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Patient Modesty: Volume 35
Continuing on with the Patient Modesty thread, one of the issues that has been implied here recently and in the past is whether the basis for the persistence and lack of resolution of the patient modesty issue is essentially a battle between the sexes. If the issue is valid then it can be expected that there will be no resolution until the mindset of both the male and female society changes toward a more tolerant and supportive relationship between health caregivers and patients of either gender. ..Maurice
Graphic: Illustration of the battle of the sexes from Mirror Company.com
NOTICE: AS OF TODAY NOVEMBER 1, 2010 "PATIENT MODESTY: VOLUME 35" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 36.
NOTICE: AS OF TODAY NOVEMBER 1, 2010 "PATIENT MODESTY: VOLUME 35" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 36.
Sorry for the above blasting announcements but I can't get them to be published in the Comment section. ..Maurice.
201 Comments:
"whether the basis for the persistence and lack of resolution of the patient modesty issue is essentially a battle between the sexes.
I don't think "in essence" it's a battle between the sexes. But I do think that battle, politically and socially, plays an important role. Remember, women are a protected minority in legal terms. Men are not. Does any one question the battle between the sexes women had to fight to gain the rights they have gained by challenging male dominated professions? I think not. Then I don't think people should discount the battle men have to fight to challenge female dominated professions like nursing (and other medical areas) and elementary school teaching.
Having said all that -- this doesn't mean that a significant number of women don't have a problem with their modesty being protected and respected within the medical field. It doesn't mean men and women shouldn't work together on this issue. And it doesn't mean that a significant number of female nurses and med techs/assts. don't try to accommodate men are willing to fight this battle with us.
But, as we've discussed, there are political and economic implications to getting more men into these female dominated professions. And it's not unreasonable to expect a significant number of those who hold to power to resist. That does mean a battle.
MER
Just one comment to the ANON about female posters.
When women needed support to gain rights, is was not all because of their fighting, marching, etc.
If it were not for the support of MEN, quite frankly, we would certainly not be where we are today. Why? Because men know men.
If a woman would not support a man on this issue, then as a gender I would find us disappointing.
At least read what we say, because we have told you reasons female caregivers are giving you such a hard time. Why bother? Because women know women.
Pretty handy if we all work together.
Anon, Ask Dr Bernstein to start a male modesty thread. Otherwise I will keep posting here for as long as I like as the title is "patient modesty".
BTW on another blog I have been following I read of a incident where a woman lying in a hospital bed had a strange male doctor pull up her gown and conduct a breast exam without her consent. This doctor was not her doctor and the patient never saw thew doctor again. I just want to point this out as you can pick your own female doctor but you can still be assaulted.
NP
This modesty issue is not a male or female thing. It is a common problem that should be binding the sexes together instead of pulling them apart.
The problem is the medical community and their efforts to erode (both female and male privacy) in order to perform their agenda in the easiest way. Yes, in in some circumstances be easier for women to have their needs met, however, abuses are more prevalent against the female gender as the statistics show across our society. That's not to say there are not female abusers, it's possibly part of the reason that it seems women have been accommodated more.
The fact that there are more female nurses is not a female patient accommodation, it is just the way the system is now.
If we join together, men and women, we have the power to change the system by refusing this opposite gender care by telling the medical profession when you need care that you need things a certain way. This is just a business and we can shop wherever we want.
As a woman, it is offensive to remove the men for their own site. We need each other to be tolerant and sensitive to each other's needs. Fighting over things just makes us as bad as the medical industry's attitude and the reason nothing has happened.
gd
Frankly, I don't take seriously the request to make this and other sites about male modesty open to only men. First of all, how can we possible really know which posters are men and which are women -- assuming we even need to know. This is the world of the web. We really don't know who is who -- we can really only depend upon looking closely at what posters write and assess the validity and wisdom of their their posts.
Secondly, I've written enough about the dangers of single gender occupations. IMO, this applies to blogs, too. We need different and varying opinions. I enjoy and respect the different ways women and men see certain issues. I enjoy discussing this issue with women as well as men (Yes, I am a male).
If this blog became one just for men -- I'd be off in a second. This is a two gender world. Men and women need to work together on this issue.
MER
I think it's clear that advocacy should not involve gender wars. People working for the choices of people is the only way anything can really get done.
However: regarding the topic of care...We have to do see this as a gender biased arguement, because really it is.
When either gender finds that their 89% majority is threatened they will pull out time honored arguements based on their own gender perceptions.
Since alot of this is coming out in the open, we need to be ready for new arguements. People do not give up entitlements easily.
The topic " why do nurses eat their
young" is actually a misconception.
Nursing in many ways paralles a
waitressing job. You are on your feet most of the time back and forth.It is a job not meant for those who are obese and/or with
other health issues. Look at those
now in nursing who are over thirty
as most are obese,smoke with poor
eating habits.They tend to binge
eat and most after work tend to
veg in front of the television for
hours on end.
Bullying is simply part of the
industry. Its been acceptable to
bully other nurses and done so in
groups. Acceptable to bully the
unit clerks,cna's and other employees in the hospital.You see
this behavior in radiology as well
as the lab. In fact,its done in all aspects of industry.It is done
for control to gain the upper hand
often to move up the ladder or to
simply say,"don't leave any work
for me". Patient care is a 24 hour cycle,handing the baton off to someone else after your shift.
Cna's were simply created by
nursing to do all the dirty work
so the nurses can sit at the nursing stations and chart,hand out
meds,etc. This increase in needed
manpower simply adds to the cost
of healthcare.
PT
Do you all notice that the female modesty part is about to finish part number 5(and counting)!!! and the male thread seems to have stopped completely at just number 2?
Maybe we are making some progress, at least with Dr Orrange. One of her latest articles is targeted specifically at men, unlike most of her articles which are blatantly female centric. The article is about erectile dysfunction, however, this time there are no jokes, disrespect or crude vernacular that were characteristic of her older articles. The first paragraph she uses her own words, the rest is just an edited down copy and paste version of another article dated 2 weeks earlier. The website has even added a “Men’s Health Week” along with a “Women’s Health Week”. That seems like some progress, at least to me.
http://www.dailystrength.org/experts/dr-orrange/article/higher-levels-of-exercise-in-healthy-men-lowers-risk-of-sexual-dysfunction
Another interesting site -- Men's Health Network with a link with advice for women about men's health. Look under "Additional Suggestions" Number 3. It reads:
3. Find out whether he is more comfortable seeing a male or female health care provider and make sure he’s seeing the one he prefers. On a related note, try to avoid physicians who tend to scold."
Now this is progress. But here's where we need to work harder. IMO, most women in health care get the fact that some men may prefer male doctors (health care providers) just as some women prefer female doctors. But they don't extend that understanding to include all the extra female staff that this entails. They don't get the fact that just because a man gets to have a male doctor, that doesn't prevent totally female staffs as assistants even in the most intimate circumstances.
So, we're making progress. But we need to continue by making the industry understand that there's more to just being comfortable with a doctor of the same gender.
You'll find a link to this page on this site at:
http://www.menshealthnetwork.org/women.htm
We should get on sites like this and tactfully and civilly explain the big picture.
MER
A female client that I see practically everyday came in (shocked) yesterday and announced that her companion had asked her to agree to only hire males if he ever needed in-home care and could not take care of this himself.
This request came after visiting his bed-ridden friend and watched as female caregivers came and went.
His friend confided that it was embarrassing and he was humiliated by
female intimate care.
My client admitted that she never believed me when I said some men prefer same gender intimate care, and would never have known had this not happened. Instead she would ridicule, and insist that hers was 'too much of a guy to let another guy touch him'.
Funny that she never bothered to just ask him.
Seriously Ladies: just ask. Don't base decisions on ridiculous outdated macho stereotypes.
Which brings me to a question: is it possible that some WOMEN have a problem with male same gender care, or is that reaching too far?
Everyone has a fundamental right to privacy and each person's need is different. Nobody including a spouse has the right to dictate something so personal and private.
Violating someone's personal privacy can cause psychological damage and quite often does. Does that mean that a spouse can dictate against the rights of a patient?
That is a gross violation of trust, could destroy a marriage; I know it would mine. Or...is it the responsibility of the patient to construct legal restrictions on a spouse if this is a significant issue and they know their spouses opinion does not match their core belief system about healthcare decisions? Opinions please...
gd
It's not about privacy and modesty anymore if a spouse has to create legal restrictions to prevent a partner from forcing intimate medical care by a particular gender. It becomes about trust, respect and the stability of the marriage. That kind of a marriage has problems that transcend the modesty issue.
I recall talking with a professional woman a few years ago about this issue. She said that recently her husband had complained about having to endure opposite gender intimate care for a procedure. But she didn't use the word "complain." She said he "freaked out." She had ridiculed him, told him to man up, suck it up.
I said to her -- Oh, so when men want same gender care and can't get it, it's called "freaking out." But when women become upset about opposite gender care,let's say in OB-GYN, what do you call it?
Of course, she didn't answer. I made my point. Some people just don't get it -- until you drag them kicking and screaming through a logical thought process that forces them to look into their own soul.
MER
SWF is your question do women have a problem with men getting intimate care from men? I think yes! I asked my wife and she said she thinks that is weird to want that for all reasons. I think most people are looking at this as a sex issue.
Harmon
It would be great if all men made their own appointments, and would ask the questions that needed to be asked. But for the women who do this (or leave it up to the office rec. or nurse) and haven't opened this subject up to the men in their lives....I would like to post a scenario that I have heard many many many (many)times.
Husband has extensive, invasive, intimate tests once/twice a year. Husband will not discuss visists. Husband gets distant a week before and is always angry with you. Husband becomes 'different' for 4-6 weeks after visists. He is distant, avoids intimate situations, will not listen/often avoids you. Snaps at you and is generally mean or at least unpleasant.
If you learn to tactfully ask the right questions, you may find:
Husband resents you. He has given up privacy, dignity, masculinity, and any personal choices that he may feel defines him as a man, as the strong protector, or just the dignity of marriage. Husband has given all of this up to....women.
Is it your fault? He may see you as the springboard. He may see you as a sort of culprit. But he may just see you as someone who doen't care about his body anymore. (Which leads to another set of complications)
This may seem extreme, but honestly it happens frequently!
Talk about it....respect his choices. Mitigate concerns together.
Well now I've heard everything. The man who is too lazy to make his own appointments is also too shy to tell his partner that he doesn't want opposite gender care. Maybe he can say I'll make my own appointments from now on if he doesn't like whom his wife makes the appointments with? I think if he is really too shy to talk about which gender he wants the appointment with he probably would also be too shy to ask somebody else to do it in the first place. "Oh honey can you make an appointment for my DRE?"
"Well now I've heard everything. The man who is too lazy to make his own appointments is also too shy to tell his partner that he doesn't want opposite gender care."
There are many posts all over this blog that speak to some men (women/children) not being able to talk about this subject. That is obviously a big part of the problem. And when a Dr.'s office make the appt., it is often not ever addressed.
But what happens in homes because if it was the point of the posts. That is rarely addressed. An attentive and observant women should be able to put the clues together, but if not...maybe the post might help open dialog, as it did all of the people in the example above.
We are afterall, looking for solutions.
I post this link below as an example of the kind of stereotyping men put up with these days within the health care culture, and even from other men. Read the article, but especially read the responses. The male modesty issue is just one part of an entire attitude that responds to men's needs based totally upon cultural stereotypes. Here's the link:
MER
http://www.kevinmd.com/blog/2010/07/kidney-stone-pain-experienced-man-woman.html/comment-page-1#comment-137803
Please will you stop saying women are a legally protected minority? Of course they are, buy only if they're caregivers (doctors, RN; nurses). What's the lowest possible you can go in the food chain??? That's right, the patient. Then everything changes, and we do get the cases of women that are very different when they're patients, yet show another face as caregivers...
What looks as accommodation is in fact the overwhelming lack of interest of Medical Operations in protecting both female and male dignity, as I've said, try to arrange an all-female operating team in a developing country!!! And a majority if OB-GYNs are male, anyway. I think we need to STOP THE GENDER WARS and look at the issue from both sides of the table...I think whoever said this nailed it in the head: "Women get an audience and men get whoever walks in"
May I suggest for those following the Patient Modesty volumes to take a look at the following blog thread on clitoral stimulation testing in young girls as part of a followup study after surgical clitoral trimming for apparent enlarged clitoris. Is there more in the issue than a patient modesty issue? Is there any relationship in that issue with the various aspects of patient modesty written on the Patient Modesty volumes? Please write your responses here if pertinent to the discussions here. ..Maurice.
The realm of experience has to be examined by both doctor and patient. While this Poppas person may feel that this work has merit, from the patient perspective this is the sexual humiliation of children in front of others and will damage them for life.
This guy is a pervert and should be charged with sex crimes hiding behind his white coat.
I wonder how he would feel if someone pulled his pants down and stimulated in front of his family?
I rest my case
gd
If it was done once by one method after the surgery with parental consent in regards to the young ones I could understand. Where teens and the older patients are concerned they could be told how to do it themselves and simply report their findings. I understand the surgeon wanting to make sure the procedure was successful.
One exam should be sufficient here. If the children as they grow up or the older patients have an issue they could report it to this doctor or their gynecologist. I'm very uncomfortable with this being done every year to check on their sexual response level. After the surgery is deemed successful it crosses the line to continue to check with no perceived problems. Do you really want your 6,7, 8, 9, 10, 1l and onward child checked in this matter every single year? Wouldn't be done to my child.
I don't intend to defend Dr.Poppas but I wonder if it is premature to call him a "pervert". Isn't perversion a psychologic term for a sexual practice or act considered abnormal or deviant? Can the term pervert be applied to an individual for a first time behavior carried out as part of a study of practical significance and without any knowledge about the individual's prior sexual proclivities? What I am trying to say is whether branding him a pervert is a bit premature without knowing a prior history. I am willing to listen to arguments against my cautionary comment. ..Maurice.
p.s.- I am trying to figure out how to best moderate the discussion on the study and it's potential consequences for readers to both threads. I think gd's comment and my response should be also made available to those who come initially to the other thread. Comments here that are essentially related to what has been previously discussed here, I will not reproduce on the other thread. Any better suggestions? ..Maurice.
Not any worse in my opinion than
exposing military personal to
non-medical clerks while conducting
a physical exam.
//news.yahoo.com
Study: Many docs don't blow the
whistle on colleagues.
PT
Maybe the best approach to moderation of this issue is to have all those here who have a comment on Dr. Poppas and his followup study NOT to write here but go to the Clitoris thread and write the comment there. ..Maurice.
Traditionally measuring scales of anything ranging from pain to pleasure are based on known experiences. From 1-10....10 being based on the most you've ever felt etc. etc. How could a little girl possibly give a range based on anything comparitive unless they did a before and after stimulation?
(Which may have it's own set of concerns here!) These test would only prove she still maintains a degree of sensitivity. Same as before? Enough to justify the operation? Should the minor decide for herself how big is too big and have surgery accordingly?
Should parents be able to speak for their own preferred size?
I copied swf's comment and wrote a reply to swf on the clitoris thread and you can read it there. I think it will be best to keep all the comments regarding the Poppas study on that thread. Please write comments there and go there to read them. ..Maurice.
Pt.'s threatening bad feedback on
customer service surveys under
general nursing discussion on allnurses. After 4 pages no one
figured it out that maybe,just maybe this patient really just
wanted some privacy.
PT
Dr. B.,
I miss the lack of comments, but you deserve the break - must be the summer doldrums. Thanks again for all your efforts.
BJTNT
A poster on the advocacy blog brought up an interesting avenue...volunteering at the rape crisis center.
Which started me thinking: how many people consider medical violations rising to the extent of "rape" or anything actionable?
Of those people, would men be likely to seek help from a crisis center? Would they even be likely to seek counciling of any sort?
The data should be interesting.
PART 1 OF 3
Dr. Bernstein recently informed me a very relevant court case that has an interesting side note relevant to patient modesty and same gender care. The case is Brenda Chaney vs. Plainfield Healthcare Center. Essentially, the case boils down to a hostile work environment based upon race. Chaney is an African-American certified nurse assistant. It also involves what Chaney claims is her being fired due to her race.
Plainfield Healthcare Center claimed that they were allowed, under state and federal law, to allow patients to choose the race of their caregiver, just as they are allowed under the BFOQ rulings to allow patients to choose the gender of their caregiver. This case involved a patient who refused to be cared for by a Black certified nurse assistant, Chaney. The nursing home allowed this, refused to let Chaney access to this patient because of her race. This caused, according to Chaney, other workers to call her names and otherwise create a hostile work environment.
Plainfield tried to mitigate the work situation, but claimed patient choice of race was okay under state and federal law. And, what is of interest to us, Plainfield used the comparison of opposite/same gender care to defend their case. Plainfield connected race and gender, saying they were basically the same under the law, and that they were allowed to discriminate under the BFOQ laws. Here’s what the court wrote about these cases:
Plainfield contended that the following cases supported their position:
Jennings v. N.Y. State Office of Mental Health, 786 F.Supp. 376, 383 (S.D.N.Y. 1992); Local 567 Am. Fed’n of State, County, and Mun. Employees v. Michigan, 635 F.Supp. 1010, 1013 (E.D. Mich. 1986); Backus v. Baptist Med. Ctr., 510 F. Supp. 1191, 1193 (E.D. Ark. 1981); Fesel v. Masonic Home of Del., Inc., 447 F.Supp. 1346 (D. Del. 1978) (aff’d by
591 F.2d 1134 (3d Cir. 1979)).
MER
PART 2 OF 3
Here’s what the court wrote about these cases:
“Taken together, they hold that gender may be a legitimate criterion—a bona fide occupational qualification (“BFOQ”)—for accommodating patients’ privacy interests. It does not follow, however, that patients’ privacy interests excuse disparate treatment based on race. Title VII forbids employers from using race as a BFOQ, Rucker v. Higher Educ. Aids Bd., 669 F.2d 1179, (7th Cir. 1982), and Plainfield’s cases allowing gender preferences in the health-care setting illustrate why. The privacy interest that is offended when one undresses in front of a doctor or nurse of the opposite sex does not apply to race. Just as the law tolerates same-sex restrooms or same-sex dressing rooms, but not white-only rooms, to accommodate privacy needs, Title VII allows an employer to respect a preference for same-sex heath providers, but not same-race providers.
