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Patient Modesty: Volume 39
Is there anything more to discuss regarding patient modesty issues that hasn't been discussed in all the previous literally thousands of previous comments on this thread? I suspect there still is..so here is another chance to start the discussion going on another aspect of the issue. ..Maurice.
NOTICE: AS OF TODAY APRIL 24, 2011 "PATIENT MODESTY: VOLUME 39" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 40.
143 Comments:
I live in the UK, the same avoidance issues prevail here as elsewhere regarding dignity.
take a look at this though
http://foi.avon.nhs.uk/Download.aspx?r=1&did=8727&f=DignityPolicy-2.pdf
and this
http://www.theprostatecentre.com/For_Patients/What_to_expect_on_your_first_visit.aspx
"most men prefer to undergo this examination in private"
THEY DO KNOW, THEY DO UNDERSTAND, they just choose to play dumb.
Thanks Anonymous from today. From the Western Area Health (medical care provider in the U.K.)regarding their dignity policy including privacy and modesty:
• For patients who lack capacity through disability or dementia, staff will aim
to act in their best interest with dignity and modesty at the forefront of their
care
• Staff will close curtains fully and position screens correctly in all areas
where patients are required to undress.
• Staff will not ask a patient to take off more clothing than is necessary.
• Following a physical examination, patients should have an opportunity to
re-dress before the consultation continues.
• Check with a patient that they give their permission to be washed or
examined by a person of the opposite sex, and respect their wishes where
this is possible.
• Offer a chaperone to patients as appropriate and giving them a choice as to
who is present during examinations and treatment.
• Where possible an escort will accompany vulnerable patients on ward to
ward transfers and transfers to other departments, when the patient has a
dementia or physical disability an escort will be required.
• Obtain written consent from patients requiring clinical photography
(including the use of digital cameras) having first informed the patient of
what to expect.
• Encourage patients to dress in their own clothing during the day if clinically
appropriate.
• Encourage patients to wear their own night attire to sleep in. When this is
not appropriate or possible, patients should have access to hospital
clothing that protects their modesty and is acceptable to them.
• Adequately cover a patient at all times, should they be wearing their own
clothing or hospital nightwear and are too unwell to do this themselves.
• Ensure your patient is appropriately dressed prior to leaving the ward.
• Ensure any patients being transported out of the hospital are dressed if
going home, or appropriately covered if too unwell to get dressed.
• Where possible provide quiet areas for patients
• Provide nutrition and assistance to eat and drink, using crockery and
cutlery appropriate to care needs.
• Clarify the wishes of adult patients requiring assistance to eat and drink. Do
not assume they wish to eat with bibs, spoons, beakers/feeder cups, take
care to recognise the human rights of the individual.
It would be great if all medical care institutions would display such a policy AND FOLLOW IT! ..Maurice.
Anonymous -- Your second link didn't come through. Here it is:
http://www.theprostatecentre.com/For_Patients/What_to_expect_on_your_first_visit.aspx
Here's what they actually say: "You can expect to have a physical examination. This will involve a digital rectal examination, where the prostate gland is felt by the doctor with a gloved finger while you lie on your side. Most men prefer to undergo this examination in private, so if someone has come with you we will normally ask them to leave the room while it is performed. However, if you would like them to stay with you, or indeed if you would like another of our staff to be present, please let us know."
You really have to read between the lines, but when you do, it's "seems" clear the patient can pretty much call the shots as far as who is in the room. But it fascinates me how gender is completely eliminated from the language of the above statement. On the surface, gender doesn't exist for them. Beneath the surface, it does.
But when the say "...if you would like another of our staff to be present, please let us know."
What does that mean? It implies that "other" staff will be in the room with the doctor, but if you want "another" staff member there, let us know. Are we talking male versus female assistant? Who knows?
Note that they say nothing about any other of the procedures, who will be present, what choices patients have -- but my interpretation is that they would listen to patient preferences regarding gender. They just don't want talk about it using words like "male, female, gender, etc." Absolutely fascinating. Why is medical culture afraid to use plain, ordinary, clear, unambiguous language when it comes to the issue of gender and modesty and patient preference? Statements like what I quote above, leave so much open to interpretation.
Would someone in the medical community please try to answer that question for me?
Doug/MER
Doug, here is the active link to the site you are discussing. ..Maurice.
Doug/MER,
easy to answer your question.
Clarity makes ambush more difficult.
"Clarity makes ambush more difficult.'
Don't think the answer is as simple as that, anonymous. That assumes there's some kind of conspiracy. I think it's mostly an subconscious response that takes into account the dangers of discussing gender issues in our culture today. The predominant (not the only) point of view in medicine today is that gender doesn't matter, esp. in areas of modesty. It's assumed that when patients enter a hospital they automatically and consciously acknowledge this and give up modesty rights. Thus, it's not only unnecessary to talk about modesty, but, for those caregivers who do see the issue, it's dangerous and/or politically incorrect to talk about gender access to patients. That's just my take.
Doug/MER
The only way out of this is to flip the power differential and REFUSE treatment, make a big deal out of it and walk out. If enough people did this both male and female, the medical community would have no choice to make an adjustment that is in accordance to what the paying public wants and demands.
gd
I've often made comments on this blog about the culture of medicine and how this is connected to the privacy and modesty issue. A recent survey was taken of 5000 medical school faculty (from 26 schools) with a 53% response. Here is some of the results that I see connected to the issues of this blog:
51% said the the administratin is only interested in them for the money they generate. Time is money. Dealing with patient feelings, concerns, privacy, modesty takes time. Is this attitude being absorbed by some medical students?
31% said the culture of their institution discouraged altruism. How much of this is being absorbed by medical students? Patient dignity, modesty, privacy isn't just a legal issue. It's a moral, ethical, altruistic issue.
30% said they were reluctant to express their opinion for fear of negative consequences. This, I believe, is a huge issue in medical culture. We've talked much on this blog about how doctors and nurses observe privacy and modesty violations but are afraid to speak up or even report these behaviors.
What's primarily taught in any institution of learning isn't what's in the curriculum. What's taught is the way in which the curriculum is taught, the attitude and value system behind it, the culture of the entire institution. That's what students are really learning.
Having said all this -- I'm encouraged that the medical profession isn't afraid to acknowledge this problem, publish it, and try to fix it.
You'll find my source for this information here:
http://www.kevinmd.com/blog/2011/02/medical-education-moral-crisis.html
Doug/MER
Dr. Sherman and I have posted part two of the History of Modesty by Jan Henderson, PhD. You can find it at
http://patientprivacyreview.blogspot.com/2011/02/history-of-modesty-part-2.html
Doug,
Thanks for these articles; very interesting perspectives.
gd
The following was sent yesterday to an inappropriate thread but seems appropriate for this one. ..Maurice.
I carry a no implied consent, recognition of my own autonomy, and the right to my own self determination card all witnessed w/ a health care agent. This is all because I will never willingly have a foley catheter inserted again!!! The time I did have a catheter I was held down by 4 nurses while a fifth nurse installed the thing in me. I feel violated, traumatized, and because of this I will never willingly go to a hospital again. I realize That if I'm unconscious I probably won't have a choice. Therefore I've also learned the mechanics of a foley and can pretty much remove it myself which I will do just to piss off the staff. All of this because they did'nt respect me. I feel they've pretty much signed my death warrant. By the way this also resulted in a settlement with the hospital, I would rather of had the respect..... steve
My article on how to respond to privacy violations has been reprinted on KevinMD blog. Take a look. Not surprisingly, some physicians don't take kindly to it.
Too bad for them. It's difficult to speak up when you are humiliated and traumatized. It's after the fact that the anger intensifies, hence in the extreme POST Traumatic Stress Disorder -- after the fact. The problem is...what is the intent by these violations. Some of them are done on purpose; some not. It's important to find out what's happening and the only way to do that is through research.
gd
Steve
I know of several cases,one which involved a quadraplegic who
was catherized against his will while in a nursing home. He sued
and was awarded $250,000 and brought
criminal charges against the nurse.
PT
There has been a lot of discussion regarding caregivers not reporting modesty violations for fear of being punished or fired, but have you thought about the issue of patients keeping silent because they respect their provider too much or fear compromising their care, or even retribution?
Of course, not everyone will agree; mainly the health industry will deny this ever happens, on the other hand those for which it's a real possibility, and many, many others will probably be misinformed...
Maria: Patient fear of some kind of reprisal for complaining is not uncommon. For the most part, I don't believe that fear is warranted (I'm not saying it never happens) but it is what some patients feel. Most caregivers realize this. I know this because you will find, within a significant number of patient rights documents, the specific right to complain with that affecting care. If this wasn't an issue, there would be no need to put that protection with these documents.
Doug/MER
Correction -- Meant to write that some patient rights documents specifically state that patients have a right to complain without the fear of that affecting their care.
Doug/MER
Doug,
I think retribution or otherwise depnds on if we are talking about a particular doctor or a more general issue when a complaint is raised. For individual doctors/nurses a very specific compliant certainly results in a very adverse reaction. Just peronal experience, so not the subject of any survey, but it makes sense to me.
Chris
I don't suppose it would be possible for a patient to set up his own video camara in the OR would it? That would be an interesting video to watch and would keep the surgical and pre-op nurses honest. I imagine it would be against "policy" though. If nothing else it would offend the OR team to know they aren't trusted.
Doubt they would allow that,however,I do believe one
Should be allowed to bring an advocate to sit in on the
Procedure. One of the same gender.
Certainly brings up the question in their mind,"what,
Don,t you trust us".absolutely not!
Pt
I’m a 55 year old man who is starting to research prostate cancer and the available treatment options. I found an organization in California that specializes in this treatment for low income patients.
Under the subject “What happens during the Surgery?” they talk about getting anesthetized, an incision is made, the prostate and lymph nodes removed, then you wake up in the recovery room. They then go on to say that once you wake up you will find “a tube coming out of your penis”
Shouldn’t they have mentioned that a catheter would be inserted back in the section “What happens during the Surgery?” Also they fail to mention the presence of other personnel in the OR besides the anesthesiologist and the surgeon, the prep and exposure that will occur, etc. Of course the gender of the staff isn't mentioned anywhere.
This has taught me that if better communication needs to happen it will have to be initiated by the patients because the medical community simply doesn’t want to tell you everything that will be done to your body once you go for treatment.
http://www.california-impact.org/documents/hospital-stay.pdf
Brad
For the blogs consideration. This youtube video shows what is typical in the operating room prior to draping and surgery.
This appears to be a training video on induction and patient positioning. Although this is not a US video, it is nonetheless the world wide common practice.
Typical Prepping in the OR
To the poster a few days ago that mentioned video in the OR, it is becoming VERY common for live video feeds from the operating room to be streamed to conference rooms for classroom observation of surgery, or for institutional scheduling of the OR. These video feeds generally are not turned off. With the proper password, anyone can access the feeds from their laptops anywhere in the world.
The OR today is anything BUT a private place. And as you can see, the patient generally at the beginning and end of the operation is completely exposed.
