Patient Modesty: Volume 34
This thread has been continuing since August 2005..approaching now 5 years. With the literally thousands of commentaries written to this topic of patient modesty on this blog, I challenge our visitors here to go beyond simply expressing their concerns here, much of which I do consider valid, and now progress to the necessary chore of broadcasting the concerns to the general public, the medical system, the politicians and the government. I would like to see evidence of such action since I am sure that this will be the only route to real change, real change that I now realize (which I hadn't prior to 5 years ago) is necessary. So "go to it!"..Maurice.
ADDENDUM 5-15-2010: Those who wish to participate in advocating to the public and the medical system your views regarding the need for more attention to patient modesty and gender selection of healthcare providers, a long time visitor to this thread, swf, has set up an advocacy blog to begin this advocacy challenge. Go there and start the process.
Graphic: from various Google sources. Thanks.
NOTICE: AS OF TODAY JULY 2, 2010 "PATIENT MODESTY: VOLUME 34" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON Volume 35.
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posted by Maurice Bernstein, M.D. @ 8:14:00 PM
135 comments
135 Comments:
Does anyone here think that I am pushing too hard for some evidence that those who hold the view regarding the need to change the medical system and psychology of those who practice medical care with regard to patient modesty and gender selection are attempting, in an activistic way, to promote these changes?
In this Volume let's begin by answering my question. If my view is appropriate, let's use this Volume to get started by communicating through this blog and through e-mail about getting started to "spread the word". Let's try to limit further expressions of personal experiences and other hearsay stories and statistics. We have ample examples throughout all these thousands of comments. Now is the time for action! What do you think?..Maurice.
I think that people who have been vitimized by the medical system in these ways are beside themselves and see the medical system similar to the Catholic church in hiding abuses (and that is exactly what modesty violations are purposeful humiliation are)only instead of children it's the sick and vulnerable.
They might have comes to this blog and others as a way of self expression, frustrated, unable to communicate their feelings and that, Dr. B. turns into activism for the healthy minded.
The only way for these changes to be promoted is an acknowledgement from the medical system acknowledging that some of the "standard of care" practices are damaging to sound mental health.
While ten people exposed to the same stressors will not all develop mental health issues, all ten would if you knew what "buttons to push".
Stripping patients, ignoring their dignity, unnecessary bodily exposure and gawkers in the ER, OR or humiliating procedures while awaiting surgery performed in a very public way are all traumatic experiences for many. The emotional damage from these incidents can be lifelong leading to avoidance of all medical care and a large segment of complaints and lawsuits are over issues such as these. departments.
Let's be healthy, using activism, acknowledgement, apology in medicine and a new basis for earned trust and that's a "win win" for everyone.
gd
From today's AOL news:
"Rare as restroom rights are as a subject of national debate, the relative lack of women's toilets in public buildings across the country remains a flagrant example of gender inequality, witnesses and congressional members of both parties argued at a hearing on Capitol Hill today. The House is considering a bill that would require new and renovated federal buildings to have at least as many facilities for women as for men."
My goodness.. if Congress is going to handle the issue of gender inequality in toilets, shouldn't that encourage those on this blog about getting something done by our government regarding patient modesty and gender selection? Another.."What do you think?" ..Maurice.
Dr. Bernstein said
If my view is appropriate, let's use this Volume to get started by communicating through this blog and through e-mail.
Email who? A bunch of my friends who read here for awhile have tried your email medical.privacy@yahoo.com
from one of your blogs and no one answered. Why arent you using it anymore?
Anonymous, I recall this e-mail address was previously posted on one of the earlier Volumes but, of course, it wasn't by me. Hopefully, the visitor who posted it will respond to your concern. We should get someone to be the leader of this activism movement and set up an e-mail address so that those interested in joining and participating have someone to communicate with. I don't know if MER want's to be such a leader here or some other frequent visitor. Those who want to participate in this activism movement may use these Vomumes to inform others about what is going on. I just want to see some action by those who feel the hurt and a reduction here of just "moaning and groaning" but yet not doing something about it. Yes, I believe "moaning and groaning" within a safe and interested environment like these Volumes is truly therapeutic for the individual but is not the way to fix anything that needs fixing. ..Maurice.
I ended up cancelling the surgery-
I´m the woman who was required to undergo a 12-lead EKG, history taking, full physical (yikes, with pelvic & Pap smear)for eyelid cosmetic surgery. Besides, not only would I have been handed a completely transparent white paper gown, (absolutely no underwear allowed) but would be dragged in a gurney alongside the hall and put in an elevator (seriously, I can document all this). buy the humiliation would not end there: in the OR there would be at least six people, three of whom, including the anesthesiologist, would be male. There is always a male orderly regardless of the gender of the patient. They may be very helpful for elderly gentlemen who might be barely able to walk, but I am
a)very tanned
b)slender
c)well shaped
d)relatively young, really under forty
Don´t you think it is really to much to ask them not look??? I beg somebody answer me, even if they wanted to, can they possibly not notice those things?
MAJO said
"There is always a male orderly
regardless of the gender of the patient."
Not so! Cosmetic eyelid surgery is
done as an outpatient at an out
patient facility. Those places
don't hire "male orderlies". Fact
is male orderlies don't exist.
It is a nurse that takes you
back for pre-op surgery and from
my experience,I've never ever seen
a male nurse employed at an out
patient surgery center. Furthermore
I've never seen a male nurse
employed at any hospital surgery
suite. Nurses in surgery perform one function,circulator.
That job specifically entails
charting,retrieving supplies that
the scrub tech or surgeon requests
during the surgery. After the surgery their job is to return the
patient to pacu(post-op) and give
report to the pacu nurse. At an
outpatient facility the circulator
is also the pacu nurse.
PT
Having worked in healthcare for
many years its interesting to note
that most employees that work in
a hospital never come for care at
the facility where they are employed. Isn't that interesting!
I've heard comments from nurses
such as "cover me up if I'm ever
brought here." Or, I'll never come
here,I don't want anyone staring at
my cooch! Whatever that means.
Yet,its interesting that female
nurses and others make these comments when nursing staff is over
95% female,respiratory is over 98%
female and registration is over 99%
female. What about males who are
patients there and who DON'T WORK
THERE. What should they do?
PT
If everyone would cancel their surgery, they'd start paying attention. Your needs comes first and if they choose not to accommodate, there's always someone who will
gd
" Fact
is male orderlies don't exist."
Well the last time I looked my orderly friend was male.
And in 2008 when I had my baby a male orderly was pushing my gurney.
NP
I've taken your advice Dr B, as my
comment has been made on the modesty issues on allnurses. Lets
see how long it takes for them to
boot me off.
PT
Good work, PT. Dr. Bernstein has asked us to focus on activism. I strongly believe that getting this topic on various doctor and nurse blogs is a major form of activism. It wont't always work. Sometimes we'll get booted off. But I think that happens less and less these days because this topic is coming out of the closet relative to all the discussion about the Muslim culture and what's called transcultural nursing. Occasionally we'll get posters like DonMD or several nurses on allnurses who advocate for this cause. Non medical professionals can only get so far, but when we get a doctor or nurse advocating for us it makes a big difference. We can all understand how someone within a profession possesses more credibility within that profession that those advocating from without.
So -- let's get on these blogs, let's be respectful and civil -- and I truly believe that this form of activism is one way to get the message out.
MER
MER..but I want to see something more! Look, all those visiting these blogs are coming because of some interest. They may not be the ones who need to be educated. What is needed is to engage all those who are initially disinterested in your concerns and convert them. This means, as a beginning, getting the general media interested in spreading your word. (Yes, there are disappointments in such a tactic such as NO FOLLOWUP RESPONSES TO MY REQUESTS TO HOSPITAL.COM for their participation.) Nevertheless, everyone interested in developing change should be doing something in this regard. But it also means about getting a group of activists together, using an e-mail address to create a sort of listserv where approaches and delegation of duties can be disseminated. Anyway, these are my thoughts at present. ..Maurice.
NP
Lets take a look at your definition of "male orderly". I've
worked in healthcare for over 30
years in hospitals all across the
U.S. and I've never seen one.
Are you referring to a transporter? Why don't you tell us
where he works. Lets take a look
at the OP's comments. One by One.
"In the OR there would be 6
people. WOW,I've never even seen
that many people involved in a lap
chole,even for open heart surgery.
Typically,you have the anesthiologist,the surgeon,the scrub tech and a circulator.That's
4 people for major surgery. In most
simple plastic surgery cases such
as a blepharoplasty(eyelid surgery)
there is no anesthesiologist.
Its a local anesthetic,most
often lidocaine! In these and most
simple plastic surgery cases its
just the surgeon and her assistant.
PT
Anyone want a blog just for advocating?
http://advok8.blogspot.com
I can share it with another blogger if they want to work together. (?)
boshemian2@aol.com
swf, there you go! That blog will be a good beginning meeting place for all those interested in the goals of patient modesty and gender selection in medical care. If you really intend for the blog to cover primarily one advocacy issue (those noted in the last sentence) then I would suggest changing the name of the blog so that the name would advocate what you will be advocating! ..Maurice.
I agree, Maurice, that there are many more things we can do to be proactive. But don't underestimate the power of blogs and social networks. Repetition is a key element in marketing -- keep posting on all these different blogs, over and over and over again. Maybe we need a Facebook page, too.
Try this: Let's write letters to the editor or call and write newspaper, radio, TV reports and give them the URL for Dr. Bernstein's and Dr. Sherman's blog. Tell them this is one of those "under the radar" topics. The media likes to be the first to grab on to a new trend or issue.
Let's see if we can get some articles written about these blogs and this issue.
MER
MER, I didn't think of Facebook..but, yes, that would be very important. Someone should start that! But, I suspect,as in all advocacy programs, there should be some central coordination of the various approaches to set the goals and set the methods so as to make the goals more likely to be reached. ..Maurice.
OK.. who starts Facebook? Again, as I have said previously along with MER and others.. whatever one advocates..and hopefully it will be with a consistent and unified theme..a critical point to remember is TO ADVOCATE WITH CIVILITY! Anything short of that will definitely diminish the value of what is written in the eyes of the reader and adversely affect what is written by others. THINK before you write and write with CIVILITY! ..Maurice.