Note what the court said about privacy and “undressing” in front of a doctor or nurse. I would strongly suggest that if the court feels this strongly about the mere act of “undressing” in front of the opposite gender, they would certainly feel even more strongly about having intimate exams or procedures done by the opposite gender if it's not the patient's preference, esp. in non life-threatening or emergency situations.
MER
PART 3 OF 3
What’s the message for us?
First, the courts have shown their support for the patient’s right to choose same gender for intimate care. That’s clear. Second, that if men push this issue, and take it to court, hospitals and clinics will most likely be forced to hire male staff under the BFOQ laws. Right now most of the cases involve female patients. As I see it, under gender equity law, the courts can’t allow women to have choice of gender for intimate care without granting the same rights to men. Third, we should be moving in two directions as far as advocacy goes.
First, educating men that they do have these rights and that they shouldn’t be afraid, ashamed or intimidated into not claiming them if that’s their choice. Second, educating hospitals and clinics about these laws. My experience has indicated to me that there’s still a significant amount of confusing within hospitals and clinics as to the difference between race and gender regarding this issue. Show them cases like this and explain to them the implications.
But the key is getting men to stand up and confront this issue. Until that happens, not much else will happen to improve the situation.
You can find the court’s opinion and an audio file of the case here:
Official Circuit Court Opinion: http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=rss_sho&shofile=09-3661_002.pdf
Oral Arguments (audio): http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=rss_sho&shofile=09-3661_001.mp3
MER
Here is what constitutes sexual misconduct in a medical setting in Washington State. The thread involving the clitoral experiments ties into this sexual misconduct.
Additionally, many complaints as heard on this thread and others constitutes misconduct in this and most likely many other states. Why isn't this enough?
http://apps.leg.wa.gov/wac/default.aspx?cite=246-16-100
gd
Here is a comment by a visitor today to the now closed thread "Naked". Click here to review the context in which the comment was written. ..Maurice.
"To all the "jealous" husbands: Where have you been all my life? I could never believe other men put up w/male gynos examining their lovers, wives and daughters! You've restored my faith in men.
And to address all the anti-american prude baiters: Check out unnecessary pap smears, Europeans and Australians think US dr.s are sick perverts when they come here b/c these women are not groomed and coerced into endless pelvics and paps the way American women (beginning now in their pre teens) are and pregnancy is not medicalized, which actually leads to a lower maternal/infant mortaility rate.
The issue isn't just one of sex but privacy and intimacy. If someone has no respect for such things, I have nothing more to say to them.
BNW"
Although the availability of gender selection in medicine isn't always available out there, especially for men when it comes to staff assisting doctors -- I think we need to realize that the basic philosophy that backs it up is embedded within the system.
This comment from KevinMD.com:
"A definition of patient centered care advanced by the Institute for Health Care Improvement (IHI) includes consideration of “patients’ cultural traditions, their personal preferences and values, their family situations, and their lifestyles. It makes the patient and their loved ones an integral part of the care team who collaborate with health care professionals in making clinical decisions… [and] ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient. When care is patient centered, unneeded and unwanted services can be reduced.”
That reads pretty clear to me. I don't see how that statement does not intrinsically include the whole modesty issue and patient preference of gender for intimate care.
So, patients need to go into hospital situations, not only speaking openly about their preferences and values, but also arming themselves with copies of definitions like the one I quoted above.
Make your values know, then demonstrate that the ethics codes, core values of the hospitals already support your point of view. Demand that they make it happen, that they make the rubber meet the road.
You'll find the quote above at this URL:
http://www.kevinmd.com/blog/2010/08/abim-patient-centered-care-crucial-health-reform.html
MER
What's this world coming to?
1866: Equal rights regardless of race and color.
1968: Equal rights regardless of national origin and religion.
1974: Equal rights regardless of gender.
1988: Equal rights regardless of disability and familial status.
2008: Equal rights regardless of
sexual orientation.
2010: Men still don't have fair and
equal status to privacy in healthcare.
PT
Here's where I disagree with you, PT. Men do have that right, ethically and legally. They just don't insist upon it. They don't demand it. In fact, many men (if not most) don't even speak up and state their preference. Now, in an ideal world, they wouldn't have to do that -- it would just be offered to them. But this isn't an ideal world. And all those in the past fighting for equal rights at to stand up at some point and make demands. That's were we disagree.
As I've tried to point out, the core values, the mission statements, much of the operating philosophy of hospitals are clear about protecting patient dignity and respecting patient values. Men have the ammunition to fight this battle. But don't expect it to be handed to men on a plate. They'll have to fight for it.
1866 -- Almost half a million soldiers died to obtain equal rights for all races.
1966 -- Martin Luther King and the civil rights movement. Remember that? The marches, the attacks, the deaths, the beatings.
1974 -- Women had to fight for equal rights. Many went to jail. Many filed lawsuits.
1988 -- Disability rights didn't just happen. That was a battle, too.
2010 -- Men need to step up to the plate and demand equal treatment regarding intimate care within hospitals and clinics. In some cases, that will mean a fight. In other cases, just standing up and challenging the status quo will frighten do death some in health care and they'll cave in.
MER
MER
If men had fair and equal status to privacy would we be making posts to this site? I
think not. My reasoning for
listing such events in
chronological order was to show
progress for people,yet no
progress for men in the healthcare
arena.
You have pointed out core vales
and mission statements within hospitals and other medical facilities. I too have pointed those out and I've also stated that
most physicians and nurses would not be able to recite one single
core value or mission statement of
their facility. Fact is,most don't
even know they exist. The truth of the matter is most nurses have no
idea what the components of the
nurse practice act consist of.
This fact is very evident when
I review state by state regulatory
journals of nursing with regards
to disciplinary actions. The mere
fact that most outpatient facilities are unable to accomodate
men alone makes for my argument.
In conclusion,I'd like to share
some aspects of over 32 state
nursing board guidelines with
regards to sexual misconduct and
boundary violations.
Sexual impropriety
Disrobing or draping practices that reflect a lack of respect for the patients privacy,deliberately watching a patient dress or undress.
Inappropriare comments about or to
the patient of a sexual nature.
How many nurses do you think have
honestly reviewed the nursing
guidelines for their respective
state regulatory board.
PT
PT wrote: "most physicians and nurses would not be able to recite one single core value or mission statement of their facility. Fact is,most don't even know they exist.
The fact that may not know they exist doesn't make them nonexistent. The exist. So...they can't recite one single core value? -- then we men recite the core values for them. We carry them, printed out from their own websites, in our pockets.
PT writes: ". My reasoning for
listing such events in
chronological order was to show
progress for people,yet no
progress for men in the healthcare
arena."
The reasoning in my response is to point out that the progress made in those areas had to be earned. There were fights, battles. Men as a group haven't engaged in this. Progress didn't just happen in those other areas.
The fact that, as you correctly say, "most outpatient facilities are unable to accomodate men..." is because males as a group haven't demanded it. When they do, you can bet it will happen. You've got to push for these things.
PT writes: "How many nurses do you think have honestly reviewed the nursing guidelines for their respective state regulatory board."
I honestly don't know. But I do know that these guidelines are available on the web and any male patient can print them out and bring them to a hospital or clinic and, if ridiculed or challenged regarding gender preferences, can haul them out and show them.
Sorry, PT. I'm frustrated, too, at the status quo. But I just get tired of men complaining but not willing to fight it out on the ground level. My experiences has led me to three conclusions.
1. Most healthcare providers, although not perfect, do their best to deal with these modesty issues.
2. Those that don't, are not intentionally being disrespectful or purposely compromising modesty. That doesn't make it right. But when reminded, most will make it right and the really good ones will apologize.
3. The very few who may knowingly disrespect patient modesty are bullies, and like all bullies, they will quickly back down and crawl away with their tail between their legs if they are assertively, intelligently, rationally and immediately challenged.
MER
I have been following this blog for the past several months because this is an important issue to me as a woman and I can totally understand it being important to men, also. Just a few things that I heard/noticed recently regading getting more men into nursing. I live in Texas and heard an ad on the radio yesterday that said this: "are you man enough to be a nurse? Find out at Lone Star College". I also noticed on America's Got Talent that a contestant billed as the "strong man" - he was a big, brawny guy- got a big round of applause when he announced that he was an OR nurse. So, maybe attitudes are beginning to change about men being in that female dominated professtion. I do think it would be a tremendous relief to a lot of people, both male and female, to be able to have same gender care in not only a doctor's office but also in out-patient facilities and hospitals. More mixed genders in all areas of medicine would give those who want that type of care better chances of getting it and thus having a more positive, comfortable experience. By the way, even though you feel like women have a greater chance of getting same gender care, it is still difficult to get a female anesthesiologist. I think that is still a predominately male area. Jeanart.
MER said
"Most healthcare providers,although
not perfect,do their best to deal
with these modesty issues".
"Those that don't, are not intentionally being disrespectful or purposely comprising modesty."
I've sat in a meeting and heard the cno(chief nursing officer)
tell a group of er nurses to start
providing privacy to patients.
Nothing changed. Personally,I
believe that
a) most don't care.
b) most will provide privacy only
if you ask for it.
c) I believe at least a third
of all nurses deliberately with
intention and purpose compromise
patient privacy.
PT
A comment from an allnurses.com
thread:
"I am an American Muslim and registered nurse. Men are very common in the nursing field in the middle east. In fact some years there are more men than women in nursing programs in Jordan. The reason for this has to do with the cultural preference for same sex nurses. It is not necessarily a religious preference and some cultures will be less tolerant of personal care given by the opposite sex."
The rest of the comment can be found at:
http://allnurses.com/general-nursing-discussion/treating-muslim-patient-429119-page4.html#post4466815
MER
This comment has been removed by the author.
swf, unfortunately not all doctors as patients get as complete an experience as other patients regarding life on the patient's side of the bed railing because they may be given VIP (very important person) treatment by all their healthcare providers. ..Maurice.
This may be true, in which case your experience would differ greatly than most of the people contacting me.
But as I have said here and many many other places, I find doctors (and particularly male doctors) MUCH more positively responsive to gender apprehension. Whether this is just my experience, I can not say. So from this standpoint I maintain that I see respect.
I would clarify that I use the term caregiver usually as general medical/care support staff. As to that, I still see glaring disrespect, entitlement, and the lack of ethical and moral protection of the patient.
Sorry for the rant, there are just days where each step forward seems to take you nowhere.
I think while it will take a large orchastrated effort to change the system, and the effort to achieve that may or may not come from this group, this could very easily be the spark that ignites that movement. I would also not discount the value of individual victories and achievements that have been inspired by this blog. I have seen posts on numerous threads from Dr. Orrange to the female sportswriter that goes in the USC mens locker rooms and stated from her point it worked just fine. I have seen numerous providers challenged by people from this thread and I have to believe to them, it makes a difference in not only their lives, but perhaps touched someone else and inspired them to perhaps be that game changer. For me, I took to heart a comment from Dr. Berstein, venting on this blog might be good for the soul but doesn't change much. So I took some time away to put my energies to work. Don't be discouraged, every cause from the civil rights movement to women's sufferage took time and a will not to give up...alan
I am apalled by the comments on the "naked" thread... When a human being is stripped of his underwear, talked down by strangers, his basic human rights are being ignored. when one is told "you're having X done" they choose for us, and the right to self-determination is just nonexistant. They just don´t get we are not their property, for if the wished of the patient can be ignored like that, we´d be indeed their private property.
Some of us (especially females that can document sexual abuse) don't want strangers looking, touching or doing anything to our genitalia. Although I would be far less offended by a female caregiver, they're right... GENDER DOESNT'T MATTER! Because I would not want any of these procedures or examinations done, under any cirscumstance. I reaaly don´t care about the gender of the caregiver, standard practice for an examination (If you do X, you have to also do Z). If I am not striking for my health, I am not going to do it to spare their feelings or advance their careers. I care even less about the medical need for a procedure, if informed consent is lacking, it is simply a violation. THAT'S WHY I DON'T GO TO THE DOCTOR ANYMORE THESE DAYS. I consented to procedures under duress and I regret it. The lack of respect for my wishes was so great, and so much the humiliation suffered, that I really don't take into account whatever gains could have been made form the medical point of wiew. Make no mistake about it, would die ten times without hesitation if the click could came back. As for the battle horse of the communicable disease, no treatment of such things requires enforced nudity, just isolation.
The thing with medical personel is that they make no distinction between health and quality of life. A woman submitting to intimate exams she does not agree will have a substantially decreased quality of life, (and very likely for very limited or no improvement in their health, either). Our privates won´t fall of because they don´t check them.
Sadly, some of us will decline health care we would accept, (blood pressure taking, etc) because the industry doesnt't want or is unable to realize that it is our constitutional right to refuse treatment we find degrading and we don't want any intimate care at all.
As I have written in other places (and to be practical) this change in heathcare choices will probably have to be a market driven decision. Alot of Americans facing decreasing healthcare benefits will have to find ways to afford the same care that they have been used to, and this will be tough. The amount of new people that can now "afford" coverage will not balance the millions who, due to rising costs, will only seek care in yearly or extreme circumstances. With $20 co-pays turning into $1500 deductables, people will wait until that $1500 is most medically advantagous. And dispite the fact that many people believe that choices will be less opportune, I have to believe that this gives the edge of demand to the consumer.
Caregivers will be looking for the competitive edge to make sure they are the facility that gets that healthcare dollar. When looking to make/boost profits, you look to markets not being tapped at a high percentage. If statistics prove that in medicine it is men not seeking heathcare, this is a large monetary opportunity. “What can we do to attract more men into spending heathcare dollars?”
Perhaps the savvy business person would finally offer them a less stressful environment and perhaps less humiliating experience?
Unfortunate but true, if it translates to dollars then profits should generate the interest needed. I have no doubt that money was the driving force behind the ocean of choices for women, not the fact that we are such fragile and gentle creatures. That too was simply a marketing tool to get our dollars…which apparently worked.
It may not be a decision based in ethics, but in the end the results could be the same. We really need to view every situation as an opportunity for change.
swf you are right on the money in more than one way. Many of the modesty issues we are trying to deal with are driven by the administration which is business focused vs patient comfort focused. Patient satisfaction is a tool to drive volume which drives profits. Again, simple example hospital gowns that everyone knows we all hate, why would they be the only option...money. There are some simple things you can do to plant the seed. Call a hospital, ask them if they have a male tech for imaging...if they say no ask for the patient advocate and just send them a letter telling them you were looking for a facility that could accomodate and plant the seed. I live in a rural area so I found out who the board of directors were, they are local lay people and I wrote each of them a letter....they are patients who have impact on decisions at the hospital and can identify with us without having the conflict of interest. If you don;t have the time or finances to form a group. Sit down and send letters and e-mails...it all helps....alan
Recently scheduled for an echo stress test I made it abundantly clear that I wanted a same gender team. It was assured. When I arrived, the female tech had gone home for the day.
The male tech came out and explained that there was an emergency and offered a chaperone. I offered, "I'm going home." Good thing I needed to be near their facility for other testing or I'd have been yelling and screaming and demanding cabfare home as I live an hour away!
Not only did I refuse the procedure, I also notified the facility that I wasn't going to reward their behavior by re-scheduling, and that they lost three other diagnostic tests that had been ordered. If that doesn't talk, I don't know what does.
gd
gd
I'm a little confused about your post regarding this echo stress test. Personally,I think
a nuclear medicine test is much
better,however,the heart monitor
leads could have been attached by
anyone.
Secondly,the breasts are in no
way exposed for the echo probe to
visualize the heart.I've known many
patients to simply wear a sports
bra and simply wear the gown with
the opening in the front and only
exposing the midline of the chest.
For those unfamiliar with echo,
it is an ultrasound machine but
often separate from the ultrasound
department and primarily used for
echocardiology.
PT
gd,
Kudos to you. It's all about control in medical operations. They were going to show you who's boss. Where is the integrity in medical operations?
My PCP is OK, but this blog has given me the confidence to say "good-bye" the next time they want me to suffer their unnecessary control.
BJTNT
They are never the boss; they just don't know it. If the men would exercise their rights, they too, would be on a more equal playing field. More men would be hired in nursing as well they should be.
gd
Hi PT
The echo stress is chemically induced in this case. The gown open in the front cannot have sports bra due to leads and the ultrasound probe. You can't wear a sports bra open in the middle in the front.
My comfort level required same gender team. I hope I answered your questions. I also needed a regular echo at the same time.
the reality is that unless people like us (yes wierdos like us) actually start being obstructive, non-compliant and unco-operative, they will NEVER get the message. I tried to explain to my wife tonight why i prefer same sex care for personal issues, when I asked her if a woman would be asked the same thing (she is a nurse of 30 years standing) she seemed to accept my point of view more readily.
Stop being compliant, stop being passive. stop accepting bullying - stand up for yourselves.
As I previously said!
An Echocardiogram,also known as
a cardiac ultrasound,uses no contrast dye. There are "NO" chemicals used in ultrasound!!! Sound dosen't bounce
off of nuclear isotopes,nor barium sulfate,nor isovue(iodinated contrast dye).
There may be a resting and a stress test. The resting version
is done with you lying down. The stress version walking on a treadmill. You have a gown on,therefore you can have a sports bra on. You have ekg leads on which
certainly would not be a problem as
long as there are no metal components in the bra.
PT
PT
The test I'm talking about is a chemically induced stress echo test that is done when people cannot walk on a treadmill.