Shown here also is a brief view of foley placement which in my view was gratuitous.
From interchanges with Dr. B, his contention is that he sees nothing wrong with this picture. Modesty has no place in the OR. He has never really given an opinion however regarding the ethics of broadcasting from the OR. Generally the pt is forced to sign a video waiver as a condition of treatment.
-amr
Brad:
You're right. There is a bit of illogic there. What must come out has had to have gone it at some point, right? They should go into that, the going in part -- and you're right. They won't talk about gender unless you mention it. But, they do say:
"3. Ask the anesthesiologist about anything that you do not understand or that worries you."
They also say to ask questions of your doctor and the nurses. Now I realize that a significant number of patients don't know what to ask,and don't know what to expect. but if you read documents like the one you refer to, if you read them carefully -- patients should be able to surmise where the holes are and what's not being said.
If gender issues bother you, e.g. opposite gender care, you should bring them up. Yes, they should bring these issues up. But the odds are they won't.
Be honest with your concerns. If you want the details, ask.
Doug/MER
Thought you might be interested in this report where nurses have been dismissed in an Austrlian Nursing Home for:
"The anonymous whistleblower told The Sunday Telegraph that the "Genital Friday Club" involved photographing the genitals of the residents on an iPhone and then passing the images around for colleagues to guess who they belonged to.
It was alleged three nurses had told an elderly woman with dementia that her husband was having an affair with her best friend while she was in care."
This is the link to the article.
http://news.ninemsn.com.au/national/8220305/nurses-fired-for-abuse-of-elderly-residents
Chris
For the blogs consideration. This youtube video shows what is typical in the operating room prior to draping and surgery.
This appears to be a training video on induction and patient positioning. Although this is not a US video, it is nonetheless the world wide common practice.
Typical Prepping in the OR
To the poster a few days ago that mentioned video in the OR, it is becoming VERY common for live video feeds from the operating room to be streamed to conference rooms for classroom observation of surgery, or for institutional scheduling of the OR. These video feeds generally are not turned off. With the proper password, anyone can access the feeds from their laptops anywhere in the world.
The OR today is anything BUT a private place. And as you can see, the patient generally at the beginning and end of the operation is completely exposed.
Shown here also is a brief view of foley placement which in my view was gratuitous.
From interchanges with Dr. B, his contention is that he sees nothing wrong with this picture. Modesty has no place in the OR. He has never really given an opinion however regarding the ethics of broadcasting from the OR. Generally the pt is forced to sign a video waiver as a condition of treatment.
-amr
I feel the opposite of many - I'm female, and wouldn't want a female gynecologist - I'd be much more uncomfortable being examined by another woman.
The first post talks about patients being offered a chaperone when appropriate - but for a gyn exam here, a female chaperone would most likely be forced upon a woman. I personally would be horrified.
I realize I am unusual in this, but I think I'd have no luck these days being able to have my privacy desires accomodated.
TAM
TAM, you are definitely not alone. I am a female who also feels more comfortable with male gynecologists, and I HATE chaperones of either gender. (They just gawk, and make an uncomfortable situation even worse.)
But I doubt we would be accomodated if we choose an all-male medical team for surgery.
They would probably think that was even stranger than patients who want same-gender teams.
LAV
Punitive treatment with loss of dignity and forced nudity constitutes at the very least cruel and degrading treatment and at the very most psychological torture and is against the law
gd
I am curious if LAV and TAM have had much medical care, ie surgery or child-birth as your experiences do seem to be very different from the vast majority of women.
~Charlotte/Gail
BJTNT caught a SPAM posting written to this volume on March 7 2011 which was a reproduction of what BJTNT had written to Volume 33 on May 10, 2010.
I deleted the spammer but am presenting BJTNT's comment here because I think it remains pertinent to the current discussion. Thanks to BJTNT for picking up the blog violation. ..Maurice.
Monday, May 10, 2010 1:24:00 PM, BJTNT said...
It's appropriate that we are critical of medical operations for their unnecessary control of patients, especially when it comes to modesty. But, keeping some perspective, control is inherent in human nature.
A scientific study showed that when people are waiting for a parking spot, the parked car driver takes longer to vacate the spot.
A key point is that we expect higher standards from medical operations and I believe Dr. B. agrees. We patients need to keep the pressure on. This is easy to say, bu difficult to accomplish because of the fear of retaliation by medical staff. The violation of patient modesty is done with impunity because the supervisors have the same mind set. The administration can't be bothered with patient modesty other than token denunciation. It's beneath the dignity of an MD to be concerned with such mundane matters.
Therefore, from the medical staff standpoint, retaliation is a no-brainer for them since they can almost always get way with it.
BJTNT
Charlotte, I've given birth four times, have had three surgeries, and a couple of out-patient procedures. With the exception of the male doctor who performed my colonoscopy, the males have always treated me with respect & dignity, and were compassionate & empathetic. Not so the females. One female ob/gyn actually made a face when she saw all the moles on my body during an exam, and told me I "really needed" to see a dermatologist. I felt like a freak. I mean, if a doctor thinks you are disgusting , you must be! No male doctors ever reacted that way when looking at my body, or at least they knew better than to show it.
I have a poor body image as it is, and always feel judged by other women...
that may have something to do with my gender preferences.
LAV
I haven't had children, but yes, I have had medical care and I have had surgery.
I agree, I wouldn't want a chaperone of either sex, but somehow, another woman is worse. I believe it just feels more "natural" for a man to touch me, than another woman. No big reason why, it's just how I feel.
As far as surgery, I'm different from some here. I really don't care who's there, who looks, how naked I am, whatever. I doubt my body is that unusual and interesting to them. Since I'm unconscious, I don't know about it and it doesn't bother me at all. Frankly, I don't even care if they make jokes, since I won't know about it.
Video and pictures of surgery - I wouldn't care, as long as it doesn't show my face, and if shown to a group later, my name isn't given.
I did, however, tell them they had to put me out before they did any prep, and they accomodated that. I did not, however, present it as an option - I just said "You may not prep me until after I'm out".
I don't mean to discount anyone else's modesty concerns - this is just how I feel, it doesn't mean I believe anyone else should feel the same.
TAM
When you take the comments of TAM and LAV into consideration it is easy to see that everyone has different preferences and comfort levels. The issue that a lot of us more modest folks have is that the medical community doesn't seem to understand that it is a significant concern for some (and maybe a lot!)of both men and women. I do agree that women providers, as well as men, can be insensitive, inconsiderate bores; it's all based on the individual. But that said, I would still feel more comfortable with a woman doctor, nurse, etc. if I have to be in any state of undress (I am a woman). Actually, I am not too comfortable being that way in front of ANYONE and it is probably the main reason I dislike going to the doctor. Fortunately I have been able to avoid a lot of medical care because I have excellent health and don't go in for all those "recommended" screenings precisely because of the embarrassing nature of them. I have, however, had a few incidences that were less than positive and those incidences wouldn't have been as upsetting had males not been involved. Just my feelings. Again, everyone is different and it would be nice if that was acknowledged in the medical arena instead of them treating all patients in the same way.
Thanks Lav, Tam and Jean. It is late as I am reading these posts so I am probably too tired to write a "proper" reply but I appreciate the feedback. I guess one thing that does occur to me is that our experiences can very much dictate how we feel about this issue. And, I agree, to a certain extent that, what I don't know won't hurt me. In other words, it is easier for me to accept the fact that, with surgery, I may be exposed, as most people are, for a short period of time and that some exposure can not be avoided.
However, I had a recent "modesty violation" of such magnitude that my opinion has changed on all of this. I have had children (many years ago) and other medical procedures also. I am of the age where we did not have the choice of having a woman doctor, there just were not any around. Some of my past experiences with male physicians were very negative but I got past them until the most recent situation. It would take a long time to explain and this is probably not the forum. So, now I am going to avoid male physicians when it comes to more intimate care and will make a point of recommending the same to other women. I am sure we could have an interesting discussion about this topic and I would be glad to give you all my reasons and opinions and would enjoy hearing all of yours in more detail too.
Thanks, again for your replies.
~Charlotte
Lav and tam
I can appreciate your perspectives,yet it is much more
Involved for the male patient. Any aspect of unprofessional
behavior among medical staff almost always involves a
male patient. Inappropriate cell phone pics,comments and
Lack of appropriate draping to sexual assault. This is
Nothing new to males as it starts in high school with sports
physicals,continues with military induction physicals and
furthers whenever medical intervention is needed.
The problem is two fold,the high percentage of female
Nursing staff,about 95 percent and the perception that
Anything is fair game with male patients.
Pt
Lav and tam
I can appreciate your perspectives,yet it is much more
Involved for the male patient. Any aspect of unprofessional
behavior among medical staff almost always involves a
male patient. Inappropriate cell phone pics,comments and
Lack of appropriate draping to sexual assault. This is
Nothing new to males as it starts in high school with sports
physicals,continues with military induction physicals and
furthers whenever medical intervention is needed.
The problem is two fold,the high percentage of female
Nursing staff,about 95 percent and the perception that
Anything is fair game with male patients.
Pt
The comments TAM wrote made me shudder, not so much because of moral outrage, but because the medical community does take advantage of such a mindset to get the job done, which sadly, seems to be all they care about.... Just because you're out doesn't mean something didn't happen!!!
That said, don't get me started when they do things to you that they don't tell you, only for you to find out later, if at all.
I also wonder what other posters, especially those that have different ideas regarding modesty and body exposure would consider retaliation, and whether there's such thing as a man's idea of retaliation vs. a woman's.
MARIA
Interesting comment from a student nurse blog:
"It IS, in fact, totally possible to objectify the bodies one cares for. After seeing thousands of genitals, they are no longer the mysterious thing that society's dress code tries to disguise them to be. A few might think such desensitization to the sacredness of the "private part" is somehow inherently wrong, as if social mores were absolutes in all contexts, but this simply isn't true. If by losing my inability to giggle about penises and vaginas helps me to be a better caregiver, then such objectification is, in fact, the superior moral choice. To simplify: in this particular circumstance, seeing the things s/he sees prepares the nurse to be a better person rather than a worse one. To shyly turn away from serving your patient's best interests would be the perversion.
That being said, it is NEVER acceptable for any healthcare professional to perform a procedure the patient feels would violate him or her in any way. If a man requests a male nurse insert his Foley catheter instead, I would certainly make every effort to accommodate those wishes. When I assist a bed-bound patient in bathing, I always ask "Would you like to bathe your private areas, or would it be easier for you if I did it?" 99% of the time the patient doesn't care. But practicing sensitivity separates good nurses from excellent ones.
Those of you who feel extremely defensive of your penises, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like prostate exams! We women learn to get over much of our shyness earlier in life because of pap smears and childbirth. Men certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Urethral Resection of the Prostate (Google it) because of that choice, well, what's the point?
A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather her laugh, blush, and turn away? Or would you feel better if she treated it as business as usual?"
