about yourself, what good are you to anyone else?
MER
Jean, I think the discrepancy in funding between breast cancer and prostate cancer is not due to sexism. It is due to the nature of the cancers. Breast cancer is a far more aggressive cancer and it strikes people at a younger age. Prostate cancer is a slow growing cancer that usually strikes men at an older age. If a man is diagnosed with prostate cancer often the treatment is no treatment because the the patient will die of other causes years before prostate cancer would have killed him.
NP
NP,
in the Uk breast cancer kills roughly 13,000 women per year.
Prostate cancer kills 10,000 men per year.
Unit funding for the 2 cancers?
Breast cancer receives 16 times as much funding for screening, treatment and research as does prostate cancer.
Equality in action?
It has been estimated that approximately 10% of nurses are
chemically impaired according to a Duke University study.
The American nurses association(ANA)estimates that 6 to 8 % use
alcohol and drugs to the extent
that they impair their professional
performance.
Emergency and Critical care nurses are three times as likely to use
marijuana or cocaine as nurses in other specialities.
The perspective to keep in mind is that these numbers only represent
those that have been caught.
Imagine for a moment you present yourself to the ER with severe pain from a possible SBO,Kidney
stone,diverticulitis or cholecystitis.
You tell the nurse you are still in pain after the pain injection
and that its not working. At that
moment you are labeled a drug seeker,yet no one assumes the nurse
is stealing your drugs.She's only injecting you with a flush(saline).
Don't expect these people to advocate for you in any capacity,as
their only concern is when a pain med order is written.
Trust only applies to EBAY purchases and not to you and healthcare.
PT
PT, I am not challenging your nurse statistics but I just would like some internet links to the resources you used to review the context of their presentation. ..Maurice.
Anon:
I just want to be clear on what your point is. Are you encouraging men not support WAPC because yet again those pesky women are envolved? Or are you just saying that you feel their motives are not pure therefore they do not warrant our attention? Quite frankly, I would think that any action at this point by anyone is better than none. And if women are reaching out to say that this disease is killing their male loved ones and something needs to be done about it then it is a pretty sympathetic plea.
*** And once you have that sympathetic ear, keep reminding them that many men avoid care due to modesty issues. Despite the fact that women who post here already understand and are frustrated by this issue, don't assume that other women wouldn't care. It is not so long ago that some here thought that doctors knew about this plight and could not care less. But as Dr. B. has shown here and other sites that I have read, it has only recently been an issue that more men cared about than he realized, and encourages advocacy if that is your need.
It's alot easier to push a rock that is already rolling. Take advantage of the actions that are already out there.
I agree with you, swf.
Women tend to organize for themselves better than men do. Look at how women organized to help girls that were having problems in our schools. Now the data is clear that boys are having just as many problems, many worse -- but do you see men organizing to help those boys? Not many. But you do see women organizing to help those boys. Why is that? Women tend to hold families together better than men do. Stats show that women make most of the medical appoints for their families, including for their husbands. When the kids get sick, the wives tend to be the caregivers. That's just the way it is -- not that it has to be that way -- but women are and have been socialized in our culture to be caregivers.
I think we all look toward our own self-interest, unless were saints and fully altruistic. Of course these women who formed this prostate cancer group look at the affect the husband's illness will have on their sexual and other relationships, and the affect it will have upon the children and the family. That doesn't mean they don't care about their men and look out for them. I don't see it as "the women are in charge or want to be," or "it's all about me."
I'm encouraged to see more women concerned with men's health.
MER
Maurice
On several occassions I've worked in an er when a nurse was
stealing pain med from patients.
It is not a pretty site I can
assure you. My point was to illustrate that privacy,modesty issues certainly are the last thing
on their minds.
www//duke.edu/~mageorge/papers/substance%20abuse.pdf
www.cartercenter.org/new/document/doc591.htm
PT
"Women tend to organize for themselves better than men do. Look at how women organized to help girls that were having problems in our schools. Now the data is clear that boys are having just as many problems, many worse -- but do you see men organizing to help those boys? Not many."
Men are too busy working and paying all the bills. Women have to do something don't they? It's easy for women to "organize" and "make appointments" when they have nothing else to do with their day. Organizing things and tending to the family shouldn't be praised, it should be expected.
I found this good comment from Carlos at another site.
Having worked in hospitals for years, I know that you have the right to demand a male orderly to perform such an intimate procedure for the sake of your dignity according to the "Patient's Bill of Rights". After all, that's why they were hired; certainly not to shave females' pubic area -- females are automatically protected. If they say "No", insist upon the hospital administrator's presence immediately with a copy of such document or you will call your lawyer. If they don't do that, call the administration office yourself with the same demand & threat. It is total hypocricy that a male RN could not work in the Maternity Ward, but every single nurse in the Urology Unit was female. Stick to your guns and demand a male as I did, the Dr. himself will have to perform the procedure if he hasn't properly provided his patients with appropriate staff. The usual tactic by the overbearing female abuser is to try to ridicule the male into submission with her attitude & words, making you think that you hve no choice or that there's something wrong with you because "nobody else minds". This is a lie; over the years, I've seen most men of all ages balk at this feminazi surprize attack, it may work because the men are not forwarned or prepared.
"It's easy for women to "organize" and "make appointments" when they have nothing else to do with their day."
It's easy to simplify reality with stereotypes.
Times are changing. Read the recent Pew study that came out regarding the reversal of male/female roles in the workforce and salary since the 1970's. Also, there's a tremendous amount of research out there now about gender brain differences. We're all humans, but now we can quantify to some degree how men and women think differently, perceive the world differently, use different parts of their brains, etc. I could list some of these sources, but I get the impression that some of those who need to read these will never do so. Their minds are already set.
There seems to be a tendency with some men (and women) to perpetuate a "gender war." That will get us nowhere. Men and women are alike in many ways. But our differences need to be recognized, acknowledged and respected. Each gender, generally, has certain strengths and certain weaknesses. Now science is looking into these differences -- especially when it comes to learning styles and how that affects our educational system.
Rather than complain and bitch, men need to get organized and lobby for the young men in our culture who are searching for male role models. This thread has been talking for months (years?) about forming an organization to lobby for male modesty needs. Rather than criticize and resent female skills in organizing, we need to learn for their successes.
Enough for the complaining.
MER
I agree MER!
In an attempt to move away from the bashing and be constructive, I did "speak" with Jimmy not too long ago. He has kindly agreed to attempt to build the site we spoke of last year. I did build a separate blog to copy all of the great ideas that were flying too fast and furious to keep up with, in an attempt to keep them in one place. Please let me know if you are interested in reviewing the blog/site.
Todd, thank you, for your concise and well-worded questionaire for female healthcare providers, related to intimate care. I would like permission to use your list of probing questions,for future use, when discussing the issue with women. Acknowledgement would be made that you are the source. You posted the challenge on Saturday, and here it is Tuesday night, and there has been no response. My read: Is it possible in the chess-board of life, the pawn (male patient), has check-mated the queen (female doctors and nurses)? Be assured, the game is not over.-REV.FRED
"It's easy for women to "organize" and "make appointments" when they have nothing else to do with their day."
Small point: If they had nothing elase to do with their day, then we wouldn't have the problem that we have. They're not home, they are working in hospitals.
Rev. FRED:
Excellent job making your needs known, and having the courage to stand by those convictions.
As has often been stated here, if you don't fight for what you want, you wont get it.
Hopefully other men (and women!) will read your posts and be inspired and couragious enough to finally say "no" themselves.
Of course Rev Fred! It would be my pleasure if you used my questionaire. I was sincere in my inquiery. It's a shame Dr Lisa and other women don't want to respond.
Todd
Todd, thank you, for allowance to make use of your list of questions, related to intimate care, to be used in possible future discussion. A seventh question might be added: a male nurse inserting a urinary catheter. Recently, someone posted that he or she has prepared a suitcase, ready to be admitted to the hospital, at a minute's notice. Several years ago, I did the same; but I am going to add one more item to my cargo. Kinko's will be commissioned to print on laminated neon yellow card-stock, a sign, which reads: FOR POSSIBLE INTIMATE EXAMS, PROCEDURES, SCANS,TESTS & CARE, PATIENT REQUIRES SAME GENDER PROVIDERS. (Knowing that the sign might be lifted from over my bed, if I were out of the room, I will have several made for replacement. One must outwit his opponents.) For 37 years in pastoral ministry, I have witnessed family members posting hand-made signs above the patient's bed, as advocates for their loved ones, related to many different concerns. It is their attempt, to call attention to important matters, which are ignored, or overlooked. My placard will be guaranteed to provoke conversation; I just hope and pray, I do not have to use it.-REV.FRED
"Small point: If they had nothing elase to do with their day, then we wouldn't have the problem that we have. They're not home, they are working in hospitals."
You're right, women are the problem so let them help to find some answers.
It's pretty ironic that the biggest problem for men concerning prostate cancer is women. If men didn't get talked down to, humiliated and ganged up on by women healthcare workers they would be more liable to have the proper testing done.
MER,
Your comments regarding gender differences is absolutely on target.
What you didn't mention is that women have a greater sensitivity (in general) toward having their bodies exposed. It effects them differently, not necessarily in a more or less way than men.
I've been wondering as the last several posts have nothing to do with modesty but this gender war.
Why can't we all recognize that our individual rights have been trampled on and that together, noting our preferences call for equal rights, envoke the privacy rights that we are all entitled to.
gd
"It's pretty ironic that the biggest problem for men concerning prostate cancer is women. If men didn't get talked down to, humiliated and ganged up on by women healthcare workers they would be more liable to have the proper testing done."