I don't know if the Facebook site titled Medical Patient Modesty or the linked web site "Medical Patient Modesty"
represents the work of anyone who visits and writes here but it appears inactive with regard to any participation. It deals with the issues presented here along with similar stories. It appears to be inactive however with no evidence of visitor participation and has one ad for an "All Female OB/GYN Directory".
If you haven't seen these sites, go there though I was thinking more of a site, perhaps closed, where those of similar interest from my blog and Dr.Sherman's could begin to work out plans to initiate a more active campaign. ..Maurice.
I have just reviewed again Dr. Sherman's blog where the ongoing thread of how to proceed with "spreading the word" has been long discussed as it has been discussed on these Volumes. What is missing, I think, has been formal organization of a group and that group should have their own site for planning. I know that Jimmy, swf and MER have all been involved in commentaries at Dr. Sherman's blog but I didn't see that there has been a final outcome to the discussions though I do know that swf has contributed with the first unified site "Constructing the Advocates Site". What I think is needed is for others to simply join swf together at one site and start the advocacy planning there. If I am misunderstanding what is the current status, let me know. ..Maurice.
I believe the Facebook site is the same creator as
http://patientmodesty.org/index.aspx
Interesting and helpful, but read it carefully. Everyone can do as they choose, but it was a site I declined to be a part of. A good site if you support all of their convictions though.
Something that I would like to try for us with the new modesty blog (that worked well for the advocates) is "no comment moderation" for now.
**A) It made the blog everyone's, but comments could still be deleted if needed.
B) Many times two were on at the same time and could have a viable conversation in real time.
C)We trusted the content but did delete a few upon request.
(example: conversations with other modesty website builders)
If anyone would like to try it that way let me know. It really does give the sense of belonging to the entire group, and that is the goal. If we run into trouble we can always enable moderation later, but that would only happen if many many new people visit the site.
Anyone?
Well, two things.
Dr B. will this blog stay open for comment? I don't want to trade one for the other. But I like the idea.
SWF I was going to say no no no you can get into lots of trouble with no moderation but it is nice posting and seeing it come up right away. If you get lots of hits though you will go to the net and then will need to rethink.
Anyway, to be honest I will probably wait to see if anyone writes there.
Of course this thread will stay open for comments. But I would like the pertinent organizational discussions to go to swf's blog if that is what everyone wants. It is better not to dilute planning by skipping from one blog to another. I also agree with swf to have her blog non-moderated (particularly if the visitors are limited to those who are aware and understand the function and goals of that blog). Non-moderation will allow back and forth communication more easily to occur. ..Maurice.
PT
I'm in Australia. What is an orderly according to your definition? I had a male transport me from the operating theatre to recovery.
Anyway, when I had my baby last year I had no less than 12 (yes twelve) people in the operating theatre when I had my caesarian as I had a very high risk pregnancy. Besides the obstetrician, there was a gynecological oncologist, a anesthiologist, a urologist, and an another surgeon assisting the obstetrician. The extra staff were there in case I had a huge hemorrhage and they had to perform an emergency hysterectomy and repair my bladder as I had placenta percreta. Dare I say that health care may be superior here?
NP
"OK.. who starts Facebook?"
Has someone started that yet? I only see Misty's site.
swf
The key isn't a website, or a Facebook site. Anybody can start one of those, and most just linger with little activity.
The key is marketing strategies. Anyone on this blog with marketing training, especially with web marketing? There are techniques we can use that would call more attention to these sites.
But part of our problem here, it seems to me, is our unwillingness (me, too) to come out of the closet with who we really are. See -- one thing we could do as get all our Facebook friends to become members of our new Facebook site, and become members ourselves. But that would require letting the world know who we are.
Maybe it's time we all do that. As I'm beginning to see it, that may be our next step.
MER
MER and others,why is it that virtually all of those who comment on this blog and describe their own experiences and feelings do not identify themselves or provide an e-mail address for direct communication with others. The conflict is clearly between the visitor and the medical system and the conflict is apparently not uncommon and doesn't represent some sort of defect of being a person. So then, why is there hesitation to be open about ones views and feelings. This almost sounds like the gay and lesbian closeting from decades ago.
Do you think that this "hiding" is part of the problem which is preventing change in the medical system towards this problem?
..Maurice.
p.s.- I'm glad to see that there is a tendency begun for the discussions on this thread now to be looking forward rather than looking back.
"But part of our problem here, it seems to me, is our unwillingness (me, too) to come out of the closet with who we really are. See -- one thing we could do as get all our Facebook friends to become members of our new Facebook site, and become members ourselves. But that would require letting the world know who we are."
It never occured to me that most of us were 'in the closet'. I post advocate updates on my facebook regularly, and have family members in the medical field. They are not thrilled with view, but I'm not thrilled with theirs either.
I know of one advocate who 'didn't want to start family trouble' saying his real name, but is that really the case with most of us?
Sorry. I do not see how we can work on this in secret.
Dr. B,
As I have mentioned before, at least for us right now, the issue of anonymity has to do with retribution. My wife only has 1 doc on her approved provider list for her health insurance. We have already 1 time complained about the fact that Medical Reps were in her OR even though we had explicitly discussed the modesty issue with the Doc. The doc claimed that he threw the guy out, but the official legal record shows he was in the OR for several hours. We were told this is "common" so that the rep can show he was on the job. Essentially the Rep is lying and the VERY LARGE teaching hospital is involved with the lie by falsifying a legal record. Either way, it is bad. Someone is lying. The doctor made it clear he never brought it up to us because as soon as he saw the guy he threw him out. There was no need to "inform the patient", even though eventually we found out because it is right there in her OR records.
A "loss of trust" obviously has taken place, but we might still need him. This is cancer after all.
Hospitals and doctors and insurance companies represent the ability to deny care which could in fact be a life threatening event.
Also, the reaction that some of us get when expressing our views are met often times with derision.
Question to you Doctor B: Is there a way to "come out of the closet" without potentially risking being cut off from medical care? This is a tough one.
amr
amr, if you are going to be "denied medical care" (does that mean abandonment, which is unprofessional for a physician or illegal for a hospital under EMTALA laws?) simply for being identified as an individual who is campaigning for patient modesty and gender selection of healthcare providers, you have no business being under the care of those entities. This would be the same unethical and illegal behavior if a physician or hospital refused to care for a identified Republican voter or one who voted for Democrats. I have confidence that neither your doctor nor hospital would stoop to that reaction. ..Maurice.
MER said:
"The key isn't a website, or a Facebook site. Anybody can start one of those, and most just linger with little activity."
MER's right. It didn't really take much for me to do a blog. No interest sparked with the website idea. And most "linger with little activity."
If anyone has ideas on moving forward that would be great. I'm confused on which way everyone wants to go. If I can help....let me know.
swf
Hospitals,emergency rooms and
physicians offices are most of
the time extremely busy and
very stressful places to work.
Common sense and courtesy will
go a long way in getting the most
out of your experience. When you
recieve care from the nurse,physician or staff say
"thank you very much". If possible
leave idiot family members and
friends at home.
Those kinds of people can bring
down the quality of care you recieve through their senseless
interaction with hospital staff.
One big pet pieve of mine is the
physician walks into a patients room and there are 5 family members
and 2 friends. He asks the patient
a question and before the words
leave his mouth a different response comes from each family
and friend before the patient gets
to answer. No,it is not the ER's
job to find food for all your family and friends.Thats what
resturants are for.
Most importantly,there are other
sick people as well waiting for care and many worse off than you are.
pt
Hospitals,emergency rooms and
physicians offices are most of
the time extremely busy and
very stressful places to work.
Common sense and courtesy will
go a long way in getting the most
out of your experience. When you
recieve care from the nurse,physician or staff say
"thank you very much". If possible
leave idiot family members and
friends at home.
Those kinds of people can bring
down the quality of care you recieve through their senseless
interaction with hospital staff.
One big pet pieve of mine is the
physician walks into a patients room and there are 5 family members
and 2 friends. He asks the patient
a question and before the words
leave his mouth a different response comes from each family
and friend before the patient gets
to answer. No,it is not the ER's
job to find food for all your family and friends.Thats what
resturants are for.
Most importantly,there are other
sick people as well waiting for care and many worse off than you are.
pt
Dr Bernstein, I know you don't want to hear anymore anecdotes but this post by a doctor really has shaken me.
"I am a doctor myself, in a smallish town in the midwest. I'm in a specialty where we do not do pelvic exams, but of course I was trained in how to do them while in medical school. It has always bothered me, for a couple of reasons, but the male/female thing has been the main thing originally. I always got a small, secret thrill out of doing a pelvic exam (or a breast exam, for that matter) on an attractive woman. Because we were told that "it's not sexual," "it's just a medical procedure, nothing sexual about it, no reason to have sexual thoughts," I though I was weird. I didn't worry that much because I knew I wasn't going into an area where I would do exams, but...
Then, during residency, I worked with a lot of doctors in the community, and discovered that, for most of them, it WAS at least partly sexual: they would sit around in the lounges and such and sometimes discuss the anatomy of beautiful women who'd been in, and on two occasions discussed, in front me and everyone else, the sexual anatomy attributes of women who worked in the hospital, nurses and such that were mutual acquaintances. I was horrified! I have to say, too, that many doctors, when I asked (because it bothered me), talked about it like, "Oh, it's just another test to have to do, kind of boring, really."
Still, the inescapable fact is that a guy likes to look at a naked woman. Period. Doctors are no different. They like to look at naked women, too. So, if they get PAID to look--I mean, really LOOK--at a woman's sexual organs, and even better, they get to touch them, well... So much the better! I'm not saying that doctors do exams just to get a sexual thrill, because the circumstances really don't allow a full-out sexual experience, but given a choice between doing a lung exam on an 80-year-old guy or a pelvic exam on an attractive 30-year-old woman, I'd say most docs would MUCH rather do the latter. They're only human. They would flatly deny having any such thoughts (in most cases), but deep down, they ARE men, after all.
It's from here http://blogcritics.org/culture/article/unnecessary-pap-smears/comments-page-8/#comments
NP
SWF: This happens every 9 months or so. No offense to you I'm sure.
First there was Jimmy and he started a group a few of us joined. Then Alan came and we were rolling some. Then you came and bang bang bang everything was planned for the website to go live. I think it was actually built twice! Then guess what?