Here is the link:
http://iamanursingstudent.blogspot.com/2005/11/foley-catheterization-genitals-and.html
I saw that article months ago and as always I thought it
Was unprofessional. What would she think if the roles
Were reversed and when she showed up for her
Mammogram there would be a young male standing
There to do the procedure and commented,sooner or
Later a male mammography will see your breasts.
Pt
I just posted the following comment on the blog mentioned above:
"Good discussion. I would just like to challenge a statement made by one poster:
"We women learn to get over much of our shyness earlier in life because of pap smears and childbirth."
If that's the case, then why are most medical students studying OB-GYN females, and why is it not uncommon for men to be discouraged from going into that area? And why do the majority of younger women today prefer female gynecologists?
I don't think many women "get over" their shyness. They just didn't have a choice in the past. Now that they have a choice they're demonstrating their preferences. Frankly, the same goes for many men. When and if they ever get a choice, they'll show their preference. Don't confuse compliance, especially from a vulnerable, anxious patient -- don't confuse their surface willingness to go along with the program -- with acceptance.
That said, many other points made on this thread are interesting and well-taken."
That was my post. Objectifying the body isn't a problem, as far as I'm concerned, as long as the "person" isn't objectified as well. During a tricky procedure, the caregiver must focus on what he or she is doing -- which may involve focusing on a body part. As long as they never forget that there is a person -- a living soul attached to that body part.
Doug/MER
There is a surgical center in Pa. that is now offering all female staff for female patients and they've seen their female patients rising. They decided to do this because they could based on staffing. Should this turn out to be a major money maker and success, why not offer the same to the male patients? I'm going to write to them suggesting just that!
gd
There is an interesting topic and response to that topic on allnurse. the thread is since when did it become ok to abuse patients. The author I believe might have been motivated by an earlier post where nurses were discussing patients who reject nurses, sometimes based on things such as race. One of the posts talked about how an elderly female patient rejected a LPN and wanted a "real nurse", so they sent in a male RN with a bed pan knowing it would be humiliating to have a male the inference was that will teach her. Whe she started the thread she got toasted by most of the nurses, and the thread was quickly closed by the moderator, a RN. And this ladies and gentlemen is what I see as the core of the problem, the us and them menality. They really raked her over the coals for basically siding with the patient. I still contend the issue of modesty to providers is completely different when the provider is a patient. They feel threatened when challenged with the hypocracy. It truely is a us and them mentality...and yet, we are to trust them without questioning them....there are times when the site encourages me, and times when it disturbs me, providers do not take criticism well...alan
I tried the iamanursingstudent address but could not connect, it sounds like the jest is, if we are ok with it, you should be ok with it, once again ignoring the fact that guess what ITS NOT ABOUT YOU
Doug, I agree 100%.
Women have not gotten over shyness (i.e modesty), we just did what we had to do. Most women over 50 did not have an option, we had to accept care by a male ob/gyn if we were going to have a baby, etc. We had to endure the discomforts and loss of modesty of giving birth because there were not a lot of other choices other than hospital birth and male doctors. Woman today are choosing midwives, doulas, homebirths etc. I think a lot of this was a needed reaction to the way things were done when childbirth was male-dominated.
Without the networking that the internet has brought, we would have thought we were being prudish or weird to be uncomfortable with male doctors. Now you can easily "google" this topic and find a lot of women who state they would never go to a male ob/gyn. You will also find some who say they prefer a male, probably due to a particularly bad experience with a female doctor but I would maintain that they are in the minority. I think women will continue to seek out same sex care more and more as I even know women my age who, after years of going to male doctors are deciding that they want to feel more comfortable and open in discussing their health concerns and are making the switch to female physicians. By making these choices and being more pro-active, women are getting what they want. Men will have to do the same but I think they have a longer way to go because many have not been willing to speak out.
The nurse's comments which you also refer to only undergird the assertions made in this medical-modesty blog, which are that patients want to maintain their modesty and dignity in a hospital setting and they want health care professionals to appreciate this. If this nurse had to view "a thousand genitals" to become desensitized, how can a patient be expected to be desensitized during his or her visit to the hospital??
~Gail
It's occasionally good to be reminded [student nurse's blog above]of the medical operations' viewpoint concerning patient modesty. It's good [and a worthy goal] that nursing schools teach perspective regarding medical modesty.
If the medical operations' premise regarding patient modesty were "Most/many/some nurses and MDs can be taught to objectify the human body most/much/some of the time", then there could be good interplay. Their generalization [Quote: "It IS, in fact, totally possible to objectify the bodies one cares for." Unquote] is too broad to be accepted. Maybe it is possible to make some people believe this premise most of the time.
For the sake of discussion, let's accept the premise that nurses and MDs can [and should] objectify the human body. Why would they want to deny their sexuality and their humanness? Why would I want an MD to oversee my medical treatment by medical personnel that see me as an object? Objects are disposable. Objects have no rights - they are controlled by owners and modesty isn't even a consideration.
Then again, maybe we patients are just objects to be controlled by medical operations at their convenience.
BJTNT
I can't speak as a doctor -- but here's my thought on this. There's an interesting drama enacted between doctor and patient within hospitals. Is it any accident that operating rooms are called "theaters?" Ernest Goffman and other sociologists write about this dramaturgy. Patient begins as a person, often, when meeting the doctor and staff. "How's the family?" "How as your vacation?" Then the shift begins. The patient escorted to the examining room or the OR. The patient is given a gown. The patient is gradually stripped of his/her humanity/clothing. The two are connected. The patient gets on the examining table. The doctor and staff begin their work. Assuming the patient isn't knocked out and can listen he/she notices that the conversation between caregivers becomes less focused on the patient and either more technical or more focused on themselves. Most often the kind of personal interaction I quoted earlier doesn't happen now. The patient becomes an object to be worked upon. Speak only when spoken to and answer the question. When it's over, the patient gradually becomes a person again and is regarded a such. He/she leaves the exam room or OR, becomes more alert, may get a change of clothes (out of the gown), etc.
I've simplified this, but you can find some writing in this vein among sociologists. It's a little play, a little drama, with it's own script and dialog. I don't mean to suggest that doctors and nurses don't care about people as persons -- but at some point, their focus is on what they are doing, and that focus may be a leg or a gall bladder or a heart. Can the process become too much focused away from the human being and into the body part? Certainly. If caregivers start talking about the "gall bladder" in room 102 (doing this on a regular basis) instead of Mrs. Jones, then they may begin losing some perspective. But I think most doctors and nurse understand this dynamic well and try to keep it in balance. Obviously, some don't.
Doug/MER
There'a another piece to this. The objectification allows the medical personnel to perform their job leaving emotionality out of the equation. It is when this mode goes into full gear that the medical community disengages from the personhood and modesty issues thereby don't exist. There's an excellent book called The Objectification of the Human Body in Medicine; an interesting read.
gd
" We women learn to get over much of our shyness
Earlier in life because of pap smears and childbirth. "
In 1980 to 1981 there were 109,035,000 visits to ob/gyn's
By women aged 15 to 44 years of age.
During these two years female ob/gyn physicians averaged
49 patients per week while male ob/gyn physicians
Averaged 69.5 patients per week.
Clearly,women ob/gyn's certainly were less busy and could
Accommodate more female patients.
In 1981 there were 400 female ob/gyn physicians completing residency programs versus 900 male ob/gyn
Residents.
If a female patient wanted a female physician to deliver
Her baby that was clearly Not a problem.
FUrthermore,you never saw and even today you still don't
See male nurses in L&D.
Try to get those kinds of statistics when you are a male
Patient with a urology problem!
Pt
Part 1
If there were ever a caregiver who gave us a clear view of the process and truth of medical game playing, it would be this one.
“We build up the most interesting environmental associations. Being in a certain setting, playing a certain role, and wearing a certain costume makes all the social rules change. Sometimes the roles can be de-humanizing (people expect super-human responses to their problems, especially from doctors). When someone fails while playing their role, we are disillusioned and disappointed with the role (profession!) as a whole, and not just the offending individual”
We have discussed this often, but what is she really saying?
“I have chosen to earn my paycheck by becoming a member of a special club. This club will promote the idea that I am beyond all social boundaries, and has the built-in agendas to assure that this will usually be accepted. People will project on me their beliefs that I am noble and virtuous, and will accept therefore any and all humiliation and embarrassment as part of my caring nature. If I do not play my ‘role’ well, the illusion will shatter, and people will realize that this is just a game I play every day with their bodies and minds. If people become ‘disillusioned’ then I will no longer have power and control, or a paycheck.”
Can it be any clearer that?
Part 2
But perhaps the most telling in exposing the selfish nature of the ‘game’ is this..
“Those of you who feel extremely defensive of your penises, beware. You are getting older. As you age, you will have many more opportunities to be in "vulnerable" circumstances. Like prostate exams! We women learn to get over much of our shyness earlier in life because of pap smears and childbirth. Men certainly have the right to refuse their checkups out of modesty, but if they end up needing a Trans-Urethral Resection of the Prostate (Google it) because of that choice, well, what's the point?
A day is coming, fellas, when a nurse will see your penis. It might not happen until you're 85 years old, but it's very likely to happen. On that day, would you rather her laugh, blush, and turn away? Or would you feel better if she treated it as business as usual? “
This is not caring treatment. This is a threat to all men that something terribly humiliating will happen to them , likely beyond their control, and there is not a damn thing they can do about it. Yes, I see how noble that is….
If men feel” defensive of your penises” then that is their right. If men have social, ethical or moral views of their naked bodies, then that is again their right. If men (and women!)” will have many more opportunities to be in "vulnerable" circumstances” then that is a tragedy, not an opportunity for threatening exploitation.
Her point is really to give up now, stop fighting those with inevitable control.
Bullying, threatening and coercing people into submission, in or out of a facility, is a disgusting practice. I can only hope that she is either one year smarter than her last post, or we are all one year stronger.
PT, I couldn't agree with you more. I think it's important to see why this happened and how it happened. The bottom line is that men are not aggressive in spelling out their demands. when that happens, it will be a more playing field.
I encourage my husband when he has intimate testing to ask for a male team and he has been accommodated. More men must have the courgage to demand that their doctors staff the office accordingly.
I would encourage every male who goes to a urologist ask for male assitants. When the doctor won't accommodate, take your business elsewhere and shop openly about your gender preferences. If enough men did this, they will be heard; just as the women have been heard.
gd
Here's an interesting thread on medical students feeling uncomfortable about using each other for physical exams and they aren't even intimate.
http://forums.studentdoctor.net/showthread.php?t=485309
"Clearly,women ob/gyn's certainly were less busy and could
Accommodate more female patients."
Many female ob/gyns have family commitments.
And there are male midwives around at least here in Australia.
NP
At my medical school, the students do examine each other within limits of modesty set by the student who is being examined. As their instructor and as the school itself, we listen to their expression of limits and do not force an act that goes beyond those limits. Nevertheless, except for direct breast exams in women students (though they do wear sports bras for cover for their chest exams)and for genitalia and rectal exams, examining by other students, regardless of gender differences, the remainder of the systems to examine is accepted by virtually all students. My conclusion: if students being examined in class can speak up and be listened to and made comfortable, physicians should treat their patients who have specific modesty issues the same way. ..Maurice.