Sometimes it seems like we are running in circles here. 32 volumes of what we know the problem is, and very little positive about what is getting done. Is there really so little good news, or so little effort to make changes?
I received the following e-mail from a visitor today. ..Maurice.
Yes to SWF. Nothing is going to be done by medical operations to benefit the patients. MDs haven't and won't accept responsibility and assume leadership to improve benefits to patients. It's not about patients, it's about medical operations. Symbolic of this is nurses saying "I've seen it all before" and MDs saying "All I want to do is see patients". It's all about them.
BJTNT
BJTNT:
While I see your point, my question was really posed to the posters. What are WE doing to fix the problem? You simply can not leave it up to the medical arena to say "I get it, and I will change it".
At this point, more posts about affirmative action would be nice. Be a part of the solution.
swf, I agree and as you and other long time visitors here know, this is the very mantra which I have been advocating and advocating for many volumes: advocacy, activism and affirmative action--the 4 A's.
I think one item of business that needs describing here is what is the current status of the 4 A's but beyond a 1:1 patient to doctor communication (despite the good experiences of Rev. Fred) but in terms of advocacy groups to system interaction.
In this latter regard, I am a bit disappointed in the hospital.com who earlier presented offer to participate in the dissemination of the views expressed here. I have written to them twice in the past month about following up on their offer with no responses. I even fail to find my commentary there was even published.
I think that after 32 volumes, everyone knows what are the issues of concern. We should now see a reflection here of what is being started to move forward. ..Maurice.
These issues have nothing to do with gender wars. When you chip away and the dust clears it settles
down to discrimination against men.
Many people wonder why a woman
would want to work as a female
guard in a federal prison.
Why would a female nurse want to
work at a urology clinic without
males nurses employed there and
yet, why would a urologist at a
busy urology clinic hire female
nurses exclusively? Maybe his
female office manager does all the hiring.
Recently,I noticed a number of hospitals in my city owned by the
same conglomerate. Within some of these hospitals are a urology clinic,mammography suite and labor
and delivery. Of course there were
no male mammographers and no male
nurses in labor and delivery at the
facility I looked at in particular.
What was peculiar about this facility was that there were no
male nurses employed in urology.
Keep in mind this was a
hospital,a corporation that accepts medicare and medicaid. All
hospitals in some way are recipicents of tax dollars and public funding as well as private
donations.
Combined with medicare and other programs nearly 1 in 3 Americans are covered by publicly financed health insurance programs.
Medicaid costs are shared between federal and state governments. All publicly funded
discrimination towards men!
PT
During the last few years, I've had some surgery and had the opportunity to do some research while in and out of clinics and the hospital. What I've found has just reinforced the views I've expressed here of 30 volumes or so.
1. It's about communication. I've gotten better myself at opening up topics that typically aren't discussed. It's more about how we approach the topics and our tone than it is about the topic itself.
2. My experiences have all been positive -- giving me even more respect for the caring, talented people we have in medicine today. I know there are exceptions, but they are in the minority. That doesn't make the patient experience any less negative. The medical culture does have problems that need fixing. I've pointed out some myself. But it's not always a black and white, right and wrong problem (sometimes it is). It's most often much more complicated.
3. Our attitude as patients directly affects the response we get from caregivers (and vice a versa). There are many ways we can behave like "good patients" without giving up our autonomy or self respect. We need to turn these medical encounters to win/win scenarios. Respect the hard, dedicated work of most health care professionals, and they will respect you back.
4. Customer service should not be a bane to the health care system. I've encountered excellent customer service -- but it most often translates into plain manners and courtesy and basic human respect and empathy. When possible, going the extra mile works for both patients and caregivers.
5. Our whole health care system isn't broken. In fact, in many many cases it's not just working fine, it's working exceptionally fine. This is not only from personal experience, but form imput I get from most patients I talk with.
6. These observations, of course, come from someone fortunate enough to have decent health insurance. Without being political, I will say that a culture we need to find a way to gain all people access to basic health care.
7. How we are initially approached by caregivers, and how patient dignity and respect is embedded in their particular workplace, plays an essential role in how patients respond to gender roles in intimate care situations. Despite what some have experienced, I've run into caregivers who are excellent communicators and make patients feel empowered, safe and respected. Success for health care is not only in the big picture, but also in attention to many of the non medical details -- the whole medical environment.
8. For me personally, opposite gender intimate care isn't a big issue if I'm initially made to feel empowered, safe and respected. What follows is then, trust.
9. But I will fight for those who feel they must have same gender care. I will do this as part of a respectful battle to help improve American health care by encouraging more open communication and patient involvement.
10. But I will not tolerate the misogynist attitudes I sometimes find on blogs like this. I like women. I enjoy women. I trust women. I mean all this, of course, in a respectful way. Men who don't have other issues to deal with besides medical modesty.
MER
Rev Fred, I have done the same thing you wrote about, regarding the "male intimate caregiver only" sign. I haven't actually printed a sign up yet but I have convinced several of my closest relatives to hang a sign above my hospital bed and make sure it stays there. I don't expect a positive or friendly response from the female caregivers, but I don't go to a hospital to make friends. Good idea.
MER, you said caregivers almost always treat patients with respect in regards to intimate care. It all depends on your idea of respect. To send in a woman, especially a teenager with 2 or 3 months of education from the community college, to perform intimate procedures on me or observe is nothing close to respect. At the very least we should be asked, and the default intimate caregiver should always be of the same gender for men, as it almost always is for women. That is what I consider respect.
GR
Dr. Bernstein, I hope that you make allowance, for two letters I sent certified mail, to two male urologists. Dear Dr. N., American humorist Will Rogers quipped: "A person has only one opportunity to make a first good impression." The good news is that you made a favorable impact, during my initial appointment in late December. Your reserved demure, gentlemanly mannerisms, and impeccable appearance (I like to see the return of the bow-tie), are all applauded by me. There is no challenge to your high level of competency as a physician. I came to see you about my chronic retractile testicles; your presecription of 2 MG of Valium, twice daily, almost instantly remedied the condition. Thank you, for your diagnosis and solution. And now for the down-side of my visit: a disappointment over your dismissal of my concerns related to modesty by opposite gender providers. Upon our introduction in the examination room, I requested allowance of ten minutes to explain, how it was, that a (city withheld) resident sought out an urologist, sixty miles away, in (city withheld)Beginning with my story of contacting the United Jewish Federation, consultation with Dr.N., and his comment that Dr.N., a man of faith, would possibly be sympathetic to my stance of same gender providers, you broke into my discussion with two questions: "Why are you here? And how can I help you?" From my perspective, a physician should take a wholistic approach to patient health. My emotional, spiritual, and moral dimensions of existence, are just as vital to me, as my physical organism. Leaving your office, it was unresolved, that should I need intimate exams, procedures, tests, scans, and care, that you would be an adovocate for my rights to patient privacy and dignity, with the expectation of same gender providers. (Hospital name withheld)is my hospital of choice, and your affiliation with this medical institution would be a plus. Due to your unwillingness to display sensitivity with this matter, I must release you as my doctor, and I will subsequently cancel my appointment scheduled for March 15th. As a religious professional who lives a consistent celibate life, I believe that you fail to recognize that my genitals are a symbol of my spiritual consecration, which you have relegated to insignificance, resulting in much personal vexation. Women are commonly conferred modesty; it is denied to men. I will not accept this disparity. Rather than dismiss me as a temporary impediement frustrating your day, maybe there is something stated here of substance, and you need to reveal humility, and address them. I perceive an attitudinal problem, attitude is a mindset, and a mindset can be changed. I close with the words of the great Rabbi Hillel;: "If I am not for myself, who will be for me? If I am only for myself, what am I? And if not now, when?" Sincerely yours, Rev.Fred. (In the next post, I will share the cover letter I sent to the Department head.)
(cover letter to urological department head) Dear Dr.N., Enclosed is a letter releasing your associated, Dr. N., as my urologist. My motivation is not one of malice, but based upon my perception of indifference. I hope that Dr. N.'s stance is not reflective of your position. When ordained in the United Methodist Church, my vows included a sacred pledge, that I would uphold celibacy in singleness, and fidelity in marriage. Committed to a consistent chaste life, I have enacted numerous disciplines, to safeguard a code of holiness, including standards of modesty. Several years ago, I had surgery for a left inguinal hernia, at the (hospital withheld). I was traumatized by female staff, subjecting me to full frontal nudity, genital shaving, and snickers and smiles. I was treated as if I were the Rev. Howard Stern! Embittered by this experience, I have absolute disdain for (hospital withheld), and would not go there, if my life depended on it! For 37 years, I have been in and out of hospitals and nursing homes, and witnessed firsthandedly, unnecessary indignities foisted on patients, especially men! Parishioners have cried on my shoulder, shuttered at inflicted embarrassment, and even caught stripped naked by their pastor, due to hospital neglect! If I were to make a print-out of my observations, with this issue, I could wallpaper the ceiling of the Sistine Chapel! Doctors and nurses wrongly interpret compliant silence as agreement! I find the medical industry to be a telling institution, rather than a listening one! Today, it is commonplace, for hospitals to feature gourment menus, candlelight dinners for the parents of newborn babies, and wide-screen TVs and InterNet access in patient rooms; but no one appears to promote patient modesty as a marketing attraction. I am not demanding mandatory same gender care for patients with intimate care, as is found in the Islamic Republic of Pakistan; I welcome patient choice: "same", "opposite" or "either" gender providers. Seeking to be pro-active, and not wanting a repeat of (hospital withheld), I proposed a strategy. Recognizing that Mormons and Orthodox Jews, are two sub-cultures with strong modesty traditions, for both men and women, I contacted the United Jewish Federation. I was put in contact with its family coordinator, Mrs.Name., to discuss my needs. Requesting the referral of observant Jewish doctors who might be sympathetic with patient modesty, she supplied me with the names of three (city withheld) specialists: Dr.Name, and his twin brother, Dr.Name, and Dr.Name. Last summer, I had a consultation with Dr.Name. His summation was that most of the population has such low morals, that modesty concerns are no issue. Affirming me to be in the minority, Dr. Name reminded me, that the Patient Bill of Rights guarantees me privacy and dignity, and that I can refuse a medical treatment, with which I am uncomfortable. Dr.Name gave me the names of two men of faith, whom he felt might be sensitive to my expectations: Dr. Name, and yourself. He stated that he had knowledge that you employed some male nurses on your staff. Dr.Name is taking no new patients; and I was informed by your receptionist via telephone, that you only take patients diagnosed with prostate cancer, which rules me out! I anticipated that your associates would exemplify an inclination to support the special needs of patients; I discovered that I possessed a faulty assumption. (to be continued) - Rev. Fred
I agree with you, GR. But for a situation like the one you describe -- that's where good,
open communication comes in.