Jimmy is MIA. He never told us who we all were. Some of us have emails. That's it.
If you really want to start over I will think it over too. Like the guy/gal above, I'll probably wait to see what anyone else does at this point.
Sorry. From my experience two is hard and one is impossable. You need more and I'm just being honest here.
Dr. B,
You said: "amr, if you are going to be 'denied medical care' (does that mean abandonment, which is unprofessional for a physician or illegal for a hospital under EMTALA laws?) …"
Care for my wife under this institution and particular plastic surgeon has been over now (thank God) for 2 years. There is no "ongoing" care, but there could be further cancer or revisions in the future. We have limited options given the insurance company's preferred providers' list.
The medical profession (industry) is frankly like any other. It is big business which is always thinking about itself first. Just because denying services is wrong or unethical or illegal, doesn't mean it doesn't happen. I think it is naïve to think that laws protect people. Rights are always what you assert, not what you are granted. Most people do not understand that, much less understand what their rights are, much less have the time and/or money to assert those rights.
Besides, should a patient subject themselves to a surgeon who doesn't want to do the work, or is now afraid of a law suit. What about the hospital?
With respect to modesty violations that one doesn't know about, or doesn't know to ask about, it becomes even harder to deal with, especially where there are no laws to protect you, and no real way to assert your rights. To further my discussion with you about modesty violations being common place in the OR, which clearly you have never been a party to because of your position as a teacher, this AllNurses entry made by a telephone technician about what he sees in the OR clearly spells out what we as patients are up against. When he complained to his boss, the boss said essentially that it was commonplace and that the tech would get used to it.
With your assertion that you don't believe there would be retribution by this large teaching hospital in Los Angeles (the one that is always in the news about celebrity patient violations), are you prepared to indemnify my wife against such violations? Are you willing to put your money on the line for this assertion that the law will protect us?
If so, let me know and I'll be happy to draw up the legal papers. Then I will be happy to "come out of the closet".
amr
NP -- When I read stories like yours, I can only respond with this: There are some things we as patients have no control over. Some things we do have control over.
What doctors and nurses talk about in private among themselves, is something we can't control. I realize that for some, that explanation will not suffice. I've said numerous times that when this kind of backroom talk gets out on the web, and it often does these days, it does much to destroy trust among medical professionals and patients. That's a different situation, and we can, as patients, advocate to keep this stuff private. And, if we as patients somehow here this kind of talk among caregivers in places (like parties) where it shouldn't happen, we should certainly speak up.
Your main point seems to be about how much sexual or other pleasure or some doctors may get from examining attractive women. I've found enough studies to indicate this can be a problem for some doctors. And, by the way, this isn't limited to male doctors and nurses. Let's be honest. Just the other day I was talking to a female med student who was shocked at some of the talk in the break rooms not just about bodies, but also personal info about patients that others really had no use to know. This backroom talk was among females. Again, we can't control what's in people's minds.
I suppose a woman could decide never to deal with male doctors. Same with men and female doctors. Although I respect a person's right to do that, I do think of that decision as an extreme one.
So, I suppose I saying this: It's difficult enough for us to deal with issues we do have some control over. I can't control what people talk about in private or what they think. But, you're right -- it doesn't make make some patients feel safe or respected that this may be going on. But personally, I need to focus on the things I do have control over.
MER
"SWF: This happens every 9 months or so. No offense to you I'm sure."
I'm not offended. I was expressing confusion, and frustration at an entire planned website disappearing and everyone with it. Lots of work...
"I'll probably wait to see what anyone else does at this point."
I appreciate the honesty, but if you wait nothing gets started because everyone is waiting.
I vote for MER to direct traffic, so the rest of us can get back to working on things again.
swf
Most hospitals in many states are
not required to report infection
rates.These are infections you
acquire while in the hospital such
as from surgery or indwelling
urinary catheters.
By keeping unnecessary visitors,
observers and students out of
surgical suites you essentially
can dramatically reduce the rate
of nocosomial infection. Additional
protection provided surgical staff
do not wear their scrubs outside of the suite.
This is not from a perspective
of privacy,but a health issue for
your well being.
PT
NP
Respectfully...we really can not have it both ways. We can not keep insisting that Dr.s are only human, and be shocked when we find examples that they are only human. We are all only human: The universal truth. There are Dr.s who fully understand the weight of what they ask us in intimate situations, and all they can do is assure us respect. There are Dr.s who have forgotten that weight,but provide modesty perhaps out of long habits. And yes, there are those who probably can not wait to chat up about what they saw that day.
We can not change them. We can only change our right to choose BETWEEN them.
But they can not change us either. If we find unacceptable or unbearable options within this human truth, all we can do is search and fight for options that we can find acceptable.
swf
To all: Think about it. Doctors and nurses and others in the healthcare profession who as part of their professional activities have access to and physically interact with the unclothed or partially clothed patient do not have their innate and common sexual feelings vaporized into nothing. What happens is that they are hidden, suppressed by what they understand is professional behavior and by the need to attend to the task of their current professional activity with the patient.
I have a feeling that the descriptive and/or humorous talk later between the professionals about their experiences is a reaction to such necessary suppressions. It may be a demonstration to others that the healthcare provider's experience with the patient was not that of a unfeeling robot but of an aware and sexually interested human being.
This ventilation is obviously something that if heard by the patient easily would not at all be considered acceptable talk. It also might not be comfortable for some of the professional's colleagues themselves to hear who may feel that such talk would be an unprofessional way of ventilating.
In any event,we all have to accept that patient modesty is a human and cultural function and sexual thoughts in a medical professional is part of being a human. Together, realistically,they are both part of the doctor-patient relationship and there has to be some control or limits to both for the end result to be a safe and effective relationship to the benefit of the patient. ..Maurice.
I would guess at this point keeping in "the spirit of the blog" re this volume, at may be appropriate to ask:
1) Are there those that even want to form a group to work together?
2) Is this decision based on being able to remain anonomous?
3) Do we want to meet at the separate blog to plan?
4) Is there someone who would like to direct the flow in an organized manner?
It is not my intent to put any specific person in a spot to have to publicly say no, so any volunteers?
5) Would it help if we made a specific e-mail address with a forwarding mail list?
6) Is our hesitancy based on trusting our fellow posters to advocate as we would ourselves?
I know these things are basic, but first things first and maybe we could have a plan of action.
What does everyone think? Do we have enough interest in group action?
Sorry to go off on a tangent at this point.
This blog has been a great support group, but are we tilting at windmills?
It would be a waste of time to tackle the medical operations administration. They see themselves as a bureaucracy which means they exist to serve themselves and are impervious to outside requests/demands. They rationalize that they are a monopoly, so there's no need to listen to patients because they are not customers. I'll quality this to say that if could give them bad press, they would certainly give the proper response [thy can talk the talk, but we need then to walk the walk]. If somehow we could keep the pressure on, we might actually get a change. Can we mobilize a campaign to get the mass media involved?
I believe the next generations of MDs is our best hope to effect change. For example, I had good luck with a "new" MD, but she was fired after six years for being too concerned for patients. I attended a "rally" for her. It made the local newspaper with exactly our point. A year later she was still looking for a job. Why should MDs stick their necks out? But, how do we get MDs involved?
BJTNT
swf, MER and et al: I would suggest you look into a communication system where multiple participants can communicate simultaneously if necessary and is far less complicated and more "in real time" than a blog or listserv.. and that is Google Wave. Check out Google Wave at
https://wave.google.com/wave/
Documents, photos and videos can also be part of the instant communication on the Wave.
You may had to have a google.com e-mail account first but that is simple to get.
Let us know what you think as this way of getting started. ..Maurice.
SWF,MER,BJTNT,AMR,GD and others.
First,thanks for all of your activism.Lets Thank Dr B for
hosting this platform and creating
a mechanism by which our ideals
can come to some fruition.
We are visionaries looking down
the same path,wanting the same solution,yet,we are looked at by
many in society that consider us
somewhat cuckoo. We certainly are
not odd in our ideals when you
read about physicians,nursing
staff and others being terminated
for some of the very concerns we discuss here.
Healthcare and patient care satisfaction in todays market
is at a crossroads of change. You
often hear the words of entitilement,positive experience
and certainly some of this is in
my opinion unachievable and unrealistic.
I do believe now is the time
though for our ideals to find
roots if you will and look for
avenues of opportunities to ever
plant that seed of thought not only
in the general public,but to those
in acedemia and medical facilities.
The general public is the first
place to begin in that it is here
most likely to effect change.
PT
Modesty issues are not just a privacy issue; they are a health issue as well.
People with fundamental belief systems protecting their modesty have theirs violated essentially against their will. Stress causes blood pressures to rise, cortisol levels to rise and a whole host of problems with people who may have preexisting conditions such as heart attack or stroke. This is as much a medical issue as giving a stroke patient a diet of hot dogs (full of salt).
gd
Is there hope? Four years ago when my wife had cataract surgery, she had to remove all clothes and wear a gown. This week, she had cataract surgery on her other eye. She was told to keep her street clothes on below the waist. This surgeon was a generation younger than the one four years ago. This supports my hope that the younger generations of MDs is our best hope for change.
BJTNT
Dr. Bernstein:
Googlewave looks like an interesting place to stream thoughts and ideas. Looks easy even for a non techie like me.
suzymcares@googlewave.com is me. I think I'm just about everywhere now......
PT and BJTNT: Both of your posts sort of hit on something that (I believe it was)MER pointed out. Public awareness and media attention.
There are thousands of little footpaths that can take you to the top. Each one helps get others there. So, no single effort is the be all end all. Websites, blogs, letters, groups: all small things until they come together as mass exposure.
PT: Can we discuss your ideas on getting to the "general public first" ?
Perhaps that can eventually help lead us to BJTNT's question of "Can we mobilize a campaign to get the mass media involved?".
swf
(suzy)
Mentioned on this and Dr. Sherman's blog, that allnurses thread about patient, especially male modesty where a doctor, DonMD, posted an interesting comment about male modesty that elicited numerous responses, mostly, it seems, from not medical professionals -- patients. I notice today that we find this comment as the last post: "Thread closed for staff review." That usually means, with this subject, that the thread is permanently closed and may eventually be taken off the blog.
