Bioethics Discussion Blog: Patient Modesty: Volume 38

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Saturday, January 08, 2011

Patient Modesty: Volume 38

As of the beginning of this Volume 38 dealing with patient modesty issues, it is the beginning of a new year, 2011, and it is time for everyone to consider their own the New Year Resolution. Such a resolution should be that the individual resolves to a change in behavior or action which was not previously attempted or completed but is possible of being followed during the remainder of the year and beyond. So, now, what should the resolution be about as written to this thread?

Well, we are all patients or potential patients and we all, at some time will or have in the past, been involved in the doctor-patient relationship. So let's think of a New Year Resolution, pertinent to this thread of patient modesty that the visitor as a patient will resolve now to follow to develop or improve such a relationship. Of course, the relationship is not one sided and the doctor also has responsibility to make the relationship the best, towards primarily the interest of the patient.
But without the product of your resolve, the relationship may never be fully satisfactory. What do you think? ..and what do you resolve? ..Maurice.

ADDENDUM 1/31/2011: WE ARE PUBLISHED ON AMA NEWS!

I want to announce that Doug Capra and myself have had our article
published today in the AMA News (weekly newspaper of the American
Medical Association) website. The article is titled “What can physicians and patients do to improve the medical encounter?”
It deals with both the doctor and patient making a New Year’s Resolution, the patient to “speak up” to the doctor and for the doctor “to listen and pay attention to the patient.” There is a scenario where the doctor and patient engage in a colloquy with the main concern of the patient..guess what? Patient modesty!

Go to the website and read the article and then return and post your comments here or on Doug’s and Dr. Sherman’s website and maybe you could write a comment directly to the editors of AMA News. ..Maurice.

NOTICE: AS OF TODAY FEBRUARY 18, 2011 "PATIENT MODESTY: VOLUME 38" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 39.

149 Comments:

At Saturday, January 08, 2011 10:56:00 AM, Anonymous Anonymous said...

This problem is not only one sided. I once asked a trusted physician how they feel when a patient doesn't return. I wondered if it was taken personally, if they thought about the patient's well being, wondered why the relationship ended and what physician's can do to have a better emotional outcome for their work. The answer wasn't what I expected; cool, detached, a defense mechanism.

Today I base every relationship on trust whether it's a doctor's office or a procedure in a hospital. Tell them what you need, negotiate compromise when you can and if something doesn't go your way yell and scream it to the roof tops. This is not meant to be punitive as much as without the screaming, an individual isn't heard and when one isn't heard; all are not heard. Create a problem and everyone knows the issue, the remedy and the institution involved won't do it again. They don't want to have to deal with the backlash an negative publicity.

If every patient communicated their needs together with consequences of violation, emotional damage and the like, the negative publicity alone would have them reeling.

For all patients who don't do what's necessary, you are part of the problem enabling it to exist. I know that this is not easy, but nothing worth having comes easy and it wasn't easy for me. It came to the point when I didn't care anymore, and now the sky is the limit.

Knowing you're in control, telling them that you know the law and consequences of violating your wishes, isn't a bad thing; it's an informative thing. Without it, you are vulnerable.

I have found good communication in a productive way will open doors for all the same gender care you need and if they can't accommodate, go elsewhere, but...tell them you did and why. Tell them about all the money they lost and then you have contributed to getting what you need. That's feels good, it feels empowered.
gd

 
At Sunday, January 09, 2011 1:22:00 PM, Anonymous Anonymous said...

A very reasonable this issue on allnurses. Some of the assertions could be challenged -- but note that the idea of modesty accommodations for both men and women is generally accepted. As you study threads like this, you'll find that nurses and cna's will accommodate patients when it is at all possible. I believe they don't like to emphasize this because the feel it might backfire on them -- more people might ask. The message -- If you want accommodation be proactive. Check ahead, and when you're in these situations speak up. My contention is still that most of the time serious attempts will be made to accommodate you.
Here's the thread:
http://allnurses.com/general-nursing-discussion/how-do-male-525312.html
Doug/MER

 
At Sunday, January 09, 2011 5:37:00 PM, Anonymous Anonymous said...

I could not agree more Doug with a little caveat. I have asked for accomodation, and brought up issues and I can say that personally I have never been treated poorly for these efforts and for the most case been accomodated.
While I personally feel I should not have to ask, it is what it is and at this time it falls on us to be our own advocates until something changes..if it does. While I think we all would like to see some grandious organized effort to challenge the status quo..until then this and Dr Sherman's thread has helped equip some individuals to make this more managable...alan

 
At Sunday, January 09, 2011 9:07:00 PM, Anonymous Anonymous said...

Mer


Regarding that thread from allnurses. Most of the responses were
from males with the exception of a few. One of the responders,a female
who goes by leslie D seems to respond
to only foleys caths and anything
pelvic threads.Disturbing if you ask me.
I personally don't see the
relationship with accomodation and
this thread. Its not any kind of an
indicator or litmus test.
What is interesting though is
the ent physician in New Mexico who
had groped many male patients during
surgery.The story was posted on
allnurses recently. One female nurse
initially thought it was a joke.What
does that tell you,these problems are
not even considered.
I'd like to point out the recent
ruling with regards to the arizona
inmate and strip searches. Keep in
mind this case was not a complete
strip search in that he had his boxers
on.The court still ruled in his favor.
People are strip searched every
day in healthcare,trauma patients,icu
patients and radiation oncology patients to name a few. If you are
exposed to unnecessary viewing
personel then it is a strip search,alert or not. Military personel
undergoing an induction physical were
strip searched when unnecessary observing females were present.


PT

 
At Monday, January 10, 2011 5:24:00 AM, Anonymous Anonymous said...

Excellent way to explain it swf.


"Statistics show that 90% of sex offenders are male; it's as simple as that."

I think that so-called "statistic" is just part of the ever-present "double standard" in our society. Women do many of the same things that male "sex offenders" do but are never charged for their crimes, or even arrested for them. A very common excuse is that women are "motherly" or "nurturers", and would never intentially harm anyone. Many women know of that stereotype and take advantage of it. gd herself stated "it's all in the eye of the beholder". Unfortunately when the "beholder" is the American government women are almost always considered innocent and in any questionable incident they will usually be considered the victim.

 
At Monday, January 10, 2011 6:41:00 AM, Anonymous Anonymous said...

This may seem off-topic at first but it does concern patient modesty and rights. Though I don't agree with prostitution and will never take part in it, I don't understand the illegality of it. If you ask me, prostitution is less offensive than many hospital experiences. I've personally never heard of a female prostitute forcing her services on anyone, whether by deceit, by drugging the "customer" or by physical force that might include the assistance of other people.

Hospitals on the other hand do this quite frequently. When nurses, nurse's aides and some types of medical technicians do many of the same things a prostitute does to patients (victims) they use the excuse that it's "for their own good". Can you imagine a person that sexually assaults someone in the real world using the excuse that it's for her own good, and getting away with it time and time again?

Outside the hospital doors if you do the same thing that hospital workers do numerous times a day you will be charged with sexual assault, battery, kidnapping and sodomy, at the very least. Can you imagine if a man in the outside world informed a woman that he was going to strip her and play with her genitals, she said "absolutely not" and tried to resist, then he told her that she isn't able to think clearly at the moment and gets two of his buddies to hold her down and sedate her so he can assault her "for her own good"?

How about if a guy found an unconscious girl at a party and stripped her, shoved half of his hand up her butt and forced a tube into her vagina, all while several of his friends watch and take pictures. Could he use the excuse "We did it because you couldn't speak for yourself and we assumed you would want it this way"? I forgot to mention the professional camera crew that was invited to this escapade to document every part of it for a television show, planning to ask the girl's permission after it was all over.

Why do we lose our rights the moment we walk in or are taken in through the hospital doors? Why are hospital employees able to get away with so many things that normal human beings would be sent to prison for? If we're supposed to believe that all healthcare professionals are gender-neutral "angels sent from God" and everything they do is for the patient's benefit and nothing is perverted, why can female healthcare professionals get away with doing the same things that would get male healthcare professionals fired and thrown into prison? Why do humans (patients) born without a penis deserve to be treated with respect by these "angels" but those with a penis don't deserve to be treated respectfully? Why don't the angels in this magical world have to be held responsible for the same crimes that would get any non-angel convicted and sent to prison?

I would love to post these questions on allnurses.com to read some of their reactions (excuses and justifications), but the mere mentioning of these things would get deleted and I would be banned.

 
At Monday, January 10, 2011 6:57:00 PM, Anonymous Anonymous said...

Here's a blog from one of those gender neutral "angels sent from God". Note not a single comment calls this unprofessional.

http://juicynurse.blogspot.com/2009/09/penis.html

 
At Tuesday, January 11, 2011 8:14:00 AM, Blogger ~Charlotte said...

Anonymous, I just posted a comment even though that particular blog dated back to 2009. That is one of the worst things I have read by someone who is supposed to be a trusted health care "professional."

 
At Tuesday, January 11, 2011 2:37:00 PM, Anonymous Anonymous said...

I also posted a comment.
Hopefully she gets the message.

Chris

 
At Tuesday, January 11, 2011 3:09:00 PM, Anonymous Anonymous said...

My guess is that once this "nurse" notices the negative comments, if that is really her trade, she will be scrambling to hide all traces of impropriety. Nurses these days are defending their licenses for posting a lot less.
Once she notices....blog is gone.

 
At Tuesday, January 11, 2011 7:00:00 PM, Anonymous Anonymous said...

Its interesting that my comments don't appear as yet.

So as noted above, maybe she is getting the "message"

chris

 
At Wednesday, January 12, 2011 5:45:00 AM, Anonymous Anonymous said...

This person is more likely not a nurse. I'm surprise that this would be posted on this site
gd

 
At Wednesday, January 12, 2011 10:03:00 AM, Anonymous Anonymous said...

Have any of you read the entire blog? It isn't that long. Having read it, it seems to me that this person is a nurse. The "penis" article is one of many. There are another few articles I would question as far as appropriateness, but most posts indicate to me that this person is a nurse. I could be wrong. I'd appreciate if any nurses on this blog would read the entire blog and give us some feedback.
This problem, inappropriate posts on social networks, isn't limited to nurses. We've discussed doctors doing similar posts on their blogs, too. Remember Dr. Orange? I know I'll get flack for this, but if you read the whole blog, you'll see that this person seems to be, in other ways, a caring, empathetic person. The question we need to address, I think, is why sometimes good people demonstrate such poor judgement as this particular post shows. I don't condone this post. But my take is that we've got a nurse who is very immature, and naive and possessing poor judgement. Because of this, regardless of whatever skills she may possess, I would never allow her to care for me or any of friends or relatives. I couldn't trust her. Nurses need to realize the consequences of posts like the one we're discussing.
MER/Doug

 
At Wednesday, January 12, 2011 11:39:00 AM, Anonymous Anonymous said...

Patients exist in a state of vulnerability for many different reasons. It seems to me that because of this, and because of the damage that can be done to patients, that psychological evaluation be done on any and every person who has direct contact with patients would be part of the interviewing process just as a police investigation would be appropriate in order to become a police officer.

The idea that people with deviant/inappropriate/malicious or other intent works in this environment and...due to the consequences to the patients that psychologically mimic rape with all it's psychological manifestations that more should be done to limit the kind of person to those who earn the right to take care of others. What does everyone else think about this?
gd

 
At Wednesday, January 12, 2011 12:30:00 PM, Blogger Maurice Bernstein, M.D. said...

gd,all I can say is those of us who teach and supervise medical students do pay attention and respond to their behavior (talk and actions) with real patients. What happens after medical school and particularly when they have gone out to practice medicine, that is another story. I suppose it is up to their patients and the other medical professionals who have seen them interact with patients to speak up. ..Maurice.

 
At Wednesday, January 12, 2011 4:35:00 PM, Anonymous Anonymous said...

Already -- 3 hospital staff in Arizona fired for unauthorized accessing electronic patient information of those involved in the recent shootings.

http://www.washingtonpost.com/wp-dyn/content/article/2011/01/12/AR2011011205034.html
Doug/MER

 
At Wednesday, January 12, 2011 4:40:00 PM, Anonymous Anonymous said...

Actually, it's 4 -- three clinical support staffers and one contracted nurse. At least the hospital seems to be pretty quick at catching them.

http://www.politico.com/news/stories/0111/47515.html

Doug/MER

 
At Wednesday, January 12, 2011 5:20:00 PM, Anonymous Anonymous said...

Maurice, thank you for responding to my post, however, with all due respect, I don't think my question was answered. While you and others who teach pay attention, you may not be qualified as a licensed psychologist to recognize the subtle signs, especially when teaching a group of people. Again, why not have everyone subjected to testing because of the potential of doing devastating harm to patients?

Additionally, patients only speak up AFTER they've been damaged and it's not their job to police medical personnel behaviors.