And this is where patients can assume too much as well -- assume that all these female nurse are out to get you; assume that even if you ask you won't get what you want; assume you're in a hostile situation and then responding based upon that.
It is possible for a patient to be civil, assertive, friendly and yet clear. Just in case, I would also have on hand a copy of that hospital's patient rights sheet.
Here are two examples from the hospital I just left. Patients have a right to:
-- Kind and respectful care which recognizes your personal values and beliefs. (How can a statement likes not include your choice of gender for intimate care?)
-- Be fully informed about your health and any procedures
suggested for your care. (To me "fully" informed includes the info of who will do what.)
-- Respect for your personal privacy.
-- Refuse any care offered to you and still receive other care that you agree to.
Those are direct from a patient rights and responsibilities sheet.
Have that sheet with you, and if you're challenged, take it out and politely point out the hospital already has confirmed that you do have that right.
But I do agree with you GR. For medical professionals to "assume" too much regarding modesy -- that's form of disrespect -- but I would also say most of these caregivers do not intend to be disrespectful. They may need to be reminded. I know -- some of you may so they shouldn't have to be reminded --they should ask. I agree. But in the real world, they may need to be reminded. That's just the way it is
MER
(continuation of letter) Thank you, for taking the time and reading this prolonged letter. Perhaps, I am receiving the ten minute discussion, denied to me, by Dr.Name. I close with an appraisal of Sir Winston Churchill: "Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things." The envelope of this letter is sealed with a prayer, that you would attempt to take a closer look at this issue. Permit me to recommend the blog-sites of Dr. Maurice Bernstein and Dr. Joel Sherman. Just type in "patient modesty"; you will be amazed by the number of disgruntled patients. Respectfully submitted,Rev.Fred. This morning, I receive in the mail a letter from the department head (he has national prominence; Dr. Bernstein would know his name). This is the totality of what he said: "Thank you for your thoughtful letter dated March 1, 2010, detailing your experiences in our Urology practice. I respect your opinions and perspectives and appreciate the effort to notify us about your concerns. I am happy to see the diagnosis and treatment provided by Dr.Name has 'remedied the condition.'" (That's all folks!-Rev.Fred)
MER you said,
"8.For me personally,opposite gender care isn't a big issue
if initially made to feel empowered,safe and respected.
What follows is then,trust."
Realize that most of us on this site including myself are
here because we have not been
respected nor have we a reason
to trust female providers,that we did not feel empowered,safe and respected.Therefore that word trust means nothing to me.
PT
I realize that PT, and I don't question your integrity or doubt your experiences. I've had different experiences. I do believe that there are too many modesty violations happening, but still by a minority of caregivers. The big, egregious violations are really in the minority, too. I fear that sites like this can turn into self-fulfilling prophesies -- stories of all the bad things that happen with little if any of the good things that happen every day in health care. Readers then expect the bad to overpower the good, because of the balance on sites like this.
In my talks with patients, I've found as many good stories (probably more) than bad experiences. Overall, our health care system has problems, many problems. But individual hospitals are doing fine jobs every day. But nobody writes about that.
I also sense a tremendous amount of anger on this site, anger at the health care system, at some doctors and not just at female nurses, but at women in general. That bothers me. Some men (and women) go into hospitals and clinics expecting the worst, planning on being treated badly. They may actually contribute to the problem -- rather than approaching it from the point of view that says "these are my values, these are my expectations,
make sure we're communicating and that you know where I'm coming from on this." Expect the best, have high expectations -- and communicate to your caregivers.
The doctors and nurses I've had working with me, although not perfect human beings, have respected my modesty and dignity. I don't deny modesty violations are a problem. I've learned how to deal with this when I find it necessary, without alienating my caregivers or endangering my health.
But I support you and others who have been violated and lost your trust. That's why this issue is so important. How many times can a patient get burned before he or she loses trust in the health care system? The system pays a high price when they lose good patients along with patient trust. Stakes are high.
It seems, though, that every other post on this thread is filled with animosity, even hatred for female caregivers, and women in general. If that's the purpose of this site, to vent, then so be it. But after 32 volumes, I don't see that behavior getting us anywhere.
MER
One problem, and it's a big one: contrary to what most people in this blog think, in the OR many women, actually have more problems having their needs met than men: many of the surgeries there are carried out by oncologists, surgeons, with anesthetists in attendance, which are too often male, and not by their gynecologist...Some women even got an all male team!!! And if a woman refuses a PAP TEST, to get the Pill or other contraception, she is BERATED, and refused many, many times any other care...I think WE NEED TO STOP THE GENDER WAR. Right now. It'll get us nowhere.
MER, I am bewildered by some of your observations; you sound like Rodney King, "Why can't we just all get along?" I don't need to read Dale Carnegie's HOW TO WIN FRIENDS AND INFLUENCE PEOPLE, as a man of God, I intentionally seek to become an instrument of peace, not a catalyst for conflict. As a religious professional, ordained to a celibate lifestyle, living a consistent chaste life, and imposing many disciplines on myself, to safeguard my sexual behavior, do my recent letters shared on this post,indicate that the doctors respect my values? If I have to engage in a tug-of-war, to be heard, and I am discounted by the system, what about the individuals, lacking the articulation, or the perseverance to fight for what they want? I wish there could be some way that you could identify your location, hospital, doctors, and nurses, and I would hop in my car, to go there, for possible care. What we need to do, is call a conference, go through the legal hoops to create a legal organization, and collect monies to fund an advocacy program. I am certain I could secure my church as the site for the kick-off. Also, MER, Dr. Bernstein has made several attempts to contact hospitals about this issue, and a man of his caliber has been ignored. You are under-estimating the problem facing us. -REV.FRED
I recently made a appt with my gp about a lump on my scrotum and I was told I would be seeing a different dr. that was a female. Dr. comes in we chat for a moment and she asks " If I want one of the girls to be present for the exam?" I decline she says fine that she always asks.She does exam and says she is sending me to a urologist and will do a follow up in 6 weeks. After urologist visit I really didnt see the need for a follow up with gp but had other issues that I wanted to discuss. At follow up I was told as before strip from waist down and handed a drape and aid left the room. Dr. comes in we discuss what urologist said. She is then ready to start the exam but she cant find exam gloves.She excuses herself and leaves the door all the way open.I am still draped but I found that annoying to say the least.She comes back with the 20 year old female who had just taken my blood pressure etc. and says Meagan will stay in the room for the exam.Since she didnt ask this time about a chaperone I thought she remembered my feelings from previous exam.At initial exam I kept my penis covered with my hand.When I covered my penis this time she said some kind of no and took my hand away and then slightly moved my penis and poked twice on either side of my groin area and never touched my scrotum.She said something about the lump was to small.As all this was going on my so called chaperone was standing 3 feet away watching. I think I was starting to get an erection but I WAS NOT ENJOYING THIS.Now I have another follow up in 6 weeks. I was so shook up that I dont know if my follow up is for the lump or my other issues.Do erections happen?Was my Dr. out of line? Please comment. T in Tampa
Rev. Fred, I most appreciate your open and frank commentary. However, I want to express a correction to your last posting. I have not made any attempts to date to contact hospitals and hospital administrations about the issues these patient modesty volumes. I have talked to a number of physicians about what is written here and I have talked to some members of the faculty of the medical school where I teach and, of course, I have talked to my second year medical students about the subject. I have presented the issue as presented here but without making any judgment comments except to encourage awareness and consideration of the issue, just as I have repeatedly said here that I was made aware since these volumes began.
I don't intend to defend MER's approach to describing these discussions, he can ably do so himself, however I am in full agreement with King's question and suggestion "Why can't we all get along?" This suggestion of King should definitely be applied to some physicians but it also should be applied to some patients. "Getting along" requires understanding of the values and needs and duties of others and working together to accomplish common goals. This is what I think is necessary to resolve the conflicts described on these volumes. ..Maurice.
Sorry, Rev. Fred, but I stand by everything I have written over most volumes of this blog. Have you read everything I've written? If you have, you'll see I haven't underestimated the problem. I see you don't mention the misogynist attitudes that appear on this blog. I'm sure that doesn't fit into your goal of being an instrument of peace; indeed, these attitudes act more to create a catalyst for conflict.
You also don't mention the patient rights document I quoted from. How about your hospital? Do they have a patients rights sheet? Have you checked it out? Maybe you could copy of few of its items here.
Yes, let's get along when we can get along. When we can't let's fight for the rights that patients already have as written in many patient rights documents. Let's start by using what's already out there, and insist that these polices be followed.