Read the post just before the closing post. It's obviously from a patient calling for activism on this issue.
The appearance, at least to me, is this:
1. Once patients get on these allnurses threads, especially topics like this modesty one, and post controversial comments, the threads often get shut down.
2. The last thread frightened and bothered this older generation of nurses who are running allnurses. Why would these posts by patients bother these nurses? I think we need to study this if we're going into an activist mode.
3. They know this is an issue. They also know that in most cases they may not be able to accommodate men. They also know that to get to a position where they will be able to accommodate men, they will actively have to recruit more male nurses in nursing schools and then actually hire more male nurses. All this may involve some kind of an affirmative action model where some women may not be hired because more men are needed.
4. We need to realize that the practical aspects of change for this issue involve politics and economics. It also involves the old guard within a single gender profession holding fast on to the power they have. It's always about power to some degree.
5. We need to keep this issue on the table despite attempts like this to keep it off the table. We may -- and I do say "may" -- want to encourage other patients to begin threads like that thread on allnurses and blogs like it. If they get shut down, they get shut down. But we must not stop challenging attempts to prevent discussion of patient modesty which includes the patients themselves.
5. Finally, read that last post again before the thread was shut down. It offers a way for the profession to begin changing the current situation, the double standard with men. For some, this is a dangerous movement. Have no doubt.
As we move forward with this and go public, we'll find some allies in the health care system, many who consider the subject a non issue, and some who will fight us all the way to the bank. Apparently, those nurses running allnurses may be among those who will fight this issue, at least an open discussion of it. As I read it, this old guard may even want to move toward change, but they don't want patients involved. They want all the discussion and change to occur on their turf, behind the screens, out of the public view.
We need to go into this with our eyes wide open.
Here's the link:
http://allnurses.com/operating-room-nursing/modesty-issues-130341-page10.html
MER
Mer,
Can you contact DonMD and invite him to look at this and Dr. Shermans blog?
amr
I'm not at all surprised that the
thread on allnurses was shut down
for staff review.Why does staff
need to review it.Are they going
to discuss it amongst themselves.
It's just an excuse to stop the
discussion. The issue I find very
disturbing is posts on allnurses
such as "Can I keep working as a
nurse if I have a felony conviction
or Things you'd like to tell your patients." Yet these kinds of posts
keep going and going with all kinds
of positive reinforcements.
For the modesty post that was shut
down that is advocating for
patients,yet for male patients is a problem. I posted on that thread
with my identity as PTismyname.I
recieved a response that "the op
posted this 5 years ago." So what,
its obviously still a problem in
healthcare. The allnurses site has
removed whoa innapropriate and in
time they will remove the modesty
threads as well. Thats OK,I've
already printed all the posts.
PT
I must say I noticed also the closing of this thread on allnurses.Its great to see people raising concerns and challenging the protocal the tension is definately rising.I myself have posted and raised questions to nurses on why certain things are happening(I wont go into details here) but consistantly I have been ignored.Go figure..........
upside down
It would benefit both the medical community and patients to have a dialogue opened between disgruntled patients and the medical staff.
It would provide a voice to patients and allow the medical community to understand how people feel, the damage that can be done and an opportunity for healing.
It won't help the deviants who will enjoy hearing of others pain. It is up to the medical community to do their own policing.
gd
We can take a lesson Florence Nightingale, who had a maxim thus:
"Proceed until apprehended." That's what we need do. Keep posting. Refuse to let the topic be shut down. We still must be positive in our discussion, civil, polite, use logic and reason and make our criticism constructive -- but keep the subject on the table.
MER
"Bill Would Let Patients Pick Nurse Gender" is the title of a thread over at allnurses (about 5 yrs old though). Maybe legislation like this is exactly what we need. Take a guess how the nurses react to this idea: ~Jean~
http://allnurses.com/nursing-news/bill-would-let-100775.html
This bill did pass however, not stringent enough. It focuses on patients with mental health issues choosing care of provider in medical situations. The bill also states that if there is no same gender worker that it must be documented and then they can have an opposite gender provider.
The problem I have with all of this is that laws are in force to stop all of this, however, the medical community is so arrogant they ignore it and bully the public
gd
Jean -- That bill came out of Alaska and it was specific to the mentally ill. It passed, I think in 2008. It didn't include choice of gender for OR prep, but it did require institutions who were not able to make accommodations due to staffing, to record that in their charts. If patients were traumatized, esp. possible with the some mentally ill, they had a written record of the lack of accommodation. It certainly sent a message to the mental health community. Administration fought it.
When I heard about it, I went online, wrote some letters, and got copies of the bill and the testimony. What's interesting is that the arguments used to get the bill passed could easily be used for everybody, not just the mentally ill. A good amount of case law was cited in the briefs. During the debate, some senators wanted the law to apply to all patients, not just the mentally ill, but those sponsoring it, probably correctly, thought it might not pass if became too broad. The bill was pushed through by a women who had suffered from mental illness and is now an activist.
MER
Reference gd May 22,7:05PM QUOTE:
"The problem I have with all of this is that laws are in force to stop all of this, however, the medical community is so arrogant they ignore it and bully the public." UNQUOTE
Amen! I would only add "condescendingly" before arrogant. We should use this attitude of medical operations to further motivate us.
BJTNT
3 things:
1) To settle the e-mails (if I may here): NO, I am NOT the same Suzy. She posted before me, which is why I picked swf to avoid this confusion. We differ greatly in our views, so only swf are mine.
(* no disrepect to her and her views*)
2)http://allnurses.com/general-nursing-discussion/nurses-clients-power-380651.html
This thread was started a year ago about this very blog, and is still open. I wonder if this would not be the perfect place to post some new views? It would be ironic if they closed the blog for us to post about ourselves!
3) This week I will be on googlewave from 9AM to 12PM Pacific time (Nevada).
suzymcares@googlewave.com
If anyone wants to chat about ideas on moving forward. Also, my advocate blog which is un-moderated.
Please.. I would encourage visitors to write here about their views of the matter of forming an advocacy group composed of those who read and write here. I would like to read my visitors views about the pros and cons of such an activity.
Is the formation of an advocacy group of interest to the visitors here and is it feasible? Please.. let me (us) know. ..Maurice.
Re-reading these volumes I am awed, inspired, and overwhelmed at the amount of information that has literally been showered upon us. Here it is raw, humiliating, painful, inspiring, moving, tearful, and hopeful. It is all things human.
We've helped many, enlightened some, and empowered a few. But when a fellow human being pours out tearful experiences or fearful situations then I know I have not done enough. That is a "pro" that I have no imaginable "con" for.
I know from my point of view I would love to see an advocay group for this issue. I have no idea where to start or how something like that REALLY gets off the ground. I'm open to any info and ill be researching the topic as well.What has been great about this blog is we know were not alone and millions of people have had the same issues but never had an outlet or protection and medical professionals have enjoyed taking advantage of that. I think someone here mentioned a facebook page. I think that will bring even more people into the topic and have an outlet and get other people even outside this blog.Not that facebook is enough but as far as getting a message across its seems like a great tool. I did look up other patient advocate sites but it had to do with insurance,information and other issues not even closely realated to modesty.
As MUCH as I would love to think medical workers will be on our side......nurses say they are the "advocates" for the patient but reading or talking to these people any more than 5 minutes you easily realize that is not the case.Like I said I am more than happy to research step by step how a group like this (considering the fact we are all over the country) gets started.
upside down
upside down, my suggestion is to have the nucleus of a group made up of those here and on Dr. Sherman's blog to communicate more directly with each other exchanging ideas and suggestions. Occasional posting on my thread or Dr. Sherman's blog is not the best for group discussion. Instead, there should be a to and fro interchange going on all at scheduled times. The use of the free service of Google Wave (as attempted to start by swf or even the free Skype where video of group communication is possible should be seriously considered.
This nucleus of like-minded blog visitors, communicating together in real time, must be the way to get an advocacy group and program started. There are the internet tools to make this happen. It just takes a little initiative to start it and begin the process.
As I have said, this thread can be used for setting up such communication sites and times. ..Maurice.
upside down:
"I know from my point of view I would love to see an advocay group for this issue. I have no idea where to start or how something like that REALLY gets off the ground."
I asbolutely understand your points. It seems a daunting task. And there is the issue of those wishing to remain 'anon', at least for now. But the first step is always simply to meet someplace and say "what now?". There's no risk in seeing if we even find our goals possible, or even defining what the goals are.
Not everyone has time or energy for everything. Not everyone is suited to every task. We really just need to begin the conversation and go from there.
http://advok8.blogspot.com is anonymous and unmoderated. Googlewave can accomodate a real time conversation.
Anyone have a preference?
I work for someone who posts here. I'm not 'coming out' period.
This blog IS advocacy. It HAS been for years.
Anonymous from 11:18am today: I am not saying that simply communicating via text (not video) that one couldn't contribute to discussions about goals and planning in real time while maintaining personal anonymity. Of course, the anonymous participant could write just as they do on these Volumes and remain anonymous. On the other hand what is the issue about "coming out"? I don't think there are any moral suspicions about a patient who insists on attention to personal modesty in patient care.
Finally, yes the slant of most of the comments here suggest advocacy for patient modesty and the opportunity for gender selection, I have not closed these Volumes for opposing views and describing the burdens or restrictions which may interfere with full patient modesty and opportunities to provide selected gender care. I have hoped for physicians, administrators or others to give their views but to only minimal response. I don't look at my blog thread as advocacy except for the tone of those who end up writing here but for those who want advocacy I don't think just writing to my blog or Dr. Sherman's blog is the most effective way to spread the word. ..Maurice.
" I work for someone who posts here. I'm not 'coming out' period."
I don't understand.....seems you two would have something in common. (?)
On the other hand, I have 22 clients who will only read this blog and/or post from my business. They don't want their family to see that they support medical modesty.
We need to somehow overcome the stigma that modesty carries.
I believe this blog is only small advocacy. Short of forming a group, which I'm not against, there are many things we can do to advocate.
First, don't let blogs like allnurses shut down the conversation as they did with that other blog. Get on professional medical blogs and start threads like this. That's advocacy.
Get on your community hospital or health board and bring the subject up there. Pass along articles and/or books and/or comments from blogs like this.