Male ob/gyn physicians have family commitments as well,
but as I've said before,whatever happens in Australia
Is not my concern.
PT
"My conclusion: if students being examined in class can speak up and be listened to and made comfortable, physicians should treat their patients who have specific modesty issues the same way. ..Maurice."
You make a good point, Maurice, though I wonder whether what medical students learn in that regard carries over into their practice after a number of years. But the point is well-taken. Given the discomfort a significant number of them feel with the exams by fellow students, you'd think they'd then understand that many of the general public feel the same way. But, the reasoning I often see from medical students is that their situation isn't the same because they are working with colleagues, fellow medical students. The assumption seems to be that it would be completely different in all cases when working with strangers, even from the patient perspective. I question that assumption as a general truth. People vary considerably. Some would feel comfortable having intimate care with people they know. Others would not. And some patient don't feel any better modesty-wise just because the caregiver is a stranger. The caregiver may feel better in that situation, dealing with strangers. But that's another issue.
Doug/.MER
If you're interested in the legal aspects of patient privacy, take a look at my just posted book review.
"you'd think they'd then understand that many of the general public feel the same way."
I think that is a good point. Of course they understand that people feel the same way.
This is not the big doe-eyed mystery that the medical arena wants to keep making it out to be. We all make modesty decisions in our daily life from the time we wake up until the time we go to bed, and caregivers are no exception. Curtains, doors, clothing, sex,strangers: modesty is simply a part of our daily life.
It is impossible for modesty to come as a surprise when everyone engages in modesty decisions everyday. Likely 2 or 3 times before you even get to work, so where is the surprise?
This really is not high level science.
This point of students being concerned about modesty of their own bodies points out that
they ARE aware and sensitive to it from the very beginning. Just because they want their own bodies to mean more or be more superior/sacred than ours does not make it so.
Honestly, if someone I am uncomfortable with wants to do something to my body that I don't want them to do I say no. Just because I am in a facility does not change the rules, just the games being played.
They can believe whatever they want, but if I am their inconvenient truth then that is their burden to bear...not mine.
swf
I really don't think there is much doubt in my mind they know, however to acknowledge they know means they will have to do something about it, which either they can't or more likley don't want to as it will take time and money. So instead they provide what is easy for them, they use professional terms, explain what they are doing, they profess they are professionals and they justify it that since they have done these things they have addressed the issue. the problem is they do so on their terms, not the patients terms. Often when a provider is a patient the facility makes special provisions claiming familiarity makes it different, they know, its just really inconvient to acknowledge or accomodate so its deny deny deny,,,alan
Alan, I want to emphasize that I teach and I know my colleagues also teach the first and second year medical students who are learning to perform physical examinations on real patients that now and throughout their career the students and later as physicians must have the patient's permission for any examination unless it is an emergency with the life of the patient at stake and the patient is in no mental state to provide consent and no surrogate is available. I warn them that anything short of such patient consent represent legal battery. They know this and I watch them and they are getting consent. What happens in later years.. well, only the patients really know! ..Maurice.
I've never seen any exam without consent in practice - except in the ER.
Like I've stated before, it's common practice to remove the surrogate to the waiting room.
I hate to use the example of TV - but that's one thing that seems fairly accurate - you commonly see people waiting nervously in the waiting room, with no idea of what's happening to their family member.
TAM
Dr M, Even in an emergency, you can still decline treatment if you are mentally competent. I personally, have a letter on file attached to advance directives at my hospital. Should anyone ever try to do anything against my will, they will be punished to the fullest extent of the law regardless of the result of their interaction.
Modesty issues are so fundamental to who we are, our past experiences and attached to the psyche than any other type of experience, it doesn't make sense that the medical community wants to ignore this issue. It is just as important (and in some cases more important) than medical care received.
gd
Dr Bernstein, I have no doubt you and some others teach this aspect of patient modesty. Your and Dr. Sherman's blog really makes me believe you and by extension others recognize this. I think the problem comes from several areas, first over time providers (nurses, Dr.'s etc) become numb to the issue, they "see it all the time" and project their lack of issue with it onto their patients, if its no big deal to me it shouldn't be a big deal to the patient. This could be simply self serving or just the course of time taking over. The second thing that wieghs in is the shortage of time. Providers are pushed to do more with less as the cost of medical care becomes increasingly examined. It does take time to accomodate if a patient asked for a different gender provider for intimate procedures, so they don't ask justifying it in numerous ways. And 3rd, the one I feel has perhaps the largest effect, medicine is a business, we have administrators who are business people running hospitals. They are not on the front lines dealing with patients, they are looking at P&L's and balance sheets. They are going to find the cheapest way to handle the largest number of patients. Incuring additional labor or appearal costs (surgry, colonoscopy shorts etc) does not benefit the bottom line, if we can intimidate,or if we can still get the patient and not accomodate, thats what will be done. It has to be people like you teaching this, and people like us saying no, I won't just take it in larger numbers to change this.....alan
Dr. Bernestein never said mentally competent patients couldn't decline treatment in the ER, gd. He said if they weren't mentally competent and no surrogate was available to make decisions on their behalf. The situation would become one of implied consent at that point.
Dr. Sherman and I have posted a new guest columnist, Carolyn Thomas. As a heart attack survivor, she has written about her experiences and how staff burn out may contribute to modesty violations. You'll find the article here:
http://patientprivacyreview.blogspot.com/2011/03/privacy-modesty-staff-burnout.html
Doug Capra
Anon said "He said if they weren't mentally competent and no surrogate was available to make decisions on their behalf. The situation would become one of implied consent at that point."
Yes, but the key there is if no surrogate is available. There often is one, but their consent is not sought. The ER staff creates that "implied consent" by simply keeping the surrogate out of the way so they have no chance to object.
I believe any spouse, parent, etc. is by default the legal surrogate. Yet, often they are not consulted. Even if you have it in writing, the surrogate is often not consulted.
People have their clothes cut off, catheterized, etc - the surrogate is not consulted, nor even informed until well after the fact.
TAM
A few days ago, I had the plt, I arranged for all female personnel that isn't always easy (sorry PT). I wear my own shirt that I prepared with a velcro front keeping it closed during the echo portion of the test. Additionally, I wore a thin flimsy (for a better lack of word )sports bra that I simply pulled up to my neck while exiting the treadmill keeping me still so to speak.
I will say that the tech did not leave the room while I prepared but there was a curtain partially pulled giving patient privacy.
gd
There is an interesting thread running on allnurses, it was started by a guy who said his girlfriend is a new nurse and talks about her patients penises to him and with her other "nurse" friends. The conversation is spirited and runs pretty consistant, the nurses condemn the activity, say it is not common, unprofessional, and unacceptable. But the interesting thing that came out of it was under cross it seemes his girlfriend is not a nurse, but a CNA, and the discussion goes to how many times are the actions of those in scrubs attributed to "nurses". Thinking back I recall a conversation I heard at a party that was totally inappropriate and I talked about how disturbing it was to hear a nurse talk about patients that way. Looking back she was a nursing student....just an interesting note. Not that it makes it better, but we might be more cognicent when we say "nurse"
gd
There is no reason to apologize to me as in my
mind this entire problem entails male patients primarily.
Women have an entire support staff,options,nation
wide female mammography techs and all female L&D
staff. Over 87 percent of all chief nursing officers are
female.That means someone in administration will hear
you roar should you have concerns about your privacy,if
your complaint gets that far. Over 90 percent of all
directors of outpatient services are female and over 91
percent of all directors of nursing floors such as
Intensive care units,burn units,neuro step-down units
and surgical floors are female.
Furthermore,the directors of All L&D floors from what
I am able to gather are 100 percent female. Now for those
threads on Allnurses about male patients not getting privacy,well they have a solution for shutting them up.You
see in my opinion to some degree it's about the first amendment,freedom of speech.Yet to quiet them they
simply shut down the thread.That's the easiest thing for them to do.
Another tactic that's used is for many women to pretend that their problems surmount male patients privacy issues,
yet,many can't face the facts that they are well past their prime and no one is really looking at them or gives them
a second thought. The problem is all in their minds and by
creating these so called issues somehow makes them in their mind desirable.
PT
PT, It wasn't an apology to you as much as an acknowledgement of your struggle interest and support of it.
While statistics may show that women get more support, the struggle of we women when it comes to getting accommodations is sometimes daunting as well, especially when it comes to diagnostic testing, surgery and the ER.
It is my hope and expectation that in years to come, both accommodations will be easily met for those who need them due to the detrimental mental health issues that accompany what amounts to forced opposite gender care, forced bodily exposure and psychological sexual assault for everyone who chooses same gender care. The laws already in place support it. We all have work to do and that includes the men. They will have to choose between their macho ideas of themselves for for what they really want. A really strong man will stand up for his rights and let "sticks and stones" lay where they may.
It is good that men have that advocate in you, PT. The men though do have the additional burden of overcoming the psychological issues that keep them from speaking up and when ridiculed, let the staff have it. We women do it every day and we get what we want...most of the time.
gd
gd said
" the laws already in place support it. "
Would you explain that law please.
Some of the your comments I agree with,however,
when you visit these hospitals and clinics all you see are
Sea's and sea's of women. How is it then that accommodations for all women staff can be so daunting.
Last year on a flyer I saw a new cardiac cath unit
that had opened and with this new unit came a flyer.On
the flyer were pictures of the three cardiologists and a portfolio landscape of the nurses and technicians.There
were 60 of them,all women. You can't tell me that they
could not find at least one or two males,come on.
PT
I recently saw an article on MSN about people working in professions dominated by the opposite gender. One of course was male nurses, it said 6% of nurses are males, up .75% from 10 years ago. The think that caught my eye was the statistic that hospitals are 80% or more female. While I understand the attitude that patients don't or should not care complicates things for females as well, the sheer math shows it is much harder for males. Toss in there the attitudes that males don't care or even "get off" with female providers, and the whole area of affirmative action and males are really up against the wall. A friend of mine just had a urinary scope, he told about being in the stirups while the urologist did the proceedure an a female nurse just stood by the Dr. and did nothing at all, not even handing the Dr instruments. Would we ever see a female GYN have a male assistant just stand and witness a pelvic exam...doubt it. Not saying at all women don't face some of the same issues, but anyone who thinks it isn't more difficult for males is kidding themselves....redfaced in at the Dr's
Yes, when the Civil Rights Act was passed in 1964 it said that no one could be discriminated from work due to age, gender, religion or race.