MER
Rev Fred, so although Dr N did resolve your medical issue, he wasn’t the least bit interested in discussing your modesty and provider gender requirements? You requested 10 minutes to present your case and he cut you off (broke in as you put it) and just wanted to get down to business (Why are you here? What can I do for you?). I use the term business because that’s exactly what this is. He’s got 20 patients to see today to diagnosis, treat, prescribe, chart, plus some follow-up calls & a couple rounds of golf, etc but the special modesty needs of patients are not important or even worth discussing. It’s a non issue to them. The second Dr is so busy he’s not taking any new patients unless they have prostate cancer, so you won’t get a chance to present your case to him either.
I applaud you for trying and doing so in a respectful and eloquent way, but I am disappointed that the doctors basically just blew you off. I encourage you to be persistent but respectful, changing the current medical profession attitude about patient modesty concerns is going to take some time unfortunately.
Jean
Great job Rev Fred. You are a great advocate. Keep it up. I am a Mormon so I'm happy you mention my religion and understand our morals.
Some good suggestions MER, but I'm not quite as understanding as you and don't tolerate bad attitudes and lack of respect as well as you. I am one that goes into a hospital expecting to be treated with disrespect, but instead of starting anything I just have my answers ready for my defense.
T in Tampa, I think you were treated with a lot of disrespect. If I were you I would stick to a male gp so likely you won't have an "assistant" present and if he does, be more assertive that she is not welcome, like you did the first time. That behavior shouldn't be tolerated.
PT and Maria, good points. Maria, I think it is just as important for woman to do what they need to do to feel comfortable too. Most of this advice has been for men but women can take the same advice.
GR
GR wrote: "Some good suggestions MER, but I'm not quite as understanding as you and don't tolerate bad attitudes and lack of respect as well as you."
You misread me. I've never said I tolerate bad attitudes and lack of respect. I don't. I won't tolerate it and neither should anyone on this blog. But I do try to gage whether the caregiver is really disrespectful and insensitive or whether there may be something else going on. I've noticed some careless behaviors from caregivers that I didn't reduce to a purposeful act. They were trying to do their best and make me comfortable. They needed some patient education -- so I did politely direct them to correct the situation -- which they did.
Part of this struggle, I think, is about choosing your battles. Save the big guns for the big battles and then go all out. Find ways to compromise with smaller battles, if you can. But before assuming you'll run into a battle, try to work with the caregivers. Be prepared for a battle, but don't go looking for one.
MER
I agree with MER that physicians can behave like everyone else can behave when under stress from time limitations, anticipated patient loads, anticipated problems, yet unsolved issues that need solving soon, phone calls delaying patient attention and ..and.. and..and who knows, argument with the wife at home, on call and awakened during the night and that occasional indigestion. Why should anyone think that with an M.D. (or those with a D.O.) after their name physicians should behave any more patient, any more tolerant of changes in routine, any more aware and all understanding and immutably tolerant of every person who comes into the office than any other person who is under the effect of stressors. Are not all physicians just humans and there are times when they don't seem to meet all the necessary criteria set by their patients? I know, as a doctor in practice, I have felt that way too at times.
Does anyone want to try this: "Doctor, you seem a bit upset, a bit distracted and like you have something else on your mind. Is there anything I can do to help you?" ..Maurice.
Mer
The tendency for most who advocate here do so to imparct
their ideals with hopes of finding
common ground as well as being tolerant of others,despite the
baggage most bring to the site.
You are correct in that there
exists a tremendous level of hate
at this site,hate at the health care system,hate at some physicians
and women in general.
I Have a built in distrust for
the health care industry,some physicians and all female providers. They want to feed me the can of dog food when I don't evan want the opener.
Yet women in the populace should hate women providers just
as well. Consider the number of
public indecency cases currently
in the U.S.,What prompts men to
want to flash in public.
Has it been a manifastation
that has been growing among our
youth. Are these festishes seemingly out of control.
Perhaps started in grade school
after hernia exams,military induction physicals,visits to a
urology clinic with many young females observing. The festish
evolves to a raincoat episode
after flashing young girls at a grade school.Next thing the man
is facing prison with lifetime as
a sexual offender. Cause and effect.
Understandably,children who
suffer sexual abuse often grow up
to abuse children. Male prison
inmates leave prison to one day
rape an ex female prison guard for
all the unnecessay strip searches.
The list goes on. Visit the
Bostonherald.com about the 41 year
old female english teacher who sent
nude email photos and a promise of
oral sex to her 15 year old male student. Why.
PT
PT, I still think that most of your case examples are statistical outliers and I can't see how one can make generalizations out of them despite the repeated occurrences of such sexual abuses as reported in the news. What makes you certain that the remainder of the pool of teachers or nurses or doctors or others who interact with the public are just waiting to commit the same sexual abuse acts? ..Maurice.
You cannot blame abusive behavior on one sex or another. In the medical setting much has to so with the culture of the institution. That's where respect starts.
Patients without a history of abuse or assault who are treated respectfully would be more agreeable to opposite gender care if they present a respectful culture to patients.
Abuse comes in both genders, all colors and all religions. It's a fact that deviants gravitate to healthcare. It is the medical communities responsibility to set up the proper background checks and processes if an employee receives complaints of this nature.
This blog is filled with gender blame. However, privacy rights are important. It shouldn't be a production to honor gender requests for those who need them.
I just read an article that said 75% of women who need colonoscopy screenings avoid them because of embarrassment.
Medical people...get on board. Can you imagine how much revenue a hospital would gain by accommodating easily and offering privacy protections?
It is utter arrogance and stupidity that the medical community pushes opposite gender care. Will they ever "get it"?
gd
from PT:
Consider the number of
public indecency cases currently
in the U.S.,What prompts men to
want to flash in public.
Has it been a manifastation
that has been growing among our
youth. Are these festishes seemingly out of control.
Perhaps started in grade school
after hernia exams,military induction physicals,visits to a
urology clinic with many young females observing.
I've long believed the discrepancy between the number of male vs. female exhibitionists, and fetishists in general, is directly a consequence of the many modesty infringements young males experience, the medical being just one. In such a large population of victims, it is virtually a certainty that these "outliers" will be created. The only other explanation, incredibly dubious, is that there is something genetic or hard-wired in the male psyche that leads to greater instance of sexual deviance. BS, IMHO.
And even in the majority of men who do not respond so drastically, they rarely forget the violation although they grow around it. To think that this suppression does not affect them psychologically is to believe that men are superhuman.
--rsl
To gd: Great comment. I can only add this: More hospitals than we realize, maybe many, are sensitive to gender issues and try to accommodate. The problem is, they don't advertise this or even let patients know up front. I was recently talking with some hospital administrators who came right out and said hospitals, in general, just don't know how to advertise themselves well. You're right -- it's not only an ethical issue -- it could also be a positive financial gain for hospitals willing to come right out and face this issue and let patients know up front, on websites, in brochures, that they are sensitive to patient modesty and gender preferences. These hospitals would draw a significant number of patients their way, and force other hospitals to recognize this issue. We see this more in the UK, Canada and Australia, all countries that have national health care systems. These issues are embedded in written policy statements. Now, whether these goals are carried out in everyday practice, that's another issue. But at least patients can carry around the policy statement and, if denied the care they prefer, can hold that written policy up as the standard that needs to be followed. From my research, you don't find these detailed written police statements in the US covering issues like gender preferences, chaperones, etc.
MER
Let us review my dismissal by two urologists,mentioned in my prior posts, from a business standpoint. Every day we make choices and must live with the ramifications of our decisions. I was the doctor's first appointment of the day--he should have been a fresh as a daisy!I was not a charity case; the brief visit cost me hundreds of dollars, paid out of my own pocket. If I sought to discuss modesty--put it on my bill. As soon as the doctor entered the room, I stood at attention, as a gesture of respect. I awaited for him to extend a handshake; none was offered. Dressed in a fine suit, my outward demure was that of a professional man--not a religious flake. (Frequently, when visiting hospitals, nurses and patients have mistaken me to be a doctor.) The unwillingness of the doctor and the department head to discuss modesty with me has implications. Living in a geriatric community, my congregants and townspeople often turn to me for recommendations and information about nursing homes, doctors, and hospitals. Pastoral care is a major feature of my ministry. We all know that the best advertisement is word of mouth. With my high profile, loved and respected by many people, inside and outside my parish, crossing all denominational lines, I possess tremendous potential to influence hundreds and hundreds of possible patients for any medical practice. Would it not have been good PR for the urologists to make some attempt to accommodate me? I thought two heads are better than one!It would be ungodly for me to publicly mean-mouth the doctors without provocation; but if probing is initiated by others about their practice, or an individual is seeking out a urologist, there will be no compliment or encouragment. If the doctors will not be my advocate, they can hardly expect me to be their promotion agent!A good shepherd takes care of his flock. If my shabby treatment is representative of their compassion and courtesy, what conduct awaits my sheep? If only one of these doctors had taken a concilatory posture, I would become their campaign manager, and personally chauffeur members to their front door! These guys will never get another penny from me, and now a dam has been built to block some of the cash flow into their bank. Mark Twain made the assessment, "When it comes to money, we all belong to the same religion." In my letter, I invited the department head to inspect this blog-site; if he does, and wants to extend an olive branch, a reconciliation is always possible.-REV. FRED
Here is a link to an Australian hospital's "carers rights and responsibilities" statement. Note it does not specifically address same gender care but it does mention that a person's spiritual and religious beliefs respected".
http://www.sesiahs.health.nsw.gov.au/Poster-final.pdf
NP
Dr.Bernstein, Oops! Please excuse my blunder; I incorrectly stated that you sought contact with hospitals about modesty issues, with no response. Your post of Thursday, March 4 reads of your unsuccessful efforts to communicate with "hospital.com." I don't know if I can blame this faulty info, on an inabilty to read or of typing! T of Tampa, make certain that you were not charged with the presence of a chaperone! If you were, refuse payment. Todd, still no response to your questionaire for female healthcare workers. I think I know the answer for ignoring your invitation. MER, if you have read my prior posts, there is no way that it could ever be implied that I am a misognynist. (I've always had difficulty with both spelling and pronouncing "misognynist".)My present beef is with male doctors. Women participate at all levels of decision-making in the congregation; and the constitution and by-laws make allowance for a female pastor. And sir, my views on the importance of modesty were primarily formulated and fostered by influential women in my development. I'm trying to preserve a foundational building block in my make-up, laid by these ladies, which other women (and men) are seeking to erode.-REV.FRED
"Yet women in the populace should hate women providers just
as well."