Make many, many calls to clinics in your area and ask if they have male and female med assts and techs. Call urology clinics, sonogram, xray, clinics. Ask. Ask. Ask. Have your friends make the same calls. If they don't offer gender selection, make the point that you'll find another clinic.
Approach the ethicists of hospitals and ask for written polices regarding gender selection of caregivers by patients and chaperones, and OR policies regarding gender. Keep calling or writing.
Check the mission statements and core values of these hospitals and ask how they walk the talk regarding modesty and gender selection.
These are just a few things we can do individually. When a group forms, we can work together with projects like this and publish our findings. Publish policy statements from hospitals. If they refuse to give you such policy or give you the run around, publish that fact with the name of the hospital.
MER
There are private ways to advocate as well. When something happens, do something about it; be vocal; be public. Recently someone in a medical office forged my name. I plan to go to the District Attorney.
This is a felony! It's not clear whether it happened at the doctor's office or a lab where the information was sent. I wasn't sure how to handle it at first and then decided that this is not my problem and when this hits the press there will be reverberations everywhere.
gd
"WOW,I've never even seen
that many people involved in a lap
chole,even for open heart surgery.
Typically,you have the anesthiologist,the surgeon,the scrub tech and a circulator.That's
4 people for major surgery. In most
simple plastic surgery cases such
as a blepharoplasty(eyelid surgery)
there is no anesthesiologist.
Its a local anesthetic,most
often lidocaine! In these and most
simple plastic surgery cases its
just the surgeon and her assistant."
In my spine surgery, I had the scrub tech, 2 circulating nurses, the anesthesiologist, a physiologist who did nerve testing, the surgeon, an x-ray technician, and the assistant surgeon (yes, definitely an assistant surgeon; I'd already met him). So at least 8 people. Another guy wheeled me to PACU, where there were a couple of additional nurses.
Except for one of the circulating nurses and the PACU nurses, my team was all male. My surgery was delayed for a long time after I left pre-op. Imagine my surprise to at one point hear one male voice ask, "what are you doing?" and another male voice over my right shoulder answer, "having sex with her." I was too sedated to move but tried hard, my mind fighting and horrified, and resorted to grunting loud to indicate I was awake, "uuuuHHHHH." I believe I was sexually assaulted because that accords with the physical sensations I had then and afterwards (and I don't think patients are commonly intubated on their left sides). I was too in shock/having such difficult time with recovery I did not report. I wanted to think it was anesthesia hallucinations and didn't want to deal with it. But I remembered conversations in pre-op and being awakened by nerve testing during (intentional awakening during anesthesia) and this was a different place I was in. Even if two people were making a joke between themselves, it was inappropriate and has been extremely traumatic. I have been under many times and not had anything else like this.
Right now I am not up to people questioning my experience or telling me it could not have happened (even the main hospital administrator says it could have).
Issues of patient modesty are closely interconnected with patient safety. I've probably had at least 450-700 medical appointments + days of hospital stay in my life (avg. 1-1.5 appointments per month), almost all of which include seeing nurses, lab or radiology techs, and sometimes students; that may be way underestimating if I include PT and chiro. care. I've had 4 creepish incidents, of which this was the worst. So a low incidence, but nonetheless horrible. Horrible.
Certainly the medical profession is not immune to getting abusers in it--what better job for a molester than one of the med tech jobs (or anesthesiologist not following protocols)?
When reading the little I could find on assault under anesthesia, I discovered that people have anesthesia fetishes--apparently another species of the genus of criminal perverts (another of which is the disability "devos"). Unable to attract conscious women, they focus their sexual lives on unconscious women and children. Gee, what kind of profession would they work in? You can prettily easily find these people's videos and their followers on youtube.
I think medical professionals need to turn a more wary eye on one another.
Also, I am a strong advocate for patient modesty and patient safety and want to advocate for (if not help with) with educating medical professionals about medical abuse--education through local rape crisis centers and RAINN, for example.
I do think my doctors are good with patient modesty; when I move out of routines and with other personnel, I am more vulnerable.
I will never leave my child alone with a radiology tech, even female.
The readers here might be interested in reading the recent comments by AL on the thread "I Hate Doctors: Chapter 2". Can one's views end up only harming oneself? ..Maurice.
Someone named esunasoul posted this recently, pretty much a "get over it" attitude........It IS, in fact, totally possible to objectify the bodies one cares for. After seeing thousands of genitals, they are no longer the mysterious thing that society's dress code tries to disguise them to be. A few might think such desensitization to the sacredness of the "private part" is somehow inherently wrong, as if social mores were absolutes in all contexts, but this simply isn't true. If by losing my inability to giggle about penises and vaginas helps me to be a better caregiver, then such objectification is, in fact, the superior moral choice. To simplify: in this particular circumstance, seeing the things s/he sees prepares the nurse to be a better person rather than a worse one. To shyly turn away from serving your patient's best interests would be the perversion.
That being said, it is NEVER acceptable for any healthcare professional to perform a procedure the patient feels would violate him or her in any way. If a man requests a male nurse insert his Foley catheter instead, I would certainly make every effort to accommodate those wishes. When I assist a bed-bound patient in bathing, I always ask "Would you like to bathe your private areas, or would it be easier for you if I did it?" 99% of the time the patient doesn't care. But practicing sensitivity separates good nurses from excellent ones.
Those of you who feel extremely defensive of your penises, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like prostate exams! We women learn to get over much of our shyness earlier in life because of pap smears and childbirth. Men certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Urethral Resection of the Prostate (Google it) because of that choice, well, what's the point?
A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather her laugh, blush, and turn away? Or would you feel better if she treated it as business as usual?
http://iamanursingstudent.blogspot.com/2005/11/foley-catheterization-genitals-and.html
So many problems with the above post, and I would say that if any of us ever thought that there was NOT a need for advocacy then they were obviously wrong.
1)Many female caregiver tout the fact that no man ever speaks up and says no. I have to wonder, because guys did speak up on the blog above and their opinions were dismissed. So, is it really that they do not object....or that female caregivers are not hearing?
2) "If by losing my inability to giggle about penises and vaginas helps me to be a better caregiver, then such objectification is, in fact, the superior moral choice."
As an adult woman I have never laughed, giggled, or pointed at a penis. Not a superior moral choice, just a part of growing up. Some people mature, some do not. Some are caregivers, some are not. Not exactly a statement that would make a man with modesty standards change his views. But perhaps a comfort to some.
3)**"When I assist a bed-bound patient in bathing, I always ask "Would you like to bathe your private areas, or would it be easier for you if I did it?
99% of the time the patient doesn't care."
99% of female caregivers I have spoken with say that if they are able to wash it then have at it! So really, giving an able patient the choice is odd....seriously, when caregivers are so pressed for time?
4)"A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen."
This statement really shows that this caregiver does not understand the difference between professional and ridiculous entitlement threats. Moreover, we care about how we feel being touched and naked, not how you feel touching or seeing us.
And we may very wellsay that we have "the superior moral standard." Really just depends on which side of the genitals you are on.
How are they not hearing anything we say?????
Comment on discussion:
Maurice, in answer to your last question, one can harm onself, but sometimes harming oneself feels a lot better than having someone else do it. I found when I was bleeding from the kidneys it was easiest to say, "I've experienced sexual assault" and leave it at that so that she could work in a more gentle, aware way. It helps to have doctors who are willing to work around this or who can look at less invasive options.
Objectification isn't neutral--there's benign objectification and harmful objectification. (In the first case, performing a procedure without getting queasy oneself, being able to ignore private parts rather than concentrate on them; in the second case, making degrading comments, misogyny, seeing patients as less than human, failure to listen rather than assume.)
Comment on activism:
I am willing to help. Stories on NPR? Newspaper feature articles? Writing our own blogs and asking people to post to Grand Rounds or other places where a lot of physicians/nurses/others read? I posted one yesterday that could be used this way, though I worry about attack.
I am trying to follow the conversation about blogs vs. google wave, etc. I know there's a lot of decisions to be made--would you mind making a general post when the place is established? (If it's not the advocates site?)
I wouldn't mind speaking publically with other patients or physician advocates to physician groups about this and other issues. I would be unlikely to specify my details in person because of fear of jeopardizing my care--or maybe it would take some time to develop a sense of safety with it. I think we as a group should talk more about anonymity.
One reason patients remain anonymous on the web is searchability--we are also employees, parents, volunteers, family members. While I don't mind doing some advocacy publically, I can't be as candid as when I'm anonymous.
The comments by Anonymous, Tuesday, June 01, 11:30 PM show that our advocacy is needed more than ever.
I'm not trying to be super critical, but balance is needed.
The culture of medical operations is that we are the good guys and are here to help you, so be appreciative. It's analogous to President Reagan's humorous comment that "we are from the government and are here to help you."
If we, medical professionals, say you shouldn't be modest, why can't you accept that? Our motives are pure. It's out of the goodness of our hearts that we are helping you since no other profession/occupation can help you.
BJTNT
FridaWrites:
Googlewave is sort of a "chat room". I think it is a great tool if everyone picks a time to be on.
2 or more can chat about ideas in real time. You can also set up groups.Very helpful. (Thanx Dr. Bernstein)
In the meantime and while we are collecting e-dresses, I think it would be helpful if we started posting advocacy ideas on the advocacy blog. It would be a clear stream of thoughts and ideas, and continuity would be better. (my opinion)
http://advok8.blogspot.com/
We could also discuss anonymity if anyone is concerned.
Anyone want to just start meeting there for advocacy and see what happens?
If you haven't found it already, you need to check out this allnurses thread. It looks like the administration of allnurses has come around to discussing this modesty issue seriously, looking at it from a practical point of view. This particular thread is specifically about surgery, modesty and the possibility of same gender teams.
The last few pages of the thread have turned to practical solutions to the issue. I must advise that, if those on this blog decide to post, simply complaining will alienate supportive nurses from what has turned into a productive and important discussion. We've been looking for ways to advocate -- will this is one way right here. You'll find the thread at:
http://allnurses.com/general-nursing-discussion/patient-modesty-concerns-196068-page10.html#post4342236
MER
Prepping and draping seems to be the most vulnerable time for patients who have modesty concerns. Why can't they do the prepping and draping in a small area (or pull a curtain around the patient) to ensue privacy. What's the rocket science here?
gd
The allnurses conversation is interesting, but I'm not holding out any hope. I think their attitude of 'give us suggestions' was really a way to deter complaints. As soon as discrimination ( a poster yesterday) rears it's head, then things usually turn to trying to legally justify entitlements and rights to perform proceedures for a living over the emotional well being of people/patients.