There is still a prevailing culture in medicine to hide the problems instead of addressing them protecting co-workers. There should be a system of quality control/assurance incorporating all aspects of healthcare for reporting individual offenses and appropriate disciplinary action to go with it. Furthermore, the system should include punitive consequences for anyone who helps to "bury" an incident.
gd

 
At Wednesday, January 12, 2011 7:02:00 PM, Blogger Maurice Bernstein, M.D. said...

gd, as doctors cannot be monitored regarding their behaviors throughout their lives by professional psychologists, neither can such monitoring be done with medical students. What can be done in medical school is the attention of each student in small groups by physicians who have experience in observing students both with patients and how the students behave away from the bedside but in relation to their fellow students and instructors. I have had 25 years of such experience and most of those instructors I work with have likewise a number of years experience. With one instructor for 6 students over a continuous period of 9 months each year and with professional and humanistic behavior being scrutinized we can discern students who have trouble in these areas. Students with problems are attended to.

There is no magical testing available to prevent misbehavior in the future. And yes, it does require "speaking up" both of patients and other observant physicians to medical boards and other responsible agencies when unprofessional acts or misbehavior is noted.

You write "There is still a prevailing culture in medicine to hide the problems instead of addressing them protecting co-workers." I would say not so much to "hide" or "bury" but for various personal concerns to "ignore". In any event, monitoring is grossly inadequate, hopefully discussion here and in other public and professional forums will demand and allow changes to occur which are surely necessary for the best medical care. ..Maurice.

 
At Thursday, January 13, 2011 6:38:00 AM, Anonymous Anonymous said...

It wouldn't surprise me if that woman is a real nurse. She sounds like many of the nurses that comment on allnurses. If you believe what you read at the voy forums it is quite common for nurses to brag about their exploits.

Unlike medical school, nursing school is quick and easy, so any nutcase or pervert can easily become a nurse or a nurse's aide. If they get fired for inappropriate behavior (which seems to be fairly uncommon) they can just move on to the next job. They can make about the same amount of money working at 7-11.

I'll bet if truth be told, even we at this blog would be very surprised at how many women get into nursing just to meet guys, especially those that can't get men any other way. I actually have a relative that has been a nurse for about thirty years and has never been married. Why put up with the baggage that a boyfriend would bring into a relationship if you can get all the nudity and fondling you can "handle" at work every day?

Nursing is also a perfect way for female pedophiles to have the time of their lives without looking suspicious. Any man that so much as glances at a teenage girl in a bikini is suspected of being a pedophile, meanwhile nurses have their hands all over young boys' bodies and they are called "professionals". Is it any wonder why men are accused of the vast majority of sexual assaults, including minors? The only difference is that women get away with it.

I've always said that nurses aren't true professionals, and the whores at the juicynurse blog and at allnurses.com prove my point very well.

 
At Thursday, January 13, 2011 8:47:00 AM, Anonymous Anonymous said...

Wow that was harsh. I used to read the voy forum but it is openly a "voyuer" fantasy blog, all one has to do is look at the side threads. I do feel allnurses by and large is nursing driven. The vast majority of topics are strictly clinical in nature, nurses looking for advise on IV's etc. I also disagree with your characterization of nurses on and off allnurses. I have found the vast majority to be great people, male and female whom are professional. I go back and forth as to the level of the support they have for patient modesty, but lean heavily to they understand. The biggest issue I have with them is they are willing to go with the status quo rather than be proactive in accomodating patients when they know there is an issue. That is a long way from being evil, vile people looking to take advantage of people.
Dr. Sherman I have a couple ques/comments. I agree the medical community prefers to ignore issues, the female Dr in NM who was in trouble for abusing patients under anesthetia wasn't hidden by the State board of health, they just basically downplayed the offense refusing to acknowledge it for what it was, assult. If they don't acknowledge the problem they don't have to deal with it.
Dr. Sherman, do new medical, don't know if you can answer about nurses or not, take any kind of personality tests before they enter school or the profession? I started requiring all managment candidates take a starndardized personality test as part of the hiring process. It is uncanny how accurate it is. We have found it to be accurate both when we used it and when we ignored it. I would think it would have application in this field. I use it to protect my customers and my money, protecting a vulnerable patient would be even more critical....alan

 
At Thursday, January 13, 2011 9:15:00 AM, Anonymous Anonymous said...

We cannot start assuming that mainstream medical personnel are deviant. While it is recognized that deviants gravitate to professions where others are vulnerable, we must believe that most go into their professions for the right reasons; that most of us are healthy and that the others are the exceptions.
gd

 
At Thursday, January 13, 2011 4:24:00 PM, Anonymous Anonymous said...

I had a duh moment, I meant to say I agreed with Dr, Bernstein's comments and meant to ask Dr Bernstein & Dr, Sherman if they were aware of students taking any type of personality testing to see if they were emotionally suited for the profession. As I said the tests are uncanny in predicting whether ones personality/temperment was conducive to the job they were entering...alan

 
At Thursday, January 13, 2011 5:32:00 PM, Anonymous Anonymous said...

I've never heard of any medical school giving students a personality test before entry into the program.

 
At Friday, January 14, 2011 2:46:00 AM, Anonymous Anonymous said...

I agree with anon. Why are men that strip and fondle women called perverts and criminals but women that do the same to men are called "professionals"?

 
At Friday, January 14, 2011 5:27:00 AM, Anonymous Anonymous said...

That's exactly the point. You never heard of it and probably neither did anyone else. Why is it a stretch to test anyone who works where public safety is as risk. If this issue isn't a public safety one, I don't know what is. This kind of testing is done for police officers, drug tests are done in many settings. Humans are interesting creatures. If you can't see it, it doesn't exist.
The kind of damage that occurs is so severe is some cases, that this issue of testing is not something to be scoffed over.
gd

 
At Friday, January 14, 2011 11:35:00 AM, Anonymous Anonymous said...

The blog,juicynurse.penis did not
impress me in the least. I've seen
this behavior for decades among
female nursing staff so its nothing new to me.
Female nursing staff in my view
are exhibitionist facilitators. In
other words they like to leave male
patients uncovered and exposed. Some
kind of a fetish that exists in their
culture.The digital age has only made
this even more possible. With pics
of patients plastered every where from
twitter to facebook and the like.
Here is one example of what I'm
talking about. No one should be taking
pictures of trauma patients and posting thm on the web without their permission. If that is not enough this
female nurse feels the need to add
some kind of caption to this.
Note the comments,"Letting it all
hang out".

HTTP://Traumadiva.blogspot.com

Scroll to bottom of page to see
trauma pic of the day. Note
caption at bottom of page.


PT

 
At Friday, January 14, 2011 5:29:00 PM, Anonymous Anonymous said...

For those interested, I wrote on open letter to the authors of both of those offensive blogs recently mentioned -- Juicy Nurse and Trauma Diva. You can find my article here:
http://patientprivacyreview.blogspot.com/2011/01/open-letter.html
Doug Capra

 
At Saturday, January 15, 2011 6:13:00 AM, Anonymous Anonymous said...

The photo of the patient with his guts hanging out was so horrifying to me that I didn't notice the needless exposure of the patient. I actually had to go back and look again; I had no idea. There is no excuse for the outrageous privacy breach in this circumstance. It makes you wonder if the people responsible are human...or not.

It is instances like this where the medical community should execute prompt dismissal of personnel. You can't tell me that the propensity for such behviors wouldn't come out in a screening test. This photo and the behavior speaks for itself.
gd

 
At Saturday, January 15, 2011 8:20:00 AM, Anonymous Anonymous said...

What a picture at Traumadiva. Do you think she took that picture herself or did she run a search for naked male patients? I'll bet there will never be a picture of a naked woman on her blog. Is it just me or is the nurse on the left of the patient with guts hanging out seem to be particularly interested in his genitals?

The administrator of that blog not only seems to think it's OK to disrespect male patients but also hates Americans. What an all-around great and professional person.

 
At Saturday, January 15, 2011 3:17:00 PM, Anonymous Anonymous said...

As you all may have heard of the shootings recently in tucson az.
Apparently,some of the shooting
victims were taken to University Medical center. This article was recently posted by MER just a few posts back. While at the hospital
their medical records were
accessed by a contracted nurses and
other support staffers not involved
in their care.
If you all may recall just last year
this same hospital made the news
whereby 4 nurses and 4 techs were
fired for taking a cellphone pic of
a male patient's genitals. The patient died 2 days later.


PT

 
At Saturday, January 15, 2011 6:21:00 PM, Anonymous Anonymous said...

As it is an open blog to the public I do think permission has been given to post this picture. Given the gruesome extent of his injuries he would be identifiable and the rsik to the party posting it would be too great not to obtain consent.

 
At Saturday, January 15, 2011 10:55:00 PM, Anonymous Anonymous said...

a) Considering the extent of his injuries I can assure you he did
not give consent at the time the
photograph was taken.He was most
likely intubated.

b) I do not see a problem with a
photo being taken by the attending
trauma surgeon to document the injuries which could have been taken
by the police,who knows.

c) Question is did he survive and
if so did he give permission for
anyone who came upon this photo
second hand to post it on the web?

d) I do think it is in very poor taste
to have posted the comment below the
photograph.

Hospitals have very strict rules
on photographing patients and whose
hands those photos fall into.
Personally,I'm willing to bet the
patient is unaware of this photo
having been taken at all,let alone
it was posted on the web.
Because of the littany of other
photographs on her site I do intend
to notify all of the trauma centers
in the Dallas,Ft worth area as well
as the Texas state board of nursing.
The fact is that it serves no
educational purpose and in the very
least is innappropriate.


PT

 
At Saturday, January 15, 2011 11:52:00 PM, Anonymous Anonymous said...

I would like to add a footnote to my
last post. Permission,consent from a
patient to take their photograph
means absolutely nothing! It can still
get you in hot water. Last year I
knew of an ER physician who took a
pic of a patients penis.The patient
presented to the ER with his penis
caught in the zipper.The next day the
physician was promptly fired.Despite
the fact that the patient gave the ER
physician permission to take the pic.
I,ve known of nurses and respiratory
techs who were fired back in the late 80's,long before hipaa,just for posing
in a group photo with a patient.
An ER nurse or any nurse for that
matter has no business or justifiable
reason to be in possession of such
a photograph let alone posting it on the web,even if he/she has consent
from the patient. Dosen't matter if
the patient can or cannot be identified. In addition to the
american nurses association which
will address workplace ethics issues
the web site to log a complaint in
the state of texas is
www.bne.state.tx.us


PT

 
At Sunday, January 16, 2011 1:59:00 AM, Anonymous Anonymous said...

I agree PT. I'm glad to hear you're notifying the hospitals in the Dallas area.

Have you noticed Jeanette Vaughan's comment under the topic "Angel of Mercy" in her "coming out" blog page? She wrote "Not all male nurses are gay. Nick Gentry is a drop dead sexy hot oil truck driver from West Texas..." Sounds to me like she is arguing that "Nick Gentry" is the one hetrosexual standout among an occupation full of gay men. Not many people represent their occupation worse than this woman. I can't believe she isn't afraid to show her face. Now I don't only feel sorry for her male patients but also her male co-workers. She deserves to be fired immediately and never re-hired.

 
At Sunday, January 16, 2011 2:05:00 AM, Anonymous Anonymous said...

Her email is jeanette.b.vaughan@gmail.com
if anyone would like to discuss "Traumadiva's" blog entry with her.

 
At Sunday, January 16, 2011 4:25:00 AM, Anonymous Anonymous said...

Congresswoman Gifford was photographed on the stretcher on her way to the hospital. It was apparent to me that if she had the choice, this photograph would not have been shared with the public. Laying on the stretcher, she was uncovered on her entire lower half. It's not whether you could or couldn't see anything, it was not the way one would want to be photographed.
gd

 
At Sunday, January 16, 2011 12:53:00 PM, Anonymous Anonymous said...

Interesting thread on allnuses. An "doctor" writes that his wife wants an all female team in the OR for a particularly embarrassing elective operation.
Most responders seem fine with this, saying to ask and that most facilities will accommodate if at all possible. A few responders talk about upscale facilities that will certainly do this. On page three of the thread a male gets on and brings up the opposite situation, a male asking for an all male team. Then an OR male nurse gets on and says he's never heard of such a thing but would have no problem making this accommodation if possible for either men or women.
Throughout, there are interesting comments that suggest that this "doctor" could easily request this accommodation as a professional courtesy request, regardless of who regular patients might be treated. Near the end, a few posters suggest that this "doctor" is really a "troll."
So what happens. The thread is closed, apparently due to posters claiming the OP is a troll. The staff member does say that in most cases, esp. for elective surgery like this, cultural and modesty issues may be accommodated and patients should ask.
I still wonder why threads like this are closed. Does the system recognized that they will accommodate if possible but they don't want to advertise it? Do they realize that they can easily do it for women (except quite often for the surgeon), but are less able to do it for men? Is it that this thread turned from a women being accommodated to a man being accommodated?
Why was the thread closed? You can read it here:
http://allnurses.com/general-nursing-discussion/wife-wants-all-526491.html
Doug/MER

 
At Sunday, January 16, 2011 4:11:00 PM, Anonymous Anonymous said...