While "hate" may not be correct, we already discussed at legnth that a big percent of the population of women are upset. To be brief and not incite the same hate riot as before...these women consider female nurses "the other woman" who entitle themselves to the same intimacy of their husbands body that only a spouse/SO should share. Women like to control who intimately view and touch their husbands. Just a simple fact. We can dispute, argue, debate, or even ignore it: but the more women I interview the more I find it to be true. I am willing admit, more than I imagined before.
But even more interesting is the percentage of females who prefer male caregivers, even in intimate care. Surprising to me, but apparently a fact.
And so it seems that these women can't get the care they feel they deserve either.
PT:
"The tendency for most who advocate here do so to imparct
their ideals with hopes of finding
common ground as well as being tolerant of others,despite the
baggage most bring to the site."
I like that.....
Now if we ALL did that, there would be power in numbers. But let's remember that advocacy should not be based on hatred, but rather a common goal of respect for choice whatever that choice is.
Rev Fred -- I'm not suggesting you're a misogynist. I respect your battle to protect your dignity. But you must admit that there's a significant amount of misogynist comment on this thread.
The only thing I question is that, it seems to me that you're framing your whole argument within a religious context -- which is fine. That's your situation. But one shouldn't have to be a minister, rabbi or priest or nun or other religious figure. I'm sure you agree. But the medical community, with all this focus on cultural medicine, is more apt to grant accommodation to religious men and women. It's fine that you can use the religious card, but most people can't. It's more difficult for the system to refuse you than it would be for them to refuse accommodation for non religious reasons.
MER
A same gender request is a same gender request. They should all be treated equally. It should make no difference if the person asking is of the cloth or a married father of four.
"A same gender request is a same gender request. They should all be treated equally. It should make no difference if the person asking is of the cloth or a married father of four."
Well, of course. But you're talking about the "shoulds." I'm talking about what I perceive to be the reality. When you look into the - what's called -- Transcultural medical texts, it's mostly about religion and/or foreign cultures, foreign meaning mostly non Western cultures. Gender is discussed mostly within those contexts. Look at the big American cities. Look at the various races and ethnic groups that make up the population of those cities. Those are the "cultures" these books focus on when they talk about becoming more open and knowledgeable about sensitivity to culture in medicine. In our politically correct culture, it's much more difficult turning down a gender specific request for religious reasons that it is a gender specific request of "just because these are my values" reason.
MER
OMG That's wierd!! I don't know any female's who prefer male's!
>>But even more interesting is the percentage of females who prefer male caregivers, even in intimate care.<<
ANON "OMG"
I often listen to people who have preferences that would make me uncomfortable, but they have a history that is not mine or a struggle in their heart that I have not experienced. My head can still understand and my spirit can still be one of compassion. I would hope that they respect my needs as much as I respect theirs.
I just finished writing to the Hospital Association of Southern California to see if their website could provide a resource for "spreading the word" to the medical system about the patient modesty and gender issues that are being discussed here. I'll certainly let you all know about any response. ..Maurice.
To the Anonymous poster (without initials) who said, "OMG That's wierd!! I don't know any female's who prefer male's!" :
I am a female who actually prefers MALE gynecologists, and I am NOT the only one who does. I get offended every time someones acts like there's something wrong with me, but my reasons are just as valid to me as those who prefer same-gender doctors. It is wrong of you to think of my position as "WIERD," but I'll bet you don't want anyone to think YOUR preference for same-gender care is "wierd" ! Can't you see the hypocrasy ?
An interesting discussion about men who have been discriminated against in nursing school and in the profession. Quite disturbing. Apparently, it's a larger problem that is publicized. I realize that some nurse claim that men sometimes get the opposite. It probably varies considerably from region to region, site to site. But this thread is not pleasant to read. It's a long thread. Start at the end and read backwards.
MER
http://allnurses.com/men-nursing-forum/discrimination-against-men-116888-page17.html#post4170021
MER,
Of course there is discrimination against men in nursing school. There is discrimination anywhere where one sex dominates. I'm sure female surgeons find it tough too as that is supposed to be a very macho specialty. It's stupid of course, but a fact of life.
My female friend became the first 747 mechanical engineer for her airline. She had to put up with foul language, porn and all the other macho stuff. But instead of being a whiner, she just took it all in her stride. This attitude won her over with her colleagues in the end.
NP
"I've long believed the discrepancy between the number of male vs. female exhibitionists, and fetishists in general, is directly a consequence of the many modesty infringements young males experience, the medical being just one. In such a large population of victims, it is virtually a certainty that these "outliers" will be created."
I don't disagree that exhibitionism can be a consequence of the many modesty infringements in health care, but I've seen that there are way more female exhibitionists than legal statistics show. The difference is that they very often aren't reported or charged with a crime. From what I've seen and heard men just don't report female exhibitionists. It seems the majority of men and boys enjoy seeing a woman exhibit nudity, and many that don't enjoy it wouldn't be caught dead complaining about it. Even other women often laugh and stare.
I believe the lack of respect for male nudity has a lot to do with exhibitionist tendencies, but men shouldn't be condemned as a group for exhibitionism while women are praised and adored for doing the same thing.
You miss my point entirely, NP. My point is, and has been, that this kind if discrimination has been recognized and is being dealt with in fields where men dominate and women are in the minority. Look at all the effort going into dealing with women in the military, women in police and fire fighting, women in high levels of business and the board room. Many men walk on tip toes in these areas, afraid they'll be accused of who knows what.
But there's little concern for men in female dominated fields like nursing -- and if you read the thread I posted, you will see what I'm talking about. One male nurse talks about the high rate of males dropping out of nursing school due to discrimination. Males are in the minority in nursing school already. He notes that if any other minority had such a high drop out rate, that problem would be noticed and dealt with.
Your answer to the problem, just accept it and fight it out, could have been said to women and African-Americans 30 years ago. Of course these minorities should fight for acceptance and prove themselves worthy. But they shouldn't have to accept blatant prejudice and discrimination from those with power over them. And in our culture, women are a recognized "minority" with legal and social advantages that men don't have. Prejudice and discrimination go both ways.
I'm not saying this discrimination happens everywhere. In fact, I suspect we're just dealing with a few bad apples in the nursing schools, who probably bully the female nursing students, too. If you read the blogs, you see that academic bullying is almost epidemic in some nursing schools and a some hospitals. Didn't the Joint Commission within the last few years come out with a new category for evaluating this kind of unhealthy hostility one sometimes finds in hospitals among some staff? Men in nursing are still too often regarded as tokens and not allowed the kind of access female nurses are allowed. Check out this article and study:
"Cautious caregivers: gender stereotypes and the sexualization of men nurses' touch"
by Joan A. Evans PhD RN
found in the
Journal of Advanced Nursing
Volume 40 Issue 4, Pages 441 - 448
MER
Thanx Mer.
I read both of the sites posted, and I have to say that it was not only an interesting adventure into hypocracy, but also a blatant display of denial. I have to say it was frustrating, and would wonder if you felt the same...
The allnurses thread started in 2005.
Most of the beginning posts rejected the idea of discrimination by both male and female posters. Those who admitted it may be true suggested that these men man-up and plow through. Interest in the site seemed to slow down when more men posted that discrimination was their experience also.
The second site showed an article written in(unless I'm wrong) 2002 that stated men were flocking to nursing in record numbers. ?
Where are all of these male nurses? Statistics have not seemed to change much in the female vs male nursing percentages in the last eight years....
Hmmmm.
I noticed the allnurses thread was still open for posting. Anybody care to update the info with actual statistics? Perhaps they too might wonder what happened to the "hordes of males" being welcomed with open arms.
Mer, The laws, I would presume protect either sex from discrimination. Thus the male nurses should take matters further if they are so inclined. Not wait for "the problem to be noticed and dealt with". This, I am afraid is the crux of the problem with all the issues brought up here. I.E. male modesty being ignored, bullying in female dominated occupations, (BTW nursing has always been notorious for bullying behavior) and perhaps less funding in male health areas. I think men are waiting for women to take charge of their issues.
NP
"I noticed the allnurses thread was still open for posting. Anybody care to update the info with actual statistics?"
I'm afraid if someone posts anything proving the fact that men are treated unfairly they will close the thread, as they always do when the moderator's opinions are opposed.
@NP:
It's not so much that men are waiting for women to take charge of their issues as it is that men do not really have a powerful advocate. Organized feminism--virtually a fifth estate--ensures that women's health concerns (among others) will be addressed and given every priority. For instance, scores of women's health commissions exist despite women having better health and greater longevity than men; no male counterpart exists.
Without significant organization, the efforts of individual male nurses will come to naught. And even if they organize, there will be a lot of entrenched opposition from powers that feel men have no valid complaints.