We have no unified presence. We don't have a group to call them to task.They have no accountability.
Yes gd it's not rocket science. I was reading another thread where a women complained about being prepped for a c section and couldn't have her husband with her but the male orderly was allowed to just stand there and gawk. It's just common decency which people running hospitals don't have.
NP
I just want to add if that's what happens when you're conscious god help us when we're unconscious. That woman made a complaint to the hospital.
NP
swf and others: I think the allnurses discussion is significant. In the past, mytake is they would have shut down a thread like this because so many patients were participating. I think it's very positive, despite some of the more negative comments. This is advocacy. We getting the topic discussed among medical professionals and we're part of the discussion. Don't discount that so much. We're planting seeds. Some people are thinking about this issue in a different way -- could same gender choice offerings actually be a money maker? Perhaps it could. Is it worth the experiment? Perhaps. That's progress.
MER
You're probably right MER....patience is a virtue.I have a tendency to want to rush the tides of change....
And this is probably the first that they have been introduced to the reality of same gender clinics, and the percentage of people who want them.
Many things that we have long discussed here may very well be things they are considering (earnestly) for the first time.
Hi! You haven't heard a peep from me for awhile! With permission, I would like to share letters I have sent regarding patient modesty. The first is to an Assistant Director of Nursing at one of the major hospitals in the state.
Dear Ms.Name:
Several weeks ago,we had a telephone conversation related to my expectation for same gender providers for possible intimate exams,procedures, tests, and care at Name Valley Medical Center. It is hoped that I displayed courtesy, and that you found the discussion to be both meaningful and challenging.
You asked me, if I have had any success locating a facility which has a policy of accommodation; I am happy to report two findings!
Attached is a copy of the Name General Hospital's patient rights. Please take a look at Number 1 (capitalization mine).
. "A patient has the right of respectful care given by competent personnel, in a safe environment, which includes CONSIDERATION OF PSYCHOLOGICAL, SPIRITUAL, AND CULTURAL ISSUES, AS WELL AS PERSONAL VALUES, BELIEFS, AND PREFERENCES." As a never married religious professional, who has taken a vow of celibacy, and has and does, and seeks to continue a consistent chaste life, I would imagine that without any difficulty, I could build a defense for same gender providers with intimate care, with this above legislation, under a number of different headings. How my need would be implemented remains to be seen; but isn't it great to see an institution recognize that possible "psychological,spiritual, and cultural issues" exist with patients, demanding attention! Also, the Name Home Visitation Nursing Association, out of Name (near Name), employs four full time male nurses. The director assured me that I am not the first man to request same gender providers, and that every effort would be made, to meet my comfort level, should the need arise. Guess which hospital and nursing program will receive primacy in my medical declaration, to be prepared by my attorney? From my perspective, the medical industry should take a wholistic approach to patient health. My emotional, spiritual, and moral dimensions of existence are just as important to me, as my physical organism. In a highly competitive world of hospital marketing, it appears that there are a few places and groups who are thinking outside the box, and see the potential with an accommodation of diversity, especially the significant minority of us, for whom modesty is a conern. If a patient, a hospital would not impress me by its advertizements of large screen TVs, InterNet access or gourmet menus; I welcome a health care facility and staff, which makes a genuine effort to uphold patient dignity as he or she defines it; and not relegate the matter to professional entitlement. Due to the inability or the unwillingness of Name Valley Medical Center to make a commitment to safeguard patient modesty, it grieves me, that I am forced to delete your hospital from my declaration. I leave you with the wisdom of the great Rabbi Hillel:"If I am not for me, then who is? If I am only for me, what am I? And if not now, when?"-REV.FRED
I've returned to make comment about this first letter: I received no reply! Secondly, I am troubled that this Assistant Director of Nursing revealed that she was made the temporary head of the Pastoral Care Department! I questioned her, if she believed it was appropriate for a male nurse to give a full body bath to a nun! She answered that she had no problem with it! From my viewpoint, this hospital not only has a person in a place of authority pushing entitlement, I can't even find a spiritual director at this facility with sensitivity towards people of faith whose beliefs and values differ with her own! Her attitude gives me a second reason for permanently crossing this site off my list. My PCP is affiliated with this medical center; I refuse to go there for a urine test!-REV.FRED
The following is a letter I sent to a director of nursing, for a church-affiliated visitation nursing agency: Dear Madame: During March, I had a telephone conversation with your office, stating that I am preparing a medical declaration with my attorney, and plan to include my preference for a home visitation nursing association, should the need arise. The solitary designtion goes to the Name Visiting Nurses of Name, for a reason I will explain. Informing your representative that I am a never-married religious professional, who included in his ordination vows a promise to uphold celibacy in singleness, I live a consistent chaste life.Regarding my genitals as a symbol of my sacred consecration, I expect same gender healthcare providers, for all intimate exams, procedures, and care. Relating that I was not the first guy to voice modesty concerns, your rep disclosed that Name employs four full-time male nurses. I was assured, that upon request, efforts would be made to meet my situation. Being up-front, it was explained to me, that the only foreseen scenario which might unfold making it problematic to recruit a male provider, would be the event of an emergency. After telephoning numerous nursing agencies in the area which visit Name of Town, your group is the only one which conveyed any attempt at accommodation. Your sensitivity, courtesy, and consideration hold great value. Name of Agency will be the only home visiting nursing program to be welcomed at my door. Please do not go out of business; and keep men on your staff. Word of mouth is the best advertisement; be assured that I will put in a good word for you. As a high profile pastor, serving in ministry 37 years, 30 of which have been in Name of Town, ministry to the sick, convalescent, and dying, is a major feature of my work. Congregants often turn to me for recommendation; you got mine! For some patients, male or female, the gender of providers for intimate care is no big deal; for others of us, it is of paramount importance. By supplying your clientele a choice in this matter, you are thinking outside the box, and need to be commended. Please do not overlook the potential of marketing your employment of male nurses prepared to take care of male patients. I believe you will be surprised by the positive response. Patient modesty, for whatever reasons, is a topic the medical industry refuses to address. I thank you, for your recognition of a patient's right to privacy and dignity.-REV.FRED
The allnurses advocacy is great; I've been worried by other things I've read there that confirmed what I suspected is going on other places--anesthesiologists abandoning patients. I had CRNA answering a cell phone right before I went out--I thought, "hey! zzzz."
My guess is success will take a many-pronged approach. It does mean going out and being missionaries.
Enough patients have had problems with sexual assaults (and I mean those outside the profession) or are phobic of one gender because of abuse that it's insensitive to deny someone a request. I was uncomfortable before my surgery (creep vibes) and wish I'd spoken up or walked out then, but there's the whole looking like a nut thing. I believe in gender equality in theory though and had, ironically, become more comfortable with health care professionals who were male, after only selecting women for a decade.
Semi-private rooms,nothing private
about it at all.If you are looking
for a hotel,motel room would you expect a semi-private room while traveling. Why should we expect
a semi-private room when we are ill.
Should private rooms be given first to those with insurance? Why
is the word private even considered when nothing else seems
private,certainly the bathroom isn't. Neither is your medical
chart when its left lying around
all day at the nurses station.
Whats to keep anyone from snooping through it. The face sheet
has more on it than the finance
company that issued you a credit card as far as personal information
is concerned.
PT
I got into the link to the All Nurses thread in which a male nurse asks whether it's ethical to bathe a female patient who refuses or objects, and apparently thinks it's OK to do it, even if you're anesthetized, if he's under doctors orders. I was truly horrified: how can that even be an issue??? Not to mention that a female, especially if she´s so sick and injured that she cannot bathe herself, will really not have the physical strenght to repel a male. That's the reason why, besides from choosing same-gender care, (females are easier to manage) no health care worker (especially down in the food chain, where they have little to loose but big potential for being really creepy)ever gets to be alone with me. I´m always with my husband, who in addition to carry a camera, (the idea of actually getting filmed in any weird thing really scares the pants off them, very especially male workers) but has been known to tell them should them attempt something like that, he'll certainly get a black eye. BTW, no whining about "health care worker abuse", a female my height (4"8", and very little strenght, really) probably has a legal case, besides that punch in the face by hubbie should he give me the unauthorized bath!!!!
That's disturbing someone wrote that--patients still have the legal right to refuse to consent to something. That's assault!
I think the idea of carrying a camera that will take video is a good idea.
I've had so many responses from caregivers that ask if a spouse is present would they rather have them do it, (bedbath) especially if it is only opposite gender that is available.
Would anyone here have a problem with that?
Quite frankly, anything that I am capable of doing I would do for someone if asked. I just do not have any qualms about helping with these forms of care.
There is a BBC documentary called “What’s the Problem with Nudity” its well done and about an hour long. Warning, it does contain full nudity. Starting at the 49:50 mark- “Human babies are helpless for many years and this has a major consequence for human sexual relationships. What this means is that human children require a great deal of care. Because of this, human mating strategy is one in which (most) men mate monogamously, at any one time they have a single partner and they raise offspring together. Paring for life ensures our babies get the all the care they need to survive and pass on our genes. Humans live in large populations and we cooperate with large numbers of individuals. This poses a challenge because those groups provide a source of temptation. The human body is a supreme sexual advertisement. Nudity is a threat to the basic social contract because it is an invitation to defection. They have exposed their person, their body and their sexual selves in a way that presents an opportunity for sexual behavior outside of the principle union. The shame of nudity serves a real purpose. It encourages us to stay faithful to our partners and share the responsibility of bringing up our children.”
This makes total sense to me, it is why nudity is normal and natural between spouses but is not normal between them and everyone else. However, just when this was all starting to make sense to me, the show throws a curve ball. I viewed the experiment as a slow, deliberate desensitizing of the subjects to nudity, which is the same thing I think that happens to medical personnel.