Not only did they close the thread but the comment at the end about being against the law to have all same gender is incorrect. Embedded in the Title 7 Law is that when the privacy of the consumer is in questions, same gender is fine. This exception can be seen in fitting room assistants, bathroom attendants. Healthcare just wants to ignore this issue.
gd

 
At Sunday, January 16, 2011 5:57:00 PM, Anonymous Anonymous said...

MER


The thread was closed as the discussion moved toward male
accomodation. Most OR employees are
female with the exception of a few male scrub techs and the anesthiologist. Which brings us to
an interesting cornerstone. You see,
In over 30 years I've only seen one
female MD anesthiologist.
Female nursing wanted to change
all that.So they created what is called a nurse anesthetist. This is simply a nurse who attends a two year
program.
This is not the same program an
MD or DO resident would attend. My
oponion,wouldn't want a kia mechanic
working on my ferrari. Most hospitals
won't hire them or should I say most
anesthiology groups don't use them.
If they did then that would
certainly solve nursings goal of
having 100% female staffed in all or
suites.


PT

 
At Sunday, January 16, 2011 9:37:00 PM, Anonymous Anonymous said...

A RN can have a two year degree or a four year degree but a CRNA must have a Bachelors degree. That is the minimum educational requirement. They also go on to a graduate school that specializes in nurse anesthesia. Their education and training surpasses that of a standard RN.

 
At Monday, January 17, 2011 1:48:00 AM, Anonymous Anonymous said...

"against the law to have all same gender"

Are you kidding me? I didn't read the allnurses thread because when I do I want to beat the crap out of every nurse I see. Did someone actually write that? Do they claim that it is that way for female patients as well? If it is anywhere close to the truth there must be some kind of medical conspiracy that forces every patient to be humiliated for no good reason and every OR employee to have the opportunity to enjoy some OR nudity.

 
At Monday, January 17, 2011 3:33:00 PM, Anonymous María said...

There's a person that posts in the blogs whose comments are to say the least, enraging. I'm talking about PT. To begin with, are you male??? Yes, you must be male.
Your comments sound deeply sexist essentially because, while women may be expeced to be more modest, it's often no more than just lip service.
I live in a developing country, (Third World is more like it) and since the majority of top doctors are male, as well as virtually all anesthesiologists, so no, women cannot be accommodated the way you say, except is some cases for very minor surgery, they cannot be acommodated at all.
What you do not seem to believe is that many a female patient wants to slap female nurses in the face, too. If they dislike a girl or woman in their care for any reason, they disrespect her. And yes, they may even team up with males caregivers when they fancy (I'm really not making this up)...They're raging hypocrites, the ones that don't care for the modesty of either gender, but close doors when they go to the toilets and of course it's different when they're the patient. I forgot to mention that they also give VIP treatment to their own kind (the Us and Them mentality), but to hell with any regard for the patient.
Believe or not, women may have more serious medical decisions made for them, even without their consent, (the "another foolish woman" thing)... and throughout history we've been treated unfairly.
I wonder why you have never answered any of my posts, not even refuting any of this. I understand what you mean: you are against that sort of gender feminism that without even creating freedom for women, seeks to destroy that of men. Unless the perverted machinery that opresses women is thoroughly dismantled, it will not be possible to do so with the one that also opreses men, which, admittedly, is starting to get in motion with startling speed.
BTW, famale nurses enjoy humilliating women that are young and attractive as much as they like playing pranks on males on their care. Let's say that in the current state of affairs, if I had a young and pretty teenage daughter I wouldn't leave her alone with a caregiver of any gender. same thing for boys, if anything goes seriously wrong, it can be too traumatizing for the young person. Hope you all understand!

 
At Monday, January 17, 2011 11:27:00 PM, Anonymous Anonymous said...

I must point out that many posters
on allnurses made assurances that
females would be accomodated. Yet
when the subject of males being
accomodated was suggested thats when things got ugly. Troll is their favorite excuse to use and that dinosaur who shut down the thread
will get an e-mail from me. She thinks Doctor of jurisprudence is
her speciality.

Maria

As you may know I couldn't
care less how medicine is distributed
in third world countries. A plastic
card in my wallet allows me a level
of care exceeding the hill-burton law.Rightfully so,I'm paying for it.
I just don't like being
discriminated in the process while
providing a livelihood for others.
Maria,are you suggesting that nurses in third world countries
are more hateful,spiteful,deceitful,
obese,backstabbing,more knowledgeable
than physicians and simply jealous
of younger female patients than their
american counterparts.How can that be!


PT

 
At Monday, January 17, 2011 11:48:00 PM, Anonymous Anonymous said...

I'd like to add a footnote to my
last post.

Maria

If I were a black man would
you hold it against me if I left spouts of dissatisfaction on perhaps
kkk sites.

Then why would you hold it against me if a group discriminated
against me because of my gender?

A group that takes an oath to treat both genders equally,yet does
not!


PT

 
At Tuesday, January 18, 2011 12:48:00 PM, Anonymous Anonymous said...

After reading this blog and several others I realize that there is no reason for me to continue living if there's no hope in being treated with respect by healthcare professionals. What's the point? Sooner or later I will end up in their hands, so I might as well take my own life before they can get their hands on me. And it might as well be sooner than later.

 
At Tuesday, January 18, 2011 2:20:00 PM, Blogger Maurice Bernstein, M.D. said...

This statement by Anonymous 12:48pm makes no sense to me. If you die now, you are dead now. If you have "no reason to continue living", I would assume that you find no benefits from living in other respects beyond whether through some slight statistical chance you would end up with a "disrespectful" healthcare professional. This response by a patient, to me, would sound like the need to consider clinical depression. Although over the past 5 1/2 years on this blog thread, I have become more appreciative of the concerns of some patients regarding patient modesty issues, I would never consider rational a patient killing themselves or denial of life-supporting diagnostic procedures or treatment simply for modesty issues. There is much more to a human's life than dealing with the occasional disrespectful physician behavior. ..Maurice.

 
At Tuesday, January 18, 2011 5:31:00 PM, Anonymous Anonymous said...

I would hope the comments Dr. Bernstein commented on were meant in jest or sarcasism. I try to
take into account we all are unique and have our own opinions and preferences, something we condemn the medical community for not recognizing. I really don't agree with the evil-doomsday version of the medical community and think the majority of people are in the middle of don't care at all and nurses are all evil and there to do harm. Through the years...that is strange to think it has been years, of reading this blog, while I am disappointed we have not achieved that large scale organization to attack this issue, individually, in my case at least, I have developed a whole different attitude moving from feeling like a victim of the system to advocate for what I want, and hopefully in doing so, there is some collateral benefit for others...alan

 
At Wednesday, January 19, 2011 1:10:00 AM, Anonymous Anonymous said...

I sincerely hope that the post above was meant only as an exclamation point to the end of our many many sentences. A sort of collective outcry of frustration.
I understand that these blogs can be overwhelming, but they can be inspirational as well.
It's an emotional topic. But it's
no longer a hopeless one.



swf

 
At Wednesday, January 19, 2011 8:01:00 AM, Anonymous Anonymous said...

Sorry, Dr. B. You don't get it. Some people value other things like their autonomy more than their physical health. They don't want to feel humiliated. There are some who will go to any lengths to avoid being or feeling humiliated. It is a disgrace that the healthcare field not only won't recognize this, but put practices in place to ensure patient safety. Psychological safety is just as or more important than physical integrity. It's not until this is digested and understood by the medial community that things will change.

To Anonymous...it's important for you to top feeling victimized and empower yourself by learning your options, protections from the law and becoming your own advocate. It's not easy but you can do it.
I will help you if you want
gd

 
At Wednesday, January 19, 2011 1:15:00 PM, Anonymous Anonymous said...

" I would never consider rational a patient killing themselves or denial of life-supporting diagnostic procedures or treatment simply for modesty issues."
Dr. Bernstein: While I understand what you are saying, it seems to me that this is almost a 'square one' issue. For many more people than we want to acknowledge, there is no such thing as a simple modesty issue. It is a way of life/personal commitment/ or simply the protection, safety and mental well being that nothing is going to happen to them against their will. Each person within that context had to determine what exactly they are willing to do or give up to gain anything they want or need in life.
How can anyone assess a level of humiliation that another person should be able to accept?
These are not circumstances that can really be dealt with on a practical level. Too much personal outlook and emotions come into play for one to tell another what an acceptable level of immodesty should be, and further: how to accept it into their way of life and move forward.
Perhaps what we can do, and something I realize I may have been guilty of, is participate less in the negative and highlight more often the positive actions in patient care solutions. Perhaps some will see that the instances we speak of here are not inevitable scenarios to dwell in fear of everyday. I know that my next blog article will be one of progress.....and how far we together have all come.

swf

 
At Wednesday, January 19, 2011 4:11:00 PM, Anonymous Anonymous said...

Reading these last several entries takes me back to my horriffic experience that I encountered when I was in the hospital.

A gang of medical people all starring down and me simply "observing" when one said to me. "Don't worry the humilaition will be over soon".Well that was many years ago and I'm still affected by it. I think about what happened to me practically on a daily basis. When are these people going to get it?

 
At Wednesday, January 19, 2011 4:13:00 PM, Anonymous Anonymous said...

Sorry I didnt sign the previous comment referrng to "Dont worry the humilaition will be over soon" was by upside down

 
At Wednesday, January 19, 2011 8:05:00 PM, Anonymous Anonymous said...

Another shocking admission over at allnurses of how unprofessional SOME nurses and docs are. Some of the things they say there make my jaw drop. It's over a year old though.

OP was new resident doc called a baby "stupid" and another night called one "F-ing baby". To someone's credit they posted "It makes me sad that some of you take care of our most vulnerable patients" to which someone else posted "In that case, let me urge you never to walk through a NICU in the middle of night when all the parents are gone, or you'll hear plenty of horrifying discussions of which babies are annoying, or ugly, or are probably going to die, or have funny-looking penises. And while babies may be vulnerable to infection or hypothermia or dehydration, they're not vulnerable to being called stupid, because it doesn't mean anything to them."

http://allnurses.com/general-nursing-discussion/help-resident-calling-435493-page3.html#post3946171

 
At Wednesday, January 19, 2011 10:30:00 PM, Anonymous Anonymous said...

Anonymous -- Have you read the whole thread you refer to? I have. You'll find 99% of the response horrified by those remarks. Most recommend that these people get reported. My point is that these twisted people represent a minority, a small minority. We can only hope the culture within the system is healthy enough for the good people to make it clear they won't tolerate this behavior.
MER/Doug

 
At Thursday, January 20, 2011 5:19:00 AM, Anonymous Anonymous said...

It was amazing to me when my son was able to speak, his recounting of an experience that happened to me before he had the capability. I don't believe that children are unable to comprehend language before they have the ability to "spit back' what was said; just the same as a young child who experiences sexual abuse still has that experience, even if they don't know what it is.
gd

 
At Thursday, January 20, 2011 10:39:00 AM, Anonymous Anonymous said...

Respectfully:
I'm a bit confused about the site referenced above re: allnurses.
Is it to show some nurses are disrespectful and some are not?
I guess I'm just not getting the point.

 
At Thursday, January 20, 2011 11:24:00 AM, Anonymous Anonymous said...

Following is an important thread to read on allnurses that may help you understand some of the stuff you read there. Now, if you hate nurses, don't bother to read this. You can't be convinced. But if you're open minded, and realized that nurses are people just like everyone else,than read this. I don't condone some of the attitudes I find on the site, but there is a context for it.
http://allnurses.com/general-nursing-discussion/have-nurses-always-527358.html
Doug/MER

 
At Thursday, January 20, 2011 2:01:00 PM, Anonymous María said...

The posts of a person in the blog, PT, sound very chauvinistic. I'll just ask: PT, are you really male? Yes, you must be. Let me make this plain to you: women, especially in developing countries, (for me, Third World is more like it), simply cannot be acommodated. The overwhelming majority of surgeons and almost all anesthethists are men.
What we get is mosty lip service, (often with ulterior finncial motives), and female nurses do hummilliate us, too, because we just aren't as assertive as males are. At the very least, many caregivers do think "another foolish woman". They seem to care about our modesty, but insult our intelligence more. At the very worst, we may have important health decisions made for us, even without telling us!
I was wondering if at least you would refute me. I may be wrong about the details, but you don't seem to have even considered those "ideas".

 
At Thursday, January 20, 2011 2:49:00 PM, Blogger Maurice Bernstein, M.D. said...

There are just too many Anonymouses and this really takes away from trying to maintain continuity in understanding the various views. Please, please..everyone end your comment with some unique anonymous name. Even if you don't want to sign on to Blogger.com with some anonymous name, at least leave one consistently at the end of your commentary. I am sure those of us who read the comments would really like to know which is from who. So please begin now writing a unique fake name but if you can refer back to some recent commentary that you wrote and identify yourself as the one who wrote it will be very helpful. Thanks. ..Maurice. (by the way, my name ending my commentaries is mine!)

 
At Thursday, January 20, 2011 3:52:00 PM, Anonymous Anonymous said...