Regardless, many facilities will not permit women to leave on their bras. Futhermore people who have been victimized often won't wear a hospital gown if their trauma occurred in a healthcare facility while they were wearing just that.
gd
PT,
I don't know if you are aware but the echo portion of the test is an ultrasound of your chest that cannot be done with anything but a bare chest.
gd
Dr. Joel Sherman and I have stareted a new blog titled "Patient Modesty and Privacy Concerns" at http://patientprivacyreview.blogspot.com/
You, who have known me as MER, will now know me by my real name. I think it's important we all stop writing anonmously.
Doug Capra (MER)
Joel and Doug, best wishes on your new project. I'll be watching and occasionally contribute a comment.
I particularly like Doug's "Talk with Us" 15 suggestions to doctors. Here is the active link to click on to get to the blog.
Again, best wishes. ..Maurice.
gd
On a number of volumes back I commented on several of the more
sensitive exams in ultrasound,
those being testicular and trans
vaginal ultrasound. I mentioned
that although I am not an ultrasound technologist,I have used
ultrasound on some of my patients.
What I know for certain is that
transvag exams can be done with the
patient completely covered.
If the technologist really wanted
they could do a testicular exam
with the patient covered.
If they really wanted,an echo
cardiogram could be done with a sports bra on. I rest my case.
PT
PT,
Actually, gd is correct....see this url for further info....
http://www.medicinenet.com/echocardiogram/article.htm
Thank you Hexanchus. I, too, was wondering how an ultrasound using gel (I've had an echo before) could be performed on top of clothing.
gd
PT,
After some thought we might be into something a little different in the frame of mind of "uncovered". While I'm sure most sensitive tests can be done with minimal exposure, patient comfort is a different issue.
Some people are just not comfortable being that vulnerable when their modesty means so much to them; especially sexual assault survivors who don't fear being assaulted as much as feeling degraded or humiliated that has nothing to do with the competency of the caregiver; only the mindset of the patient. They just don't want to be in a position of being exposed in front of the opposite sex.
gd
gd:
Your post does a good job of pointing out a few very interesting issues. "Modesty" is an incredibly large umbrella that we use here to cover a wide range of issues. Most are related ultimately with how we view our bodies or how we believe others view our bodies. Some are not modesty issues at core level; including entitlement, trust/fear, (some)religious/moral, ethical, and marital. Although many (not all)of these require same gender care for resolution, the medical arena needs to know that all of these issues are as varied and complex as the nature of the illness/proceedure itself.
And sometimes...well it really is an issue of modesty.
Offering gender choice would be so much easier than trying to dissuade the relevancy of all these issues.
there is an interesting thread on allnurses going about students at a nursing school being asked to bring bathing suits to wear to practice bed baths. While there are more than a few who say students should do it to see what the patient feels like, that are a fair number who were outraged, the majority of them make the claim that knowing each other makes it different, nothing like what they are asking patients to do....I counter you with a classmate in a bathing suit is different, but is it worse than asking a patient to be naked and allow you to place a tube in my penis or shave my pubic hair, give me an enema....get real. And this is just one reason people have a hard time trusting providers. Not all are like that, but enough to make it hard to accept. The thing we need to remember, there were a significant number who felt it was appropriate to do this to get a glimspe from the patient side. One even said, its not about how you feel as a nurse, its how they feel as a patient...bravo
The human heart sits in the anterior aspect of the chest cavity
just slightly to the left of the
breastbone(sternum). If you have
situs inversus which occurs less
than 1 in 10,000 people,your heart
will just be slightly offset to the right of the sternum.Your internal organs will be reversed as well,first drawn by leonardo
da vinci.
In an Echocardiogram several locations are central in imaging
the valves and chambers.Through
the breastbone and the axilla or
armpit with the transducer. It's
important where one places the
transducer in order to get the
best signal strength,locations that are closest to the valves.
Echocardiology is only about
anatomy,not function. Nuclear
medicine myocardial rest and stress gives important functions
such as ejection fractions,etc.
If you are obese then as expected echo produces poor image
quality and this explains why you
can't and don't attempt to image
the mitral valve through the breast as you are trying to obtain
images through much tissue and distance.
This further illustrates why one
can get an Echocardiogram wearing
a bathing suit top or sports bra
since the transducer is placed at
several points on the breastbone
with a small amount of ultrasound
gel.
Visiting websites that describe
these exams convey very little
truthful data as they are often written by people who don't even
perform these kinds of exams and
complicating the matter even further considering the exams differ slightly from one facility to the next.
Finally,there are more female
echo techs than male techs just
for everyones information.
PT
PT
Have you been able to determine how may areas are left where men are still a majority? Or at the very least....half?
Hospital procedures converge with modesty issues when there is more than one person in the room. Example...for a chemical stress - echo there is always a doctor in the room. Those of us wanting same gender care then need to arrange for all participants to be of the same gender.
Furthermore, I called the facility and frankly , PT, I don't know where you're getting your information, but the ultrasound requires gel to be rubbed on all the areas of the test that includes between, under and around the breasts. They told me at the cardio lab that this test is never done with a bra on; that's it's impossible!
gd
I have confusion with gender/modesty issues.
I had to have an angiogram. Past experiences have taught me to be afraid of being a patient. Seeing my level of anxiety, the nurses received approval to give me Xanax prior to procedure. I tried to check out of my head as I removed my clothing and put on the gown. The female nurse explained WHY and WHAT had to be shaved. Its really very little on each side near femoral artery. Using several sheets/towels, she kept most of me covered and exposed only the part that was being worked on at a time. She kept a steady conversation. I didn’t feel judged or belittled about my modesty issues.
Then I was wheeled into the operating room. Huge! Not a small intimate space. I couldn’t see all of it to know how many people were in the room. The nurse in there did not care about modesty and fear. She whipped my gown up to put yellow stuff all over my skin including my belly. My belly which carried a 10.5 baby which I love but do NOT like to expose my ugly belly to anyone! Then as I’m uncovered, she yells over to the male nurse and asks him something unrelated to me. He does not turn around to answer; he keeps his back to me. I don’t know how or when he was clued into my feelings. Then this nurse walks across the room, leaving me exposed. I automatically start to cover myself. She YELLS at me that if I cover myself she’ll have to start all over. How do I protect myself? I wish I could have walked out like gd. How can I NOT be bullied?? I wish I was the type of person who got mad fast. I was trying to be a good patient. I really hate that woman. She deliberately sabotaged my feelings of safety and well being.
Then the female cardiologist comes out and does the procedure, no exposure. Then the male nurse is left to remove the catheter (?) from the vein. He asks if I would prefer the female nurse. NO. He tells me what he’s going to do/touch before he does it then asks if I’m ok. He showed me respect the entire time.
Two weeks prior to this, I was air lifted to the emergency room. As the team swarmed me, I told them I had to get out of here! And tried to leave. No one physically restrained me. The Doctor In Charge (male) started asking me questions like my attention was the most important thing. He masterfully managed my panic and modesty. Then a male tech lifted my shirt to put the leads for the EKG (I think). He didn’t expose me, he looked under. He had to do this several times. I kept pushing my shirt down automatically. All the while, the Doctor was demanding my attention with questions. Looking back, I can remember the tech looking askance of the Doctor if he should continue and the Doctor nodding yes. Once I was stable, the Doctor slumped in a chair, I think he spent a lot of energy keeping me calm, and had a casual conversation with me as I waited to be admitted. I feel slight embarrassment about the male tech doing the EKG, but it’s not the stuff of nightmares. I don’t feel wronged or anything from this. In fact, for the first time in a long time I thought I might be “normal” because I handled it so well. Then I had the angiogram experience and it makes me sick.
Actually, this is clearing my confusion and I’m realizing why it’s so difficult. It’s not male/female issue. That’s easy to identify. The most important factor is to have compassionate professional care. Maria, I think we share similar experiences and wish I could talk with you. It sounds like I’m not the only one.
~tear
I think the gender issue is part of the problem not THE problem. I think there are several parts to the over all problem. One of them I believe is an us and them mentality. Go to allnurses.com and search bizarre learning bed baths. The thread goes 10 pages of posts on whether it is acceptable to ask student nurses to wear a bathing suit to class and practice bed baths. The response is mixed, but there are a significant number who do not feel it is Ok and state they would refuse. They feel of course since they know the students its worse than if were doing it to a patient. Of course they know they discount the fact that they would be wearing a bathing suit and the patient naked, they ignore the fact that they are the ones who are supposed to be involved in the education process not the patient. While reading the thread i could not help but feel one of the bigger issues is the us and them mentality. One even related how they provided extra consideration such as choice of providers/gender etc when providers were patients. I think the issue to a large degree is the ability of the providers to create an US and them mentality. Those that have the greatest division of US and Them have less concern for the patient. Those that have the least have greater compassion and concern. The gender is a magnifier of he issue. Because gender is the main item that creates the anxiety it is mistaken for the main problem. But think if the providers all made the effort to treat us as they would prefer...they would understand gender is an issue and ask, they would want to be given the same consideration, But since it is us, and not them, they can justify it with the old its different because we work with eachother ignoring all of the others factors. Perhaps its a coping mech as someone questions...but to a large degree, it boils down to an us and them.
In a way, I am pleased to see far less activity on this thread than in the past. I hope this reduction of complaints means that those interested in the issues of patient modesty and need for gender selection in medical care are now out spreading the word of their concerns and informing the public and the medical profession and system of ways to mitigate the concerns and make for a more fair healthcare system. ..Maurice.
I agree with you, Maurice. I think these modesty threads had their use, but it's time to move on. As I've stated from the beginning, I believe the key, from both the medical professional and the patient side, is better and more open communication. Medical professions need to be educated about this issue and be trained to help patients open up about it. And patients need to make their preferences known and be willing to discuss options in terms of what will be best for both the patient and the system. In most cases, people should be able to work something out. Dr. Sherman and I will continue to compile articles on our new website
(http://patientprivacyreview.blogspot.com/)
and try to make coherent some of the debates and arguments that have appeared on various blogs. The time for anonymous complaining is over. We need to identify ourselves, come out of the closet, and argue our case intelligently.
Mer/Doug Capra
I hope so as well Dr. Bernstein. For me that has taken the form of doing it on an individual basis. While I had hoped there would be something more organized. And perhaps someday there will be, there is opportunity on an individual basis. Trisha Torey does a blog on advocacy. She touched on male modesty and sort of indicated suck it up and do it, it touched off a firestorm and I noticed in a recent post she had been invited to do a webinar to 1,000's of med students and included modesty in the presentation, another the daily strength raised the warth on 10 reasons men don't go to the doctor. I recognized several posters from this thread. Personally I advocate for myself in the community and have started proactively. I have called several local hospitals and asked do you have males in imaging etc. If they say no I simply drop the COO a note and tell them I would like to use their facility but...I would appreciate it if you would advise me when this is available. I also have been involved in getting a couple of scholarships and more importantly, advertising their availablity for males entering nursing. Lastly, I write letters constantly to ads, billboards, etc which portray nursing as female, including ads for hospitals, nursing schools, etc. Not sure how much impact it has, but we can at least plant the seed. I hope someday someone organizes, but until then. A side note, it appears women are much better at organizing for causes than males, example Sept is prostate cancer awareness month, compare the ads this month to breast cancer awareness ads....don't know why, but we just don't organize behind a cause
I have been reading some of the posts on medical modesty for some time as I am trying to shake a six month duration of post traumatic stress syndrome brought on by insensitive and thoughtless treatment in the area of patient modesty.
I think that one of the difficulties with organizing is that one does not appreciate this problem until one is actually in a situation where your rights as a patient are violated.
After being numb for a while, I then wrote a lengthy (and, I must say, excellent) letter of recommendations which I hand-delivered to one of the top administrators at the hospital. I believe that I have helped future patients as this letter created changes but this has not helped my emotional or psychological state all that much.
I think, though, that putting the words on paper is important but until new practices are accepted and instituted just like the patient's bill of rights or HIPPA laws, health care workers will continue to do what is easier or more efficient because efficiency means saving money and being considerate of patients takes time.
~Charlotte
Hi Charolette
I am very sorry to read of your experience with PTSD and a medical encounter due to the way you were treated. I know EXACTLY the way you feel and what you are going through as I have been dealing with the same thing for years.
upside down
Charlotte, I have been there, while some things that really upset me are still with me, they and things like this thread have helped me to position myself to lessen the chance of it happening again. We can't change the past but we can use it to change the future. I hope you find some solace from the fact that you will be better positioned to prevent this from happening in the future and that you have helped. You will find that the next time you are in this situation you will not just take it or allow it to happen. I took it the first time and after finding out from Dr Sherman & Dr Bernstein's blogs I was not alone, I became encouraged to stand up and tell what I wanted. alan
Is it then that September is prostate awareness month.Really,I
woundn't have known considering the
volume of soliciting the local
grocery stores in my area have done
this month for breast cancer and
the susan g. komen foundation.
Odd they never solicit money for
prostate cancer or is it just a
coincidence that these rallies for
money happen to be on the same time
frame.
The mentality Trisha Torey maintains on her advocacy blog is
certainly disturbing "suck it up"
or is this just talk to initiate
feedback. Sounds like she has been
educated on the jargon if you will.
For the uninitiated,these threads give the notion of a bunch of overly self conscious souls,but
rather we are keen to deception and
behaviors that cross professional lines.
As I see it nothing is going to change until one person comes forward with a voice that unites
and educates everyone on this subject.
PT
Anonymous, yes, I have found my voice that is for sure. Interestingly enough I am also married to a doctor who has been active at the hospital for over 20 years. I think that many folks do not have the courage to speak out, as it was very difficult for me.
However, I realize that at some point, those of us who are not in the day to day medical world do have to accept that surgery/illnesses/etc have to do with our physical bodies.
I visited Mayo Clinic for a second opinion (this was an airplane trip for me, I do not live in Minnesota) and they have a very, very, large naked bronze body on the way in one of the foyers. This is a good reminder that what is going on has to do with our human bodies and examining them is essential to good medical care. However, there are many, many things that can be done to show sensitivity, thoughtfulness and respect for individuals. I don't know if we have sufficiently identified where that point is but I think there are certainly things that could be agreed upon.
For example, my husband agreed that my treatment during radiation therapy was unacceptable as he and other surgeons show more respect draping and protecting modesty in the operating room than was done for me as a fully conscious patient. And for those of you who have written with concerns about surgery, surgeons DO take special care with draping and protecting patients. They have to keep their temperatures stable as well as keep fields sterile. I don't have a big problem with surgery (which I had) except that I requested no students. I think that surgical training in today's medical schools does not allow for disrespect of unconscious patients like it may have in the past. There ARE standards that are being set and met.
Charlotte, I agree we have to be willing to accept exposure as part of medicine. And for the most part, I think medicine does have concern for modesty. The part where it all falls apart is that they apply dealing with modesty from their side, what works for them, not the patient. That is where it comes apart, if they are considerate in draping...they think it trumps a patients desire for same gender, if they are considerate in how they act, it cures the patients anxiety over being exposed and wearing open backed gowns when it isn't absolutely required....that is where we part way, and when they have a different protocol for one of them vs us...it all becomes evident.
Anonymous, I posted a comment a while ago but it seems to have been lost. I am still getting the hang of this. What I basically said was that I am definitely on the side of patient modesty, in other words, don't get me wrong. My experience was definitely horrible, actually the word I like better is "monstrous" but I am trying to find that place where I realize that treating bodies requires seeing some parts of bodies.
The other thing that I said was in regards to a topic that I noticed on these blogs which is male modesty. I do not know if you are male or female but I have become more conscious of this too. I requested a meeting with the director of the radiation therapy center where I had the privacy issues and (among many other things) I brought up the fact that his facility needed to realize that women had modesty concerns (the director and all of the radiation oncologists at this center are men). He somewhat sheepishly admitted than there were many men who were uncomfortable dropping their pants also in a room full of technicians. But, unless people make a point to speak out, put words on paper, nothing will change. So, I think I may have helped both male and female future patients at this facility but doing so was difficult and anxiety producing for me.
I'd like to see a copy of the letter Charlotte wrote. Would you be willing to post it, Charlotte?
PT -- I also have some problems with some of Trisha Torry's expressed positions on modesty -- but check out the following URL. She recently spoke to a class of medical students about what patients want them to know, and in her report she mentioned the modesty issue. The fact that she picked that specific issue to highlight as something medical students need to learn -- that's significant. That's progress. She has many followers to her blog and is gaining a national reputation. We'll never all agree on the specifics of patient modesty -- but I think we can all agree on some of the general principles. Here's the URL:
http://patients.about.com/b/2010/09/20/meeting-the-students-and-fulfilling-a-dream.htm
Meanwhile, keep checking on the blog Dr. Sherman and I have started and give us some feedback. We're trying to write a series of articles designed to help patients with this issue, and educate the medical community.
Doug Capra/MER
Let me think on this a while. I am still sort of new to this blog.
My "letter" was 8 pages long and filled with very specific recommendations to the RT center regarding the things they submitted me to. I have to think of a good way to tell my story, it is graphic and these wounds are still fresh.
And, thanks for the URL for the Patient Advocate Blog.
Charlotte:
Good job speaking up. Caregivers often tell us that things will only change if people start speaking out for change.
It's slow, it's often hard, and many times painful....but with everyone's help and the support of each other I believe we are moving toward where we need to be.
Good Luck Charlotte.
(swf)
MER
Actually,we really don't know
what she said to these students and
even if any of it,referenced men.
For the most part I believe most of them will return to the classroom and within the confines
of the classroom learn "what" is
exactly taught to them. Don't expect any of them to think outside
of the box. Besides,what is the point of bringing a vet student into these issues. That in and of
itself essentially told me the entire ordeal is pointless.
PT
Sorry, PT. Again, we' have to agree to disagree. Sometimes you come up with some good points. But over all you remind me of many "Yes, but..." people I know. There's no arguing with a "Yes, but..." individual. Every point you come up with is returned with a "Yes, but..." And those "buts" are rarely constructive, just complaints.