“As the weekends gone on, going through these exercises, they have somewhat habituated stress, they are more relaxed, and they know each other. So its become a more comfortable setting. Lucy clearly still has some reservations, but Phil, Alex and Catherine have become surprisingly matter of fact about nudity. Their attitudes and inhibitions have changed and this is the crucial thing about our relationship with nudity. We’re not born with sexual modesty so we are free to shift the boundaries of what is acceptable and what is not. So long as everyone agrees we can create new rules and avoid the risk of offense. After 2 days of social nudity, its mostly ok.”
~Claire~
http://topdocumentaryfilms.com/whats-the-problem-with-nudity/
“As the weekends gone on, going through these exercises, they have somewhat habituated stress, they are more relaxed, and they know each other. So its become a more comfortable setting. Lucy clearly still has some reservations, but Phil, Alex and Catherine have become surprisingly matter of fact about nudity."
Interesting write up, Claire. For me, the key words above are "As the weekends go on..." and "they know each other."
I do think most patients begin to feel more relaxed with the same medical staff as they get to know them. A good example is in Art Stump's book "My Angels Are Come." He writes about how is relationships develop with the same staff with his prostate cancer treatment.
The problem, as I see it, is with these many medical encounters patients are thrust into with little or know time to develop any kind of relationship with the tech or caregiver. Take for example those going for any kind of intimate sonogram or xray. Granted, a good tech can make a person feel comfortable, but many are just too into the specific task and don't really focus on the patient. the same applies to patients who leave their friendly primary care doctor and go to a specialist who they don't know who then brings a third party into the exam room, a med tech or nurse.
These kind of naked encounters are frequent in medical care, and these and the kind of situations that some people don't like.
MER
Dealing with major illness, my doctor arranged for same gender team or she knew I wouldn't enter the hospital.
Finally, a good medical experience. When the male techs came into the room to take vitals they were way off and I told them it was medically necessary to send in a female because the readings weren't accurate. They did, the blood pressure came way down. I taught them something and they taught me.
The number one rule is that we have the right to refuse. Let people know your needs in a kind, civil way and they will try their best. Let them know you know your rights in a subtle way and they will try even harder.
MER some people like myself would prefer a total stranger for intimate care, somebody we would never see again. It is so embarrassing for us that we would prefer to be in a way anonymous and to forget who saw us naked and perhaps they will forget us too. I recently had a baby delivered by a male obstetrician and when I saw him after the birth I did start to feel uncomfortable if I thought about it too much.
NP
NP -- That makes perfect sense. And that's what I've found with interviewing patients. I believe that's an important strategy patients have to get throught their embarrasasment. Another strategy -- some patients just won't talk about these things. To talk about it makes it worse for them. But the point is, we're all different.
MER
I'm troubled by some of the statements made by a few of the bloggers; if we are just sweet and nice about our need for same gender providers, without any hesitation, our wish will be granted. Maybe I need to take remedial courses in psychology. The experience of many on this site, plus myself, indicates the wall of resistance.As a religious professional, I have shared the lack of reception from hospitals and doctors. I have a letter from a nationally recognized urologist who called my request for modesty as an "opinion"; but offerred no strategy of accommodation. I resent his appraisal, consigning my holiness standards to the status of an "opinion." My stance on President Obama's bowing to monarchs is an opinion; my commitment to chastity is a core value of my consecrated vows. Are physicians unable to distinguish between a patient's point of view and his worldview? Am I confronting an institution with a collective entrenched secular mindset, staffed by physicians who are so task-oriented, that knowingly or unknowingly, have created a perception of unfriendliness towards people of faith? I have sought to politely and rationally discuss my expectations; but all I get is a door slammed in my face! No one is going to accuse me of relishing conflict! I will not cave-in to the cavalier mentality which knows it all, holding onto an attitude: "like it or lump it!"-REV.FRED
Just tell them that opposite gender care during intimate procedures is degrading to you and doesn't fill their obligation to provide "dignified care in your belief system" that is in their patient bill of rights. Tell them you would consider it a sexual assault and is against your will and that you refuse treatment.
Good Luck!
Came across a thread regarding male nurses and chaperones.
"So my hospital just released a new policy stating that all male team members (including nurses) must have a female present when your patient is female and you are going to be behind a closed door or curtain. Any violation results in termination"
The post does NOT in anyway state that an intimate exam is about to occur, just that WHENEVER doors are closed and/or curtains are drawn. That is alot of CYA staff. And again, aren't they discouraging males from attending female patients, and thereby discouraging male nursing?
The hospital will write policies regarding gender (and somehow avoid percieved discrimination)when it benefits the facility but not when it benefits the patient.
How can we use this to our advantage......
swf
That policy then should apply to females as well. It makes the
assumption that only male staff
are unprofessional. I'm interested
in what state and city this facility is located.
PT
A poll about OR team gender requests over at allnurses is linked below. Only 14 nurses have bothered to respond to the poll, only 3 have left comments so far. Would SquirrelRN71 say the same thing about women wanting same gender OR teams as she says about men wanting the same thing?
http://allnurses.com/operating-room-nursing/patient-requests-gender-484852.html
PT
I absolutely agree. I was pointing out how blatant the statement is. Obviously either the hospital has had an 'incident' or they are avoiding potential problems.
If they can afford so much CYA staff, they can afford to offer same gender staff and just avoid the problem.
Now if you were a male nurse there, would you fight it? Would you go to another facility where you were not treated everyday like a lawsuit waiting to happen? Would you decide that perhaps the medical field is not for you?
Female caregivers keep telling us discrimination against males does not exist, it's just that there 'are so few males to hire'.
I just do not see how they justify that position given the above thread.
So, unless men start asking for a chaparone everytime the door is closed or curtains are pulled, I see a problem with male nurses almost becoming a thing of the past. Again.
And (sorry) regarding http://allnurses.com/operating-room-nursing/patient-requests-gender-484852.html re: squirrelRN71..
Her posts are always defensive and full of entitlement issues. She continues to spout about 'not getting excited about seeing men's penises' while avoiding the point. Trust me, she gets it. She just doesn't want it out there.
If a male handed her a towel at the public pool shower I have to wonder if she would say "they see a hundred naked women a day..it's just their job" or "what stupid managment thought it was O.K. to hire a male to be around naked women".
“And again, aren't they discouraging males from attending female patients, and thereby discouraging male nursing?”
Yes, this kind of policy discourages male nurses in the profession. These are some of the
Hidden agendas within healthcare that discriminate against men. Many male nurses,
Confronted with such a policy, wonder -- if a female nurses has to be in the room with me while I’m working with a female patient, why am I there anyway? Why can’t the female nurse just do the job herself?” See what’s happening? Polices like this make male nurses less flexible and thus more expensive to employ. You can use a female nurse to deal with both male and female patients -- but a male patient needs an extra hand, a chaperone, to deal with a patient. This is the main reason that you’ll find almost all females as medical assistants in clinics. They tell you that they can’t find male medical assistants. But it’s not the truth. It’s cheaper, more cost effective for them to hire females. Same basic principles apply in hospitals. Consider all the various tech jobs/ PT always talks about here being no male mammography’s -- that’s why. Why so few male sonographers? Under many polices, they’d need a chaperone. Of course, all patients, male and female should be able to choose caregiver gender -- but under these polices the patient isn’t even asked whether they mind or want a chaperone.
MER
http://allnurses.com/men-nursing-forum/male-nursing-needing-479434.html
Interesting. Looks like women get a male nurse and an audience. Men get, well whoever walks in.
DR. Bernstein:
There was a post on the advocate blog saying " It seems like there's been a lot of success with teaching empathy in medical school through teaching medical narrative/novels, having med students accompany patients to appointments, etc. So I think one potential strategy is to include patient modesty issues in these courses."
I will give my responce, but said I would ask you and Dr. Sherman if I am correct to date.
"I know that they have been very clear that modesty in it's general form is discussed (dignity, draping, communication, respect,) but preparing medical student reactions for patient's same gender requests didn't seem to be part of that."
Did I misspeak?
Thanx in advance!
Wow!!! really interesting stuff here. I must say this may be a little off topic but this reminds me of an incident that happened several years ago when I was back in college.I used to work at a daycare center and we had a male worker who worked with the children.
We would routinely have people come in from the state to examine the facility,watch the staff interact with the kids, observe and make sure things were up to code etc..., . Their was a girl who was crying because she wasnt able to go on a field trip because a permision slip had not been signed.
The caregiver who was a young male had the kid in his lap and had his hand on her back consoling her because the kid was terribly upset and crying. The people from the state saw the kid sitting in the guys lap and the word "MOLESTATION" was used because the kid sitting in the caregivers lap was considered "innapropriate touching". I'm not sure if he was fired or quit.The bottom line is that was HIS LAST DAY!!! I had a fellow worker (female)say she thinks it happened simply because they dont want guys working there.
This facility was an open area. It was easy to see room to room simply because of the layout and design of the building.There were clear wall like structures as well so just walking down the hallway you could see into the rooms. Also the doors were partially clear so the rooms at all times were CLEARLY VISIBLE. Also depending on the number of kids their were also at least 2 workers in the room at a time.
I feel that simply because he was Male the idea was that he MUST be a child molester and doing something innappropriate was the reason he no longer had a job.
I think in a lot of ways this attitude applies to nursing.And i'm sure noone that had any sort of leverage at the daycare center. (particularly the director) would even speak up and defend the poor guy. Thing is its just OBVIOUS to everyone he was being singled out because he was male.
P.S the people who came in on behalf on the state were TWO females.
upside down
I don't know about the other instructors but since reading these Patient Modesty volumes regarding gender selection, in the past several years I have emphasized to my students to what I read and learned. ..Maurice.
I think I have the solution to the lack of male nurses.http://www.independent.co.uk/life-style/health-and-families/health-news/robots-to-do-hospitals-dirty-work-2003988.html
NP
Preparing for this weekend's sermon, I discovered some material pertinent to our discussion, in Rabbi Harold Kushner's WHO NEEDS GOD. "...Why do we keep certain parts of our bodies covered out of a sense of shame? Why is it acceptable for men to go around bare-chested in hot weather but not for women? Why are some people aroused, and other offended, when movies or magazines show people displaying their private parts? The answer, I suspect, is not that sex is dirty, but rather that sex is holy. Without realizing why we feel what we feel, we have inherited that outlook from ancestors who saw the presence of God in the ability of a man and a woman to create life out of their love for each other. The parts of the body which we cover are the ones that contain the secret of generating and sustaining life, and because the creation of life is holy, we cover them out of an instinctive memory of reverence. When we lose that sense of reverence (and I am convinced that it is reverence for the life-force and not modesty or physical vulnerability that is at work here), when we become casual about nudity, we become like animals, for whom mating and reproduction are purely a biological process. The holiness of life, the holiness of love and birth, are lost to us when God is factored out of the equation." (WHO NEEDS GOD by Rabbi Harold Kushner,A Fireside Book by Simon & Schuster, 1989, page 55)-REV.FRED
"A poll about OR team gender requests over at allnurses is linked below. Only 14 nurses have bothered to respond to the poll, only 3 have left comments so far."