"Respectfully:
I'm a bit confused about the site referenced above re: allnurses.
Is it to show some nurses are disrespectful and some are not?
I guess I'm just not getting the point."

Oops..I am sorry....that one was me.

swf

 
At Thursday, January 20, 2011 6:31:00 PM, Anonymous Anonymous said...

I understand what doug/mer is getting at. For another example is go to allnurses, click on one of the threads on the side about a nurse fighting to get her lisc. back after 20 yr suspension. The story is a hospice nurse had an affair with a male patient with ALS, which obviously caused a problem with the wife and family, and the patient when the nurse dumped him and told him she was pregnant by another man. Long and short the vast vast majority condemned her and felt the sentence of 20 year lisc suspension was either right or not enough. When a scarce few tried to justifiy it the others attacked them. I think this shows the majority of nurses are ethical, moral, compassionate people. There are problems, I do not think nurses are proactive enough in protecting patient modesty, but I do feel the majority are good people with a minority whom are just bad people....alan

 
At Thursday, January 20, 2011 7:52:00 PM, Anonymous Anonymous said...

I'm anon from 1/19/11 @ 805pm. Yes I do realize many in that thread condemned the doc & the NICU behavior when all the parents are gone but several defended it saying they were just tired or frustrated or venting and it doesn’t mean anything. Well I don’t buy any of those excuses, it is reprehensible behavior. And the funny looking penises quote indicates that even male infants are fair game for these perverts. So are all nurses perverts? No, but clearly some are. At allnurses they admit this behavior exists but what do they do to run these pervs out of the medical profession?

 
At Thursday, January 20, 2011 8:13:00 PM, Anonymous Anonymous said...

My confusion is with the Anon's post RE:http://allnurses.com/general-nursing-discussion/help-resident-calling-435493-page3.html#post3946171

I agree with the OP that the nurses' comments were out of line,
but was that the take-away Anon? Or that most there said it was a horrible attitude and should be reported? Or was it another example of rude nurses?
Guess this one is just lost on me.

swf

 
At Thursday, January 20, 2011 8:59:00 PM, Anonymous Anonymous said...

Maria

Why is it that when men ask to
be treated equally and respectfully we
are considered a chauvinist.Do you all
see that!
Why would I care what happens in a third world country,not my problem.
I'm paying for my healthcare
and I have expectations of the way
I want to be treated,not by someone
on a power trip.
Nursing is not the most trusted
profession.I have more faith in house
keeping. Too bad that most of you
haven't a clue what these people say
and do.

PT

 
At Saturday, January 22, 2011 2:04:00 AM, Anonymous Anonymous said...

"You'll find 99% of the response horrified by those remarks. Most recommend that these people get reported."

I think that even on an anonymous blog, what many people say and what they do and think are very different. It's likely that many that condemn that sort of behavior actually participate in it themselves.
Even those that swear on the bible that they and all other healthcare professionals are completely gender neutral and never even notice patient nudity spend a lot of time staring or are excessively "thorough" while checking for hernia or inserting catheters.
wl

 
At Saturday, January 22, 2011 10:43:00 AM, Anonymous Anonymous said...

Is it 'wt' or 'wl?' Anyway, you have a point. Actually, I think people can be more honest when writing anonymously on the web. As I've stated before, a big problem in medicine is that the workers with the least power, nurses and their assistants and techs, are closest to daily, hourly patient care and observe much. But because they have the least power, and the hierarchy in the medical culture is so strong, they fear reprisal for challenging the status quo. Now, I'm not condoning that. People need to stand up for what's right and face the consequences. But human beings are human beings. I'm just reporting what I see as the reality. Many will be quiet while they observe what they consider unprofessional, unethical, questionable or even immoral behavior - but later post their displeasure anonymously on the web.
As far as the gender-neutral stance -- as I've written before -- we need to see this from both perspectives. For example, from my view of a nurse's perspective, you've got to strive for this gender-neutrality. You've got to be able to treat both males and females skillfully and professionally, with compassion and with modesty in mind. You can't be a nurse and say you won't treat one gender. How they feel personally? We can't get into people's minds. What do any of us "really" think as we do what we do?
Now, that's my take of the nurse's perspective. The patient's perspective can be quite different. They may not be gender neutral in their attitude and feelings. We know from this blog that many are not. Do most nurses realize this? Of course. Do most respect this? Yes. Are some oblivious to it, or do some ignore it? Sure.
The answer? As I keep saying -- communication. Will that result in everyone agreeing all the time? No.
Sometimes? Yes. Mostly -- I think so.
Doug/MER

 
At Saturday, January 22, 2011 4:22:00 PM, Anonymous Anonymous said...

Doug while I agree with 90% of what you say, I am not ready to go that far. I agree 100% that the system, not the nurses are responsible for most of the problem, I agree nurses have to try to be gender nuetral so they can treat both genders, I agree nurses face reprisal and repurcussions from fighting the status quo and since they are only human will likley not take heroric steps on behalf of their patients. Where we part, there are simple things nurses could do, like ask. As you said I think they realize it is an issue for many patients even if it isn't to them, but do not take the lead and ask...that is where i have an issue with providers. I do not hold the nurses evil opinion expressed here. I do however feel nurses have bought into the don't ask don't tell policy of medicine....alan

 
At Saturday, January 22, 2011 7:21:00 PM, Anonymous Anonymous said...

I just can't get behind the term gender neutral. Can't most of us (as adults)be "gender neutral"? I can certainly look at a nude male and not giggle, laugh, point, and/or act frightened and embarrassed. So really...isn't that just a marketing tool geared toward justification of nursing staff availibility?
I'm not saying nurses are evil either. I'm just saying it is rather deceitful and misleading. So I'm not willing to give nurses a total pass, because they chose the profession knowing the gender neutral illusion and predominate it as an actuality instead of an illusion or theory.

swf

 
At Saturday, January 22, 2011 8:17:00 PM, Anonymous Anonymous said...

alan and swf -- You both make some good points. I agree with much of what you say. But keep in mind, this gender-neutral motif isn't something you'll find only in medicine. It's embedded in the intellectual elite of our culture, the academe. It's an intellectual concept, and like a significant number of intellectual concepts held by the intellectual academic elite has little basis in the reality of the norms of the majority culture. I recently read a comment by an intellectual who essentially implied that this whole idea of patient bodily modesty has no place in what he called post modern thought, i.e. "moderns" have transcended this idea of modesty and shame in medical contexts. It's only the more uneducated, or undereducated or primitive thinkers who maintain this old fashioned attitude or world view.
This is the world view taught in universities esp. in the 1970's and 1980's and even in the 1990's. Now, post modernism is passe, but the power structure in medicine was raised with this philosophy. How much of this world view pervades medical education today, i can't say -- but if the old-timers are the teachers, it's still there to whatever degree.
My point -- this is what doctors and nurses have been (or are being) taught -- as an intellectual truth or theory. As we've discussed, as patients they don't necessarily view life this way -- but it's the embedded truth of their medical culture, or has been. Things may be changing.
Doug/MER

 
At Saturday, January 22, 2011 9:23:00 PM, Blogger Maurice Bernstein, M.D. said...

By the way, Doug. I am from before the post-modernism philosophy was developed and therefore I carry the pre-modernism genes. I still see that the bulk of the human population are not naturists and that physical modesty is still in vogue in most cultures. I think that physical modesty is a protective device to prevent unwanted attention, sexual or otherwise by others or even unwanted sexual arousal by oneself.
However, as a physician, I feel there must be a limit to a patient's modesty issues when it comes down to needed medical or nursing intervention.

Except for some health provider outliers, I still think that all patients should have confidence that virtually all physicians and nurses attending to their patients are directed to their professional duties and not for playing sexual games. But, obviously, many who write to this blog don't agree..so the discussion goes on! ..Maurice.

 
At Saturday, January 22, 2011 10:16:00 PM, Anonymous Anonymous said...

Dr. Bernstein:
My concern has never really been whether they are " playing sexual games", but rather: whether their presupposing entitlements to my body are valid. Just because one decides that my body is of creature value does not make it so. I decide who touches me...it is just that simple. They may want entitlement by virtue of self-importance, but that does not make it so. If I felt entitled access to your body through permissions I have assumed myself, I'm willing to bet you would say no.

swf

 
At Saturday, January 22, 2011 10:42:00 PM, Blogger Maurice Bernstein, M.D. said...

swf, for me, I never thought that "entitlement" was the issue. All physicians are taught and keep in the back of their minds that the patient's body is the patient's own private property and that any attempt (except in the case of a true medical/surgical emergency with a patient who has no capacity to reject examination and treatment and who has no legal surrogate available) to inspect, touch or treat such a patient without the patient's consent can represent a criminal act. Again, I want to stress "entitlement" is not a debatable issue as far as the physician is concerned. We know we can't violate a patient's denial of access to their body. Period! And those who do so (photograph or manipulate the body in one way or another) certainly deserve the criminal and professional penalties if their acts are performed without patient permission. ..Maurice.

 
At Saturday, January 22, 2011 11:07:00 PM, Anonymous Anonymous said...

I guess I should make clear that I have never had a doctor attempt forceful or coersive actions. I have, however, has secondary caregiver staff attempt coersive actions. While I deeply resent the attitude, I have been able to deny their attempts.
Perhaps doctor's attitudes differ from other healthcare staff?

swf

 
At Sunday, January 23, 2011 7:09:00 AM, Anonymous Anonymous said...

Dr. B,

How do you justify patient trust when patients (and probably more than not on this blog) have experienced violation of their values, abuse, and psychological damage as a result of medical behavior.

What you might be missing, is that the amount of impropriety or deviance is greater than you might dare to think. What if your wife, yourself or your child were sexually abused or humiliated for no reason in a healthcare setting, how would you feel then? Trust needs to be earned and right now the medical community isn't earning it. How about some acknowledgement of this issue because it is the driving force of this blog.
gd

 
At Sunday, January 23, 2011 9:49:00 AM, Blogger Maurice Bernstein, M.D. said...

In my over 50 years in the medical profession, I have never witnessed any signs or heard from patients of any experience of "impropriety or deviance" as expressed by gd. I can't conceive that all this professional misbehavior is going on day in and day out in the vast majority of doctors offices, clinics and operating rooms without my awareness despite being immersed within the medical and medical teaching profession. Well, at least until I started this thread 5 1/2 years ago, yet I honestly don't think that what is written here by my visitors represents any valid statistical evidence that is worthy of supporting painting the entire healthcare profession as sexual deviants or something less strong.

With regard to what if I or my family was "sexually abused", I can tell you I would be the first to notify law enforcement and let the law decide if my claim was valid.

Nevertheless, despite what is written to my blog and despite it seemingly being the driving view, I find nothing to support that trust by the public in the medical community is failing. In fact, rather than making assumptions from what is written here, let's look at the current and past Gallup polls for some more valid documentation and support: " Nurses continue to outrank other professions in Gallup's annual Honesty and Ethics survey. Eighty-one percent of Americans say nurses have "very high" or "high" honesty and ethical standards, a significantly greater percentage than for the next-highest-rated professions, military officers and pharmacists. Americans rate car salespeople, lobbyists, and members of Congress as having the lowest honesty and ethics, with the last two getting a majority of 'low' or 'very low' ratings." And physicians rank 4th in highest or high trust.
Enough said by me in this posting! ..Maurice.

 
At Sunday, January 23, 2011 10:26:00 AM, Anonymous Anonymous said...

Dr. B

It was never in question that I thought the medical profession as a whole is deviant. And...when speaking of such, we're talking about across the board from the lowest levels of healthcare to the highest.
What I am saying is that there is evidently a problem just as there is in the general population.

My question to you regarding a personal invasion of trust to you or a family member wasn't about what you would do as a matter of course, but about whether you would dare trust enough if the violation was severe.

We can't argue the complaints of elder care abuse in facilities, the fact that deviants gravitate. I do still believe, that the majority of healthcare workers are sincere and treat them that way until otherwise directed.

All I'm saying is that the statistics may support overall public approval, however, there is problem, and that (aside from you and Dr. Sherman) is not of paramount importance as it is for the patient population.

There is someone I know you is a ph.D in psychology who deals with heatlhcare. She believes that the probelm is much more prevalant than we would like to believe. It would be wonderful if she decided to post on this blog; I will speak to her about it. It's just another perspective on the subject. Nobody can dismiss all the people on this blog who have had problems. No one can argue that measures need to be placed as even Dr. B mentions.

I will note that you seem very angry by my post.
gd

 
At Sunday, January 23, 2011 11:11:00 AM, Blogger Maurice Bernstein, M.D. said...

gd, I am not angry with your post or all the others who write about their confrontations with the healthcare profession (doctors, nurses or others)and the bad acts or bad vibes they received. What I am concerned about is to, beyond stating a realistic problem in the healthcare system (inadequate response to gender selection requests by patients), there has been a tendency by some to paint virtually the entire population of healthcare providers as untrustworthy and practicing in a unprofessional manner. What I am saying is to do so without any statistically valid documentation and in face of opposing statistics such as Gallup is unfair for the professions. To all--keep writing here---tell your personal stories, if you think there are more to tell--but avoid generalizations unless you can provide us with statistical evidence and explanation of how one evidence is more or less significant than another. Valid facts is all what ethics conclusions are about and so should ethics discussions such as on this blog. ..Maurice.