Progress is made with small steps, and to get Trisha Torry to take this issue on is at the very least one of those small steps. I personally think it's a big step. By the way, I was the one one who originally contacted her about this topic and convinced her to write about it. That's advocacy -- and it does more good than to just complain and complain on this blog.
MER/Doug
MER
You don't have to say you are sorry for disagreeing.The vast majority of these people are not
healthcare oriented and have no medical experience with little idea
of the logistics and how the system works.
Allnurses is a perfect example
of that. How many threads have been
shut down or otherwise disregarded
in a negative fashion. I can list at least 10 nursing forums where
subjects of male privacy have been
brought up.
The issue first needs to be brought to nursing schools because
thats where the double standards
begin.From there the mentality spreads throughout the medical community,ie female only mammographers and L and D nurses.
One needs to ask who it is that she is really advocating for,women.You even said yourself
that you had issues with the jargon
she used,"suck it up". Women are NOT going to help advocate for men
which I believe will only hurt them
in the long run. You can only discriminate against a group for so long!
PT
"Women are NOT going to help advocate for men"
Really? I would like to point out that from the time I let people know that I would be advocating for men, most of those who e-mail me and/or STAY in contact are women. A (female) friend asked me to write an article "woman to woman" about male modesty issues. Her goal is to reach out to women in hopes that they will finally become sensitive (or even aware at this point) to men's modesty concerns. I did that, and (most) responces have been positive. How powerful would the message be if men backed up the article?
The problem is that
1)A lot of men do not seem to realize that women ARE advocating for them, and
2)Women are not getting enough male feedback on how to be even better advocates, and
3) Men and women are still not really joining together in male advocacy.
Both genders need to work together if anything substancial is going to happen. It can not continue to be separate ventures.
PT, if you keep telling women that they are not helping then soon they will not want to bother. Before you consider whether that makes a difference, remember that most nurses are female, and women are starting to hold them accountable for not being honest about choices for men.
(swf)
I think we can all agree that this issue is important to both men and women.
PT, why do you want to force women to accept men in labor and delivery and for mammogram techs? A vast majority of us don't want men viewing our bodies during these intimate situations. Your mentality suggests two things. First, if men aren't getting what they need, to heck with the women; they shouldn't either.
Second, you are envoking your entitlement mentality and this is the very essence of what we as patients would like to eliminate in healthcare.
What's wrong with accommodation for people who feel that their sense of modesty is being violated? It is their legal right, their psychological health and YES more should be done to accommodate men. Let the men earn their modesty rights by speaking up, refusing treatment, shopping elsewhere and guess what will happen....the doors will open up.
You have many great points but I always feel there's this chip; not sure where it's coming from but for all of us to have our modesty needs met, we need professional to lose the chip and be inclusive, innovative and supportive of patient need to propogate strong mental health.
gd
To swf and gd
First,I must say I've never seen
either of you comment on Trisha Torry's site or for that matter womenagainstprostatecancer. I always use mammography and L&D
as the gold standard to illustrate
the double standards.
Yes,I do feel that if men don't get privacy then neither should
women.That certainly would level the playing field quickly wouldn't
you say. I know of no woman in healthcare that ever advocated privacy for male patients let alone
some woman with no healthcare experience starting some blog.
On one nursing forum female nurses asked why would a male patient refuse opposite gender care
and laughed. These are people who
have healthcare experience,not someone just starting a blog. What
is interesting about some of those forums were a few male posters pretending to be female posters.
I picked up on that rather quickly in the game.Fact of the matter is and as I previously mentioned not advocating for male
patients will only hurt women patients in the long run. Sooner
or later nursing will become equally saturated with both genders
and the mentality "gender neutral" will prevail.
PT
PT, the playing field will never be equal. The statistics on sexual victimization by gender shows that women need the protection more than the men just based on the numbers. When you add to the equation that women develop ptsd more often then men after sexual assault, it becomes even more important to protect them and I suppose for these reasons, that's why they are.
Thank you for admitting that you feel women should lose their privacy rights because of the unequal playing field. Does that also mean that every minority who is discriminated against elsewhere in the world should suffer the same here?
Where is your compassion? Where is your healthy mindset to correct a wrong with positive innoventions; not negative ones.
I don't know what you do in healthcare but if you are a nurse, you are who we are all afraid of.
Oh...and where are the men advocating for women???
gd
PT,
Gender neutral will never prevail because the law of the land says otherwise and...patient refusal and taking their business elsewhere will prevail!!!!!! It already has in mammography and labor and delivery and you just can't stand it.
Patients who refuse opposite gender care, who are paying for services will always have the last word. They will not allow the medical industry to hold them hostage.
The medical profession does not have right of entitlement to our bodies and everyone has a right to their privacy under the law. Just because the medical industry has been ramming this issues down our throats since the civil rights act was passed, doesn't mean we have to take it. This blog is evidence that we won't.
gd
PT
I wonder why you attempt to create conflict with people who are on your side. How can that possibly work in your favor? I welcome debate and discussion, but your disdain is pretty clear. 'Honestly' why is that?
Yes I am a woman, and no I'm not a caregiver. You tell me what credentials you would like people to have before they post here.
I also wonder why you assume to know where we all post. Reread Trisha's site, you will notice a couple of people from here posted there. You can tell by the way they 'speak'.
As to the rest...well I'm not sure where you are going with it but it seems you prove the point that female caregivers are not listening, so we need more female advocates to appeal to them.
At least, that is how I see it.
swf
Women never stood up and said "we
want only female caregivers",female
hospital management simply blocked
males from mammography,L&D and other areas and that is fact.
My idea of entitlement is this,
everyone should get fair and respectful care,entitlement has
nothing to do with it!
Entitlement is when a 350 lb patient with no insurance presents
to the ER with abd pain after just
eating fast food all day.
Entitlement is bringing 4 of your family members to the ER and
expecting the ER to feed them,the
ER is not a resturant.
Entitlement is coming to the ER
just to get pain meds and the list goes on and on.
Entitlement is using the ER as
your prenatal care facility.
I don't expect anyone to have any specific credentials,but the
expectation that men expect privacy
and respectful care. Statistics on
sexual victimization say nothing
about gender staffing in hospitals
and is irrelevant. 95% of nurses are female as well as the majority
of direct and indirect care staffing.
Female prison guards certainly
hold the record for sexual victimization according to the justice dept.Every innapropriate
cell phone pic carried out in hospitals I've read about was done
by a female employee.
Quarterly reports issued by the
state nursing board in my state by and large list female nurses as having previous felony convictions,
stealing patient meds,boundary
violations as well as sexual assault against a male patient.
When I'm a patient its the female nurses I'm afraid of!
PT
I think it is a great idea to advocate for male modesty. I think though that you men need to tell us women that you have modesty issues and what it is that you want. One thinks of the different ways that men act in the shower room versus the way women act etc., which has always given me the impression that men did not care.
I met with the director of our Radiation Therapy Center over privacy issues and he had to admit that men were reticent to expose themselves also. I was actually very enlightened and glad to hear that. It validated my concerns. To know that both men and women want to be treated sensitively and with dignity gives women credibility. We don't sound like silly prima donnas. I do think though that men are going to have to voice their concerns because historically society has wanted women to be modest and punished them if they were not. So, women are starting from a different place.
Can anyone tell me what exactly a colonoscopy tech does and where they are located in the exam room? Are they able to see a patient's private area (front or back)?
The only gastro clinic in my town has only female colonoscopy techs. Can I still preserve my modesty?
LL
Colonoscopy staff ALL stand at the foot of the bed/near your waist. Everyone present has a "ringside" seat.
Don't waste your time looking LL. You'll never find a place for a colonoscopy that will treat you with respect. My local Gastroenterology clinic has only female technicians as well. It took me three phone calls and a visit to finally get a straight answer out of them. They admitted having only female technicians early in my quest for answers but they still won't give me a direct answer about whether the female technician can see forbidden skin during the colonoscopy.
It seems to me that if they refuse to give you solid answers they know that what they do is wrong and they have a lot to hide. They know perfectly well that what they do is unethical for male patients, so instead of giving a real answer they read you a standardized speech (probably written on a 3 X 5 card that every medical receptionist in the country is issued). If you ask something such as "will the female technician be able to see my butt" they'll give you a generic answer like "we do our best to preserve your modesty and make you comfortable". What does that even mean? It's the same answer I got for almost every question I asked. My best guess in translating that response is "you'll be laid out naked on a table for all nine people in the room to gawk at throughout the procedure as well as anybody that happens to walk by, but you'll be unconscious so you'll be comfortable and your modesty will be preserved."
Even if one day I find a clinic that actually cares about their patients and offers an all male team, I still would insist on having an advocate present. Medical personnel can never be trusted on their own. They think that they know better and will lie to us "for our own good".
This is a woman's world, at least in the USA. They are treated with the utmost respect while men are treated like mindless drones that couldn't possibly have morals or understand ethics. Male medical personnel (support staff) are very limited on what they can do to naked female patients, if not completely banned from seeing them. But there is no limit for what female support staff are allowed to do to naked male patients. Male patients are required to just hand over their body to the female support staff and accept anything they decide to do. Basically our body is their private playground and they can spend as much time as they want without a chaperone, whether we're conscious or not. Or if they want they can take other women in there as well. The more the merrier when male patients are being catheterized.
It just makes me sick. I've vowed never to have a colonoscopy or anything similar and hope God will take mercy on me. Any consequence I suffer with that decision is better than being sexually abused by medical women.
GL
Re: colonoscopy
I'm not sure where the tech stands but I know if you are going to have an anesthesiologist, they will be on the other side of the table up by your head to monitor your vitals. Also, I was told before my colonoscopy (by one of the pre-op nurses) that you are covered in blankets/drapes except for your buttocks. The front of your body should not have to be exposed at all. They just lift the back of the gown to access the needed area. I do remember feeling the draft on my bottom when they did that but that was all I felt being exposed. Of course I was "out" after that. I was told that some doctors even cover the buttocks once the scope had been inserted. I don't think the necessary personell are just standing there with a "ringside" seat, staring at your butt. But if you are concerned, ask the doctor about these things if you have questions.
I would like to comment regarding what PT has said. Sadly, the issue f male modesty is in diapers, mostly because males are hugely homophobic.
Mostly, they are in denial. They are emotionally illiterate, and don´t realize the damage certain attitudes by female medical personnel are, and not to be labeled "man enough", they don´t put them in their place. But the worst problem are those that believe that, as there is no sex as we understand it, all that power trips and downright abuse are not intentional, and dangerous.
Even if they don´t date or have physical contact, a male patient that trusts a female practitioner more than their partner or tells her intimate details about his private life (which will certainly mean talking about their spouse or sexual partner), they are already having an affair, no ifs, or buts.
A long term relationship between them does not make things better, in fact it makes it worse.
Both with men and women alike, I think the issue is really denial. The medical community actually wants things to stay that way because it is more convenient for them, respecting privacy takes both time and effort, and probably even money sometimes. And God forbids you fall out with them, or they'll lose whatever respect they had left for you. I am female, and I have the bad luck of having to have a lot of contact of having to deal with the profession for a very long time. female personnel can even be more abusive than males, simply because they can get away with it, besides, since females have never been really respected in any profession, they´re so concerned with earning the male doctor's respect that the last thing they actually care about is the patient.
But I also see a problem with male practicioners. I think what happens is that since women have made inroads in Medical World, they are losing a lot of income and power. As a result, they take it on women, and the patient, especially if female, young and pretty, is an easier target for his frustrations, since his fellow women (female colleagues, nurses, female friends related to Medicine) know his flaws all too well, in addition to having inside info about how the industry works medical and medical knowdlege themselves
"I was told before my colonoscopy (by one of the pre-op nurses) that you are covered in blankets/drapes except for your buttocks."
That still doesn't make much sense unless the room is cold. I don't care who sees my bare back or the back of my legs, it's the butt I'm concerned about. Obviously we have to relent and let the doctor see it but what's the purpose of anyone else seeing it? In this day and age we should be able to come up with something to block the view from everyone but the doctor. At least covering the front is a good start.
"The statistics on sexual victimization by gender shows that women need the protection more than the men just based on the numbers"
Unfortunately the statistics don't include the number of men that believe they are too "macho" to complain, and more commonly men that don't complain because they know it's just a waste of time to mention it to anyone because they already know that nobody cares. They also know that even if they say something nothing will be done anyway, but then they'll have to endure the torture of listening to the arrogant nurses insult their masculinity for the rest of their appointment. Then those nurses attempt and usually succeed in ruining your reputation with the rest of the nursing staff in the hospital or clinic.
"women develop ptsd more often then men after sexual assault"
At least women aren't normally sexually assaulted once they get to the hospital. I think most male sexual assaults come from the nurses and aides at the hospital that are supposed to care about them.
"A vast majority of us don't want men viewing our bodies during these intimate situations. Your mentality suggests two things. First, if men aren't getting what they need, to heck with the women; they shouldn't either."
I agree with PT there. Sometimes the only way someone will understand the harm they are doing to somebody else is if they have been harmed in the same way themselves. If male caregivers put the female patients through the same hell the women put us through maybe they will begin to understand.
I really appreciate all the women that advocate for men. We've had several really good female allies posting on this blog, it gives me hope that someday more women might begin to understand that men are just as human as women. We have the same morals and emotions that they have, we just don't like to talk about it much. Thanks for what you do.
GL
To GL:
I understand your reluctance at letting anyone besides the doctor see your butt during a colonoscopy but it does have to be uncovered to do the DRE beforehand and also to insert the scope. A nurse will probably be assisting the doctor so I would imagine that he/she would also see. As far as being covered, it does make sense since it is usually rather cool in the exam room and also if a patient is sedated it is important to keep them warm. At least seeing one's butt is not as bad as seeing the entire lower (frontal) section. I am a female and was also extremely concerned about the issue when I had my colonoscopy. I had a woman doctor but the anesthesiologist and his assistant were both males. The tech and nurse were females, so I had a mixed gender team. It was very upsetting to me to have males in the room. That is why I questioned the exposure factor and was told I would be covered except for my buttocks and that only the doctor would see them (according to one nurse). I still feel a little creeped out by the fact that men were in the room but there's not much I can do about it now. I know it will never happen again unless I am in a life or death situation and have no choice. By the way, I feel like men should be afforded the same considerations for modesty as women. I would be more than happy to voice that opinion to anyone. Men should start asking for more options and going where they can be accomodated and also letting facilities that do not offer them those options that they will be going elsewhere. After all, business is business and they will start paying attention if it happens more and more.
I have had a colonoscopy performed. I was awake fully throughout. I was moved several times to help facilitate the movement of the scope. I was placed on my back at one point with my gown well above my waist area. EVERYONE in the room had a full view at that point. I did not care however as i had managed to ensure an all male team for my procedure. There was no draping at any time. The usual team of female staff were furious I had managed to schedule an all male team, why was that i wonder, did they feel their power had been taken away?
If they have trouble passing the scope, they will often have to turn you onto your stomach or back and that's when you are likely to become exposed. Happened to this person, they woke up during the procedure on their back, uncovered from the waist down.
http://allnurses.com/gastroenterology-nursing/my-1st-colonoscopy-76001.html
Thanks for the post Jean. You handled the mixed gender team better than I could. I actually learned today that the University of Utah endoscopy department will arrange an all male or all female team if you give them enough notice. It's worth traveling a couple of hours to find someone that will accomodate those of us who find the usual procedures unethical. Those of us that have enough integrity to stand up for our beliefs.
"The usual team of female staff were furious I had managed to schedule an all male team, why was that i wonder, did they feel their power had been taken away?"
Are you serious? They actually threw a temper tantrum? Does that sound like a "gender-neutral professional" they claim to be. How can anyone that horrible and immature expect to be respected as a true professional? Good job going behind their backs. I wonder if they were so upset because they couldn't intimidate you or because they were anxious to see what you look like with your clothes off. I try my best to avoid being exposed in front of other men as well but I would always choose to be completely uncovered for the duration in front of only men than being mostly covered in front of one or more women (if those were the only two options).
GL
http://www.danleemedical.com/products/exam-shortsbikini-bottoms
Danlee makes disposable colonoscopy shorts with a flap in the back, for those concerned about frontal exposure.
I have not had the proceedure, but I was told:
A) You can manipulate the scope without removing the shorts.
B) Some facilities I spoke with have no problem with clients wearing them.
There is of course a degree of exposure, but for some it is enough to feel less vulnerable and have more control over the degree of exposure while under.
I ordered one about a year ago so I could actually show people some options. For some it's enough, for some it isn't.
swf
gd you said, and I paraphrase, "men need to earn" and "the field will never be level as females are more often victims of sexual assult". While I rarely agree with PT's approach as I find it to be confrontational and conflict oriented for my taste I do have to agree with the basic concepts of his arguements. First off there is no way to compare a complaint presented by a female to that of a male in these instances. Because it has been historically the case women are automatically seen as vicitms, our society does not recognize men as victims of discrimination, we are not a recognized "protected class". A man complaining will not be given the same treatment. It is just as likely for a male complaining to be seen as sexist as a victim. Take the current issue with the female reporter who was in the Jets locker room. ALL of the media attention was on this poor female reporter who was "mistreated" in the Jets locker room. No one gave it a thought that the players may have been uncomfortable showering or using the restroom with females present. those that commented she should not be there were toasted and requred to attend classes on respecting female reporters. This thread is common, females requesting a female team is considered understandable, men are being unreasonable at best most likely sexist. As far as assult, do the people on this thread really fear being assulted in the hospital, we all know that is horrendous. This is about modesty, not assult. Even in this area are female teachers who have sex with minor students treated the same as males who do the same with female students. There are more instances of female gaurds having sex with male prisoners than male guards and female prisoners yet, that is rarely brought up in the media or treated the same. gd there is a difference in how we are treated and men are on the short end. That is why men hesitate to speak up. That said, there are women speaking up for men swf has advocated strongly and I think she has done an awesome job here and other blogs not only advocating, but encouraging men. So saying NO females does not lend credibility to your arguments. You have valid points but they are lost in your overly aggessive presentation
In reference to the allnurses thread on 1st colonoscopies. You will notice that further on the thread a gastro nurse advises the patient that found herself uncovered to lodge a complaint with the doctor and facility as it is not acceptable or necessary that this was done. A patient can still be draped even if their position is changed. There are some other comments on that same thread that state the patient is well covered during a colonoscopy. I think the individuals that find themselves exposed from the waist down have been subject to insensitive doctors/teams. Ones that just don't care about the dignity of the patient. Also, since one poster had an all male team maybe they just weren't as concerned with the issue. I personally believe that there is a large difference between how doctors and facilities handle colonoscopies. It's a shame, however, that they can't all treat patient with equal consideration since they are always pushing people to have this test; telling us how important it is. Unfortunately what happens is if a person has a negative experience they are less likely to have follow up exams.