--rsl
NP -- What you say is not incorrect. You must also add a significant amount of sexism toward men from some women in power situations -- including the courts and legislature. You can't eliminate this element. And the fear of men in power of being accused of being called sexist because they stand up for other men. Look at some custody battles men have -- how some are discriminated against simply because they are men and because of some of the attitudes our cultures sometimes has toward men as caregivers and nurturers. But right, men have to fight it out -- but the risk is that by challenging the status quo their labeled as sexist. But they'll just have to risk it.
MER
Here is a good example of where we are regarding patient modesty and the double standard in American medicine:
The first site below is for young girl teens needing pelvic exams. Note that these girls are told some girls may prefer a male doctor and others may prefer a female doctor. They are told that if they choose a male doctor, he will bring in a female chaperone. Note that the sensibilities of these young girls is respected. The fact that they have a choice is emphasized. Here's the site:
http://kidshealth.org/teen/sexual_
health/girls/obgyn.html
Now, the same site has a page for young male teens about testicular and hernia exams. No choice is indicated here. The "doctor" is consistently referred to "he or she" throughout the text. The young men are even told that they may get an erection and that it is not uncommon, not to worry about it, and that it will not bother the "he or she" doctor. The point here is that these young men are not told they have a choice and there is no attempt to respect their sensibilties.
Here is this site:
http://kidshealth.org/teen/your_body/medical_care/testicles.html#
It's about communication, about giving complete information, about recognize that both genders may have modesty problems, that both genders should have a choice. But it's clear that young men are expected to just accept whatever gender happens to come along into the exam room. The double standard is quite clear here.
MER
Gender of caregivers should be part of informed consent for many reasons.
First, for anyone with sexual assault/abuse issues, it makes the difference whether they will want to comply and second, someone cannot be traumatized if they know what to expect. A little communication goes a long way.
gd
"The laws, I would presume protect either sex from discrimination."
Do you really believe that? Do you really think they take male discrimination seriously? I don't forsee that ever happening.
Female dr.s and nurses just don't want to give up the "right" to expose men whenever they want to. They can do what most women can't, and they let wives and girlfriends know it!
Men gaurd their nudity, and these women and girls just enjoy the power of making them expose themselves. It's all about power. Listen to them in the breakrooms once in awhile. They don't want to give up the exposure rights. Men need to speak up or else it won't change, because they don't want it to.
Sad
Yes anon of 5:19 I REALLY DO believe that. I am in Australia and discrimination of any type is taken seriously. Male, female, gay, disabled, race. Everybody has a right to claim discrimination.
NP
Here's a good article in today's L.A. Times about how to make complaints about hospital or rest home care. It's somewhat California oriented, but the advice is good.
MER
http://www.latimes.com/features/health/la-he-practical-matters-20100315,0,2670976.story
MER, somebody here should write to these organizations and ask them if they are aware of the gender selection/patient modesty issues, how frequently they get such complaints and what is the disposition of those cases. That might give some insight as to the current status of this issue. ..Maurice.
"A little communication goes a long way."
I wish more people in the health care field understood that. I think most know that but choose not to do it.
To "Sad",
If I hadn't seen your name at the end of your comment I swear I thought it could have been my comment. I couldn't agree more.
GR
You know maybe the nurses behave in the way that SAD claims they do because of the power that doctors exert over them. And this is their way of compensating for that. Everybody here paints nurses as evil. But there are plenty of powerful misogynistic doctors out there as well.
NP
NP, no one is suggesting that the nurses, CNAs, et al, are vengeful or man-hating (although some well may be). Rather, that they're lecherous and exploitative, using their authority for self-gratification--much like Porky with a pass--to the point of bragging about their access in front of co-workers and the public. That they wear the thinnest patina of professionalism over leering voyeurism.
--rsl
Is this what we're calling logical, rational thinking? "Everybody here paints nurses as evil." I certainly don't. It's either this or " Rather, that they're lecherous and exploitative..."
I'm truly sorry if some of have experience nurses like this. My experience has not been as such. The vast majority of nurses I encounter as a patient have been kind and caring, seriously concerned with my safety and health and comfort.
I'm not suggesting there are not some bad ones out there -- probably too many. But we need to be realistic and not stereotype an entire profession.
And, NP, you are on to something. Historically, nurses have struggled with professional identity. At one time, they were trained solely by hospitals and doctors themselves. That's the way doctors wanted it. Beginning in the 1970's, university and colleges took over their training. Historically, doctors didn't want nurses who knew too much, just enough to take orders and follow instructions -- good observers, caretakers, caregivers. With the growth of the profession, nurses with B.S. and M.A. degrees, etc., doctors are now faced with more highly educated nurses. Yes, conflicts work their way down a hierarchy. When some of those at the top abuse those below them, some of that group then tends to abuse those below them. It works it's way down, and this is a problem in medicine. Sometimes the real bottom are the housekeepers, janitors, cna's -- sometimes it's the patients.
MER
MER
Regarding those sites you listed
referring to the double standards
in the examination of teens. I've
not been to the sites yet but I
can only imagine.
I'll bet it was written by a
female nurse practitioner that wears ugly red plaid pants(her
idea of a power suit.) Probably
drove a 1976 AMC Pacer. If you
don't know what an AMC Pacer is
please do a google search.
Can you imagine being a 10-12
year old boy needing a sports
physical being performed by
someone like her. Any moment I
can see Rod serling from the
twilight zone steeping out for an
intro.
People like her were never popular with the "jocks" and
certainlt never made the cheerleading squad. She now will
take her frustration out on others.
PT
What's interesting, PT, is the advice for the girls was written and reviewed by female doctors. They had concern for the girls modesty. The advice for the boys was written and reviewed by male doctors -- they seemed to have no concern for the boys' modesty. Interesting, isn't it. Let's assume that the male doctors read what the female doctors wrote for the female teens. They certainly didn't apply the same principles to the boys. Do they think that boys just don't have any modesty and/or have no right to a choice of genders as the girls do? Or are these male doctors just blind to this issue?
How's this for a radical proposition: I'm beginning to believe that a major source of the problems men have with modesty violations in medical situations comes form the attitudes that those in power, mostly men, have about male modesty, e.g. that men don't have modesty. It's mostly the male doctors and administrators who perpetuate attitudes and policies that put men in these situations. They're the ones who accept the macho stereotypes that real men should just put up and shut up -- perhaps because that was the how many were trained either in med school and/or during their internship and residency -- the hidden curriculum. Real men don't complain, don't cry, don't whine. Not all of them, of course. But a significant number.
Examples: Who was in charge of the draft exams during the Vietnam War? Women? No, it was men who violated the long held ritual that male recruiting exams in our culture, involving naked men, would be invaded by non medical female personnel. Who hires all female med asst. staffs (or okays their hiring) at most of these clinics -- mostly the male doctors who own them. Female doctors have started many all female clinics. How many male doctors have stared all male clinics?
I'm not suggesting that some women play no part it this problem -- but I believe more women caregivers, esp. nurses, have more empathy for men and their modesty than many male doctors do.
Just a theory, PT. I'm sure many will disagree with me. But check out that teen medical site and read for yourself.
MER
I completely understand why doctors have a hard time with nurses. They have between 1/10 and 1/4 the amount of education doctors have and just a fraction of the experience sometimes but they can be very combative, they second-guess the doctor's decisions, they expect praise for doing nothing more than wiping butts, taking blood pressure and handing out gowns, and they often get in the way of the true professionals (doctors). They have little to lose when they screw up, unlike doctors, but expect to be included in decision-making. Basically they're just helpers with giant egos. And I won't even get started in the voyeurism aspects.
I agree with "sad", rsl and PT.
A visitor BJTNT wrote me today the following e-mail about this thread which I thought was appropriate to publish. ..Maurice.
This thread is raising some worthy ways to start the process of changing patient care to benefit the patient, specifically patient modesty.
Up to this blog I was pessimistic that changes would occur, but now I can hope that patient treatment will improve for my grand kids.
First, an anecdote to make by contribution to patient modesty. About 30 years ago, I had kidney stone surgery [there are a number of stories, but I will limit to patient modesty]. After surgery, I needed a temporary urinary catheterization. When I told the nurse, she called in the very young candy stripe volunteer {I called her that because I was unaware of CNAs, NAs, LPNs, and an assistance X-ray tech that performed nurse duties years later at a different MD visit]. Rather than insert the catheter the last "inch", she said that there was a problem and that she would get the expert [yes, that was her word]. She leaves and returns with another candy striper [it was after high school hours, so it could have been a candy striper]. The two of them did the procedure. Why are these problems so common? I tend to blame the MDs who have such big egos that they can't be bothered with concerns or supervision of staff operations.
Up to the current blogs by Dr. B. and Dr. Sherman, I always thought that the patient's choice was either to accept the disrespect of one's humanity by medical operations or do without health care. These blogs are the start of the beginning and let's hope that it doesn't take the next two generations of MDs [my prediction] to make some significant changes.
BJTNT
Mer
You are correct on all levels
in that male physicians were to blame for many of these issues. The
fact is that during military induction physicials the oath of
hippocrates( I will respect the privacy of my patients) should
have been the norm.
But,times have changed as well
as attitudes and there has been a
shift in this regard. Never once
while working in healthcare did I
ever see a female nurse,cna or
female physician take a postive
respectful approach to male patients with regards to privacy.
The truth is all I ever saw it seems was the bad. There is a big
difference reading about bad behavior and actually seeing bad behavior. The difference is you
really know its true.
PT
DR. Bernstein:
Regarding MER's statement
"It's mostly the male doctors and administrators who perpetuate attitudes and policies that put men in these situations."