The poll is now closed. I am not sure what they learned from 14 votes, other than 5 out of 14 admitted to same gender OR requests.
"(and I am convinced that it is reverence for the life-force and not modesty or physical vulnerability that is at work here)"
This is a great example of how our bodies mean so many different things to so many different people. To disregard this is irresponsible, and almost inhumane.
We're making some progress. Check out this site, post some comments, but let's be civil. It's counterproductive to name call and bash professions. It makes the those who do it look like extreme idiots and hurts the cause.
MER
http://patients.about.com/b/2010/06/26/modesty-and-medical-care-one-more-time.htm
I would only add to MER's statement that even if you feel posting your experience (yet again and one more time) may be redundant:please reconsider. Trisha is also looking for a quantity of experiences..all in one place...to pass along to those she feels are relevant in the move to create change.
Please please post them..
All, thanks for pointing out specific allnurses threads. While I've read there a number of times, I've missed a number that you have pointed out.
In Healthcare,the word privacy is a
four letter word.See,hear and speak
no evil. Each month I review the
recent board actions against physicians and nurses,cna'a and
others from state to state.
Interestingly,there are some states that do not participate in
relaying such information to the
general public. To some degree,I
see the same behavior demonstrated
on allnurses.
PT
FYI:
The modesty thread on allnurses was closed.
swf
swf, and what is the significance of that? The patient modesty threads remain open on my Bioethics Discussion Blog. ..Maurice.
Dr. Bernstein:
We were encouraged to write there a few posts ago , (along with a few others)by anon I believe. Just wanted to update it's closure re posting.
Dr. B
Actually, the significance is that every thread that has discussed modesty issues on allnurses ends up being closed (or outright removed) by the "owners" of the blog.
It might be of interest for someone to write an email to them asking why they are consistently censoring discussion of this patient issue. What is it about this particular subject that they find so objectionable that they find it necessary to stifle discourse.
Could it be political in nature that they find cross-gender care issues as an employment "right"? And unlike other thread this one was thoughtful and civil. But still it was closed.
amr
Dictating our personal preferences is a direct affront of exertion of patient power. The more power patients take, the less power the medical industry has. Nobody wants to give up power and control.
I actually did sent a private message to the staff member that closed the thread "for review". I was polite, simply asking about it's closing.
I usually get some response about staying on topic. Honestly, posting there sometimes is like walking thru landmines set off by eggshells if the wind blows.
If the female nurses think we might make any strides in this direction, they will fear for their jobs. As we have said...more male nurses equal less female nurses. And even pointing out that a patient may /should be able to choose their care causes resentful attitudes.
Even if they keep closing the threads, we are learning alot from their responses. For me, (mostly) it validates the entitlement attitudes, and demeans the patient's right to choose their care.
SWF,
It looks like the thread was closed for review after the latest poster went off topic on a prolonged and vehement anti-circumcision tirade.....it was definitely off topic, if that is the issue
Thanx Hexanchus....I can not seem to get past page 22. Yes, that would be a bit off topic!
There is someone who controls what gets posted. Seems to me if they wanted the topic discussed, they would have chosen not to publish the off topic comment
It seems that these modesty issues hits a primal nerve for both patient and clinician. It is important to unravel it. Unless we do, we cannot solve a problem when the underlying information needed to remedy is absent.
gd
There may be many reasons why these threads get shut down. But, more often, posters are given warnings to stay on topic. Or, the managers can decide not to post something that isn't on topic. In cases of modesty discussions, the threads are shut down for "staff review," which essentially means they never come back.
Yes, this topic is a hot button issue. Yes, it's political. Yes, it's economic. But, I'm going to go out on a limb and express an opinion, a theory as to why see this kind of control of discussion exists on allnurses.
-- Control over nurses is embedded in nursing history. Historically, nurses have had to fight to gain autonomy. It didn't really begin to happen until the 1960's with all those social changes,especially with the rise of feminist activism. Remember, two female professions, elementary school teaching and nursing are closely related. Those in charge needed to control these women closely. Talk with nurses who were trained even in the 1950's to see some of the rules they worked under. Nurses were chaperoned, closely watched, supervised to death. Their personal lives were under as much scrutiny as their professional lives. They had to fight to even be taught more sophisticated medical information. Some doctors didn't want nurses to know too much. They just wanted them to follow orders and do what they were told. This is the historical tradition out of which nursing emerged.
2. What we see on allnurses, I theorize, is the remnant of this tradition. Those managers in charge of what gets posted want to control what kind of information gets out. It's a matter of control and power.
3. It's no accident that on allnurses and other nursing blogs, a common topics is bullying and nurses eating they're young. Bullying has even been important sectionals at nursing conventions. This is connected to what I've written above. People who feel powerless, feel they lack autonomy, feel disrespected, feel bullied themselves -- can pass on that bullying to others around them. I call your attention to an essay on allnurses. It's very revealing. The writer says: "Typically, when mammals eat their young, it is an instinct which satisfies dominance. There is a clear lack of emotional bond and attachment, so what creates their desire to dominate? The young are simply perceived as a threat, that's what. A threat to what, you ask? To the natural progression of things. To safety. To the way things 'should' be." Bullying and disrespect works its way down the hierarchy. Read the rest of the essay at:
http://allnurses.com/nursing-articles/nurses-eating-their-486865.html
So, what we're seeing on allnurses, IMO, is the carrying on of this tradition of control, power, dominance. There is this perceived need to control the discussion which is connected to controlling the patient. I support nurse autonomy. I support their professionalism. I believe they are not just doctor assistants, but autonomous profession whose role is essential to patient survival. I've talked with a number of nurses who have expressed disappointment and disgust with how disrespectfully they were treated by some instructors in nursing school. (Doctors have complained of this, too).
The post that ended the discussion was technically off topic. But as I explore this topic, I've found the need to consider foundational issues that may sound off topic but are intimately connected to this whole issue of patient modesty and the double standard. Though technically off topic, the post did connect to the general double standard regarding female genital "mutilation" as it's called, and the accepted practice of male circumcision.
MER
I generally haven't found a true "off topic" issues written this blog thread. If rarely, there was one, there are so many topics on my blog, that I easily can post it on the appropriate thread. Actually, the most common postings I delete are the ones that begin or end with with "Wonderful blog and wonderful topic" but the main text are advertisement links to buy Viagra! ..Maurice.
If the problem is women, why do they keep posting? seriously. They ar e WHEREVER we go.I live with women who write here now. I work with women who write here now. Alnureses is women. The advocates are women. Trisha site is a woman. They write at Sherman's site. They write at Bernstiens site. I like women, but they take everything and try to fix it. I really would like to find a nice way to tell them thanks but no thanks. We need sites to ourselves without the psyco 101. They confuse the message when they make it there own. Really, can we just talk about male modesty without them trying yo get it?
Am I the only one who gets the problem? Doesn't make sense guys. We need our own space to talk freely. Yes you want to help but you don't understand. You already have choices we don't!
Please, go to a female site.
And plaese don't delete this doctor. It is not off topic. Doesn't anyone agree?
Mer I think more simply, it's like the person coming home from work and kicking the dog. I think the bullying begins with the doctors and the nurses are powerless over that so they take it out on the patient. Perhaps they also see male doctors abusing female patients so as their way of payback, the male patient will be more vulnerable for abuse by the female nurse.
NP
To anonymous right above:
Frankly, I think we need the psycho 101 with or without women posters. It helps to look at the whole picture, the context of what seems to be happening. Also, this issue as also about patient modesty in general. I do agree there is a double standard mainly do to women dominating the nursing profession. I've certainly written enough about that. But the entire attitude toward nudity in medical settings generally goes to both male and female patients, and females have in the past and still suffer from these indignities.
To NP: Actually, I find your explanation more complicated. The bullying I refer to, that which is discussed by nurses, is nurses bullying other nurses. You've, in essences, you've extended it to nurses bullying patients, which I think does happen because, as I said, bullying works its waY down the food, and patients are at the bottom. All I did is provide my theory of the reason for this, a historical, social background. If the nurse is bullied and bullying the patient, it is like the guy kicking the dog. But it's also about a culture or atmosphere that allows that kind of behavior to continue.
Patients need to keep their eyes open in hospitals and look for clues that indicate a suspect culture. What are some clues:
-- Caregivers seem distant, not focused on the patient.
-- Caregivers don't introduce themselves or wear visible nametags that identify their position.
-- Everyone seems to be rushed and/or stressed. (In an ER that's understandable)
-- Paperwork is thrown at you to sign at the last minute.
-- You can overhear private conversations between caregivers and patients or between caregiver and caregiver.
-- You can hear arguments between caregivers.
-- You noticed the modesty of other patients is being compromised or ignored, and nobody is saying or doing anything about it.
Why don't we come up with a list of these kinds of clues patients can look for to help the assess the health of the hospital culture.
MER
NOTICE: AS OF TODAY JULY 2, 2010 "PATIENT MODESTY: VOLUME 34" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON Volume 35.
I have followed this thread off and on for some time now. Although justified, for so long this thread seemed nothing more than an avenue for venting. I must say I am encouraged by more women, and even those in the field, getting involved and that something worthwhile seems to finally be developing in a positive direction. I applaud the efforts of those such as SWF and others for seroiusly trying to get this issue to the public and not just complain about it anymore. I'm also impressed by her compassion and understanding of the male point of veiw and the right's we all should have in chosing our health care providers (see her previous post). She seems to be focused on the core issues and has the will be do something about it. We all need to get behind her and others on this thread to finally start to change the status quo. The Medical field must be made aware of the need for equality for everyone and respect for our rights as human beings. Keep up the fight SWF!
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