This new situation with female reporter Ines Sainz in a way seems comparable to the mistreatment many men get from female hospital staff. Ines Sainz is a Mexican reporter who stated she was "uncomfortable" about the way she was treated in the New York Jets locker room. The experience prompted Sainz to tweet that she was "dying of embarrassment." Among other things she complained about "extended stares" while in the locker room.
Can you believe that? She voluntarily enters a men's locker room to watch the athletes shower and SHE is the one that's embarrassed? I'm speechless! How could she enter the men's private territory where she didn't belong and not expect "extended stares"? She can stare all she wants but when these naked men stare back at her she gets offended. If the USA allows women into men's locker rooms and then considers themselves the victim I'm ashamed to be an American.
But it reminds me of many experiences I've heard, read and experienced, where female nurses, aides and techs do relatively the same thing. One or more of them enter an exam room and order the male patient to strip, or they strip him themselves. They often grab his penis (to catheterize, bathe, examine, etc) and yank it around like the gear shift of a tractor/trailer or attempt to cram a tube down it, whether he likes it or not. They also sometimes invite other women in to either "assist" or just "observe". If ever the male patient refuses, tries to cover up or tries to send the audience out of the room the nurse/aide/tech gets furious and takes great offense. They get the "how dare you?" attitude and start to insult his manliness and treat him even worse than before. Then they tell the usual lie about how "this has never happened to me before". Naturally they also give him the usual "I'm a professional!" and "you don't have anything I haven't seen before" and the "I've seen thousands of penises before yours, do you think yours is special?" excuses. It's happened twice to me personally.
How can they not understand that if there's a victim it's the male patient? He's the one being ordered to humiliate himself. He, like the athletes is the one that's being told that he has no choice. He, like the athletes in the locker room is the one that's having his dignity and his human rights trampled. Yet it's the trampler that is considered the victim. How does this happen?
Of course we can't forget the erection situation. If, when the naked patient is having his penis gawked at by one or more women or it's being fondled and it begins to "stand erect", often the female examiner is the one that gets offended and pissed off. There might be some guys out there that actually enjoy the experience but most guys feel even more humiliated when that happens. Many women just ignore it but many others yell and cuss at the poor guy as if he was doing it on purpose just to piss her off. Teenage girls are sent in to shave and prepare men for surgery, as well as a few other things I wouldn't even let my own wife do to me. Again, the women consider themselves the victims.
Those situations and others are why I refuse to see women in healthcare. I wouldn't want to offend, humiliate or victimize the poor innocent women.
Anonymous from today 10-16-10, I am just curious, what does you wife say about your views? Does she support you in this regard? Just wondering..
..Maurice.
Yes Maurice, my wife supports me. Although not as strict as me, she believes in modesty and respect too. She would never put her life on the line like I would (I wouldn't risk her life either) but she tries her best to find female doctors and specialists. It's been very easy to find only women to treat her. Years ago she went to a male Ob-Gyn but we have several good female Gynos in our area now. The only times she tries to put her foot down in regards to my modesty and dignity is when she thinks I'm risking my life.
As far as women in locker rooms and other related subjects concerning the double standard my wife is a lot like "swf". She believes in TRUE equal rights. Neither men or women should have an advantage due to their gender or occupation, medical or otherwise. Also mothers shouldn't be able to use "motherhood" as an excuse for entering men's locker rooms or bathrooms. She's a pretty down-to-earth woman.
Most female nurse educators should be fired for fostering an environment that promotes
discrimination,disrespect and non
advocacy toward male patients.
That environment as most recall
had encouraged nursing students to
assault male patients by striking
their genitals with a metal object
such as a spoon upon seeing an out
of control erection,young boys not
excluded.
An environment that is conducive
to restricting and hampering the
educational opportunities of male
nursing students.
How could one consider this academic? Apparently,many of these
ABC community college wannabe's have prospered and accepted 6th grade math as a prerequesite for
nursing admission.
Many a joke no doubt was made when male anatomy class touched on
urinary caths and bedbaths. Yet,the
disturbing part of this is that
these type of institutions by and large recieve grant monies and your
state and federal tax dollar to
operate.
PT
PT,
You have my utmost agreement on this one. I know we've had our differences, however, there should be a no tolerance standard for this kind of behavior.
As I've said before, there are deviants, power abusers that come in all sizes, shapes and genders. They all need disciplinary action and there needs to be accountability and responsibility from the healthcare system, the mental health community and men who will file charges when these kind of abuses occur.
When it comes to advocacy for all, you have all of my support.
gd
1) Thanx Anon for the kind words.
2) FYI: Posted on Doug/Mer and Dr. Sherman's new site is an excellant breakdown of information regarding how and where to go with violation complaints, depending on one's desired results.
3)I was going to let this go, but it still bothers me.
"María said...
I would like to comment regarding what PT has said. Sadly, the issue f male modesty is in diapers, mostly because males are hugely homophobic."
Is the point that MOST men are homophobic? Or rather, they do not enter the nursing field because of the misconception that MOST men are homophobic? Or rather....men want same gender care but only if it is by a "straight" caregiver?
Quite frankly, if someone asked me to advocate for an-all-male-straight-team I would have to send them on their way. This is not the direction that I am willing to take advocacy or my role in it.
swf
Draping isn't a solution for me because most often it's the people doing the draping that I don't want to be exposed to. The female pre-op CNAs, female surgery nurses and the female recovery nurses are the people I least want to be exposed to, but apparently they are most often the staff that does the draping and performs the most humiliating intimate care and prep. To have a teenage girl do the humiliating pre-op cleaning and shaving and then draping me so the male surgean only sees the body part he needs to see is absolutely ridiculous. Then to have the female nurse uncover me to insert a catheter and then quickly cover me back up again so the male surgean won't see me exposed just doesn't make any sense. Later in the recovery room the female recovery nurses uncover me again to check the catheter and re-bandage the wounds. That would make it unanimous, every person I wouldn't want to be exposed to has now seen me totally exposed, as well as fondling my privates. But they did a great job keeping the male surgean and the orderly that moved me from one room to the other from seeing my privates. What's the point? Anytime I hear the word "draping" I can't help but laugh sarcastically because it means absolutely nothing, other than keeping the people in the waiting room from seeing me.
A similar topic is my local Gastroenterology clinic and their method of performing colonoscopies. They claim to respect men's modesty by promising a male doctor, a male nurse and a male anaesthesiologist so we can feel comfortable and our rights will be respected. They failed to mention that all the colonoscopy techs are female and there's no way to avoid having one present. Again I ask, what's the point? Having one female in the room negates all the respect given to us with the (almost) all male team. Are they too stupid to see what's going on or is their claim to "respect our modesty" just another lie to get us there and to allow them to put us to sleep?
By the way MER, I used to love fishing and whale-watching in the Kenai area when I was a kid. Best place in the world to catch the pinks.
GR
there are a lot of reasons more men do not go into nursing, I really don't think being homophobic plays a big role in it. We are pushed to accept female medical care from a young age, I have yet to go to a single doctors office that had a single male nurse. We go through the process assuming we don't have a choice. The majority of media from ads for nursing schools to TV has all the nurses being female and if there is a male (ie nurse jackie) they are gay. We are told if we don't want a female provider we are sexist so we have the choice of asking and probably not getting same gender, asking and being treated like sexist, or just accepting. The competition for patient dollars has creted a more customer friendly environment. SWF I agree, I found the comment offensive and ridiculous. So then would we conversely assume there are so many female nurses becasue they are lesbians or pervs wanting to see nude males? Of course not, so to make a sweeping statement about males not going into nursing or being afraid of male nurses is really off base,
I don't think that most men are homophobic, but I do think it's a significant concern connected to the issue of male modesty. A good social indicator is the current controversy involving whether gays in the military can reveal their sexuality. I suggest that the opposition isn't coming necessarily from the Pentagon or the military leadership -- it's coming from the rank and file, mostly the young male rank and file. The leadership realizes this and how it will affect morale. A significant number of men are homophobic, at least medically, and don't want male nurses to work with them on intimate procedures. How they would feel about a male doctor may be different -- but that's another issue. This medical homophobia not only affects the actual or perceived need for male nurses in the profession, but also the perception that some nurses have about what men in general want.
Doug/MER
I have some questions about informed consent. It seems that leaving out specific important details about what will happen to us after we're unconscious aren't included under informed consent. Details such as having a catheter inserted or that one or more teenaged girls will be exposing us to do humiliating things to our privates to prep us for surgery. Apparently they don't believe that informing us of those details is important and keeping it a secret is for our own good.
What I want to know is if we (the patients) ask specific questions about what will happen are they (the hospital employees) required to answer the questions truthfully? Are they then required to do exactly what they said they would do? For example if I ask who will prep me for surgery and what exactly will be done and who could possibly witness it are they legally required to tell me the entire truth? Will they then be legally required to to do exactly what they promised me they would do? If I'm told beforehand that a male and only a male will be prepping me could I still be stuck with a female and there's nothing I could do about it since I would already be unconscious? Can they make that kind of decision behind my back (assuming it's not an emergency)?
If I'm promised an all male team and one of them calls in sick and there's not another male to fill in for him will they honor my request to cancel the surgery at that point? If I learn that there's only a female to fill in for him and I'm still conscious I would cancel the surgery myself, but if I'm unconscious can I count on them to do the right thing and re-schedule for another day? Of all the unethical things that are done to patients I believe lying to us is among the worst.
GR
GR,
Yes a lot of details are usually left out in the typical "consent process" prior to surgery. There are several reasons for this, most commonly:
1. It saves time
2. The assumption that many patients either don't care or don't want to know.
3. They (prep, positioning, etc). are considered part of the overall procedure.
If you want details, then you have to ask for them. Most staff are willing to provide the details if you ask. If you get resistance, just make it clear you are withholding your consent (won't sign the consent form) until your questions have been answered to your satisfaction.
Any verbal promises regarding all male staff, or anything else for that matter, are pretty much worthless. Bottom line, if it isn't written down, it didn't happen. If you have been promised an all male team, there is a way to control it somewhat - just make your consent conditional in writing on the consent form. Write something like "My consent is conditional on an all male team as promised by my surgeon. If that condition can not be met for any reason, my consent is immediately withdrawn and the procedure is to be canceled."
One thing that puzzles me is why they think patients need to be unconscious for so many surgical procedures. There are lots of alternatives to general anesthesia or moderate to heavy sedation, like a combination of local and regional anesthesia, that could be used for most surgeries. In India they've even done hundreds of open heart surgeries, including CABG & valve replacements, on conscious, alert patients using a combination of thoracic epidural and local anesthesia. Tell your surgeon you want to be awake & alert during the surgery and ask what anesthesia options support that.
If you want the process to meet your expectations, then you have to be proactive and stand up for what you want - and it needs to be done ahead of time, not when you arrive for surgery.
Yes, some men are homophobic. Yes this can become an issue in the male modesty debate. Most certainly the medical arena can (and will)use this 'phobic card' as justification when needed.
Can we also consider that some women are homophobic? (I am not.)
I am familiar with several, and trying to understand their modesty issues vs 'just in case' issues becomes complicated. The medical arena could use this when attempting justification of more male nurses, but as we can see...they don't. It seems they like to pick and choose their 'phobics of value.
The genuine surprise (to me) was the amount of abused women who still prefer male care. Why? Because they no longer trust the women that were supposed to defend and protect them. I would go so far as to say that the betrayal may lead to rejection of all females, including healthcare workers.
I AM NOT trying to turn the male modesty issue into a female phobic or abuse issue. I AM saying that along the advocate path one can find a few surprises, and the benefit of more male healthcare workers could turn out to help more people than just modest males. I AM NOT going to mire the waters of practical advocacy with these platforms, but people might be surprised to know that when we help others we are not always sure who they may be.
swf
ai suppose there are a number of men who might be uncomfortable with male nurses for intimate care, but I would doubt it exceeds the number who are uncomfortable with opposite gender. In paticular men have been belittled and pushed to act like they don't want male providers, we are pushed to accept the stereotype pushed by the media of male nurses being gay. For me it isn't that I think female nurses have sexual fantasies, its I have been brought up to be covered in front of females and its ok around males to be nude ie in the locker room. Sex isn't part of it.
Thanks for the advice Hexanchus. Unfortunately I'm sure you're right. The suggestion about not using general anesthesia is a good possibility. If I had to choose between physical pain and being mentally destroyed I think the physical pain would be easier to handle. Losing control of my body is my worst fear.
I am also considering asking the surgean about having an advocate present with me at all times. I doubt they would go for it though. My father was an orderly in the same hospital 40 years ago and has volunteered to do whatever he can. Of course it would be very humiliating having him see me during pre-op but not as humiliating as a woman. I know he would look away during embarrassing parts though. He was also very adept at inserting male catheters but I would prefer that a male stranger does that.
Thanks again for the advice.
GR
GR,
There's absolutely no reason that choosing something other than general anesthesia has to be more physically painful for the patient. In fact, post operative pain is often better controlled - the same epidural, for example, can often be used for both perioperative regional anesthesia and post operative pain control.
Other techniques, such as the injection of long acting local anesthetics like bupivicaine into the operative wound area before closing can provide a 8-12 hour buffer of pain relief to both get post operative pain under control faster and help reduce the amount of any narcotic pain killers needed for effective pain control.
Bottom line, ask about the alternatives - you might be pleasantly surprised.
I am enraged by Anonymous' remark that females don't have sexual fantasies. I am a woman and believe me, that can certainly happen!!!
GR, I would like to say that I am a woman that is said to lack any credibility at all for being an ex sex worker. But nurses close the curtains, get to be alone with you, take off your clothes, including underwear, and do things we really would not do to clients. I've had a neighbour that used to be a nurse, and, although very rarely, she confessed she has indded felt turned on by male patients, once to the point where she had to "relieve myself alone" (in her very own words). As for the reporter, no, she's no victim, she should have been told off.
But the double standard works about men too. The sad thing about homophobia in medi cal care, is that it causes a lot of misundestandings, as well as the unsaid. Some famale nurses don't really want to do males, (especially the misogynistic, homophobic ones, for they're the ones that get a real kick out of the experience) but they end up performing such tasks because they also assume that men want opposite gender care. The stupid, close minded set will thnk there's no other way things can be, and the shy, more respectful ones will do the job, albeit grudgingly. In either case, WHY ASK HIM????
I think the everyday societal rules of bodily exposure simply do not apply in the case of needed medical examinations and treatment. Just as you must remove your clothes to bath or shower, you must sometimes do so in order for the doctor or nurse to perform an exam or treatment. This is a hospital or doctor’s office not a singles bar or ice cream social. Competency, professionalism, intelligence and compassion are what are important in a doctor or nurse. Gender is irrelevant.
Tammy
Tammy,
To YOU, it's irrevelant. How would you feel if you were treated insensitively and felt humiliated or violated by some treatment, observer, lack of privacy or the like. Would you be fine with that?
The fact is that many patients as evidenced on this blog and other are not fine with that. And, as a result of previous experience, many of us do have privacy issues.
While I respect your feelings and your right to have them, please respect ours, especially in the case of previous sexual assault victims who do not want to be viewed by opposite gender care and that the privacy laws of the land protect.
gd
Tammy, please don´t be so naive. Gender is not irrelevant. What makes me think so??? As a woman that has had to do sexual work, I had to serve many healthare workers, even doctors, and they can be extremely lecherous. Yes, I even heard things about the bodies and sexual lives of female patients I didn't know anything about!!! And males, in particular have a power thing about woman, the patient-doctor relationship doesn't change that, on the contrary, it increases te imbalance of power.
Besides, a significant ercentage of the population, especially women that have experienced real disrespect at the hands of male healthcare workers, even eschew all healthcare. And there are modest males as well, although their issues are different from women.
Lastly, many of the societal rules of nudity do (and should) apply to medical situations, too. Here's the thing: the access to nudity society gives healthare worker (which, by the way, is becoming increasingly questioned) is different from the permission a particular patient gives a particular healthcare worker, particularly of the opposite sex.
After all such males ask ME, not society, to strip, and I have every right in the world to say no.
Sounds like it's you who need to get over yourself...You have the right to your own opinions, but not to impose them on the rest of us, sweetie.
Tammy sounds like a "caregiver" that gets offended at the fact that people are questioning her motives. I would like to know how comfortable Tammy would be with a male gyno, male gyno nurses that assist with pelvic exams, a male chaperone, two 18 year old orderlies shaving her pubes before surgery, a male nurse that inserts a foley while another male watches, two males giving her her daily complete bedbaths, two males helping her with her bedpans and a male receptionist that pops his head through the door without warning at just the right time to see her receiving an intimate examination.
Add to that a room full of male nursing students observing her pelvic exam and the male salesman that's present to train the medics on the new medical devise they're using for the first time. How about all the men that have a full view of her naked body when the male nurse leaves the exam room door open when he goes out? Don't forget the male assistant or two that observe all of her intimate exams doing nothing more than gawking and pretending to take notes.