There is one exception though. It is for the privacy of the individual needing a service and is considered a bona fide job qualification for certain jobs. Example....a restroom attendant working in a ladies room would have to be female. The healthcare industry decided to ignore this issue. During the 1950's it was common to have an orderly prepare male patients and take care of their intimate needs. The patient bill of rights states issues regarding the dignity of the patient yet is it ignored. Every patient is within their legal right to demand same gender care especially those who have a history of sexual assault or abuse. This las has been uppheld in court.
gd
Some people blame Doctors, some people blame caregivers/nurses/ auxiliary staff, some people blame patients, and some people blame each other. This speaks to the frustration and helplessness we may each feel on the subject. We all have bias to some degree: I know I do. I have maintained,(and still do) that doctors have more respect and understanding of the gender, dignity, and respect issue than others in the medical arena. Whether it is because they need to see the whole person, from painkillers to anti-depressants, or they are cautious of a litigious society, or the greater human experience leads them to the field of medicine: only they can say. Does everyone agree? Certainly not.
There are also facts we cannot dispute. More female caregivers gives men less opportunity for choice in intimate care. Yes, we all know it. Many women are rallying against that so that everyone, despite gender, has the opportunity for respectful care. Are there enough women doing this to satisfy some men’s dissatisfaction against them? Perhaps not.
But sometimes the subject gets stretched pretty thin.
"Another tactic that's used is for many women to pretend that their problems surmount male patients privacy issues,
yet,many can't face the facts that they are well past their prime and no one is really looking at them or gives them
a second thought. The problem is all in their minds and by
creating these so called issues somehow makes them in their mind desirable."
One cannot suggest that someone is at once both relieved and jealous of the same circumstance. To say that women are happy about their options, but also upset they are not feeling quite as abused and used as men is absurd. That is like saying"why did the guy rape my freind and not me? Am I not good enough for him?"
I think this is perhaps a bit too farin the gender debate.
swf
swf, interesting post, not sure I completely understand your post completely, but thought provoking. I think the other side of that is to say men have it worst so women have no room to complain is missing the point. My take is men do face more challenges becasue of the gender dispairity and societal prejudices however it neither diminishes the impact when women are faced with it, means women do not face issues like this, or perhaps more to the point means the issue is not something men and women face in common, the issue is at its base root/cause the same, providers either not recognizing or pretending to not recognize the issue for a self serving reason....either way, pulling together accomplishes the same thing for both genders....alan
swf
There are many,many women who don't want
to see an increase in the number of male nurses.Who
might these women be you ask? Female HR directors,
female Cno's and directors of various nursing floors.
After all it was they who blocked men from
Cross training into mammography and blocking male
nurses into L&D. Women never held up signs telling
hospitals don't hire men. It was done by women on the
Inside.
Many women will state claims that they can't get
an all female team.Another subversive act simply to
undermine the need for male nurses. "All male nurses are
gay." Women in healthcare propagated this idea so as to
give the message to men " nursing is not a real mans
job,see only gays become male nurses.
Many male nursing students claimed they were
discriminated against and/or not allowed to care for
female patients while female nurses were allowed to
care for both.
I've read many posts on Dr Shermans site on the
womens privacy issues. Several posters I recognize as
female nurses from Australia posting on all nurses. Funny
how their disposition changes,always the victims.
Another invalid complaint you read about that there
were not enough female physicians in the past and that
women were "forced" to see male physicians. If all physicians were 95 percent female you would still see a
large percentage of females seeking out the male physician.
The most popular reason why female nurses say that
we need more male nurses " so they can help us do all
the heavy lifting" ......really,
In conclusion,women in this country should be complaining about Muslim women. Apparently,Muslim
women are seen as some kind of a special minority.
Why,I don't know,however,because of their (fatwa),
religous beliefs they are religiously excluded from airport
body imaging,and in new York one Muslim women is
sueing the state. Her reasoning,she should not have to
disrobe her face for the drivers license photo.
Sad really for me to served this country during the
Vietnam war,paid taxes all these years. I would like to
see Muslim women stand in on the military induction
physical I got with female clerks watching. My neck was
on the line so others could enjoy their freedoms,yet they
couldn't even grant me a few moments of respect for my
privacy.
But then i've never seen a Muslim women carry an
M-16 in the us armed forces,let alone a male Muslim.
PT
alan:
My point was mainly that within PT's quote the idea that woman may be older and feeling unattractive may cause a type of jealousy (my word) for the unwelcome medical attention that men face,is in direct conflict with the idea that they are happy with all of their options that men do not have. The two thoughts are in conflict and I can't see them both as valid. I believe this stretches the usual gender wars we see here quite thin.
I as well believe that the scales are extemely unbalanced as far as male vs female options, and since neither are perfect both genders have valid concerns.
Quite frankly, my blog addresses male modesty much more often than general or even female modesty.
My opinion: Male modesty options will happen more quickly when more women start standing up to other women and hold them accountable. After interviewing and interacting with so many female caregivers, I find this is a larger female-to-female issue than most care to admit.
PT: Again I will say that otherwise much of what you say I agree with, perhaps not always the way you say it. Yes, many women do not want to see more male nurses: more male nurses mean less female nurses, and with that the fear of losing a job means more to them than male patient modesty. But also realize that many other women do not consider patient modesty options fair and valid unless it applies to everyone (male and female)equally. And for that we should be striving side by side to make choices better for everyone.
swf/Suzy
While women may be equal under the law, we are different from men, physically and psychologically. Complicating matters is that one in three women will be sexually assaulted during their lifetime and men one in six. Women develop PTSD more often then men (they don't know why) and a high percentage of sexually abused/assaulted women develop PTSD. Argue as some might on this site, the bottom line is the percentage of sexual assaults performed by men versus those by women is completely lopsided. Women are the submissive in our species and the ones who fear more for sexaul assault. I'm not saying that it doesn't happen to men/boys, it does. However, the statistics show that males are primarily assaulted by other males (especially children) and the numbers are quite lopsided. Call any sexual assault hotline or simply look on the web and the answers are before us. Women feel differently about their bodie and because of their propensity for developing ptsd makes them in and of itself more vulnerable. That does NOT mean that men should have any less privacy protections and that we all need to be heard. While PT says that it's the women who prevent men from L & D and mammography, the reason that they are able to do so is because of the Bona fide job qualifications for same gender care; otherwise it would be illegal and it is not, for this privacy inclusion in the Civil Rights Act.
gd
gd
Is that the " sexual assault " card you are playing
on that last post. Let's look at assaults that occur in
Institutions such as hospitals,prisons and schools.
The dept of justice says that Female prison guards
bear the most guilt where sexual assaults on inmates
are concerned. Young boys are sexually assaulted at
a rate 7 times higher than previously thought in detention
centers by female guards.
We are seeing a dramatic increase in the number
of teachers having sex with male students and when you
look at state nursing board displinary actions,more and
more female nurses are reprimanded for boundary
violations. As far as sexual assaults on patients,hospitals
are doing an excellent job of keeping assaults from
reaching the newjspapers.
Recently,laws in several states were passed requiring
hospitals to report cases of sexual assaults within 24
hours to police. Look at the case in NM with the female
ent who was groping unconscious male patients.
Female nurses in the OR knew this was happening
yet never reported it.So much for patient advocacy and
don't think for a moment this doesn't happen often.
"while PT says it's the women who prevent men from
L&D and mammography,the reason they are able to do
so is because of the bona fide job qualifications for same
Gender care,". NOT TRUE
PT
PT, I respect your postings and statistical knowledge but I have one request to make for you and the other posters here who provide us with data appropriate for the discussion. Could you all provide a link to or some documentation of the source where the data was obtained. It is not that I don't trust you but in many studies there are nuances to the study and data which might be interpreted by us differently if we could have access to the source. Everyone, try to remember to do this. It will make the discussions here so much more scholarly and why not more scholarly especially if the references can provide added significance to what is written here. Is this too much to ask? ..Maurice.
Here's Dept. of Justice Report PT references about the abuse of male juvenils by female guards or caretakers. Plenty of stats to analyze. It's shameful how this story hit the press and then just disappeared. This is a real elephant in the room issue. Few want to face these stats. People just don't want to believe it. Others want to hide it.
http://bjs.ojp.usdoj.gov/content/pub/pdf/svjfry09.pdf
Doug/MER
PT, the unemployment act of 1964 says that discrimination in the workplace is illegal if it is based on race,gender or religion. It's as simple as that. You cannot hire same gender personnel and exlude competent members of the opposite sex that is legal EXCEPT for the bona fide job qualificiation clause due to privacy.
While I recognize your frustration (an I am in support of your stance), the problem is not just a male OR female problem and the problem is not instigaged by only male OR female personnel. The problem is instituted by both genders.
Maurice, I will research and supply links to the sexual assault issues earlier posted after all is gathered. Great idea!
gd
Maurice, As promised here's a link to sexual assault stastics from Rainn. While the data is somewhat out of date and there are constantly changes, this article puts light into the problem of sexual assault. Also, other than penetration, there is a host of sexual deviances that occur in tics/sexual-assault-victimse hospital (and other institutions) that aren't even mentioned.
http://www.rainn.org/get-information/statistics/sexual-assault-victims
gd
I have been reading this blog for awhile but until now I had no desire to post.I keep seeing the posts from women that if your over 50 they had no choice but to use a male ob doc.NOT TRUE.You had to look but they were out where.Our first child was born in 1975 and she was delivered by a older ob doctor.She was a wonderful doctor.She was like your grandmother.Our second child was born in 1979 by a different female ob doc.(first one had a stroke)For both births,I was the only male present.For the first birth I stood next to the doctor, and if I would have asked I believe she would have let me help.Both births were a very pleasant experience.For 55 years she choose to go to female doctors,and only one was a mistake.At 55 she was diagnosed with lymphoma,but I guess thats another story.My point is they were out there but YOU had to look and you may have to drive to find them.(to us it was well worth it) AL
I forgot to mention.I was present for every exam , with the doctors blessing. Al
Al, you are correct. The problem is that the female doctor was one of many in a practice and the rest were male. During pregnancy you see all and it's up to who is on duty at the time of delivery. Been there.
gd
I think Al's post makes a good point, women most likely do have the choice of getting an all female team both in primary care, and in specialty. It may take some effort and planning, but males are most likely to not even have the choice, I have never seen a doctors office that had male nurses, same with specialty including urology, again, not that it negates the need and benefit of the genders working together for a universal solution, but to ignore or deny the fact that males face unique logistical and societal issues does not properly consider all of the facts....not trying to get into a who has it worse, but we do need ot be honest about the facts that feed into this....alan
Both of these doctors were a one doctor practice(we looked for that to avoid the comment you get what you get.She was your only choice.I will admit the one doctor practice is a thing of the past.For us it was great.I will also admit for me to get that same type of care,would be almost impossible.We are eternally grateful for finding 2 different doctors that gave such great care.I don't want to argue with anyone about it.I just want to point out that it can be done if they want. Still grateful 36 years later. Al
Alan, I agree with you. Everybody has it worse who doesn't have their most intimate, psychological needs met. Neither gender has it better when you get into diagnostic testing, ER and OR services. We need to work together. However, until the men start walking out the door when there are no male nurses to accommodate their need nothing will happen. If I were male, I'd pick several doctors of the same ilk and pit them against each other. Sooner or later when they feel as if they are losing patients, see how fast they hire at least one male tech to satisfy patient demand.
gd
One strategy men can use if looking for a urologist -- Call several urologist offices. Ask if they have a male nurse or male med. asst. on staff or available. You'll find that some do. If they don't, make sure you tell them that, because of that, you can't consider them.