 
At Sunday, January 23, 2011 11:21:00 AM, Anonymous Anonymous said...

Dr. B,

I am in total agreement with you. Above all, you have been the voice of reason. Tell me this, though (and I mean it with my total being), what would possess those of us that have had horrific experiences to trust when you're going into the same environment and being treated by the same people (meaning strangers)? It is only natural to protect oneself. We can't learn to trust until the medical profession openly acknowledges that their is a problem, that this problem needs to be fixed/monitored/reported and that the remedies are swift and protective of patients.
gd

 
At Sunday, January 23, 2011 12:38:00 PM, Anonymous Anonymous said...

I'm going to have to agree with Dr. Bernstein in this discussion. We must never, never forget, as we read this blog and others, that complaint and abuse narratives are more popular than respectful and dignified care narratives. At least that's the impression one gets when doing research. When we get angry, we're more likely to report it and spread the word. When we're treated with dignity and respect, well, that's the way it should be, the norm, and nothing to get excited about. This, I think, is just part of human nature.
If you do a google search, you'll find some good experience patient stories, but you'll have to look. Frankly, I don't think the medical profession, hospitals in particular, do enough to "promote" the good work they do. Part of the problem is the privacy issue. They just can't talk about many experiences, officially, that is.
A big issue these days is the growth of the patient tech, cna, cma, med asst. It wasn't that long ago that a patient in the hospital had much more contact with only RN's and LPN's. That's not the case anymore. There used to be male orderlies. No more. The research I've done convinces me that as early as the 1970's many of the old guard nurses considered it inappropriate for female nurses to do things like foley cath male patients. Times have changed, and they've changed quickly, and they've changed not with patient dignity considerations in mind but with the bottom line ruling.
None of what I've said diminishes the importances of increasing communication between caregivers and patients regarding the definition of respect and dignity and where modesty issues fit in. Caregivers need to take the lead in this, as I've said before. They can't assume that just because the patient doesn't offer this information, there is no serious concern on the patient's part.
MER/Doug

 
At Sunday, January 23, 2011 1:20:00 PM, Anonymous Anonymous said...

Maurice,

Whilst I agree to your point in general, this is one of the problems,as if hopitals don't keep or more importantly actively seek the information, how is it possible to provide statistics? The problem with opionion surveys, and its the same in Australia by the way, is that they just record impressions or views; they do not record facts. In addition, a survey of the general population, rather than the population that has used the hospital system for example, is I would have thought problematic.

Finally, even if the polls are correct and relevant, its ranking against other professions, not a discrete survey against specific criteria for that profession alone. I would be more convinced with a survey that asks for each profession specific questions about respect for patient modesty for example.

Chris

 
At Sunday, January 23, 2011 3:09:00 PM, Blogger Maurice Bernstein, M.D. said...

Interestingly, gd brings up something that I have been thinking about. I wonder whether the unique and usually to many an unfamiliar environment for a patient to be examined is part of the mechanism of suspicion, distrust and anxiety: the doctor's office, the clinic, the hospital. Would anyone feel more comfortable as a patient if the physician was doing the exam in an environment unfamiliar to the physician but quite familiar and comforting such as the patient's own home? In this environment, the patient could sense more control of what was going on (no strangers peeking into a room as an example) and also be aware that the physician may be more cautious regarding his or her behavior related to a unfamiliar environment without customary familiar office faces and backup. If the environment of where examinations take place is an important factor in what patients anticipate and fear with regard to an examination, perhaps an approach would be to find ways to modify the environment where exams take place toward the comfort of the patient. What do you think? ..Maurice.

 
At Sunday, January 23, 2011 4:18:00 PM, Anonymous Anonymous said...

Dr. Nernstein, while I agree the setting may be a contributing factor, I think more to the point is the fact taht we are being expected to give up control of our body in a way that, perhaps other than prison, we would find totally unthinkable. While it is true there are violation such as the Dr Sparks incident(s) at Gila Regional in New Mexico, which unfortuntely the hospital covered, they are by far a rarity. the nurses and healthcare people I have met have been very professional, the absolute only negative i have had is they practice the gender nuetral model even through they know modesty is an issue for their patients as it often is with them. Even so, rather than proactively ask if this is a concern, they pretend it isn't and I believe not because they truely believe it does not matter, they do it because it is how the system works the most efficently as it is set up today. When I have asked, it is obvious they know, they just were not going to ask as it required accomodation, and accomodation is effort. This is the sense of entitlement I resent, the fact that they have the "right" to assume what the want to offer is what I will accept. The fact that they will do not ask, when they know, at least some of their patients care to me is a sense of entitlement simpley because they are medical staff. In most cases we choose our Dr, we do not choos the support staff. While it may not be entitlement in the sense if someone refuses you have to back off, it is entitlement in that since we are "professionals" we have the righ to assume you don't care. Interesting, I heard a female news caster use that same mantra about entering male locker rooms..I am a professional doing my job" even though there is no educational or training required to be a locker room reporter....alan

 
At Monday, January 24, 2011 6:14:00 AM, Anonymous Anonymous said...

Well Maurice its like this. Female nurses are at 95%. Certainly,female
patients don't have anything to worry
about in that regard. Most men DON'T
fill out surveys.
How about asking most men and what
their opinions are. Odd that the times
I was a patient I never got a survey.
They can do all the gallup surveys
they want as far as I'm concerned,I
consider housekeepers more professional than nurses.


PT

 
At Monday, January 24, 2011 7:53:00 AM, Blogger amr said...

Hello all. It has been a while since I've posted, so for those that don't know I am male. I recently went in to my skin doctor to look at some new moles and for my annual full body scan. He used to be associated with a large UCLA based medical practice, but now has gone off on his own and joined a 1 doc practice who is female. My doc is male.

After checking in I went to the facilities. As I was returning to the waiting room I caught the tail end of a conversation between the receptionist and a female patient who had arrived during my absence. It was very clear that the pt was annoyed. She thought she was going to see the female doc. She needed one thing looked at immediately but was going to have to come back for the full body scan because there was no way she was going to do that with the male doc.

The female receptionist was a little flustered at the intensity of the interchange. The receptionist, said something to the effect of: "Sure, no problem." After that the pt sat quietly and read a magazine.

I asked my doc after my exam if he has encountered situations where female pts don't want him as a doc. He said absolutely. "Especially the older ladies." - because as he put it: "I'm a younger doctor." They only want to show him a small part of their body, then often times remember other places that need to be looked at. He said it obviously becomes difficult to properly perform a scan and it is clear he is missing things.

There have been no objective studies that I know of that gauge the level of doctor selection based upon gender. It would be fascinating to find out, don't you think?

amr

 
At Monday, January 24, 2011 9:49:00 AM, Anonymous Anonymous said...

When it comes down to the, to me, the biggest question, the biggest issue that it the largest part of the issue is: How do your provide the most options to achieve the highest degree of compfort for patients when it conflicts with providers desire for increasing profits. Simple solution, actively seek, train, and staff both genders and activley seek from the paitent what is important to them...problem, it costs money. That creates the issue, then the question is when it is the provider who has control over what is offerred, what is a patient to do. The answer activley express your opinion with your voice and your money. Don't just go elsewhere, do so and let the proper people at the non accomodating facility know why...if nothing else you increase the odds that YOU will get what you want, and send a message...alan

 
At Monday, January 24, 2011 10:28:00 AM, Anonymous Anonymous said...

You see -- here's one of the main points, medically, from the last post:

"They only want to show him a small part of their body, then often times remember other places that need to be looked at. He said it obviously becomes difficult to properly perform a scan and it is clear he is missing things.'

The job doesn't get done. The scan is not done "properly." The doctor is "missing" things" and knows it, and sadly, just seems to accept it. So...to what extent does gender preference, and the lack of achieving it on the patient's part, contribute to a less than complete examination and, thus, a faulty or missed diagnosis?
I contend that this is happening much more often than we realize. And, unfortunately, I also contended too many medical professionals know it. Why? Because they find themselves in an examination situation where the patient has not made his/her preferences clear, but exhibits uncomfortable, behavior, bodily modesty. The examiner feels uncomfortable, maybe even threatened from a legal point of view, and doesn't do a full exam.
Several threads back I told the story of a friend who went for a complete physical with his male PCP with whom he felt quite comfortable. At the last minute, without telling him, he found himself facing a female doctor replacing his doctor. He was too flustered to object or complain. The exam happened. And my friend told me he didn't talk about some important physical symptoms with this strange, female doctor. For him, the exam was a sham. Granted, he should have spoken up. but you can't convince me that the medical profession doesn't know this is happening.
This is a study that needs to be done: To what extent does patient and doctor gender play in missing and faulty diagnosis -- based upon one or both parties being modest and uncomfortable for intimate exams?
MER/Doug

 
At Monday, January 24, 2011 11:39:00 AM, Anonymous Anonymous said...

Maurice

Are you aware that patient satisfaction scores at most ER's
are from 15-20%.Why,privacy is
one of a number of complaints.
Careful with what and how you
take these nurse satisfacion scores,
especially about nurses.


PT

 
At Monday, January 24, 2011 5:50:00 PM, Anonymous Anonymous said...

Doug brings up an point that while we have addressed both sides, we have never connected. Providers approach the issue that it is upon the patient to accept the fact that they are gender nuetral and the patient is at fault if they do not get adequate healthcare. The patients say it is the providers fault for not providing them the option. Now from a patient perspective, there is an interesting thread on allnurses where a nurse lost her lisc. for having sex with a patient with ALS, the argument is it is assumed that the power dynamics and the vulnerability of patients automatically puts more responsiblity on the provider since patients are assumed to be more vulnerable and less in control..an yet, when it comes to modesy, suddenly, providers put the responsiblity on the paitent, even though they know the patient is stressed, in an unfamiliar environment, and on the short end of the power dynamics. That, seems to be a conflict. alan

 
At Tuesday, January 25, 2011 5:18:00 AM, Anonymous Anonymous said...

Sexual assault is sexual assault, whether it's on one side of the hospital doors or the other.

 
At Tuesday, January 25, 2011 7:51:00 AM, Anonymous Anonymous said...

From some of the disturbing websites
we've seen lately obviously the gender
neutral model associated with female
nurses is a flop.

But then one must ask the question, if
they are indeed gender neutral why then are there no male mammographers
and no male nurses in L and D and with
more and more female obgyn residents
dosen't this model conflict with the
gender neutral model.


Whats good for the goose is good for the gander so to speak. This mentality
works for the medical establishments.

Most of those in healthcare know that
by the time nurses who work in intensive care units have hit the 5 year mark,they have killed
at least 3 patients. I've heard female
nurses say "if I ever need a foley
cath ,it needs to be done by a female"
yet never offer that option to male
patients.


PT

 
At Tuesday, January 25, 2011 10:57:00 AM, Anonymous Anonymous said...

Saw this website on the net. Lots of information that may be pertinent to our conversations:

http://www.pressganey.com/researchResources/hospitals/pulseReports.aspx

gd

 
At Tuesday, January 25, 2011 10:58:00 AM, Anonymous Anonymous said...

The reason, PT is that women REFUSE the care by opposite gender workers for intimate procedures such as mammography and L & D

 
At Tuesday, January 25, 2011 11:36:00 AM, Blogger Joel Sherman said...

I have posted on article on sports physicals on Doug's and mine Patient Modesty and Privacy Concerns blog. Please check it out and add your comments.

 
At Tuesday, January 25, 2011 4:18:00 PM, Anonymous Anonymous said...

Anonymous said

"The reason PT is that women REFUSE the care by opposite gender workers for intimate procedures such as mammograpgy and L & D."

You are incorrect in that statement in
that Men were simply not allowed to
crosstrain into mammography.They are
never hired into L & D. Women never
got the opportunity to refuse care
by them,they were never there to begin
with.

PT

 
At Tuesday, January 25, 2011 6:16:00 PM, Anonymous Anonymous said...

Has anyone here looked at a press Ganey survey presented to a patient.
Not one question relates to the
issue of privacy. Here are two of the
twelve usual questions.

1) While in the hospital did you feel
your physician spent an adequate time
with you and answered all your questions.

2) Did you enjoy the food in the cafeteria.

But if you paid close attention to the
press Ganey results you would notice
that

Patient satisfaction scores are up
over the last 5 years and

Among health professionals nurses
are the least satisfied with their
jobs.

I WONDER WHY


PT

 
At Friday, January 28, 2011 6:31:00 AM, Anonymous Anonymous said...

What exactly makes someone a medical "professional"? Is it when they graduate from medical or nursing school? Is it their first day of work or after their first paycheck? Is it after they have worked for a period of time? Or does someone have to act professionally to be considered a professional?

I have been a patient for a number of healthcare "professionals" that I don't consider professionals because they did not act professionally while "treating" me. So what do you think, at what point does someone deserve to be called a "professional"?