Who would you consider a professional? No doubt you consider yourself a professional. Are male medical assistants with little or no education professionals? How about orderlies with 2 or 3 months of training? Would two male 16 year old high school students be professionals, or the male receptionist they use as a chaperone during your pelvic exam? Are salesmen medical professionals? Are everybody that wear scrubs considered professionals and beyond reproach?
There's no doubt about the importance of removing your clothes for needed medical examinations or treatment, the question is are "assistants" or chaperones actually necessary? Should the most embarrassing procedures be done by the least educated people? Is it really necessary to take off all of your clothes for certain procedures? Should the patient's opinion matter to the professionals? Should the "professionals" have the power to decide the importance of a patient's religious beliefs or cultural taboos?
Tammy, have you ever given a thought to what men go through with all of the examples I've given? And this is only the men's side of the argument. I imagine most women would also disagree with you.
Tammy:
Whether gender is relevant or not, and to what extent, is the patient's decision, within reason.
If it isn't, then patient autonomy means nothing. At the very least, caregiver gender becomes a discussion point between the patient and the caregiver. Perhaps the discussion can help solve the issue. If the "Gender is not relevant" maxim is a rule
within hospitals, then it should apply to both genders. If one gender has a choice, then so does the other. Of course, one's health and safety is of paramount importance. But the degree to which gender and patient comfort affect the psychological state of the patient is not a fixed sum. It varies from patient to patient. Our psychological health can dramatically affect our physical health. In our culture, gender matters in many areas. I doesn't just cease to matter when we enter the hospital. For some it's a non issue or less of an issue than for others. But gender is always out there to one extent or another.
Doug/MER
I am a thirty-something year old male and I readily admit that my modesty concerns are greater than most people's. I will not use locker rooms or even public restrooms. To me, the issue of whether I receive intimate medical care from males or females is irrelevant -- the thought of either horrifies me. I am in a high risk group for colon cancer but have refused colonoscopies. Today I learned that I might need an angiogram, but will only consent if they can approach through the arm or neck. Fortunately, here in Australia, the gowns that seem ubiquitous in north America are really only used for times when practitioners really Ned access to those areas -- disrobing is not routine here.
-- outlier
I can cetainly understand that if a person/patient/customer believes that caregivers are exceptions to normal ethical societal standards then gender would not matter to them.
And I can understand that if a person/patient/customer believes that no human being is an exception to normal ethical societal standards then gender is going to matter.
I know this is simplistic black and white:there is some gray involved, but I think the point is served.
My problem would be a caregiver setting THEMSELVES so far above societal standards that my belief about my own body is either an inconvienient truth, or a petty barrier standing between them and their paycheck.
Patients do not hold a lesser place in society because they happen to be sick, and caregivers do not hold a higher place because they may be able to help. We all exist on the same food-chain level in society.
We need to look at the fact that most societal ills stem from someone believing that the rules do not apply to them and they are beyond normal ethical societal standards.
Here is a link I found while surfing. It's about nursing.
Link: http://www.rch.org.au/won/index.cfm?doc_id=6227
Just read the story of 'Jodie Palmington (First Prize)' in the section of ' Winners of the Funniest Moment Competition'. It seems that many nurses enjoy humiliating and abusing male patients. Just change the genders in this scenario and see how it looks. It's a kind of female perversion, I guess. Don't forget that this nurse got the first prize!!!
Even if we assume that the story is a fake one, should nurses crack jokes like these. If a male nurse or a male doctor says something like this, will it be ok ??? What is worst, this has got published on the official website of the RCH.
- Anonymous100
With regard to the experience of Jodie Palmington, she got to stay a weekend away in Mildura staying at the Grand Hotel and a hot air balloon flight, for her cold spoon experience. Other nurses seem to have 'enjoyed' her experience too. See section 'RCH: International Nurses Day Celebrations' on the same link.
All this looks very disturbing.
( For your convenience, the link is:
http://www.rch.org.au/won/index.cfm?doc_id=6227 )
- Anonymous100
outlier,
If you're talking about coronary angiography, it can be done via the brachial artery in the upper arm. The femoral artery in the groin is preferred because it is a larger vessel. Talk to the doc & tell them it's the arm or nothing - hopefully they can work with you....
Tammy
On top of all the arguments
presented,I want all females to
join the military. Carry an M-16
with a 60 lb backpack on 7 mile
marches.
Don't forget the nude physical
you would get in front of non-medical male clerks leering at you
if I had my way.
PT
Dr. Bernstein
I have been following this blog for some time and I have found it really good and educative. I had posted a link regarding inappropriate conduct by nurses on 22nd October, 2010. But my comment is not visible on the blog. Did my comment violate the terms and conditions of this blog or is that topic simply out of scope of discussion of this blog?
On the other hand, I would like to know whether you have visited that link? If yes, then what is your view regarding the conduct of nurses?
You are an authority in medicine and bioethics. So your views will be very educative to me.
- Anonymous100
PT,
Your goal to hurt others to get even only hurts you in the end. You cannot (nor can anyone) find a means to an end with bitterness and revenge at it's route.
Fairness, kindness, compassion will always win out.
If you work in the medical industry and they did profiles on employees that should be mandatory, you would not be allowed to work in that environment. Would any woman knowing your mindset want to have you for someone to trust and depend on? Furthermore, you see no problem ignoring the credo, "to do no harm". You, therefore are unqualified to work in healthcare.
gd
"Don't forget the nude physical
you would get in front of non-medical male clerks leering at you
if I had my way."
I would hope that NO ONE ever comes to this blog, reads this, and thinks that the last effort in advocacy is vindictive vengeance.
swf
Maria you can be enraged if you want to but if you go back and read my post you will notice I said I, it was a statement of how I view the situation for ME i did not impose it on others. I am a very average 50 something man. I doubt any nurse has thought va va va voom what I would like to do with that average looking, grey haired, average equiped guy". I did not say they didn't have those thoughts, I am not stupid, I said it wasn't THE issue for me. Not sure what profssion you are in but it sounds like it could give you and I different perspecitives
Tammy, the others, especially Doug/MER have said it very well. There are several issues that would challenge your statement on, some are already stated by others: (1) why does medicine think THEY have the right what should or should acceptable for patients, the medical part is your expertise, what we should or should not think is just your opinion. (2)Medicine has reduced the practice of providing same gender for the benefit of their bottom line, not for the benefit of the patient, where have male orderlies gone? (3)While there are truely some cases where gender choice is not possible, most cases are just plain its easier for providers, so it isn't can't its won't or don't without even considering what the patient wants. (4)Go real the allnurse post and see who hypocritical SOME (a significant number) are about exposure when they are the patient, the ask and get extra consideration, they throw a fit when asked to wear a bathing suit or shorts to class to practice bedbaths etc. (5) as a male i feel there is blatant sexism in how males are treated in this area. There are many things we tolerate against men that we do not females as a society, medicine include ie female reporters in lockerrooms, different rules for prisons based stictly on gender etc that carry into medicine.
The concept is promoted by medical people for their own benefit and ease not for the patient. Female reporters use the mantra we are professionals, yet they do not really have to have any degree or even an education to be a reporter. how then did they become professionals entitled to enter locker rooms and view naked men....they declared themselves as such. While medical people may have degrees, and even at time an absolute need, they have expanded, I would say abused that to meet their needs, not the patients....alan
I apologize for the delay in the publication of some of the comments in the past 5 days. I have been attending the American Society for Bioethics and Humanities annual meeting in San Diego, CA and I know I had missed some but I was distracted by all the medical ethical issues I was learning about besides being away from my home computer.
I will review the topics presented and see if I can find discussions which would be pertinent to this thread that I might write about. Keep posting. ..Maurice.
gd and swf
You are missing my point in that
I'm advocating equality for all women. Women want the same opportunities as men. Therefore,I'm
saying yes and absolutely.
Join the military,serve on submarines and engage in combat.But
remember though to do that you must
walk in our shoes,experience what
men have experienced and that was to parade nude in front of non-medical clerks if indeed you wanted
to serve your country.
Remember that went on for almost
40 years at about 65 afees and mep
centers in the united states.These
were non-medical clerks so we haven't got to the hospital stuff yet!
PT
"Fairness, kindness, compassion will always win out."
Yeah, it's worked great so far. Women didn't get what they have today by being kind and compassionate. They got it by whining, protesting and refusing to do what men wanted them to do. All that kindness and compassion by the male patients will do is feed the female healthcare workers already strong egos and make them believe more than ever that men are OK with being treated the way they are. Changes aren't made by being soft and gullible. Women learned that many decades ago.
I agree PT. If women want true equality so bad they should understand ALL the aspects of being a man, good and bad. I admit I don't understand 100% of what it's like to be a woman, and I thank God I don't have to go through a pregnancy. But it seems women want to be treated equally or more than equal with all the positive benefits of being a man, but want nothing to do with all the negative aspects.
Most women alive today in the USA have had the ability to choose nearly all of the hospital staff (as far as gender) throughout their lives. I'm not saying that every woman has fought for and won all female staff but if they have the guts to demand females they usually get them. I know there are thousands of women that have very embarrassing experiences every day but that's just a fraction of the millions of men that tolerate them every day.
I think what PT wrote makes a lot of sense. If women want so bad to be treated like men in the military they should experience all the misery that men go through, starting with the humiliating MEPS physicals. If female reporters think they're entitled to go into men's locker rooms to watch the men shower they too should be forced to shower in front of men. That would be equal, right?
PT,
You seem to fail to realize that while men and women might be equal, there is a psychological difference in the way women perceive humiliation and/or cruel and degrading treatment.
Studies show that women have a higher degree men of Post Traumatic Stress Disorder and that their sense of modesty in some cases is different and when damage is done, it can be more harmful.
I'm not saying for one second that men aren't damaged, or that they don't feel humiliation. What I am saying is that studies do show that women suffer psychologically at a higher rate then men of similar experience. This could be for a number of reasons.
While boasting equality in abusive behaviors may seem acceptable to you and a way to justify it, I find your attempt at equality to be blatantly adversarial and in no way a platform to demonstrate equality.
Men do deserve EVERY consideration that women deserve, however, that equality should never be at the expense or equal abuse under the law.
gd
gd I agree with much of what you say. I do however believe PT has some logic in his statements, it is however lost in the aggressive manner in which he presents it. Again not medical but a lot of similarity. If we demanded that the locker room policies with reporters had to be the same for male & female atheletes there is a good chance the policy would change as I don't think female atheletes or society would allow the current policy to happen in female locker rooms. That said I absolutely do not think the answer is to impose pain on females becasue it is imposed on men. I think we need to work for positive results, not to say we can not use the arguement of sexism or discrimination in health care to achiveve that, but it needs to be used with caution and not to be punitive. Female patients are not our enemy, they are not the ones responsible for the problem. Inflicting more humiliation on them will not lesson men's humiliation. We can achieve more working together.
gd, I have not read your study but I would be very careful saying the impact is less on men. We are trained, forced, taught to hide that humiliation from the time we are little more than females. It could easily be that the humiliation is just kept inside more than it being less truamatic. The science of the mind isn't an exact one. Minds and people are so different its pretty difficult to make these assertions and then prove or disprove them, they are mainly theory. At one time it was widely accepted that African Americans didn't feel like white Americans so we could treat them differently, seperate but equal, all were justified with the belief that it was OK. I recall reading an old study in my psych class in college where it was determined females were to emotional to be good leaders. At one time it was felt women weren't intelecually capable of voting. There are many many places where women are still not treated equally, they still have a ways to go before they reach equality. Respect for modesty is not one of those areas, men are on the short end of that. Saying it might be becasue its more serious when it happens to women might be considered a little sexist. It could easily be like the stockolm syndrome, when a person feels they have no control of their destiny they begin to side with the captor, knowing we can't change our lot, we might be just downplaying the severity...i know for a long time I acted like it didn't matter and it really caused me a lot of anxiety, know one knew how severely it affected me....alan
Dr. Bernstein, I hope you will share what you learned at your recent meeting of the American Society for Bioethics and Humanity. I would be interested to know what the top medical ethical issues are.
thanks!
30 something Australian guy, would you be willing to tell us more about why you feel this way? The docs and nurses saw you when you were born, your parents bathed and changed you, a daycare worker changed you, a pediatrician saw you as well. You managed to get through all that, why is this an issue now?
Tammy
"gd and swf
You are missing my point in that
I'm advocating equality for all women. Women want the same opportunities as men. Therefore,I'm
saying yes and absolutely."
PT I get your point, as I have gotten it every single time that you posted it. I have responded to you one hundred times on that very point, and I quite frankly thought we were beyond the mob-mentality.
The only equal opportunity your post seeks is that everyone has the equal opportunity to suffer the same pain as each other.
Most of us seek all things better for everyone, not all things bad so we're even.
I have often said everywhere that if my gender caused pain and humiliation then I was ashamed for us, and sorry for those men who suffered.
If knowing that I carry different nightmares than you, and at the hands of men, would you finally be vindicated?
Fine. Then know that I suffer as well as you. But unlike you, I do not wish it for you. And certainly not all men thereafter.
Can we drop the need to get even and just carry on with the need for change???
swf
Alan,
Thanks for your comments. Let me be very clear. I never said the impact was less; just different. And...that implications for those differences manifest in different ways. I, in no way am I suggesting that this issue is less important nor less impacting, just different because we as people (and within our gender groups as well) are different.
What the research showed that certain types of trauma impacted women differently than men and there was a higher propensity for ptsd in the female patients. This is not my study. I will search my notes for the source and supply a link.
Again, I support advocacy for everyone. And...it's not to say that the ramifications of humiliation for men are not more damaging in other way to them than they might be for women. This is a very complicated issue.
Was recently at a doc at a major teaching hospital and he gave me an article on perceived sexual assault in the ICU when patients are on certain drugs (like tranquilizers, etc).
One example was a woman getting a perneal bath and the other was a man getting a rectal intubation. What is so interesting is the absence of informed consent and the absence of the gender of the medical provider during treatment. I wondered about the gender of the patient vs. caregiver. Also, it was indicated that nobody else was in the room at the time, so, nobody really knows what happened. What we do know is that both of these patients filed complaints.
It's time the medical profession got out their Title VII rules from the civil right's act and did some reading and adjustments on what is a bona fide job qualification and why healthcare feels it's immune to patient privacy.
gd
as my daughters would reply OMG Tammy are you serious. I would bet as a baby there were times when you ran around toppless infront of others, are you ok with that now? You let others change your diaper would you let a friend of the family change your underwear now. That is an ridiculous comparison. Even more to the point, you were just fine being around your father naked before, and him around you, you still ok with that?...
Tammy makes yet another error in reasoning. She compares the nakedness of a newborn infant, a baby being bathed, a diaper changing and a toddler being examined by a pediatrician -- she compares these activities to that of a fully grown adult's feelings.
That's not logical. No one's arguing (at least I'm not) that cross gender care for infants is questionable -- at least females taking care of male children. That's a cultural and historical fact around the world. Interestingly, some will argue against males taking care of female babies or toddlers in certain contexts, not without some valid concern -- but still, a sterotyping of men as a group.
Tammy -- Mothers bath children, males and females. Most young children don't tend to feel embarrassment or modesty in the sense we're talking about it on blogs like this. At a certain age, however, both male and female children don't want to be bathed by either father or mother -- at least in our culture. At a certain age, children want privacy when the dress or perform other private activities like going potty. As we become adults, in our culture, we have separate public bathrooms and showers, separate changing rooms, etc. The right to bodily privacy is embedded in our culture. In fact, in our culture, we can be overly modest openly. That's accepted generally. But we can't be exhibitionists. That will get us arrested.
I would like to hear more explanation of your point of view because it appears intolerant. Are you not tolerant of other people's feelings and values? Most people on this blog who have issues with their modesty in medical situations don't object to you or others not having modesty issues. Why is that you object to their preference? Why not live and let live?
Doug/MER
The 30 something Australian guy stated the thought of receiving intimate medical care from either males or females horrified him. I was trying to point out that he had already received care from both genders in the past. So if neither gender is acceptable now for "intimate" exams or treatments and he starts having a prostate problem in 20 years or so, where does that leave him? So again I ask, why does he feel this way?
Tammy
Well said Doug, I also would like to hear your point Tammy. And not meaning to be confrontational. Doug is right on the money with his question, medical staff are experts in the physical, yet you project what we should be feeling emotionally at the doctors. Why do you think a person who has conver for thier modesty should just bury them for the sake of medical staff's convienence and wishes vs medical staff asking and attempting to make the patient comfortable. It is one of the few businesses, and it is a business that expects its customers to conform to them vs the other way around.,,vs the other way around...alan
re: Anonymous100's post, the medical community is very harsh and judgmental of patients who have what they perceive as “self inflicted” ailments like obesity. If you are male and obese, look out, this is what they may think of you (from allnurses) “I had a guy with a penis that I could not find. It took me a while and the help of a couple of people to find it. When his wife came up to see him she was really big also. I asked her how many kids they had....8. There was NO WAY that little penis was responsible for those 8 kids.”
http://allnurses.com/general-nursing-discussion/things-youd-love-267763-page99.html#post3459574
Do you realize that this thread on patient modesty has been going on for over 5 years?? It all started with the posting of the thread title "Naked" and reference to the "New England Journal of Medicine August 18, 2005 issue with the article 'Naked' by Atui Gawande. M.D. Dr. Gawande is two years out of his surgical residency and has had the opportunity to talk with physicians who have practiced in other cultures around the world describing how the concern of modesty is handled in their country. He also discusses his own initial reaction about how he should examine a patient with strict attention to patient modesty such as avoiding the patient using a gown and simply or not so simply moving around the clothing. This action clearly became awkward and he resorted to gowned patients. Finally after noting the real professional problems of physician sexual misconduct but also false patient accusations due to misinterpretation, he concludes that explicit standards of what is a 'normal' physical examination be set up or tightened so that both doctors and patients know and better doctor-patient relationships can be established.