Now -- You'll be talking with a receptionist or med. assist. So who knows whether your message ever gets back to those who actually run the practice. It may or may not. So -- I would suggest you also write a letter to the owners of practices that don't seem to accommodate men by having at least one male on staff. That way they'll get the message. Frankly, it won't take many letters, maybe two or three, before these urologists get the message. Women can use the same tecnhiques when they feel they're not being accommodated -- although, from my experience, women are much more likely to do this then men are.
Doug/MER
gd:
Good idea, and here's a thought to take it one step further. What if women did the same on behalf of the men in their lives? The next time a woman needs diagnostics, check out what other test they provide. Are they a facility that does not offer men choices in care? Then make that point, and note that they have lost the business of two people and not one. Perhaps if healthcare started to lose the primary female dollars, in would make a much needed dent.
Are woman willing to do that for the men in their lives?
gd you are right on the money. While men may have some special challenges, until we men start making our preferences known nothing changes. No one can do it for us, we have to learn from our female collueges and start saying what we want and standing up for it, no one will offer. The medical community is somewhat more cognicent of womens preferences because they told them and demanded it. Women still face challenges but they have become more comfortable asking since the medical community won't. gd, thanks for the reminder you are absolutely correct.
http://allnurses.com/nursing-humor-share/true-er-stories-6272-page4.html
Most of these "humorous"stories are about scrotums and rectums. If we are not supposed to be embarrasses about intimate care, why do they all make fun of us later? If I was one of there patients and read these posts I would clearly know it was me. and...if genitals are no big deal, them why are most of there funny stories about them?
sick sick sick of liars
I'm just not quite sure what to make of this post.
Yes, it seems like their old adage "parts is parts" is apparently not true. Obviously they find some parts funnier than others.
And, yes,I would be mortified if my (albeit anonymous) humiliating story was splayed out for all to read on the web.
And further: maybe it is true that they are only 'professional and respectful' while they are in the room with you, and turn into silly children when they leave.
Personally, I would rank this thread up there with the "PENIS" site regarding respect, but that's just me.
But:
ANON: You have to tell THEM that you are offended. Let them know that they are undermining the dignity of caregivers who post respectfully. Whatever it is that you feel, let them know. Nothing will change if we just read it and get angry.
There are good and bad posts on AN. Let the bad ones know you are watching, and thank the good ones for caring.
Otherwise, it's just more painful stuff to read.
swf
I agree with swf. allnurses is a mix of the good, the bad and the ugly. It's mostly good. But patient readers need to get on an share their disgust with threads like the one described. Don't be insulting. Don't be offensive. Just be truthful and civil. They may shut down the thread. They may get the message. These kinds of threads do no good for the nursing profession when open to the public.
MER/Doug
gd
There are no laws that say men can't work in mammography or L&D. Their movement into those
positions to train or work were blocked by usually the
directors of those units. Fact is while I searched
nationwide for males in mammography I did find
males in several states who were mammographers
but had retired.
Several male nurses on all nurses mention movement
Into L&D were blocked. The notion that male nurses are
perverts or should not be giving intimate care to females
and yet, I've even found examples of male physicians
being prevented from holding such positions.
We are seeing female teachers having sex with their
young male students in record numbers, female prison
guards being convicted of rape and sexual assault more
so than male guards according to the Dept of justice,
www.the eagle.com/nation/STudies--Female-prison-guards-lead-in-sexual-offenses
Regarding young males in detention are being sexual
assaulted more so by female guards and caretakers
than females in detention by male guards. The link
Was provided by Mer.
Sexual misconduct is not a common complaint to state
Boards of nursing. 38 to 52 percent of nurses report knowledge of colleagues who have had sexual misconduct
With patients. The NCSBN' reports that in some states
sexual activity with a patient is considered a criminal
Offense.
I've looked at individual state boards of nursing disciplinary records and the ratio of female nurses
committing boundary violations as compared to male nurses is 26/1. That is for every male nurse that has sex
with his patient,26 female nurses have done so as well.
One final note on male patients who are hospitalized
and make a same gender request for intimate care yet
are told accommodations cannot be made.
One option is for the male patient to be transferred to
another facility in which case the hospital must pay for
the transfer via ambulance. I can assure you that transfer
would be on the ceo's desk that morning.
PT
I believe men should not be a mammographer or work in L&D.I would think women would be more comfortable that way.(not to mention their husbands)Seeing how all the patients are female why not require all the staff be female also.That said, why not extend the same courtesy to the men.Being forced to stand naked in front of the opposite sex is humiliating and degrading.(except your spouse).Why should a person have to give up their dignity just so the health care field can make a little more money.Some of us feel no member of the opposite sex should see you naked except your spouse.Love waits is not a easy path to walk down,but when you find that special person it was worth it.We gave each other the gift of your virginity.No garbage from your past.Cherish that gift and don't let anyone take it from you.If you don't agree with me that is your right, but don't take away my rights either.I've worked to hard to get where i am.Male or female we are on the same side.Fight for what you believe in and never ever give up or surrender. AL
PT, You are missing the point. First, the law says that it's illegal to discriminate against anyone looking for work who is qualified and that gender, race or religion is irrevelent as long as that person can perform the work at hand. Clearly, males could perform all the work required in both labor and delivery and mammography. The privacy exception is the law that allows these institutions to legally select one gender over the other where privacy is a concern. Also, please show your reference source for statistics regarding the sexual abuse by female nurse as requested by Maurice. Thank you
gd
I have recently been told I need a prostate biopsy. I live in the UK and was very concerned to read this patient experience about prostate cancer.
http://www.healthtalkonline.org/cancer/Prostate_Cancer/People/Interview/1483/Category/132/Clip/9489/
gd
No,I didn't miss the point. What is said here and what really happens in the real world are two very different
things. Show me one example in healthcare where the
privacy exception applies. If that were the case this modesty blog would not exist!
In 2004 there were 2.9 million registered nurses in
the united states. That is enough nurses that nearly every
family has a niece,cousin,mother,grandmother or sister
that is a nurse. No one wants to hear,consider,read or
analyze female nurses engaging in sexual misconduct.
Consider the statistics of misconduct among female
teachers,prison guards and the fact that 14 to 40 percent
of all boys who were sexually molested were done so by
women. These statistics beg for an extrapolation to
female nurses.They are in power positions over their
patients and misconduct often occurs in a boundary
violation.
Female nurses essentially occupy all levels of
hospital administration and not surprisingly occupy mostly
all state boards of nursing. Today,I have received the
disciplinary action for the months of Oct,Nov and Dec
of 2010 for the state of Arizona. Not surprisingly, two
female nurses held the distinction of sexual misconduct
and boundary violation for that period.
I am awaiting reciept of all disciplinary reports from
each state for the entire period of 2010 with a goal of
having this data published,broadcast etc.
In conclusion,Ncsbn's analysis of 10 years of
Nurses data(Ncsbn's 2009) 53,361 nurses were disciplined,
of them,636,or .57 percent were included in the following
Category,sexual misconduct,sex with a client,sexual
assault. 38 to 52 percent of health care professionals report knowledge of colleagues being sexual involved with their
Patients.
www.Ncsbn.org/Sexual-Misconduct-book-web(1.)PDF
PT
PT, If you are going to show stastistics for female personnel, the fair thing to do is show the stastistics for male personnel as well.
I already showed you where the privacy exception applies in labor and delivery and mammography. It applies because it was determined that to work in those departments is a bona fide job qualification for certain jobs.
I agree that there should be the same privacy qualifications regarding male patients as well.
The reason that this has been implemented is patient refusal. Male nurses have taken hospitals to court over these issues and with proof of patient refusal and embarrassment, invasion of their privacy, dictated that the male employees were not able to work in those departments because the female patients refused.
gd
gd while I do not often jump to PT's defense I think he has some valid points here that are being missed. There are court decisions and we should not automatically assume they are fair or just. In several states it was ruled male guards could not pat down female inmates but female guards could do that to male prisoners. I can't recall for sure but perhaps it was NH, I know it was east coast female guards could pat or strip search males but male guards could do niether to female prisoners. While your contentions are correct about female patients complaining, i read the acutal court case and as I recall, a female judge made the ruling and even acknowledged that while not all female patients complained, and similar situations existed in urology for men, it was not the same. It was clearly a case of a judge looking for a way to justify her ruling vs ruling on the facts. There was even a case in NM where two female guards were found not guilty of sexual harassment or cruel and unusual when they stip searched a male prisoners pointed at his genitals laughed and made jokes, the judge ruled since they did not touch him....so, just becasue a court ruling has been rendered, it doesn't mean it did not come from the double standard applied to men in this area.....alan
Alan, It doesn't matter who made the ruling. The law is the law and THAT is the reason they are able to have these same gender teams in the hospital. I never made a judgment about the fairness or unfairness of the law when it came to men; that wasn't part of the equation. All I was doing is explaining why these same gender teams existed at all and that the hospital would not be able to do it without legal support. There is no questions that the law is not always fair or equal or that men deserve their rights. I support that 100%
gd
gd
I'll tell you that staffing in mammography and L&D
has nothing to do with the privacy exemption law. The
laws don't take weekends and some facilities off. Men
were simply blocked from working in these areas by
nursing staff purely for discriminatory reasons.
As I mentioned there was a male mammographer
In Arizona but he retired. The privacy exemption law is
all or nothing and as such you are incorrect.
I did report the statistics for males when I reported
those findings. Those findings were that in the state of
Arizona from Oct,Nov and Dec of 2010, only one nurse
was guilty of sexual misconduct and that was a female.
Actually, she recieved a summary suspension for
Criminal conviction,unable to practice safely by reason
alcohol or other substance abuse,sexual misconduct and
the only boundary violation committed during that period
was a female as well.
Now gd I am going to drop my sword and throw down
my armor for a moment to convey what really is important here. Let's forget for a moment the disparity between the
genders. I spend a considerable amount of time looking at
State board of nursing regulatory journals of different states,as well as medical boards for physicians among
various states. My take on physicians is this and that
Includes those with MD or DO after their name.
Either a physician knows what he's doing or he's an
Idiot,simple as that. Fortunately,for us the majority of
them know what they are doing. I've been looking at
Physician disciplinary records for over 15 years and only
once have I found a medical doctor disciplined for having
A criminal conviction (felony).
Yet,when I look at these disciplinary records for nursing
It's disturbing at how many have felony convictions. During
Oct,Nov and Dec of 2010 the arizona nursing board
disciplined 132 nurses for things that sound like
Criminal rap sheets. Over 25 percent of these nurses have
criminal convictions. Many are for drug diversions,lying to
the board and who knows why they went before the board
In the first place.