LL

 
At Friday, January 28, 2011 7:09:00 AM, Anonymous Anonymous said...

Another subject I've been wrestling with mentally is who is it that decides what a person's individual morals should be? Do doctors and nurses have the power to decide that stripping and fondling a patient's privates is not immoral for that person? Do a person's parents, spouse or religious leaders have the right to decide for him?

Some people, like me, believe that being seen or touched while undressed by anyone of the opposite gender other than our spouse is immoral. That includes healthcare professionals. (Of course when I say touched by the same gender I mean during a necessary medical procedure) So who has the right to tell us that what we believe is wrong?

Is anyone that considers himself or herself a medical professional exempt from the laws of morality? That belief reminds me of the idea that in our society taking naked pictures of children is evil and illegal UNLESS the photographer calls it "art". Then it's OK. Same goes with medical professionals. (I excuse doctors because they're the only healthcare workers I consider professionals if they act professionally)

If a group of women knocked me down, stripped me naked and put their hands all over my genitals (with witnesses) I could have a great court case and could sue them for everything they have. UNLESS they call themselves nurses, then I should call them angels, thank them and give them a lot of money? That might be OK in our society but it's not OK with me. Who decides if a certain act should be considered "fondling" or "caring" for someone?

My intention in this scenario isn't to sue anyone for money, it's to try to keep it from ever happening. If I ever took one of those "professionals" to court it would be a criminal court, not a civil court.

LL

 
At Friday, January 28, 2011 4:05:00 PM, Anonymous Anonymous said...

As I've written in long past posts, "professional" is a word that has almost lost its meaning in today's society. For example, look in the newspaper or magazine advertising section under what's sometimes called "Professional Directory." You'll find everyone from electricians to doctors, from plumbers to lawyers.
By today's definition, a professional is anyone who:
-- Works for money rather than for free. Thus, a professional as opposed to an amateur. Now, an amateur used to be a person who did something for the love of it rather than for the money. But today the word has a negative connotation, meaning someone who just doesn't do as good a job as a professional.
-- Someone who behaves in a fair, ethical, polite, business-like, and skillful and/or competent way -- regardless of what they do.
-- Someone who belongs to what is considered the traditional professions: law and medicine.
There may be other definitions, but I think these are the main ones. As you can see, they are so inclusive as to make the word so vague as to be meaningless.
For me, in the fields of medicine and law, a professional is someone who has followed the educational pathway required by those disciplines, passed the exams, worked as an apprentice under a mentor for a considerable length of time, has demonstrated he/she knows the specialized knowledge of the discipline and can actually practice it and, follows the codes of conduct, core values, ethical requirements set out by the leaders of that discipline. Realistically, someone can be extremely skilled in the technical aspects of these disciplines yet not skilled at all in the human relations and people skills and communication aspects of the work. I don't see those as two separate set of skills. They go together. Those doctors and nurse who deal with people on a daily basis either have to have all or nothing -- both set so skills makes them a professional. This doesn't mean they're perfect and don't make mistakes. But doctors and nurse with no people skills, in my book, do not meet the definition of professional no matter how skilled they are. Fortunately, as least in my opinion, they are a minority in both professions.
Doug/MER

 
At Saturday, January 29, 2011 3:17:00 AM, Anonymous Anonymous said...

Within each state board of nursing
are guidelines that constitute sexual
misconduct and sexual impropriety.
For example,voyuerism,watching a
patient undress and staring at a
patient's genitals are a few. If you
visit your state nursing board online
the list is extensive as far as the
guidelines go.
That begs the question,if they are
professional then why have these guide
lines. Don't professional people know
what professionalism is. Boundary
violations are another. Dating a patient is forbidden and will result
in revocation. It is a question posed
on the nurse practice act. Yet,on
allnurses one nurse asked if it was ok
to date a patient. Most of the people
responding thought it was ok.
DISTURBING! THATS WHAT THAT IS OR
MAYBE JUST STUPID.
Another issue under sexual impropriety is improper draping to
deliberatly and unnecessarily expose
the patient. This reminded me of all
the trauma patients I'd seen yet the
nurses made a point to quickly cover
up the female patients but not male patients.In my opinion that is certainly sexual impropriety as it
falls under improper draping. Here is
how the arizona state board of nursing words it.
" Disrobing or draping practices that reflect a lack of respect for the patient's privacy.Deliberately watching a patient dress or undress."
If a group considers themselves
professionals,then why have all these
rules and guidelines. Its because this
behavior repeats itself over and over
everyday at just about every medical
facility,thats why.

PT

 
At Sunday, January 30, 2011 4:03:00 AM, Anonymous Anonymous said...

LL:
Very good questions. Unfortunately, they are more often ignored than they are addressed.
Moral and ethical questions will almost always be twisted and distorted into deformed versions of modesty issues because caregivers feel better equipped to argue with patients about the importance of those. They can argue that "petty" modesty has little importance compared to great big health issues, and can force a patient into feeling silly for even considering one over the other. But moral and ethical issues involve judgements that they are not willing to be accountable for.
Modesty issues are valid. Moral issues are also valid, but hardly ever discussed.

swf

 
At Sunday, January 30, 2011 2:16:00 PM, Anonymous Anonymous said...

Those "things" are every bit as important or more important. If we remember the mind/body connection and the mental damage that PT's comments reflect above, if someone is so traumatized by the behaviors, their sense of trust eroded and then that person avoids healthcare at all costs, how is that NOT a medical issue? If they are so traumatized that they dissociate and they develop PTSD (and 65% of sexual assault victims do), and connecting the dots that these things are sexual assault if they are against a patient's will, or if the patient is not in a position due to restraints (and, they are used in surgical situations all the time,or restraints & epidural block (as in C Sections) cannot, fight or flee if that is their psychological "normal place" as in fight, flight or flee, then they are putting the patient in a very psychologically damaging position. That's what's so obscene about this behavior.
gd

 
At Sunday, January 30, 2011 3:54:00 PM, Anonymous Anonymous said...

One thing I forgot....The medical industry knows the damage that can happen from inappropriate or insensitive treatment regarding bodily exposure. It is the foundation of the Patient Bill of Rights. It's the arrogance of the medical industry that causes them to ignore. It's only when they know that you know the law that they cooperate. I will say that more healthcare providers are more sensitive to patient need based on their experience. The problem is that the law is still on the side of the medical industry and that has to change
gd

 
At Monday, January 31, 2011 1:16:00 PM, Blogger Maurice Bernstein, M.D. said...

I want to announce that Doug Capra and myself have had our article
published today in the AMA News (weekly newspaper of the American
Medical Association) website. The article is titled “What can physicians and patients do to improve the medical encounter?”
It deals with both the doctor and patient making a New Year’s Resolution, the patient to “speak up” to the doctor and for the doctor “to listen and pay attention to the patient.” There is a scenario where the doctor and patient engage in a colloquy with the main concern of the patient..guess what? Patient modesty!

Go to the website and read the article and then return and post your comments here or on Doug’s and Dr. Sherman’s website and maybe you could write a comment directly to the editors of AMA News. ..Maurice.

 
At Monday, January 31, 2011 2:43:00 PM, Anonymous Anonymous said...

THANK YOU THANK YOU THANK YOU!!!!!!
gd

 
At Tuesday, February 01, 2011 8:15:00 AM, Blogger Suzy Furno-Maricle said...

Well done Dr. Bernstein and
Doug Capra!
It is exciting to see this subject vine its way into medical academia. Great job in your efforts to bring this issue to the attention of those who need to see it, as well as supporting those who will find strength in knowing that there are ways for words to build bridges.
Someday it would be interesting to see patient and doctor trade places in the theoretical scenario, proving that communication has afforded each the understanding of being in each others shoes.

(swf)

 
At Tuesday, February 01, 2011 9:06:00 AM, Blogger Maurice Bernstein, M.D. said...

Suzy, actually that scenario (the doctor and patient changing places)is not theoretical but is happening every day when a doctor gets ill and needs care by a physician and perhaps the entire medical system team. Unless the patient gets some sort of VIP treatment and special courtesy (which I am strongly against and as I have written on other threads), the doctor thus becomes the patient.

I am all in favor of doctors to have a learning experience on the other side of the hospital bed railing. Some years ago (I don't know if the practice is still going on) one of the teaching hospitals here in the Los Angeles area was requiring that their medical resident training program include several days in a hospital bed with IV's to experience the life as a patient. As I recall the description of the exercise, it was intended to be and was very realistic. ..Maurice.

 
At Tuesday, February 01, 2011 10:55:00 AM, Anonymous Anonymous said...

One of the best books on the subject of doctor as patient is 'A Taste of My Own Medicine: When the Doctor Is the Patient" by Edward E. Rosenbaum. It was made into a movie called "The Doctor" staring William Hurt. The move is good but the book is better.
Two movie scenes stand out in my memory. In the first, the doctor is in a flimsy gown laying on his back covered with a flimsy sheet being wheeled down the hospital hallway. He's looking up at two doctors who are discussing his case. They don't know he's a doctor. He looks up and adds his opinion of his case to their discussion. He gets that deer in the headlights look from the doctors. Yes, he tells them, it actually walks and talks.
The other scene is at the very end. After going through the system, the doctor has his interns all lined up in gowns and forces them to go through a series of tests. You can see the smiles on the faces of the techs who will be administering the tests. Frankly, I think these young techs, dressed in those flimsy gowns, also need to go through the same tests they give their patients every day. Many of these healthy young techs don't have a clue as to what it's like to be a patient in the situations they deal with patients every day.
Doug/MER

 
At Tuesday, February 01, 2011 12:09:00 PM, Anonymous Anonymous said...

The physician on the other side of the fence,to have to experience the
role of patient.Medical resident training program to include several
days in a hospital bed.
I'm very strongly against that in that two wrongs don't make a right.Its
simple,treat people with respect.


PT

 
At Tuesday, February 01, 2011 2:52:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, I doubt the medical residents that I described were specifically treated with disrespect. As I understand it, they were treated by the nurses and staff just as patients were treated as part of their education regarding the life of a patient. If the residents found some issues arise that made them feel uncomfortable, I am sure they would remember that and try to mitigate the same issues when they were managing their own patients. ..Maurice.

 
At Tuesday, February 01, 2011 3:59:00 PM, Anonymous Anonymous said...

Thats exactly what I wanted to get out
of you Maurice,that they were treated
respectfully. That being the case,why
do the study,the experiment? Would it
be possible to do a blind study?
Perhaps! If those residents were
sent to a facility where they were
not known,then what? Who's being tested,the residents or the nursing staff. Is it just a program to get
the residents to see whats its like
from the patients perspective.
Most people have already had medical experiences so why bother?


PT

 
At Tuesday, February 01, 2011 5:42:00 PM, Anonymous Anonymous said...

Actually my thought was much simpler than that. I was musing about the interview in the article and wondering how much different the scenario interview would be if those roles and players were switched. We would learn a lot about how these conversations would be considered biased by our own assumptions and prejudice regarding the other player.
That was really just a reflective thought....and not a judgemant about a doctor's empathy.

Suzy/swf

 
At Wednesday, February 02, 2011 8:39:00 AM, Anonymous Anonymous said...

http://www.newburyportnews.com/local/x2104924131/Ex-doctor-pleads-guilty-in-child-sex-assaults-gets-3-year-sentence

While this is going to look like another slam at doctors and abuse, my question is really
WHERE ARE THE PARENTS???

There will sadly always be people wanting to harm others no matter what the profession, but really....for so many reasons parents need to be an active part of their child's healthcare.
NONE of the doctors that I ever took my children to would see a minor child without a parent present. Nor, would I EVER send my child into an examination room alone. Please parents: what is so important that you are not protecting your children?
Most doctors are not child abusers
but some people who happen to be doctors are. My god, put down the magazine, watch what is going on, and make sure the person with your child is not one of them.

swf

 
At Saturday, February 05, 2011 6:38:00 PM, Anonymous Anonymous said...

I just found this online, a Gender Sensitive Care Hospital in Michigan. Opening a wing for WOMEN with all female staff, nothing said about men. It just keeps getting worse for men, the deck is stacked. Women have L&D all female staff to protect their privacy and dignity, now they need more all female wings. When will they get the message that "MEN ARE BEING DISCRIMINATED AGAINST". I'll bet this same hospital has a female sonographer for testicular sonograms of men's testicles, what a joke. When will we get same gender care for intimate procedures. Let's think of saving some men's lives from prostate cancer, let’s see some all male wings with all male support staff.

http://ireport.cnn.com/docs/DOC-220291

Lefteddie

 
At Saturday, February 05, 2011 11:18:00 PM, Anonymous Anonymous said...