I would be interested regarding what experiences you have had either as a patient or as a physician/nurse in the area of patient modesty and how the situation was managed. No names please. "
Obviously, what is considered a "normal" physical exam is yet still in the eye of the beholder. One can argue that the need to provide the medical treatment asked for directly in a routine exam or implied by the patient in an emergency trumps any modesty issues. But it is clear on reading the responses on this thread over the past 5 years that to some patient's modesty may trump all needs for routine or emergency treatments. And this applies even if the patient is unconscious by disorder or by anesthesia. How can a patient express to a doctor or medical institution their own view of the modesty vs therapy relationship and the requirement for this view to be accepted and followed? I see individual communication as the only way until standards of practice are changed and laws defining legal duties toward the patient are strengthened. If there are monetary expenses associated with these changes, I see only inertia. It will still be up to the individual patient to speak up. ..Maurice.
swf
Most nurses hate their jobs and many more than that hate nurses.This is a rather interesting
blog on this subject.
http://predatort.blogspot.com/2007/07/i-hate-nurses.html
More women should be on submarines,aircraft carriers and
bomber aircraft as well as carrying
m-16's in afghanistan. More women
should be in the airconditioning
repair business and roping bulls.
If this becomes the case we'd
have less women in the healthcare
business and a more equity tuned
society.I'd certainly feel more
comfortable not only in my bed at
home but in a hospital bed as well.
PT
We agree on two things PT. I talk to many women who hate female nurses. Their reasons are usually because of their perceived automatic intimate access to their husband's body. The lesser seems to be how they were treated themselves.
And yes...if less female nurses mean more male, then everyone would have more heathcare options.
That is, after all, one of my strongest advocacy points.
I find that whenever the gender wars stop here, we actually agree on much more.
swf
does what I interpet as medical hypocracy, an us and them mentality, or a do as I say not as i do mentality of providers have anything to do with this discussion with others. For me personally it plays a significant role. For example if you go to allnurses there currently is a thread about invasive pre-employment exam in which they refer to a cbc test which I took to be a blood screen. A week or so back it was about what they called a "bizarre" practice of asking students to wear shorts or swim suits to practice bed baths. To me, I am offeneded (not exactly the right word to discribe my feeling) that when providers are put in the shoes of the patient or anywhere near many have this really different view of what is and isn't acceptable. The argument was going back and forth where students felt it was unreasonable for them to have to wear shorts/swimsuits and practice a bedbath but think it is perfectly fine for them to learn on a naked patient with a supervisor watching. to me it was so ridiculous to think wearing what you would to the beach or gym was worse for them than a patient being naked infront of two people. None of the arguments including the clothes and the fact that this was a learning experience for them, not a benefit to the patient convinced them. When I read about them getting special consideration ie being able to choose staff, extra clothing, etc. really makes me distrustful of them and creates an us and them scenerio in my mind. does anyone else feel this way, or is it just me?....alan
I dated a nurse and we were in a car wreck. Her foot was crushed. Bleeding very bad and broken, she was screaming "please dont let them strip me down" . i didnt understand at the time but quickly i came to realize why. my father had surgery and when i came to see him a female nurse was putting a catheter in him. just her no male staff in the room. does that happen to female patients with male nurses? im new to all of this but i do have an opion. i was that six grade boy that had sex relations with a female teacher. i like many people who have been molested woould relive a lot of feelings again if that were to happen. I don't understand why its so hard to grasp for some. No one touches or sees me unless I'm okay with it. Period. Why is that so wrong?? If my father doesn't care that's his choice. It's my body. If I remember correctly isn't there a slogan " a woman's choice". How about a man's choice.
Jade
"When I read about them getting special consideration ie being able to choose staff, extra clothing, etc. really makes me distrustful of them and creates an us and them scenerio in my mind. does anyone else feel this way, or is it just me?"
Exactly what I think alan, your entire comment. How can they be such hypocrites? It's perfectly obvious they understand modesty, dignity and morality and even take it a step further by refusing to wear shorts and tanktops. Do they really believe themselves to be so much higher than normal humans? Do they think we "norms" don't have the same feelings, or do they consider us nothing more than objects so our feelings are irrelevant? Reading posts on allnurses where the nurses get offended at the idea of wearing swimming suits to class leaves me literally speechless. Well, I for one will never be one of their teaching dummies.
I am the guy that will live a short life and die a painful death rather than be abused by female nurses, but even I find it acceptable to be seen by female nurses in my bathing suit.
Jade, thanks for relating to us your first hand experience of nurse hypocrisy. You as well as everyone that disagreed with Tammy's comments make a good point.
LG
Hi Tammy. I have absolutely no idea why I feel the way that I do; and to the best of my knowledge it's not the result of any bad experience in the past. I do know, however, that I have felt this way since as far back as I can remember -- from primary (elementary) school at least. So it's not a problem just "now". Also, I don't think that comparisons to situations that were not under my control or that I can remember are helpful at all (but neither am I offended at all). As for prostate trouble in the future -- I guess I'll just have to suffer if it comes to that. I can't imagine it could be worse than the alternative!
-- outlier
I am not trying to condemn or beat providers up. I do not think many of the things we see happening being done with malace, I think they genuinely feel it is not hurtful to the patient and the situation is different. However, the problem we have is providers giving care as THEY see it should be delivered. While it would be foolish to argue they type of care ie which medicine, how to do a procedure, how and when to operate on a patient, how they treat a patient should at least be considered from a patients perspective. Some interesting insight into this can be seen at allnurse if you look at the current thread titled culture change. Bascially the topic is a nurse complaining that her facility is switching to a specific type of model which focuses on patient wants and requests. There are items such as keeping the caregiver constant for the patients comfort etc. There is a conversation about who the administration should be most concerned about, the wants and needs of the patients or of the nurses. To us this would seem obvious. I run retail, the customer first is pretty universal. The medical community however has evolved into a self centered, we know best for you attitude has been in place for some time, the don't ask don't question was in place for patients. As healthcare dollars become more treasured, that culture is starting to be challenged. Resistance to that says a lot to me as to why we have this issue and it relates to what I asked earlier...an us and them mentality. There is even one post who blatantly says she doesn't want to be friends with patients, she has more things to do...interesting and thought provking read, the challenge is how do we strike that conversation on this with providers...alan
Hi Alan,
Very simply. Put it in writing. Give it to your providers and keep a copy with you. Take it to the hospital too.
Keep it simple. Give them instructions regarding your privacy needs. Tie their hands with statements about your conditional informed consent, your legal right to privacy and whether you want to provide an override or not for a family member in an emergency.
gd
Part 1 of 2
Interesting discussion, especially alan's comments: "does what I interpet as medical hypocracy, an us and them mentality, or a do as I say not as i do mentality of providers have anything to do with this discussion with others."
alan also writes: "current thread titled culture change. Bascially the topic is a nurse complaining that her facility is switching to a specific type of model which focuses on patient wants and requests."
As I see it, this is a culture issue. Medical culture, hospital culture, medical school culture, etc. vs. our society's cultural norms. Yes, some cultures become extremely inner focused. It's all about them -- we can call it "hospital-centric" or "medico-centric."
Look at how difficult it is for different cultures to communicate with each other, different nations. Cultures see things from their point of view and often disregard outside opinions and attitudes. This is a natural human tendency. Because of the special knowledge and special training of medical professionals -- and because of the extremely personal nature of the work they do -- it's not difficult form them to form extremely closed, cliques.
I've found that I often get comments like "It's perfectly natural" when caregivers talk about the nudity of others, or the embarrassment of others. But too often they don't want to talk about or discuss these issues because of their discomfort. When our society's norms come up against the hospital culture, there's discomfort. They see the disconnect but don't want to deal with it.
Within their culture, what they've been taught and socialized to believe -- other's nakedness is perfectly natural. In the past, caregivers have been taught to "give permission" to their patients to be embarrassed, e.g. it's okay to be embarrassed, a natural tendency to be embarrassed within this context. It's okay. That may work for some people. A good caregiver can make the patient feel comfortable. But this strategy isn't "the" strategy. It doesn't work for everybody.
Doug/MER
Part 2 of 2
Yes, alan -- there is sometimes an abyss separating different cultures. And the culture within big systems like health care varies from the toxic to the commendable. Conditions may vary from day to day depending upon the staff you're dealing with and how they relate to each other. We find this in all institutions, agencies, businesses. The stakes are so much higher in health care because they're dealing with human beings, their bodies, their psyches, their spirits, their souls.
Is there a solution? Don't really know. But I do know that savvy caregivers know what I'm talking about, and sometimes they just need to be reminded that the culture they're living within and advocating isn't necessarily the same culture outside the hospital. not the one embraced by their patients. When reminded, the good ones will adjust. That's why patients need to speak up and not be afraid. If, as caregivers say, this nudity and nakedness within their culture is all "perfectly natural," then it certainly should be "perfectly natural" and acceptable for patients to bring up the topic and talk about it and state their preferences. Even better, it should be perfectly natural for caregivers to be willing to be upfront with this issue, not hide the details of what will be done to patients who will do what. So often, these details are a part of another element of medical culture -- secrecy -- the "we know what's best for you to know..
Having said all this, I don't want to paint all caregivers with this broad brush. Over the years, I've had generally good experiences in health care. But I do know that when I haven't spoken up, advocated for myself, the culture just seems to take over and you just get what you get. And what you get can vary considerably.
Doug/MER
alan:
I agree with you about the 'us vs them' mentality. I only wish I could be as gracious as you when you say you believe there is no intent of malace. I have to admit...I really struggle with that one.
outlier: Very good post. I often wonder why people with modesty concerns are always put in a position to defend and/or explain themselves. For some there really was no defining moment, just a personal sense of their bodies that they view as common decency. For others, perhaps there was a moment, but they do not feel the need to explain or re-live it everytime they encounter a caregiver. No means no, as I see it.
Perhaps those who have no modesty could explain why and what happened to make them feel that way.
swf
Yes, yes, yes! The medical profession is a culture and except those of us teaching students medicine in medical schools who are attempting to update the culture, the students and later interns and residents are subjected to those "mature" physician teacher/supervisor/attendings who are derived from the "old established" culture and so the culture goes on..with some remembering what we taught them but others concerned to please their superiors or find the revised culture hindering their work will stick with the "old".
Yes, the medical culture includes the awareness of personal skills and knowledge, physician paternalism which is obstructed by the legal/ethical requirements for patient autonomy, the responsibility to make the diagnosis, treat effectively, cure the sickness and save lives. All this is involved in the culture including the fear of potential malpractice with its emotional, legal, financial and time-consuming results. Factors that seem to physicians to waste time and hinder the process may be ignored. And this is where patient modesty sits: it is hard to intellectually explain to some physicians how modesty can trump the need for diagnosis, therapy and cure.
As it is hard to change the views within religions, it is similarly hard to change the views within the culture of the profession of medicine. (But as teachers of the young students..we try.) ..Maurice.
Tammy, dear, get off your high horse and stop lecturing us on how we should feel. As for your comment about what happened when we were children and when we grow up, let me explain why it´s just plain nonsense: the genitalia is the body part that changes most (in both sexes!) after puberty, so "what your parents saw" is not "what you have now", not to mention that I'm female,have only one sister and my father left home when I was one and a half...
Sounds like you're a healthcare worker, aren't you? It's because of arrogant, insensitive and intolerant people like you that I eschew healthcare completely. These people that say "Gender doesen't matter" (usually females, sadly) are the ones that make thing relly harder for all f us, whatever our sex.
Of course, you'll never believe me, but I'll die a painful death ten times rather than being in the care of such an uncaring person as you. You won't get me honey, you're exactly the kind of people I don't want lying hands on me, ever.
I get Maria's point..but for this blog, please let us all write in a civil manner and avoid ad hominem remarks. ..Maurice.
Dr. Bernstein, this is a really interesting side trip. You'd think after 5 years we would have been there done that. Do you think that within the profession there is a recognition, perhaps even a justification of the us and them culture. I believe patients see it, but do you think providers do. i could easily see how providers could feel, we have the training and the expertise and feel justified in taking the "parental" position. After all, don't we tell our kids, because i said so, from the position that we know whats best for them. Is there any discussion or recognition from providers of this or do they think they are relating to us on an "equal" basis. It seems from what I read it is assumed by providers and taught to assume the position of "parent" for not only the physical, but the mental/emotional aspect...alan
Alan, of course, I am afraid that what has been going on here on this thread in past 5 years has nothing to do with completing the hopeful outcomes.
From my reading of the medical literature, I believe that there continues a trend away from physician paternalistic thinking (away from "us" and "them") but to a necessary equality, a need that I have been repeatedly supporting on a number of other threads on this blog. The playing field has to be level between physician and patient. The patient knows their symptoms and history and psycho-social status and the physician looks to this knowledge and the patient's cooperation and compliance to successfully complete the medical goal of relief of suffering and cure. The patient, on the other hand, needs the physician's knowledge and skill to accomplish those goals. Each party has essential contributions.
It may well be that factors other than most physicians are imperious and unthinking about their patients has led to the modesty conflicts presented here. There easily could be problems within the healthcare system that has to do with monetary issues, development of educational programs, encouragement of men into the nursing field and even simply habit and stereotypic thinking on the part of those who run the system.
The way either the patients or the doctors looks at each other,there should no longer be "us" vs "them" but there should only be "we". ..Maurice.
Dr. Bernstein, I think one has to sometime take those small steps as small victories. I think the first step is to get an understanding of the issues. For me one of the things I learned is I need to be involved in this process more than I thought I should. I thought automatically modesty would be at the top of the list, it wasn't, it was there but it was in the form providers felt appropriate. I learned that if I did not clearly artciculate what I wanted that was what I could expect. Once I started asking, I found that most of the time I would get what I asked for AND they were respectful and seemed to have no problem with reasonable requests. I think on my part I have learned a lot from this thread that will help me in the future. The challenges I see are determining (1) what is the mentality of the providers (2)how do we get our message to them in any sort of large scale (3)while I feel I personally have done some things that will help me on a local basis any really meaningful change will require a large organized effort which we don't seem to be able to move forward...alam
Dr. Bernstein pointed out "and even simply habit and stereotypic thinking on the part of those who run the system." Additionally Doug/MER said "As I see it, this is a culture issue. Medical culture, hospital culture, medical school culture, etc. vs. our society's cultural norms."
I believe we could easily say also "BECAUSE of our society's norms" in the sense that:
Women are often considered the sexually benign one in the room. The medical arena often tells us that men are visually stimulated (women not so much) and they must therefore exercise some control over intimate situations involving the opposite gender. We see this attitude often when explaining why females can be used for either gender in intimate situations, and chaparones should be used for female patients involving male care. However, recent studies on female sexuality are finding women to be as visually stimulated as men involving the nude form with physical arousal times virtually the same.
Perhaps it is time for society to reconsider female sexuality and stop the outdated stereotypes that women are physically maternal and only emotionally sexually stimulated. Men might have a better chance at modesty issues if society were honest about both genders, and stopped perpetuating the theory that woman can be used as mostly gender neutral.
swf
swf, I agree with that thought, I think the other factor that sticks out is women have been vocal about this and men haven't. If men start raising their voices and backing it with their feet the way women did we will change that. I believe a big contributor to this thinking was a response when they started chipping away and gender specific care they found out women voiced opposition, men didn't so they started using women for both, and needed away to justify it, becasue we can and its cheaper doesn't cut it. Becasue women don't feel the same is much more PC. That is starting to change, but we need to keep up the heat...alan
I was very dismayed when reading the "Acknowledgement of Procedural Consent" form from the LDS Hospital in Utah. Apparently we are forced to agree that photos and videos can be taken, we are forced to allow anyone to observe for educational reasons and non-medical professionals such as vendors will be allowed to watch. The Mormon hospital was my last hope in trying to find a place that understands ethics and morals.
Even more disturbing is a statement at the end saying "I understand the health care providers involved in my care, including those providing anesthesia services, may not be agents or employees of the hospital and that the hospital is not responsible for their actions or inaction." How can they do that? If they bring in other people the patients aren't even aware of how can they not be held responsible?
I had high hopes for the Mormons but even they can't be trusted to insure the safety, morality and ethics all human beings deserve. More proof that medical care is nothing but a business and patients are nothing but dollar signs.
I can't agree with the alleged hospital statement which is required of the patient "I understand the health care providers involved in my care, including those providing anesthesia services, may not be agents or employees of the hospital and that the hospital is not responsible for their actions or inaction." The hospital has credentialed the healthcare provider prior to admission to the staff and there are hospital standards of practice that all hospitals are required to certify to the Joint Commission are being carried out. All hospitals are responsible for what is going on with their doors. ..Maurice.
Obviously my opinion is unpopular with some here, disagreement often happens, but it doesn’t mean I don’t understand your viewpoint or I’m intolerant of it, I simply disagree with it. Thank you for responding “outlier” aka Aussie guy. So, for you gender isn’t the issue, it’s the nature of certain exams or procedures, the feeling of embarrassment or perhaps humiliation it causes? Being exposed just feels wrong to you? I’ll admit that many things in health care are yucky, awkward, and embarrassing, I understand that, but its temporary. The clinician examines you in a professional and respectful manner, your needed procedure/treatment is performed, you leave the doctor’s office and you move on with your life.
So how can the medical community address your concern when portions of the body normally kept covered in public simply must be exposed to diagnose the problem and the proper therapeutic treatment applied? Isn’t the answer to this last question the reason all of us are here?
Tammy
Tammy said
"The clinician examines you in a respectful manner,your needed procedure/treatment is performed,you leave the doctor's office and you move on with your life."
Just like that? What if it was not
in a respectful manner and what if
not by a physician but say a nurse,physical theraspist,radiographer,lpn,cna er tech or what have you.Then what Tammy? Then what?
PT
An author named Lars G Petersson, a Swedish-born Londoner, activist and trained nurse has written a book called "Medical Rape - State Authorised German Perversion". In it he describes the experiences of 17 year old German boys and what they go through in their pre-induction physicals they are all required to attend. I'm not familiar with the modern German military but it appears they still have a draft.