When I'm a patient I have to be on full alert not just
concerns about my privacy or if my private information
Hippo will be violated but these are people injecting me
with morphine and so forth. I have lots to worry about.
Did I tell you that 95 percent of these people on the
disciplinary record are female! I believe it was MER who
said that respecting a patients privacy is the very first
encounter which determines the care you are to receive.
Their basic foundation is trust,something I have very
Little faith in!
PT
PT, Thanks for your explanations and "dropping the sword" for a moment. I'm feeling a little frustrated because the law is not blanket. Each facility takes a position and defends it using the law for it's goals. If there were no privacy exception to Title 7, more of these facilities would be sued and would have lost, making same gender employees illegal.
That's not to say that one facility might have different policies.
We are both on the same side of the argument and nothing would please me more than a hospital that offered the privacy requirements that we should all be entitled.
There are now areas in psychology based on health psychology and there are many people who work in healthcare that shouldn't be permitted both male and female.
So...what do you feel is the best way to help each other achieve the goals that are so important to all of us?
gd
First you need to stop listening to the crap that the medical field is trying to indoctrinate on us.Get them when their young.(nude school physicals by females on males)Liberal teachers teaching their views instead of the 3 r's.Men need to use what god gave us, and stand up for yourself, not complain after the fact.If you do not agree with what they want to do , tell them NO.STOP.If they don't it's assault.If they won't do what you ask,leave and walk away.Here is something I have done.I called some of the local hospitals and asked if they staff their urology,GI, and radiology with male techs and if I will get them if I ask.Some said yes.You may have to wait until one comes available,but yes.Thats fair.Some said no.To them I said thanks but I will not now or in the future be using their facilities.I will also tell my friends and family not to use them either.If you have no concern for my modesty,how can I trust you with my life.They have not learned the number one rule in business.That rule is take care of your customers or someone else will.Patronize those that do.Money talks.The B.S. about we are professionals or we have seen it all before.Your were born male or female with basic human needs.Eat, sleep,sex,exc.You were not born a doctor or nurse.That was learned.Human nature cannot be completely untaught.You can try but it will usually fail.The sight of a naked female will usually get the males motor running.Doctor and nurse included.What do you think they do when they get home and are in the mood?I believe they are starting to lose control and they don't like it.They don't like you telling them what you want.To them you are to stupid to know.After all,they are the ones who went to medical school.Not you.Plan ahead so when you need a procedure done , go to the places that will cater to you.Give them your business and the other the finger.Just my opinion. God Bless AL
Check out our new guest article concerning patient rights as they concern electronic medical records.
gd said
"so what do you feel is the best way to help each
other achieve the goals that are so important to all of
us. "
I've never paid to much attention to this before when
reviewing state board of nursing disciplinary records, yet
It's apparently a serious problem and presents a major
concern as far as trust goes.
Why are there so many female nurses coming before
the board with criminal convictions? From what I am able
to discern these convictions come up after background
checks.
These nurses further complicate the matter by lying to
the board. When I choose a physician I always check
with the state medical board and by word of mouth. "Do
you know of a good Gp or an orthopod.? "
When I need to make an er visit how do I know the
nurse that's following the physicians orders in giving
me a specific amount of morphine is not going to steal
my medicine or comprise my care.
Hospitals need to be more diligent in screening their
backgrounds and state nursing boards need to crack
down hard on these people. The central topic of this
blog is trust and that is terribly lacking in nursing.
Therefore, to answer your question gd, these boards
need to be notified and asked why. Hospitals need to
be notified and asked why.
PT
How come no on ever talks about medical techs exposing women's breasts? All the discussions here are about genitals. I consider my breasts to be my sexual organs,too, and have had a respiratory therapist fully expose me in ICU with no curtains drawn and how about the MALE sonogram tech who did my breast sonogram without a chaperone? I had to get counseling afterwards!
Anne
Anne, I think the challenge here is to recognize the many different challenges we face without coming off as saying our individual experiences are better or worse than others. Whether it is a male tech exposing a females vagina when she doesn't feel comfortable or a female tech exposing a males penis they have the same effect on that patient. HOWEVER, given 90+% of nurses are female, 85% + of techs are female, and over 75% of hospital staff and nearly all staff other than the Dr in PCP offices are female it would be ridiculous to say male and females face the same frequency of challenges. Off course the severity is the same when it happens regardless of gender, however, males are much more likely to face the issue just from sheer numbers, and whether you want to recognize it or not, the issue of opposite gender providers cuts against males on both sides of the gowns. The only bona fide employment qualification upheld in the courts was refusing to hire males for L&D in the medical arena, male nurses are frequently required to have female chaperones for intimate care of females, don't recall the opposite. Again, it does not make it any less truamatic when it happens to either gender, but the numbers and attitudes are stacked against males....alan
Just finished reviewing the frequency of criminal
convictions on state medical boards regarding rn and
lpn's.
Even more disturbing were the number of criminal
convictions among cna's. The numbers are staggering,
about 30 percent among those brought before the board
for various violations.
Just as interesting was the fact that for every male cna
brought before the board for a criminal conviction, 17
female cna's had felony convictions as well.
Realize these people were out there at various medical
facilities working until some violation brought them before
the board.
PT
It,s to bad that all of us advocates for patient modesty are spend out all over the world.If only we could concentrate our efforts in a local area.Things like talking to the hospital administrators about patient modesty and same gender care.If they agree to changes , sprend the good word.Hopefully their business will improve and the bottom line will increase.If they blow you off with the usual everything is fine as it is , gather up the troops and walk in front of these hospitals and clinics with signs stating things like IF MODESTY IS A CONCERN DON,T COME HERE.ANOTHER SIGN SAYS SEE US FOR HOSPITALS THAT RESPECT YOUR MODESTY.Hit them where it will hurt them the most.Their profits.Fewer patients , less money.A good start would be to simply ask the patient if they prefer care from male,female or doesn't matter.Simple solution.Alot of modesty problems gone.Now if only we had a group we could put togather.Just a thought. AL
Anne,
This is a very long blog and in the past there was much more talk about female modesty issues. Lately it has been taken over by the male perspective. Your story is also very common - unfortunately. But you are a breath of fresh air and I hope other women see that this blog isn't just about male modesty and contribute again.
--amr
I have read most all the postson this blog, and through out the posts, I have found that it appears to be more of a power issue for most female nurses. Thus the struggle continues. From early on in our lives Nude Male figures, ie David, The Thinker,and many others desenitizes us to male genitalia exposure. While the female genitilia is conceled. So many nurses think it is their right to expose the male body not only for their enjoyment but for others. I have read where Mothers still bath their teenage sons,sit in on physical exams and think it their right to do so even if the son objects. I have had female nurses walk in the exam room during my own physicals with out even knocking or asking if it is ok for them to come in. These things are the norm for male patients, let a male nurse or tech do the same thing and watch the roof blow off. What would happen if a Father were to bath a teenage daughter, attend her physical, or have a male nurse walk in on a female physical exam? It is the old double standard, "all men are preverts and all women are saints", I know that most here know that is not true, so it must be all about control and power. Women have controled the power of nursing and dont wish to be displaced by men. it is really that simple, the way for them to remain in control is to keep men out of nursing and the tech fields. Many Nursing schools discourage male students from enrolling, refuse to let men train in some tech fields. When they do enroll they are graded more harshly and checked more closely than females. Again look at the instructors 90% are female. Again it comes down to the power issues. Male modesty issues are coming more to light as more men are forcing the issue. As a patient, caregiver, I have seen it from all sides. I have had to deal with nurses refusing to let me know the condition of my own family, and being told if the patient wants me to know they can tell me, unfortunately the patient could not do that. After complaining to higher up I was grudgly given the information. It was both curt and sharp in tone. It still comes down to who is in control and who has the power.
Anne, I had to get counseling for modesty violations also. And, amr is right, this blog did address modesty issues in a more constructive fashion but somehow keeps going back to an expression of anger over the fact that male writers think that men have a worse situation because there are more female nurses than male nurses. Instead of finding unity in our mutual desire to be treated with respect and dignity as human beings when we find ourselves in a medical situation, there seems to be an ongoing theme here of resentment of men towards women.
Gail/Charlotte
PT:
Those stats are indeed alarming.
I read an article a while ago
http://www.propublica.org/article/california-will-require-criminal-background-checks-before-granting-temp-811
Among other things, it stated "Until Monday, nurses planning to work temporarily in the state could show up at the board's office and leave with their licenses the same day — a practice known as "walk-through" licensing — even though their fingerprints had not been run against law enforcement databases to check for prior convictions. If convictions were subsequently discovered, the board could cancel the license, but frequently the nurse would have already started caring for patients"
And...
"In October, stories showed how dozens of felons were able to keep their licenses for years before the board acted against them. And last month, an investigation found that the board took more than three years, on average, to investigate and discipline nurses accused of sometimes egregious misconduct, including violence against patients and stealing their drugs."
I wonder how strict other states are, what percentage of caregivers moving from other states have not been properly investigated, and how much this can account for the type of statistics you are finding?
swf
Anne-Charlotte There are two sides to your arguement, yes many men, myself included have pointed out numerous times we face special challenges because of the numbers and the attitude of society. I don't think you will find to many posts that say when it happens it is worse for men than women. I think you will however find numerous posts where women have made the claim it is worse for women due to womens concern for sexual assult by male providers. Where I stand tough on this is it is important to recognize and acknowledge the fact that men do face different challenges than women. Trying to act like men do not face these challenges leaves a very important part of fixing the situation. If we do not change the some of the underlying issues that men face we can not cure them. For example, lets say we get a law passed that providers have to ask a patient if they have a preference of the gender of the nurse/dr if exposure is required, and must provide that gender IF that gender is available. If we do not address the fact that over 90% of the nurses are female it will mean very little to males, females will be just fine, but it will have very little benefit for men. There is also a very obvius bias against male modesty in this society. From professional and locker rooms where female reporters are allowed complete access but male locker rooms but female locker rooms are restricted to prisons where female guards can pat and strip search male inmates but not the other way around. Again, when incidents do happen it is just as truamatic for females as it is males, but to deny these issues of the dispairity in staffing and different attitudes exist and play a part in this discussion is ridiculous. They are there, they do have an effect, and they need to be dealt with. That does not mean we can not work together for a fix, the similarities are greater than the differences, so we should pull together, there is strength in numbers, and to be perfectly honest, we males need your help, you are better at this than we are. But we have to acknowledge the issues involved....alan
You won't get any argument from me. I believe that every man, woman and child deserves to be treated with dignity and respect. And, I think women would be more than happy to speak out for men on this issue if men made it clear that this was as important to them as it is to women. My impression is that men take a more macho stand about modesty and except for in this blog, I don't hear any protestations. On the other hand, women do raise their voices about this, as has been discussed.
This question is for Gail/Charlotte and Anne: I had an upsetting medical experience more than a year ago that I can't seem to get off my mind. I considered getting therapy. What kind of conselor did you see? Were they able to help you and, if so, what did they do? I have been hesitant to get help because of embarrassment about the issue and also because I am unsure if it would be worth the expense.