I have to assume that in your training at some point you learned how to insert a foley. At any point in your practicing career would/did you ever step into a situation and help the reluctant male patient yourself?
Some have suggessted that Dr.'s consider themselves too high on the medical foodchain to do such petty things, but for the sake of the patient, would doctors just be willing to handle these situations themselves for the greater well being of the patient?
If female caregivers are being honest about how often this really happens, then you would not be doing it often.
swf, in answer specifically to your question, as I have noted many times on these threads, I have never had a request for gender selection of a caregiver. Yes, I have inserted foley caths as an intern and resident but virtually none since in my practice of internal medicine. In this regard, I consider myself far less skilled than a nurse who does this procedure virtually daily. Also I don't think most internists insert Foley caths themselves but rather have the nurse perform it. Yes, if the patient requested to me for a male provider to insert the cath, I certainly would do my best to try to find a provider acceptable to the patient. But this request has never occurred in 50 years of practice! Of course, I never had the reason to ask about gender selection until reading this series of patient modesty volumes. ..Maurice.
Revising my medical declaration with my attorney, I am stating my home visitation nursing program choice, and made contact with a service affiliated with the Lutheran Church-Missouri Synod. Sharing my concerns related to modesty, for possible intimate care, the rep. assured me that my request would be honored. Four full-time male nurses are part of the team, and she affirmed that I could indicate to my social-worker my expectation. The only conflict she could fore-see, would be an emergency situation, when a male nurse was not readily available. Be assured, I will place in all capital letters, underscored, and marked with neon yellow, this nursing team. Also, I will use the weight of my pastoral office, and encourage congregants to seek out their services.-REV.FRED
Here's a fascinating article in the NYT called "When the Nurse is a Bully." Bullying is an issue in nursing and the profession is trying to address it. Most of you know my positive attitude toward nurses in general, so do realize I'm not suggesting most nurses are bullies. But those few cause many problems in the profession. What's interesting about this article are the comments following it. Several responders talk about bully nurses who also bully patients. That's a topic that isn't so much considered -- but bullies are bullies, in any profession. And to think that a nurse, who bullies other nurses, won't use that same strategy for power and control with patients, I think is to be naive.
Here's the link:
http://well.blogs.nytimes.com/2010/02/11/when-the-nurse-is-a-bully/#comment-496601
MER
MER, all I can say is that when this bullying by nurses either applied to patients or to other nurses and physicians is observed and the hospital or clinic administration is made aware and does nothing, just contact the Joint Commission (e.g. pick up the phone and call 1-800-994-6610) since they will see that the administration pays attention. By the way, this bullying concern applies to any healthcare providers within a healthcare institution..Maurice.
Funny. After not seeing this site for awhile, not a lot has changed.
Mer says male doc s might be a problem, swf asks dr. MB if he would personaly help a male patient, doc says no but he would find someone for them, so back to mer and male doc s being the problem.
That was almost too perfect you guys.
For clarity, what I intended to say was that I would not, except in an emergency, attempt a procedure that I had never performed since internship and residency when a nurse with such skills was available. I would attempt to personally help the patient by attempting to find a male nurse with that skill. ..Maurice.
lol, you mean after 32 volumes of Patient Modesty we find out it's been Dr. Mo's fault all along!
"Several responders talk about bully nurses who also bully patients. That's a topic that isn't so much considered"
It isn't considered much because patients just don't matter. I have been bullied by more nurses than not. But when another high and mighty nurse gets bullied it's just not right to them because their giant egos can't handle it. They think they are too important and special to accept bullying from anyone.
I just thought I'd let everyone know I posted a response on the "Women against Prostate Cancer" site. It was about men not taking better care of their health due to privacy and modesty concerns. I sent it in a few days ago and it didn't look like the moderator would post it. I just looked today and couldn't believe it, they actually posted it. Here's a link to the site.
http://www.womenagainstprostatecancer.org/2010/02/top-10-things-women-should-know-about-prostate-cancer/
Lefteddie
Lefteddie, your letter was awesome, just what was needed to inform a sympathetic group. Good Work.
--rsl
Maurice said,
"PT,I still think that most of your
case examples are statistical outliers and I can't see how one can make generalizations out of them despite the repeat occurrances
of such sexual abuse reported in the news."
My comments of course were made regarding men who have a sexual fetish for flashing. Some time ago
A male ultrasound tech mentioned to me that a male patient made (7)
trips to different female sonographers for a testicular ultrasound. He would call around before making the appointment to
ensure a female sonographer was there. It took his insurance a while before they caught on.
How do you think his fetish started? How do you think many
who have these kinds of fetishes
start. In the Dallas Texas area
(4) patients were responsible for
2500 emergency room visits from
2003-2007. All were made for the
purpose of obtaining prescription
drugs,pain killers.The patients were known drug seekers who in turn
would sell the drugs on the street.
How many patients who are seen in
emergency rooms and physicians offices have Munchausen syndrome or
munchausen syndrome by proxy?
Do you think the explosion of
medical shows for tv is partly to
blame?It's all about attention you
know. Several years ago male paramedics and fireman responded to
a 911 call about an elderly woman with chest pains. When they arrived at the home the door was unlocked and when they entered her
bedroom the elderly lady with presumed chest pains was lying in bed. She then threw off her blanket
exposing her naked body to the
emergency responders,all for attention. True story.
PT
PT
Are you trying to tie all this in with being abused by the medical system? I am failing to see the connection from people who seek perverse attention to issues here.
SWF
My original assertion was that
some fetishes can and are attributed simply to group physicals whereby members of the opposite sex are present.If you've
read through the voy forums some
on that site admit it. Its suggested by many psychologists as well.
Who said I was abused by the medical system? Is that your assertion?
PT
No P T, that was not my assertion. I don't presume to know what people here have experinced, nor would I ever ask. We disclose what we choose. It was a general question of the above stated people.
I can understand the fetish references to a degree, but I was having a hard time tying the other examples to anything referenced here.
Eureka!I found it! After Herculian efforts involving numerous phone calls,I acquired a hospital of choice statement of patients' rights. Here is Right No.1:" A patient has the right to respectful care given by competent personnel, in a safe environment, which includes consideration of psychosocial, spiritual and cultural issues, as well as personal values, beliefs and preferences." With priority assigned to this declaration, there is enough broadness, to cover nearly any reason the bloggers on this site possess for same gender providers involving intimate care. The language affirms diversity, make allowance for unique life experience, and recognizes such an animal as "preference." The right is found in the patient guidebook,presented upon admission to the facility. This particular hospital is commended by the U.S.NEWS & WORLD REPORT, as among the nation's finest medical centers.(I do know from my pastoral experience, a Catholic woman, who attended my interfaith mid-week Bible study, shared with me, her vexation with males supplying her with intimate care. This now deceased woman was either unaware of her rights or the family was remiss in the role of advocacy.My other two hospitals of choice do not go out on the limb, with any affirmation like the forementioned institution.-REV.FRED
Good job Rev Fred! It's pretty sad that they hide it well enough that it takes "Herculian efforts" to find it. I've never witnessed anyone read through hospital paperwork so carefully and I'm sure the hospitals know that. The less the patient knows the better.
LG
REV Fred -- It's good to see that statement -- but I must tell you that -- from what I've found, most hospitals have statements pretty close to that. Sometimes you'll find all of those ideas in two or three items on their patient right's list. The "spiritual" aspect is not always present.
So, I don't think it's so much an issue of most hospitals not agreeing to that statement, theoretically. Most do. It's how seriously they attempt to really implement their lofty ideals.
The point I would make is that patients should assume that within the patient rights statement of most of not all major hospitals, they'll find what you've written in that statement. So, then if the hospital doesn't live up to it, the patient must point that out and insist that they do.
Good work, Rev. Fred.
MER
To Rev Fred above.
Whilst I agree that the statement you found should allow for same gender care as its is a "patients prference" etc; I really have my doubts that a larger hospital would interpret that statement this way.
It would be interested if they would put this in writing without some form of catch all qualification. You know: "resources permitting", "taking into account medical requirements", etc etc
Perhaps you should write to them and see what they say.
Chris
Interesting comment, Chris. A "resources permitting" phrase would be okay IF the hospital had a clear plan in process to improve accommodation for both genders in various departments. Otherwise, the phrase would just hang there as a convenient excuse, a justified reason to always say "no."
MER
Mer said
"IF the hospital had a clear plan in process to improve accomodation for both genders in various
departments."
I have to interject to say that
female patients are always accomodated. They need no
accomodating in L&D,surgery,pacu,
endoscopy or any of the intensive
care units. Should their nurse in the ER happen to be male and that is fairly rare,their wishs to be
accomodated wll be met.WITHOUT ANY
QUESTIONS.
What would Rosa Parks do? Does
it pay to be nice when you make a
point about discrimination.Do you
say "Please oh please." Rosa Parks
was arrested when she tried to
stand up for her rights.She didn't want to give up her seat for a white man nor sit at the back of the bus.
She initially got "talked to"
about it. Isn't that what happens to males who ask for fair and equal
care regarding intimate procedures.
Ever noticed that in general,that when you make a point about your rights in any scenario
that people seem to get an attitude. But this scenario is much
different,it's discrimination.
It never pays to be nice about
these issues but only gives the bully's more impetus to be a
bully. More people need to have that Rosa Parks attitude and stop
being nice. That gets you nowhere.
PT
PT -- When you're attacked or bullied you have to defend yourself. But to say that being nice never gets you anywhere is going to the extreme. I wouldn't use the word "nice," -- but being civil, polite, rational, reasonable, intelligent, calm, and knowledgeable -- that will often get you somewhere.