I haven't bought the book but there is a good description of it directly from the author at
http://www.larsgpetersson.com/military-abuse/in-english/
It describes in detail the humiliation of those young boys, examined mostly if not entirely by women and what effects it has on them later in life. In the contact section he gives an email address to apparently contact him in person. It might be a good idea to email him and invited him to check out this blog.
LL
PT,
You "hit the nail on the head". What I think we are all complaining about the range from disrespectful treatment to degrading treatment.
Some people on this blog simply have not had that experience. They don't understand it, don't even know what kinds of things would make someone feel the way that many of us do. Tammy is apparently one of those people.
gd
Thanks Tammy -- I think you understand where I'm coming from. For me it is indeed the procedure, not the gender of the provider. Probably the most fundamental thing we can all learn here is that people's individual sense of modesty lies along a broad spectrum. On one extreme are people who would be willing to be naked in front of anyone, anywhere (some naturists perhaps), then people willing to be naked in front of medical practitioners and intimate partners (you perhaps?), then people willing to be naked in front of practitioners of a particular sex and intimate partners (many people in this thread), then people willing only to be naked with intimate partners (me), and on the other extreme people unwilling to be naked in front of anyone ever. This is no doubt an oversimplification, but I guess it would cover most people, and would probably follow a bell curve. I fully appreciate that my position is that of a small minority. However, I suspect that your position of being equally comfortable naked in front of practitioners of either sex is probably a (larger) minority as well.
For the sake of empathy, I wonder if you could imagine a situation that you would find deeply, deeply humiliating and degrading. If you were placed in that situation -- even for a very good cause -- how easy would it be for you to just "get on with your life" afterwards? What lengths might you go to in order to avoid such a situation? I think that there are probably situations that most people would find so very degrading that they would be willing to undergo physical pain or even death to avoid, even if the degrading experience carried no threat of physical harm. It so happens that for me, being naked in front of a person outside an intimate relationship is one such situation. I don't expect you to understand that or relate to that, but if you can think about what might make you feel humiliated, you might be able to empathise, at least in part. I'm worried about the word limit, so I'll answer your other question separately.
-- outlier
Tammy, you asked what the medical community can do to address my concern about uncovering parts of my body normally kept covered in public. Unfortunately, for me, the answer is probably "nothing." However, most people's modesty concerns are not nearly as extreme as mine. Reading back over this thread, it seems that most people's answer to your question might be something like:
1) is it absolutely, positively necessary to uncover this part of the body? Obviously, this is the case for anything specifically urogenital or involving the lower digestive tract, but in other cases (like cardiac angiography) there might be an alternative approach or even a completely alternative treatment.
2) if it *is* absolutely necessary to expose these parts, how can the practitioner minimise or mitigate that exposure? The answer here might include limiting the time of exposure, the physical surroundings in which the exposure takes place, the number of people around, and perhaps even the sex of the people around. In the case of a dire, life-threatening emergency, a practitioner may have to ignore any or all of these considerations. In the case of routine, planned procedures, attention to these considerations could help a lot of people, even when they impose inconvenience on the provider.
3) understand and respect the fact that some people might sometimes decline a certain treatment under certain conditions because their sense of modesty precludes it. It might be silly or unfathomable to the practitioner, but this is a very real experience for the patient, and in the end it's the patient's prerogative to refuse treatment for any reason, or even for no reason at all. Above all, saying to a patient "I've seen it all before" is deeply insensitive and patronising; the patient is concerned for her or his own modesty, not the modesty of the practitioner! ;)
-- outlier
Tammy
I might have missed it, but did you ever answer the question of are you involved in the medical profession? It would be interesting for perspective. As outlier indicated there is a wide spectrum of peoples positions on this, I think there is even a greater spectrum of reasons from upbringing, to life experiences, to loss of control, to feeling disrespected (paternal attitude by medicine). There are several things that drive my feelings, mine is largly gender driven. I get really wired over exposure while I am awake, but not so much as when I am out, others don't agree with that. I also have a lot more anomosity when I feel the exposure is more from don't or won't accomodate than it is can't accomodate. It is also driven to a great degree by my feeling that many times these instances are caused by the medical community feeling their time and convenience is more important than my concerns for modesty. If I need a scrotal ultrasound, most likely I will not be asked if the gender of the tech matters even when both are on staff. The fact that providers would not take that simple step of asking to me tells a lot. I believe they fully understand this is an issue for at least SOME of their patients, but don't make the effort to ask becasue it is easier on them if they don't. That sums up a lot of the problem for me. Who decided that providers are gender nuetral? Providers did for their, not the patients benefit. would you accept a male janitor cleaning the locker room while you showered as long as he was respectful and professional about his work? Of course not, he isn't a professional right? Does that mean he is less ethical, less able to do the task without threat to you, less able to make the experience less of a sexual event and more work or professional in nature. Being a nurse or other provider does not give you magical powers that the rest of society does not posess to transcend being human and different from the rest of us. So for me I have real problems with the medical community deciding for me that even if they have the ablity to provide what I want and feel is important to me, I don't get it becasue they have decided it isn't or should not be important. That is not a respectful relationship that is a co-operation of the two parties, that is one taking the position that they have the right to dictate not only what they need for their physical being, but for their emotional being. alan
Tammy
I might have missed it, but did you ever answer the question of are you involved in the medical profession? It would be interesting for perspective. As outlier indicated there is a wide spectrum of peoples positions on this, I think there is even a greater spectrum of reasons from upbringing, to life experiences, to loss of control, to feeling disrespected (paternal attitude by medicine). There are several things that drive my feelings, mine is largly gender driven. I get really wired over exposure while I am awake, but not so much as when I am out, others don't agree with that. I also have a lot more anomosity when I feel the exposure is more from don't or won't accomodate than it is can't accomodate. It is also driven to a great degree by my feeling that many times these instances are caused by the medical community feeling their time and convenience is more important than my concerns for modesty. If I need a scrotal ultrasound, most likely I will not be asked if the gender of the tech matters even when both are on staff. The fact that providers would not take that simple step of asking to me tells a lot. I believe they fully understand this is an issue for at least SOME of their patients, but don't make the effort to ask becasue it is easier on them if they don't. That sums up a lot of the problem for me. Who decided that providers are gender nuetral? Providers did for their, not the patients benefit. would you accept a male janitor cleaning the locker room while you showered as long as he was respectful and professional about his work? Of course not, he isn't a professional right? Does that mean he is less ethical, less able to do the task without threat to you, less able to make the experience less of a sexual event and more work or professional in nature. Being a nurse or other provider does not give you magical powers that the rest of society does not posess to transcend being human and different from the rest of us. So for me I have real problems with the medical community deciding for me that even if they have the ablity to provide what I want and feel is important to me, I don't get it becasue they have decided it isn't or should not be important. That is not a respectful relationship that is a co-operation of the two parties, that is one taking the position that they have the right to dictate not only what they need for their physical being, but for their emotional being. alan
alan:
I could not have said it better. I think you speak well on the behalf of some (many?) here.
And you were correct in the above post: Men need to put their money where their modesty is. Speak up to make the same changes women did, and as you said....keep up the heat.
But even as a woman I see female hypocracy playing a large role.
My url changed when my computor crashed, so on :
http://patientmodestysolutions.blogspot.com/
I attempt to take us (women)to task. I ask women to look at themselves and ask why we want society to see us both ways: as strong yet weak/sexually bold and sexually harmless. How long can we have it both ways? And as long as we do, we do a disservice to men in healthcare, because 'both ways' gets us our modesty AND allows us to keep our jobs not honoring men's modesty.
Am I too harsh on my gender?
swf
Tammy, dear, don't speak for everybody here, a significant amount of the population, and people who "never care" are actually fewer than ours. The cause of our grief (yes, I'll call it that) is the distorted thinking of people like you. No I'm not insulting anyone, I am just stating a fact. that insensitive and callous healthcare workers of either gender is the reason why some people want nothing to do with the industry at all. by the way, since EMTs are concerned about cervical cancer and now many of them (about 60% male) have no qualms about trying to co
rner women to have a Pap tests at their own homes, so they cannot easily go away, I ditched the very last health service I had and I'm not looking back. I am not feeding their mouths if they behave like that.
When somebody you trusts not only trests you in a disrespectful but degrading manner (and even makes it clear that the whole thing was on purpose), you really are never the same again, especially females that had already been sexually abused in childhood. You relieve everything and it's ten times worse, because this person does know what he/she's doing...
Lastly, any medical personnel that says "I've never had anyone refuse intimate care to me", especially if it's an older man is
a)lying
b)giving you a guilt trip
c)trying to exert as much power over you as you can
c)showing you how uncaring he is and how insignificant you are
d)if he really cannot fathom the fact that he isn't going to see you naked, he maybe even be lecherous as well.
I think alan has explained it pretty well as it applies to quite a few people. It's more about attitude. Attitude then affects the whole modesty issue. If patients feel they are treated as objects, that time and money are more important than their feelings, values, dignity -- then that attitude tends to augment the whole modesty issue. If patients feel the reverse, if they feel that they are being respected (by being asked permission, given gender choices, etc.), then that attitude may help to mitigate the modesty issue. On the new blog Dr. Sherman and I have started, I've been writing a series about a study called "Not Just Bodies," which explores strategies doctors and nurses use to deal themselves with their attitudes and values and feelings about dealing with bodies. Some of these strategies, although they may help the doctor or nurse get through the exam, can be very detrimental to the patient. Other strategies can be extremely empowering for the patient. Much of this depends upon the caregiver's empathy and communication skills. For me, that's the key.
Doug/MER
Tammy, posted to soon. I also wanted to encourage you to not get discouraged in your posts if you are under constant "attack". Having someone challenge creates dialouge not just venting. It isn't easy taking the opposite position with such overwhelming odds, we have lost some very valuable people from the medical community. The other side is important. I think someone touched on this earlier, one thing that seems to come up often is the fact that those with modesty concerns seem to accept those who don't personal choice much more than the other way around. At one time people just accepted many of what we now recognize as horrendous practices before the civil rights movement. If they just accepted what the institutions handed out and moved on...what would have changed...alan
Dr. Bernstein
Its all right for the delay. Considering the amount of work you are doing, such delays are but natural.
In any case, thanks a lot for publishing my comments. I am looking forward to learn more from this blog.
-Anonymous100.
re: Anonymous of Monday, October 25, 2010 8:28:00 PM
"... the medical community is very harsh and judgmental of patients..."
I do not think the comment on 'allnurses' is just harsh and judgmental. Nurses are not supposed to be concerned about patients's personal lives. They have no business to do with it. Patients don't expose their bodies to nurses so as to get feedback about their functionality and looks. Patients expose themselves because they want to be treated for the particular medical condition/disease they have got admitted for and for which they are also paying. Of course, the relationship between medical professionals is not or should not be like that between a seller and a buyer, but surely there has to be a line somewhere. If a nurse finds some abnormality/condition in the patient's body which might need medical attention, she should definitely inform the relevant doctor. But otherwise, she has no business to do with the looks and functionality of her patients.
The comment on allnurses is just inappropriate.
On the other hand, the conduct of the nurses at RCH is most condemnable. I am tempted to use more severe words, but civility considerations prevent me from doing so!
Considering these and other incidents on this blog, it seems that the ethical standards of the female nursing community are badly deteriorated.
-Anonymous100.
I find myself somewhere between alan and outlier on the modesty scale. Unlike alan I believe modesty for an unconscious patient is even more important than when they are conscious and able to react. I don't stress out as much about what is happening around me while I'm conscious because unless I'm too doped up to be aware of my surroundings I know I'll be able to defend myself against unethical treatment.
What really stresses me out is being unconscious because not only would I be unable to defend myself and my principles, I also would never even know what happened to me and how many people witnessed my possible unethical treatment. As we have plainly seen through many examples on allnurses and other nurse blogs, to many healthcare "professionals" once we are unconscious we lose our humanity and are nothing more than objects.
Also unlike alan I would risk my life to protect my modesty/dignity/morality. But I don't go to the extent that outlier does to protect myself from male healthcare professionals. Other than those things I understand where you two are coming from.
swf, you are a freakin' saint. I hope you can convince other women to think the way you do.
GR
GR I think your post is indicative of the root of the problem, medical institution has taken a one size fits all approach to modesty. It is such a diverse spectrum of patients. They have chosen the path that causes them the least time, effort, and money. My personal is I do trust them, I am uncomfortable knowing I was seen nude, but when it is people I never saw, and will never see, it is easier for me to as tammy says move on. On the other hand, when I am awake I actually experience the discomfort and embaressment so I know exactly what happened and I replay it in my mind so its harder to just forget it. If there is one thing I have learned from this thread, if you want something you have to ask because they are not going to offer. They want your business, and they will accomodate if possible to get it, but if they can get it without changing their routine...they will. Tammy, hope you continue to comment, ny question still comes to this: You say they (You?) are professionals so we should just accept it an move on. I ask, if you truely care about me as a patient why would you not want to do everything in reason to make me more comfortable and the experience less truamatic. There are surgery shorts, colonoscopy shorts, bikinni cover ups, you might have the ablity to offer same gender....why would you not at least ask, and I have never been asked...do you think that approach is reasonable and patients expecting consideration for their personal view of modesty is unreasonable?...alan
Alan, your wiews are to be commended. As for swf, you're right on the spot, too, but much medical modesty violations are completely unnecessary and caregivers mess with people that seems defiant or that they don't like.
I had eyelid surgery and they put me under, something that I didn't find out until the very last minute. To insert the drip for the anesthetic, a (male) person, (nurse??? doctor's assistant???) was about to pull down the gown, which would have revealed the whole of my breast to the other two males in a team of six. I wasn`t going to spare his feelings, and shouted at him something that actually got inmortalized: Sir, do ya think you're married to me?
Can anybody in this blog explain the medical necessity of doing that, (rather than pulling it up, the way it was done, so nothing showed)???
This really happened to me in a clinic in the city of Buenos Aires on the 10th May this year, and it is well documented, (I filed a complaint about this incident.)
Thus the reason for those mistakes are insensitivity, and laziness if not plain rudeness.
There’s an amazing story of a nurse’s recent experience as a patient over on allnurses, complete with neglect, exposure to non medical personnel, CNAs falsifying records. She even mentions a male CNA, I didn't know those existed.
http://allnurses.com/general-nursing-discussion/my-day-patient-513097.html
Oh yes...the male cna's are busy trying to bathe 85 year old women in nursing homes against their will. There is much abuse in our nursing homes, hospitals, and yes, prisons
gd
I'm very curious to learn the percentage of male CNAs that bathe 85 year old women against their will to the amount of female CNAs bathing 85 year old men against their will. I also wonder if those male CNAs are as young as 15 or 16 and if they are trusted to be alone with the naked female patients.
My sister was a CNA at the age of 16 and was bathing older men alone, except when she needed help moving their practically lifeless bodies. She never saw a male CNA or an Orderly the entire 2 years she worked there. She's the type that defends most of what happened at the retirement home but admits that female patients were treated better and with much more respect. She also admits that most of the men were not happy being bathed and treated with so much disrespect by women and young girls but they had no other choice.
I won't say that the women patients should be abused and disrespected just as much as the men, I believe the men should be treated as well and given as much respect as the women. It's not the fault of the female patients (besides the fact that they complain a lot more) that the men are being mistreated, it's the fault of the nurses, CNAs and the management. They are those that should be punished. Why can't there be more laws to defend retirement home victims as well as hospital patients from cruel and arrogant nurses and CNAs (mostly women)? Are there no politicians, lawyers or judges that care about abused patients? Why won't anyone have the courage to step up? It's only us (nobodies) that seem to care.
Anonymous, there are laws to protect everyone including privacy laws. The problem is that they are not enforced, nor is there accountability or responsibility of the medical community to "turn in their own" or a policy of what to do with offenders.
I'm not sure the amount of male CNA's vs. female, however, that example was used because of the overwhelming statistics (whether real or based on who reported what). Elder care abuse is well documented and part of that abuse is sexual. There are violations of patients of both genders. What is the medical community doing to stop it? Virtually nothing. There have to be gross violations for anything to happen. There are countless of patients damaged by cruel and degrading treatment or treatment against their will.
gd
I recently watched a TV series called "Spartacus: Blood and Sand". While watching it I noticed how badly the gladiators in the ancient Roman empire were treated, and it reminded me of how I view the treatment of patients in hospitals and doctor's offices today.
The gladiators were taken to an unfamiliar place, their autonomy was taken from them completely, they were bullied by those in authority and were often forced against their will to strip naked in front of an audience. The wives of the men in authority were allowed to walk right up to the naked men to check them out and even fondle them if they wanted. The gladiators had no choice but to do what they were ordered to do. Occasionally someone from the upper class disagreed with the terrible treatment, but most of them joined in on the fun since these men were considered "less than human". To finally stop all the abuse the gladiators banded together and massacred all of their oppressors.
To me this story compares very well with how hospital patients are treated, disrespected, dehumanized and thought of only as a means to getting paid. Let's hope that the healthcare professionals realize their mistakes and make some serious changes before they receive the same fate as the oppressors in the TV series.
"Gladiators were tools for cruelty and entertainment"
Hmmm. For anyone who believes what they read in the allnurses blog and the Voy forums, cruelty and entertainment are very common activities with nurses and other hospital workers. I think gladiators and patients are more similar than you might think, or admit.
Many posters such as "Betsy RN", "Vera" and "Nurse Ratched" check in often and claim to be reputable nurses but they constantly brag about how much they exploit male patients (victims). Even our own "PT" often tells us of the victimization of male patients who he has personally seen suffer unneeded cruelty and humiliation at the hands of medical women, often for entertainment. I for one believe what he says. As for the others I've mentioned, they seem to know enough about nursing specifics and procedures to make me believe they have spent at least some time around hospitals, but I still take what they say with a grain of salt. But who knows, medical women seem to be able to get away with about anything.
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