Lefteddie -- From the article you reference, note that they talk about "gender specific units," as well as women only units -- so they've actually got themselves into a semantic bind. Say what you want, but there are two genders -- so gender-specific doesn't mean women only.
BUT -- and this is big thing -- read what else they say:
"the idea of an all-women's unit -- or so-called "women's pavilion" -- resurfaced after market research showed the majority of family decisions regarding hospitals were made by women, said Dr. Janice Werbinski, a founding president of the American College of Women's Health Physicians and a doctor of obstetrics and gynecology in Kalamazoo. "Usually if you are able to get the loyalty of the women, the rest of the family will follow,"
Marketing research. Do we all get it? Follow the money. Until men start stating their preferences, and stating those preference strongly -- until men start being more proactive with their own health, i.e. making all their own appointments and asking specific questions when they make those appointments -- until these things start to happen -- marketing research will lead the way.
MER/Doug

 
At Sunday, February 06, 2011 5:39:00 AM, Anonymous Anonymous said...

Can people that psychologically damage their patients be considered "professionals"? Especially when it's intentional? I believe that anyone that causes unnecessary problems or humiliation for their patients due to laziness, pride, ego or sense of entitlement shouldn't be considered professionals. They often do more harm than good. Patients shouldn't have to request or demand to be treated with respect.

If a person is truly a medical "professional" the first thing he or she should do is make sure the patient is comfortable with what is about to happen to them. There should be no lies, tricks or surprises. They should ask the patients about their preferences and respect their religious and moral beliefs.

A patient should never have to wake up from surgery and be surprised to see that they have no body hair and a tube has been shoved up their penis, and then wonder who it was that did it and who "assisted" or "observed". Keeping secrets from the patients can't possibly be more unprofessional. When I think about the fact that it's the doctors, surgeons or head nurses that send in the teenage girls to shave and catheterize the patients without the patients' knowledge or against their wishes I wonder if there are any true professionals in the medical world.

 
At Sunday, February 06, 2011 12:35:00 PM, Anonymous Anonymous said...

Dr. Sherman and I have a new article on our blog -- "Modesty vs Morals" a
guest post by Suzy Furno-Maricle. You'll find it here:
http://patientprivacyreview.blogspot.com/2011/02/modesty-vs-morals-guest-post-by-suzy.html
Doug Capra

 
At Sunday, February 06, 2011 8:30:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous wrote the following to the now closed thread "Naked" earlier today. ..Maurice.

I dont think there is a problem being naked in front of a doctor. I am a 19 year old male living in a conservative society here in Pakistan. But whenever I for a physical exam I am completely naked there. There are residents and sometimes medical students there as well. But it does not matter. Its just a body and everyone has one.

 
At Monday, February 07, 2011 1:38:00 PM, Blogger Jean said...

In reference to the "gender specific units" in the hospital highlighted a few posts back: the way I read it is that the hospital wing would be for women patients only and not necessarily have all female staff. I think most of the individuals posting here (myself included) are more concerned with having same gender care/staff and are not necessarily concerned whether or not every patient in the ward or on the floor is our same gender. The article said male staff and doctors would be welcome but I suppose that would be with the agreement of the patient. It just seems to be a similar idea as Women's hospitals (there is a large one in my area) where the patients are all women (because of health issues unique to them) but the doctors and staff at these hospitals are either gender. It still doesn't address same gender care.

 
At Tuesday, February 08, 2011 2:19:00 PM, Anonymous María said...

Congratulations to Dr. Bernstein!!! May all this get things to change after all.

 
At Tuesday, February 08, 2011 4:40:00 PM, Anonymous Anonymous said...

lefteddie, I tried but could not access the article, could you either post a link or perhaps give post the name of the hospital so I can google it. I want to contact and comment on my opinion that these type of efforts, while well intended only reinforce to male patients that the medical arena is targeted for females, and contributes to why men do not access health care as frequently as women. Perhaps they should consider trying to attract men instead of continuing to focus on women who already access the system.....alan

 
At Tuesday, February 08, 2011 11:01:00 PM, Anonymous Anonymous said...

Mens Clinics do exist.

Below is a link to a clinic in Melbourne Australia (my home City). The hospital is a large private hospital and whilst they don't talk about the gender of the nurses, they make it clear that you are seen by a male Doctor. It seems to me that they are doing this because there is a demand.

This is the link:

http://www.epworth.org.au/Freemasons/Our-Services/Services/Mens-Health-Clinic.aspx

Chris

 
At Wednesday, February 09, 2011 9:27:00 AM, Anonymous Anonymous said...

just a side note. I live in a small town with 7-8 Doctors and a local hospital. After another occassion where a friend told of how embaressed he was when his Dr. brought in his assistant (female of course) whom he knew for his vasectomy. He said she really didn't do anything of importance and could not see why she had to be there. It got me thinking so I went to Dr. Sherman's articles, printed the one on male modesty. Wrote a note referring to the specific incident without naming names, expressed my thoughts on how stressful this was for men in the first place but became humiliating when witnessed by a female they may or may not know. I asked them to consider at a minimum asking the patient if they cared one way or the other and offer them the option of helping instead of having an assistant present. I tried to be very positive and very supportive of them saying I knew then to be good Dr's who cared about their patients and realized how easy it was when one faced the harsh realities of healthcare with life and death, serious illnesses, etc to be so focused on the physical that the periphial issues such as patient modesty could over time be dimihished or forgotten. I encouraged them to think about these things especially in light of the familiarity small towns have with providers and patients and at least attempt to ask how their paitents felt about it as a guide to how they approached treatment. I finished with telling them I was not identifying myself as I was uncomfortable bringing the issue forward and had family members involved in healthcare and didn't want them to feel uncomfortable. I hope that being respectful and trying to not be accusing or attacking them I could plant the seed for thought. I intend to send one of Dr. Shermans articles from time to time to the various Dr.'s, Hospital admin and patient advocate, AND to the hosptial board of directors (many of whom are not providers). I realize this is not optimal and the annonimity lessens the value compared to signing it or having face to face. Perhaps some day I will, but it is a step....alan

 
At Wednesday, February 09, 2011 11:04:00 AM, Anonymous Anonymous said...

Alan,

I have a different link to that article. It also appeared in the Detroit News. It gives the name of the hospital and all the information you will need.The article appeared one year ago on February 26, 2009, I just happened across it doing a search for "Gender sensitive hospital care". The DON or Director of nursing at the time the article was written was Christine Zambricki, I tried calling her. She has been replaced by a new Director named Linda Fisher. I couldn't get her direct phone number but you can get her through the switchboard at 248-661-4100. I tried to get her email address but they wouldn't give it out. Maybe if a few of us contact hospital administration they will see some value in promoting something for men's health, I hope.

Lefteddie

 
At Wednesday, February 09, 2011 11:44:00 AM, Anonymous Anonymous said...

Good work, alan. I will say that coming out and identifying oneself isn't as frightening as it seems. Like all secrets, it holds more negative power when it's a secret than it does once it's out Once out, it allows the opportunity for communication between medical professionals and patients, face to face. It's also a matter of gaining confidence in your ability to defend your position. Those who have read these blogs for volumes and volumes, have all kinds of arguments to use in discussing this issue.
But, I do applaud you for doing what you're doing.
Doug/MER

 
At Wednesday, February 09, 2011 8:53:00 PM, Anonymous Anonymous said...

Alan,

I forgot to include the link to the Detroit News article for you on "Gender Specific Care in my last post.

http://www.detnews.com/apps/pbcs.dll/article?AID=/20090226/BIZ/902260401

Lefteddie

 
At Thursday, February 10, 2011 9:40:00 AM, Anonymous Anonymous said...

A few excerpts from lefteddie's link and my comments:

"And not all female patients who request the women-only unit will be admitted, because doctors may determine they would be better served in another department, Zambricki said."
Seems this decision isn't based upon modesty or privacy but on purely medical issues. But patients can only "request" this service. Note that I said "seems."

"We know a lot more about integrated medicine. We know that women respond differently to disease than men."
Logically, the reverse must be true. So logically the same service may improve the quality of medicine for men.

'And does Henry Ford know what men want? 'We are going to start with women...we may expand it to men."
Seems to be two issues here. First what women "want," that is, their preference. Does this preference have anything to do with modesty? Modesty isn't mentioned but that surprise me. The other issues is the "medical" benefit for such separate female units.
Note that when asked what men want, they didn't answer the question, just that they "may" do the same for men. The fact seems to be that hospitals don't know what men want because they have rarely surveyed men to any significant degree -- and men rarely state their preferences when in the hospital.
But, this may be a positive step, esp. if men for whom it matters go to this hospital and request the same treatment, and if refused, ask why, if this improves the quality of medical care, it's not offered to men.
Doug/MER

 
At Thursday, February 10, 2011 5:58:00 PM, Blogger Rev.FRED said...

I've submitted nothing to this blog for approximately 5 months. Please be assured that I check the site twice daily to remain current with your contributions. Two weeks ago, making pastoral visits at the local community hospital, I entered the open door of a parishioner's room. She was seated on the side of her bed; her room-ate had her gown pulled up to her breasts, and her legs spread, being attended by a female nurse's aide. The curtain was not pulled. Immediately, I made a pivot turn, and departed, waiting outside in the hallway, for an appropriate re-entry. After ten minutes, the staff worker left the room, looked at me, and commented, "Sorry!" I replied, "I'm not sorry for me; I feel sorry for the patient!" Making no response, "the professional" healthcare employee walked away. Entering the room, neither of the two ladies mentioned the episode, so I abandoned pursuit of discussion. As a clergy visiting hospitals and nursing homes, numerous times each week for 38 years, this is not an occasional occurrence--believe me, it is pervasive. Some of you on this blog excuse the bad behavior as that of a few bad apples. It is my observation, that nearly the entire barrel is rotten!!! Rather than dismiss me as negative, maybe I get to see and hear things unknown to the average joe. My perspective is leading me to reject all care from hospitals for myself. Dr. B. stated earlier that to reject necessary medical attention due to gender issues is not rational; I say to go into a situation and know that I will be degraded, is INSANITY. -REV.FRED

 
At Friday, February 11, 2011 4:39:00 AM, Anonymous Anonymous said...

I think the Henry Ford issue is indicative of the mentality that if we men ignore we deserve. It is an opportunity to address the issue whether you plan on attending the hospital or not. I went to Henry Ford's web site and left my opinion that efforts like this, though well intended only reinforce in men's, and societies mind that healthcare is for females. That we as men are outliers on the fringe and a second thought. I challenged them to look at the web page I was writing on, it had a distinct section for womens health and stated "for the special needs of women". I asked them if these two inatives were reversed, would we think this would be acceptable. I challenged them to think about how they could make the system something men would want to use and stop pushing the outdated model of attracting women so they will lead their men in, not all men have women in their life. We are not childeren nor are we apendages of our wife. If we do not access the medical system, look for reasons why and consider changes that make it more attractive for us to do so....alan

 
At Friday, February 11, 2011 6:34:00 AM, Anonymous Anonymous said...

Rev. Fred, I'm with you. Nobody gets it until it happens to you. It is at this juncture when you have to decide what is more important to your being, physical health or mental health. It is then, and only then can you decide what is right for you.
People who stand in judgment including Dr. B (sorry Dr. B) are out of touch based on THEIR experience and what is rational for one is not for the other.
gd

 
At Friday, February 11, 2011 7:06:00 AM, Anonymous Anonymous said...

From experience, I agree with Rev. Fred, "pervasive" is the right word.

Secondly, I think the whole point of a "woman's wing" has nothing to do with modesty and everything to do with requiring more tests to make more money and do it faster than usual. Nothing to do with modesty or patient preference.

Just like the "well woman" exam has nothing to do with keeping women well and everything to do with testing until they find something suspicious or the testing itself causes harm. If it truly was a well woman exam, it would include a heart work up!

tear

 
At Friday, February 11, 2011 7:17:00 AM, Blogger ~Charlotte said...

Rev. Fred,
I think that a well-written letter from you about human dignity and our responsibility to treat others with sensitivity and respect would be a good idea. You could send it to the administrators at the hospital as well as to the staff on that floor and the doctors who care for patients on that floor. Most hospitals have an ethics/bio ethics person in the administration and they need to hear from you. You have credibility and the poor patient who is sick or simply unable to fight this battle deserves to have others stick up for him/her.
~Charlotte

 
At Friday, February 11, 2011 9:22:00 AM, Blogger Maurice Bernstein, M.D. said...

I think there is much to learn from the news from Egypt this morning on how a multitude of voices who disapprove of a system can by coming together make a change in their direction and for their benefit.

As I have written in the past, activism on the part of a community together is the way to go for a chance toward effective change. ..Maurice.

 
At Friday, February 11, 2011 9:56:00 AM, Anonymous Anonymous said...

We all have our own methods of advocacy here -- but I must emphasize that I believe an important aspect to advocacy is coming out of the closet and making our identities known. Anonymous observations, by their nature, have less credibility. Since I joined with Dr. Sherman with our new patient privacy and modesty blog with my real identity, and since I joined with Dr. Bernstein in co-writing an article for an AMA online publication, using my real name -- since I made these decisions, the world hasn't crashed around me. I'll stand before any group or organization, before any medical professionals and civilly debate this issue. I'm not judging those who wish to remain anonymous. I'm just asking them to really think about coming forward and letting people know who you are and what you stand for and then being willing to defend that position. If people don't like it, it's their problem. Let them deal with it.
Doug/MER

 
At Friday, February 11, 2011 1:57:00 PM, Blogger ~Charlotte said...