Also -- for what it's worth -- Rosa Parks didn't all of a sudden just decide to protest. This event didn't just happen. It was a planned, calculated orchestrated event -- consciously arranged by the NAACP. She worked for the NAACP. In other words, it was a rational, civil (non violent), respectful act of civil disobedience. It was well thought out. You need to consider that, too. And it worked.
MER
PT
You say that women are ALWAYS accommodated. As everybody here likes to refer people to the allnurses forum to support their agenda, I am going to refer you here to a midwife's blog in support of mine. http://rebirthnurse.blogspot.com/2008/09/what-happens-in-c-section.html
Scroll down and read this comment by lscw mom. I'll copy it for you here.
"I also work in healthcare and I have to say that most providers are fairly cavalier about patient nudity. Particularly for women. I've never understood why they feel it is no big deal to walk in unannounced on a pelvic, or have some five to ten people coming in and out of a laboring woman's room. I find it deeply disturbing and undignifying for a woman. It's as though a woman is used to or should be fine with being displayed for all to see. It really makes me angry to see such a degree of insensitivity to a vulnerable woman's dignity as a person, not a patient with a vagina."
NP
NP -- I agree with you. It happens to both genders and women are not always accommodated, especially in small hospitals or clinics and especially those in rural areas.
Medical professionals need to constantly remind themselves of that line between patient and specimen, object or teaching tool. A patient doesn't exist in essence for the benefit of the caregiver, to study, to learn from, to observe. Patient consent is needed for this, and many patients (depending upon their modesty and specific condition) understand the need for doctors and nurses to learn and will grant student access. I Know Dr. Bernstein has written much about how he teaches his students these values.
The patient has an autonomy, a value, a dignity outside of his or her use to the system. Art Stump (author of My Angels Are Come) makes that clear both in his book and in the thread he is on within Dr. Sherman's blog. Violations like the one described on the link you provide, show doctors and nurses crossing that line. Doctors and nurse know what I'm saying; they're taught this. But within the system that hidden curriculum often takes over and, combined with time and staff constraints and other factors, the patient as autonomous human being sometimes gets lost.
MER
NP
I have never seen a male nurse working in L&D,ever.Many
neonatal nurseries are located very adjacent to L&D so the new born babies can be taken to the nursery. Now often times the nurses
from the newborn nursery will go to the patient that's delivering so that their child can be ushered to the nursery.
I have never seen a male nurse
working newborn nursery either.
My point is that mothers in maternity often have familty to
deal with but thats up to them,
they control who can be there.
Nursery employs all women as
well as L&D. Look at the intensive
care units. You might have one male
per unit as well as the er.
PT
NP, the "people" who walk into a pelvic exam or laboring woman's room are all doctors and/or women. The reason lscw mom thinks that women have worse modesty violations is because of her heightened expectations of accommodation and because she probably never really considered what men go through. Consider this AllNurse thread, especially post no. 26 (and onward), excerpted here:
"But I have been in ER with friends and family and have been shocked at the cavalier treatment of men. Women are afforded every opportunity that is reasonable in those situations, but not the men. Seriously, what is up with that? They don't pull the curtains, they strip off or cut off their cloths with no regard to anyone else in the ER including people who are not nurses or Doctors. I mean tons of other people who should not be there! It is truly shocking! I know things are a tad hectic and your trying to save lives but it is really really weird how different women are cared for than men.
"I don't get what you mean that in your experience that many men are not that modest. I can assure you that is not the case. I have talked to all of my male friends and associates and all of us hate going to Doctors and Hospitals because of the callused disregard for our modesty and privacy!..."
True, both sexes suffer indignities at the hand of health professionals (and esp. their support staff), but the sheer magnitude of the double standard is what is eye-popping.
--rsl
PT and rsl I don't think that you get it. Many women do not want male doctors there just like you don't want female nurses there. In my own experiences, when I was pregnant, I have had to expose myself to very junior male doctors. Believe me some doctors think that a woman giving birth is a side show attraction.
As far as I am concerned a doctor is just as capable of being unprofessional as a nurse.
Also PT, there was one male nurse in the nursery of the hospital where my baby was. I didn't have a problem with that.
I just don't know why the males here cannot accept that it happens to women when the female here do acknowledge that it happens to men.
NP
Women have many options when they are patients as far as their privacy is concerned. Considering the fact that 95% of all nurses are female and 99.9% of all cna's
are female leaves few options for men.
Additionally,what I've noticed is a trend on these sites for women
it seems to overly voice their concerns about their privacy.
Is this simply a tactic to draw
attention away from the concerns of
male patients,to drown out the
argument. If you look at Dr. shermans site about many of the
issues of womens concerns,its not
even about privacy.Many of their concerns are anatomic parts removed
during surgery by male physicians
they chose! How is that a privacy
concern?
Look at comments on allnurses by
female nurses. The first time male
patients comment about the fact
that its not at all about modesty,
but rather unprofessional behavior
by female nurses the thread is shut down! Seems they don't want
anyone to get the suggestion.Its
the power of suggestion in that
when the idea is mentioned,the
motive then becomes to silence the critics.
PT
PT:
Could you reference the sites that women are "overly voice"ing their privacy concerns? I'm curious as to how much is overly much. I really didn't know that there were that many sites like this out there.
swf
PT wrote:
Additionally,what I've noticed is a trend on these sites for women
it seems to overly voice their concerns about their privacy.
Is this simply a tactic to draw
attention away from the concerns of
male patients,to drown out the
argument.
(emphasis mine)
It pains me to say that this has been my observation, too, and I didn't want to bring it up. It's almost as if men on a breast cancer thread demanded prominence because men make up 1% of people with breast cancer. I noticed the same bid at overwhelming the concerns of male patients when Marjorie was posting--and failing that, she brought up history of sexual abuse in an attempt to shift the focus to women. It does not detract from one group to allow that a problem affects another group more profoundly.
And yes, NP, while the professionalism of a doctor may be an issue, the point of this and Dr. Sherman's blog is Patient Modesty. So if you had a junior male doctor, he was still a doctor...regardless of your opinion of male maturity. But submitting to intimate care by post-teen CNAs is in a whole other ballpark, and it is the rule in medical practice, not some unfortunate anomaly. The same goes with the double standard of the level of exposure in ERs. The same modesty double standard applies in nursing homes. In fact, pretty much the only way men can avoid privacy violations is to avoid medical care altogether.
--rsl
swf,
I think PT was referring mostly to Dr. Sherman's site. The women there so overran the discussion with 40-pg posts and trivial anecdotes that he gave them their own thread...which they filled 3 or 4 times with stuff unrelated to modesty.
--rsl
I believe I've said this before
regarding intimate care. Its not
about embarrassment at all. That
is where many have missed the point
completely. Its about trust,respect
and assumed expectations to an end
result.
Its about a gender group expecting,demanding and recieving
a specific package of care that
the other does not recieve.
While working in healthcare I as
a male am expected to deliver high quality care to male and female patients alike. I'm professional
and I treat both the same.
Yet,when I'm a patient a see
exactly the opposite. No such respectful considerations are
given by female providers.
Purposely keeping curtains open
when you've been asked to change.
You are in such pain you cannot talk,let alone move. Being asked to
assume a ridiculous pose without your pants on for an IM injection
while the ma kneeling on the floor
looking up. The list goes on and on.
Yet,when there is unprofessional
behavior,the comment is "sorry you
had a bad experience". That's not a
bad experience,thats unprofessional
behavior.
You as a male I assume are supposed to enjoy it.That the message. Personally,I'd rather go
without that kind of care.
The comments some make about
nursing being the most trusted profession. Where did they get
that vote. They never asked me or
I've never seen any voting process.
PT
rsl
I understand where you are coming from up a point. But if you've ever walked in a woman's shoes you will understand that unwanted sexual attention is a pretty common experience. Especially when you are young. Most women are afraid of walking alone after dark. The fear of rape is always at the back of your mind. Men do not understand how women feel. I have had to educate my husband somewhat and chastised him for not looking out for my safety in a chivalrous way. So if you think that women are more accommodated in the medical setting, it is probably because women are more vulnerable. I know this is a slightly different issue to modesty, but having your modesty violated is sexual assault.
NP
PT:
I could see your point if you were speaking only about the nursing sites. Of course they do not want a bright light shining on the issue of male modesty. They will attempt to calm the waters when their jobs are at stake.
But as far as this and Dr. Sherman's site: "Gender Preference" and "Patient Modesty" seems to be an area that welcomes both genders. As humans, we all have modesty issues and learning how genders accomplish their needs helps everyone solve their own.....if you learn from it.
And considering the female to male caregiver ratio, I personally find that I spend much much (much) more time advocating for men than women. Wasn't that our goal? Choices for everyone and advocate until it happens?
After all of the gender wars, you should pay attention to what women post as their final frontiers of choices, see how they got as far as they did, accept their help, and maybe even work together.
swf
NP wrote: So if you think that women are more accommodated in the medical setting, it is probably because women are more vulnerable. I know this is a slightly different issue to modesty, but having your modesty violated is sexual assault.
(emphasis mine)
If having ones modesty violated is sexual assault, then even outside of prison far more men are sexually assaulted than women. For the most part, people want their modesty accommodated because they value their modesty, not because of fear or history of sexual abuse. The only "fear" involved is fear of abject humiliation. Bringing up fears of the midnight rapist in the parking lot is akin to bringing up fears of the suitcase nuke when discussing the validity of torture. The fraction of people freaked out about modesty because of prior rape is minuscule. (And please, no 1-in-4 mythology.)
--rsl
NOTICE: AS OF TODAY MARCH 24, 2010 "PATIENT MODESTY: VOLUME 32” WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 33 ..Maurice.
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