Doug, you are absolutely right and I will do so when I post from now on.
Gail from Charlotte

 
At Friday, February 11, 2011 3:09:00 PM, Anonymous Anonymous said...

RevFRED: Great to see you are still checking in with us! I agree with Charlotte. Often a paper trail and hard copy is all that exists to prove these things ever happened. Otherwise, caregivers go on as usual.

Doug/MER:
My "coming out" was fairly smooth as well. The family/friends who do not agree usually just avoid discussing it. I answer the questions they do ask, but none of us have parted ways. Those on the fence feel free to discuss it and form their own opinions. Those who agree often e-mail comments instead of posting for fear that even anonymous posting is "tracked".
I have many family/friends in the medical community. 1/3 of the new people I meet are in it as well. (This helped dispell the theory that they are rare strangers that we will never meet again!)
In my experience, it helped everyone stop assuming that it is the 'good guys vs. the bad guys' (with either party often feeling like the good guy) and see us all as just people with different opinions about their bodies.
Oddly enough, even those who are hard-core eyerollers find I can come in handy at times......and they never would have known if I hadn't 'come out'.

Suzy/swf

 
At Saturday, February 12, 2011 1:26:00 PM, Blogger ~Charlotte said...

Suzy, I think there are going to be fewer and fewer hard-core eyerollers. I think for many, many years, folks simply did not ask what happened to them, for example, when they were unconscious and having surgery. And, not only were there not as many invasive procedures but there was more privacy. No one had a camera in their phone, nobody was making their own "sex tapes" and you did not have to worry about things appearing on YouTube. With the awareness that doctors and nurses were not always treating patients respectfully (as in lining up medical students to do pelvic exams on unconscious women) and that nurses were publishing unkind remarks about patients that they thought were funny on internet blogs, etc etc etc, people have become more concerned. This awareness will bring requests for more sensitive treatment. I personally take every opportunity that I can to make suggestions to people if I know they are going to have a baby or undergo some kind of surgery. I don't agree that what you don't know doesn't hurt you.
Gail/Charlotte

 
At Sunday, February 13, 2011 4:29:00 AM, Anonymous Anonymous said...

Dr. Bernstein, you said earlier "All physicians are taught and keep in the back of their minds that the patient's body is the patient's own private property and that any attempt (except in the case of a true medical/surgical emergency with a patient who has no capacity to reject examination and treatment and who has no legal surrogate available)..."

Well, in most ER's I have seen, if there's any emergency the first thing they do is throw the surrogate out into the waiting room, so they have no input into the patients care.

I've had that experience - in which case they catheterized a male patient against his will and objections, and if I had been there (I am the legal surrogate) I would have objected.

Often, they solve the "problem" of needing consent by just removing the surrogate.

At another ER, they wouldn't let me back to the patient - even thought I said I had a healthcare power of attorney, the patient had life-threatening drug allergies, and could not speak.

In case you wonder if the reason is that I am hysterical, I most certainly am not.

So being a surrogate is somewhat beside the point, as medical personnel often make sure that the surrogate has no opportunity for input.

Are there any legal rights here?

On another note - did we ever hear what happened with Hex's niece?

TAM

 
At Sunday, February 13, 2011 8:09:00 AM, Anonymous Anonymous said...

The surrogate absolutely has legal rights and what's needed is to remind the peronnel and advising that you have been retained to speak for the patient and if they do not let you speak, they are breaking the law. See what happens next. Also, you must have the proper paperwork with you when at the hospital. I do not think they have to listen to what would be considered "heresay" that you are the surrogate.
gd

 
At Tuesday, February 15, 2011 2:03:00 AM, Blogger Rev.FRED said...

Charlotte, you encouraged me to write a letter to the administrators of the local hospital,informing them of my observed indignities foisted on patients by staff. The hospital is the largest employer in the county;dozens of my parishioners receive their paychecks from this institution. When I have privately addressed some of my experiences with them, they have become very defensive of the workplace. For me to send letters to the head honchos, doctors and wing supervisor for the dereliction, runs the high risk of stirring a bee's nest, and alienating myself from some of my flock. This hospital in no way has a monopoly on incompetency, misdiagnosis, lawsuits, lack of sanition, and a wholesale systematic violtion of modesty issues; I know plenty of horror stories about other places. Having conversation and a letter with the assistant nursing director of one of the largest hospitals in the state, located in an adjacent county, I learned that she has temporarily been placed in charge of the pastoral care department.If she is representative of the chaplaincy program, I must write-off this medical center, because it is neither "pastoral" or "caring." She told me that she had no problem with a male nurse giving a bath to a nun. An inability exists for her to understand why I as a pastor under a vow of chastity might find it problematic to receive intimate care from an opposite gender provider. I was informed that entire units of the hospital do not have a single male nurse! Dr.B. has recommended activitism. Here's what I plan to do:should I find myself in an ER ,outpatient or admitted to a healthcenter, I plan to have my attorney at my side, to monitor my rights! I am willing to spend my last dollar to let the entrenched, amoral, secular, elitist mindset governing hospitalworld know that I mean business!-REV.FRED

 
At Tuesday, February 15, 2011 4:42:00 AM, Anonymous Anonymous said...

I always have the paperwork, not that anyone wants to see it. But in a husband/wife case, isn't the spouse automatically the surrogate?

I can "speak" all I want I suppose - but of course, since I'm not back with the patient, I have no idea what is going on to speak about - neat trick, isn't it? Nor, of course, can I get near anyone to speak TO, other than the front desk.

Actually, in one case - and it was my husband - I said "I have the healthcare power of attorney, he has life-threatening drug allergies, and he currently cannot speak". They still did not let me back to be with him, and in fact the security guard started watching me.

By the way, he was having an asthma attack, not a bloody trauma or anything.

I have wondered what law - if there is any - requires a hospital to let the legal surrogate be present. I'd sure like to know onw - I'd carry a copy of that around too!

TAM

 
At Tuesday, February 15, 2011 5:19:00 AM, Anonymous Anonymous said...

I've only had one experience that involved undressing for a doctor. When I was a very naive and medically inexperienced 20 year old I needed a full physical for my work, and at the time I never could have imagined that the clinic would send in a woman. When a woman entered it took me a minute to realize she was the one that would give me the examination, and after about 15 seconds of stuttering I finally stammered out that I would be more comfortable with a man.

I've never considered myself good looking, but her reaction didn't seem to me at the time or even now to be a look of being angry or offended, it looked more like disappointment. I certainly won't try to flatter myself by believing she was instantly smitten by me and couldn't get my clothes off fast enough, but she definitely looked disappointed as if she missed a great opportunity.

She finally left and sent a man in to perform the examination, and now I'm more prepared (with a lot of help from advice I get on this blog) to make sure I never endure such a close call again.

 
At Tuesday, February 15, 2011 5:23:00 AM, Anonymous Anonymous said...

I've only had one experience that involved undressing for a doctor. When I was a very naive and medically inexperienced 20 year old I needed a full physical for my work, and at the time I never could have imagined that the clinic would send in a woman. When a woman entered it took me a minute to realize she was the one that would give me the examination, and after about 15 seconds of stuttering I finally stammered out that I would be more comfortable with a man.

I've never considered myself good looking, but her reaction didn't seem to me at the time or even now to be a look of being angry or offended, it looked more like disappointment. I certainly won't try to flatter myself by believing she was instantly smitten by me and couldn't get my clothes off fast enough, but she definitely looked disappointed as if she missed a great opportunity.

She finally left and sent a man in to perform the examination, and now I'm more prepared (with a lot of help from advice I get on this blog) to make sure I never endure such a close call again.

 
At Tuesday, February 15, 2011 2:17:00 PM, Blogger ~Charlotte said...

Rev. Fred,
BRAVO! I am proud of you!
I too, feared the repercussions of my lengthy letter to the administration but as time goes on and I revisit what happened and what I wrote, I have never regretted it. Who can argue with you over dignity, respect and ethical treatment of sick human beings? You will not regret that you did this, it was the right thing to do.
I was actually advised by folks at the hospital to write. They said that these issues would never be addressed unless something was put down on paper.
I am absolutely certain that not everyone believes like the woman you mention who shows no respect for modesty and privacy I am married to a surgeon and he would not agree with her stance nor would many of the hospital folks that I know. Doctors, nurses etc. do not allow themselves to be treated like that. For example, my husband's PA had back surgery and requested to have her underwear kept on.
I am wondering where you live, if it is the same hospital system where I experienced privacy and modesty violations?
Gail/Charlotte

 
At Wednesday, February 16, 2011 6:08:00 AM, Anonymous Anonymous said...

Do nurses really believe that when they argue with a patient and make a rude comment like "Hey! I'm a professional" or "you don't have anything I haven't seen before" or "I've seen hundreds of penises" she will actually make the reluctant patient feel more comfortable and accepting? Do they think that insulting the intelligence of the patient will make him more compliant?

I just can't see this dialog happening:

Patient: "Hey nurse, stop fiddling around with my penis."

Nurse: "It's OK, I'm a professional."

Patient: "Oh, sorry. I thought you worked in the cafeteria. Go ahead then."

They need to dump the ego and get it through their heads that although they consider themselves healthcare "professionals", not all of us are professional patients. How do they expect us to respond? "Oh, so you have seen a penis before? Well then, giving me a hand-job in front of spectators can't possibly be immoral or unethical."

Hey nurses, most of us realize right off the bat that you are a nurse, not a coal miner or a SCUBA instructor. Informing us time and time again that you are a professional isn't going to ease our minds. The more times you remind us you are a professional the less professional you are acting. True professionals don't argue with or insult the patients. Throwing a temper tantrum doesn't make you look like a professional, and neither does disrespecting and lying to the patients. If we believe something is wrong or immoral you won't change our minds by reminding us that you are a professional, or by bragging about how many penises you've seen.

Remember that prostitutes technically are professionals too.

 
At Wednesday, February 16, 2011 10:45:00 AM, Anonymous Anonymous said...

ANONYMOUS wrote: "Do nurses really believe that when they argue with a patient and make a rude comment like "Hey! I'm a professional" or "you don't have anything I haven't seen before" or "I've seen hundreds of penises" she will actually make the reluctant patient feel more comfortable and accepting? Do they think that insulting the intelligence of the patient will make him more compliant?"

A few responses:

1. Let's not simplify this issue. Human contacts, especially in intimate, personal situations like the one's we're discussing, are extremely contextual. One must look at many factors, include demeanor and tone of voice.
2. Yes, nurses shouldn't "argue" with patients. Anonymous is portraying a very disrespectful encounter from a nurse. The use of these expressions doesn't always indicate a "rude" nurse.
3. Yes, some nurses are taught, either through the academic or the hidden curriculum that these expressions may help the patient feel more comfortable. And for some patients, that may be true. It depends upon the context -- the individual patient, the individual nurse. You can't generalize.
4. The patient needs to size up the tone of these remarks. If they're said with humor or with respect, with an attempt to ease the patients concern -- the patient needs to take that into consideration. This doesn't mean the patient must accept the situation. But patients can learn to respond civilly, saying that, although you think this expression eases my concern, it doesn't. I still want a change in care.
5. Anonymous's post takes a complex human encounter and simplifies it. If we could watch the film of a series of encounters like this, with various tones and various facial expressions and various body language, we could better understand how complex this is.
6. Patients have the responsibility of sizing up and judging these encounters and responding appropriately -- in ways that will better achieve their goals.
Doug/MER

 
At Wednesday, February 16, 2011 2:44:00 PM, Anonymous Anonymous said...

Doug/MER,

I invite you to re-read your comments above again. Do you realse how patronising this reads?

It not the responsibility of patients to "read" the situation, that should lie primarily with nurses. The presumption should be that any patient, regardless of their body language or whatever, would prefer a particular gender. The nurse has the responsibility to explicity deal with that. Not make staements about "having seen it all before", (which has happened to me); but to address the issue and give the patient genuine options.

To say as you did that:"Patients have the responsibility of sizing up and judging these encounters and responding appropriately -- in ways that will better achieve their goals"; is the sort of suggestions that men made to women when they complained of sexual discrimination, or to blacks when faced with racist attitudes.

Chris

 
At Wednesday, February 16, 2011 4:23:00 PM, Anonymous Anonymous said...

Dr. Sherman and I have a new post on our blog -- the first of a two-part series on the history of modesty in medical culture. It's written by Jan Henderson, PhD. She is a historian of science and medicine who writes about the history of the medical profession as well as changing attitudes towards health care. You can find the article here:
http://patientprivacyreview.blogspot.com/2011/02/history-of-patient-modesty-part-1.html
Doug Capra

 
At Friday, February 18, 2011 4:11:00 PM, Blogger Maurice Bernstein, M.D. said...

NOTICE: AS OF TODAY FEBRUARY 18, 2011 "PATIENT MODESTY: VOLUME 38" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 39.

 

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