Also, I agree that this blog has been focusing lately on the argument that men have a harder time getting the care they want as far as their modesty. While I do agree that they most likely have a harder time getting same gender care at a doctor's office (as far as nurses and support personnel), clinics or imaging centers (techs), I think when it comes to surgery and other sedated procedures the challenges are equal for men and women to obtain same gender teams. I live near a large city that has a huge medical center with a Women's Hospital. The Women's Hospital uses a group of anesthesiologists (on contract), which has only 1 woman on staff. Their website states that patients cannot choose their anesthesiologist because they work on a rotation basis. So you have to just accept whichever anesthesiologist is scheduled at the time of your procedure. And surely with it being a woman's facility, most of their surgeries/procedures are realted to ob/gyn issues. So, I think women face the same difficulties as men when it comes to that arena.
I think that the modesty issue will probably never be a major concern for the medical world. It seems to me that most medical people and probably a lot of the general public feel that if you are sick and hurting you should be thankful that someone is able to help you, regardless of their gender. Not that I agree with that and I do think that some effort is made to respect patient's modesty but I do not think it will ever get to the point where people will always have a choice of gender (except maybe in elective procedures and doctor's visits where the patient can choose the doctor and that is the only individual they will see). And with that in mind, I think the only way people will get their needs met as far as modesty and same gender care will be if they act as their own advocates. That is what I plan on doing in the future, thanks to all the helpful advice I have obtained from this blog. Jean
Charlotte I could not agree with you more. Men have to a large degree themselves to blame. It took women decades of standing tough and taking a lot of abuse to gain their rights. From that struggle they learned to stand tough in other areas such as this. Men who do stand are often called sexist, but women were called many things when they stood for equal rights. You are on the money with your comment, as is Jean. I have no idea what percentage of society feels this way but just doesn't think they can say anything, I would think more than we know since most remain silent and just accept it. And I like Jean have decided the best thing I can do is stand up for my wants and needs, and I have found in many cases all it took was asking. Also could not agree with you more on the surgery etc. a local hospital sends out a monthly insert in the newspaper. It always amazes me they have 3 gyn's, all male. Everytime I think, are you kidding, you couldn't find one female. What a crock. On the other hand all of the annesthesiologist at our hospital are females, mostly crna's as are all of the imaging techs. And I like you have this and Dr. Sherman's blogs to thank for my realization that I do have the right to ask. I also printed numerous of Dr. Shermans articles and sent them to local providers. So, thanks everyone, Charlote, Jean, SWF, Dr. Sherman, Dr. Bernstein, Doug, and everyone else who has contributed to this thread, whether you realize it or not...you have been a big help....alan
"most medical people and probably a lot of the general public feel that if you are sick and hurting you should be thankful that someone is able to help you, regardless of their gender."
When some medical professionals use that argument, and I've heard it, too -- they need to be reminded of two truths:
1. Not everybody who goes to the doctor or to the hospital is "hurting," "flat on their backs," or "dying." There are many intimate medical encounters where relatively healthy people are just getting tested or checked. Remind them of that.
2. Too many medical professionals confuse "compliance" with "agreement." Just because a sick, vulnerable patient is willing to accept what's offered doesn't mean that's their choice. I would suggest that some really sick people just give up, they're too exhausted to fight the system. Most patients do what they're told, even if they question what they're told to do. There is a power dynamic at work.
A side note you all may find interesting. France is really cracking down on Muslims, outlawing the headscarf and banning the face-covering veil. France has a strict secularism policy called "laicite." The doctrine bars religion from public life. It goes back to a 1905 law.
Sarkozy wants to tighten the law. He wants 26 measures to clarify how this law is applied. One of those measures would disallow patients within the national health system from refusing to see a male doctor. No choice. It's clear this is aimed at Muslim women who would choose a female doctor. My source for this is The Economist, April 9-15, page 59.
Doug/MER
There is much to comment on here, probably more than I can do right now. First, for Jean: my guess is that you have PSTD or post traumatic stress disorder which is what I had from my modesty violations. I got counseling from the cancer center where I was a patient because this was all related. Then I did, for a short period of time go to a private therapist which probably helped but I decided that I did not want to do this anymore as I am doing somewhat better. If you read up about PSTD, it will probably help you and then I suggest either looking for someone who does counseling for this kind of disorder or else just allow yourself to slowly heal. There are also some good websites that offer information and some networking. You need to be proactive and do the things that you think will help you.
I also agree about the lack of options for women when seeking gynecological/oncologists. This is how it used to be in seeking an ob/gyn but thankfully now women have choices as there are many women doctors in this field. I would write your hospital and tell them that they need to add a female gyn/oncologist to their staff. Do not feel apologetic, this is a valid concern. I currently drive an hour to see a female gyn/oncologist. The hospital where I went had only men and I refused to go back there post-operatively as I felt they were disrespectful.
The important thing is that patients need to speak out and WRITE LETTERS. The hospitals do pay attention to letters.
As far as surgery goes, I would make every attempt to request a female staff. You may not be able to get it but at least you will have tried and your doctors will be aware of your fears. I would hate for you not to get important or potentially live-saving surgery because you could not get an all female OR team.
I would also mention that you want to know if there are viewing windows (these can be covered) and that you do not want any students viewing your surgery. I would also state that you do not want any photos taken of you and that you do not want medical students doing pelvic exams on you while you are unconscious. I would just firmly and politely make my case, don't let the doctors intimidate you. Make it very clear that you have a lot of concerns regarding your surgery and you want to be sure that you will be treated respectfully. Then, before your surgery, I would relate the same concerns to the various staff that attends to you. But, remember, you probably WILL be treated respectfully. It is important for doctors to drape patients very carefully and completely so that there are not exposed areas which could cause bacteria etc to get into the wound areas.
I don't mean to be hard on medical students, my son is one, but your peace of mind is more important. Some people may not care and may like having students and others viewing their surgeries, but you do care and you have to live with the psychological aftermath.
I had a follow-up exam a few months ago and I told my female doctor that the way the treatment table was facing was problematic for me as it was directly facing the door. She agreed with me whole-heartedly and when she could not find a suitable exam room, she and her nurse changed the exam table around so that it was not facing the door. She thanked me because they are in the process of getting new exams rooms which were more respectful to patients and she now had something to bring to her administrator to tell them that they needed to get the exam rooms completed. In other words, because I made a respectful and firm complaint, she had the ammunition that SHE needed to get something she wanted for her patients. She said that she thought the current rooms were unacceptable and that she would not want to be examined in them either.
But, you must speak up, MEN TOO!! Doctors do listen, I know because I have been married to one for 40 years.
Doug, you bring up a very interesting and loaded topic, i.e. Muslim women. I can sympathize with France's problems and we may start to face some of those same things in the USA but I would maintain that areas of modesty have been historically unique in ANY culture. Exposing your naked body to a member of the opposite sex is different than feeling concerned that you can not see someone's face enough to identify them or having the streets blocked for normal access during prayer times,or some of the other issues of concern.
As I stated in a earlier post I have been a advocate for patient modesty since the early 70's.Back then I didn't even know what one was.My efforts were mostly for my wife.( I'm male )Since I've been blessed with good health I mostly avoid health care.But from the stories in the posts you read about all the modesty violations ,something needs to be done.I personally would never allow some of the things I read , to happen to me.If it's trouble that they want it just walked in the door.I'm very stubborn so if you want to name call be prepared to unleash the tiger.That said when you come in feet first to the ER unconscious,thats another story.In response to JEAN.I went on the web and looked up the 4 hospital chains in my near by city for anesthesiologists.3 don't really give you much info.The one we use listed 44 male and 42 female.It shouldn't be to hard for them to assign a anesthesiologist with the gender of the patients choice.The others you just by pass.As for a OB/GYN there is a clinic that has 6 doctors.ALL FEMALE.If your looking for a male OB/GYN don't go there.I pass up 4 hospitals and around a dozen clinics to get to the one's that cater to their customers.LOOK,DRIVE, and PATRONIZE the one's that show you they want your business.Don't give the others a penny of your business.If one goes out of business which one do you want it to be.We need to stop bickering about who has it worse and combine our efforts to make a difference.Alone you don't have much chance to make any real changes.You might get what you want but the meek will still get what ever they want to provide.All I ask is give us a choice of gender,then follow it.I'm modesty and shy (around women )and proud of it.Once you give that up its gone forever.The health care field acts like it's your obligation to get naked in front of the opposite sex.Why should you get special accommodations.How about I'm the paying customer and thats what keeps you employed.I guess this patient doesn't know his place ,and no big mouth health care person will ever shut me up unless I'm almost dead.So lets all get moving on a solution to this problem so neither myself or anyone else has to write another bad story about their care. AL
Alan said
"It took women decades of standing tough and
taking a lot of abuse to gain their rights."
Women never stood outside hospitals and held up
picket signs,they never stood tough so to speak on any
of these issues. It was all done for them. Done by all
the hospital nurses and by nursing administration,all
women. Women looking out for women.
Think about this for a moment if hospitals were
managed by 95 percent men. Men wouldn't have to
worry about this problem. Hospitals never took a vote
To female patients " women do you only want women
doing your mammogram" . Fact is the women already
there made the decisions for other women.
Don't ever expect women to ever make any
considerations for men in medical settings. It will take
a class action lawsuit to change years of imposed
discrimination.
PT
There is a new field called health psychology that examines all of these types of issues. You might want to find a health psychologist as this is their specialty. Depending on one's experience, it's important to discern whether you are traumatized from normal standards of practice or if something innappropriate or deviant happened to you. Wishing you the best.
gd
Maybe women did not stand outside of hospitals but their struggles have a lot of similarities and have a lot of lessons for men. The big point is if you continue to take it, if you continue to remain silent you will get more of the same. If you choose to stand up, expect resistance and be willing to take the abuse and pay the price for the promise of change. That PT was the point, if men started making noise about this and did not back down, if they did in in sufficient numbers it will change.
Here is an interesting side note. I fund a scholarship and numerous other philanthropic activities through my business. Recently I called the administrator and told them I wanted to change the parameters of the scholarship to go to males going into nursing. I was surprised when she questioned that, her question was do you think it will really encourage boys to go into that field? That is a mentality we will have to keep chipping away at. What I did was designate 20% of the scholarship fund to promoting the scholarship, and therefore got some public play on the issue of males in nursing. Its a marathon not a sprint....alan
Thank you Charlotte and Al for your helpful/supportive comments. I do agree with Charlotte that these upsetting events do get a little better over time and I am probably just going to hang in there with that in mind.
I do need to clarify one thing, though. The Women's Hospital in my nearby city does have female doctors (ob-gyn), it's just the anesthesiologist team they use that only has 1 female in their group of 10. That means you will most likely get a male anesthesiologist if you have any surgery at that facility even if you do have a female doctor. (I have never had surgery but just happened to find this information out from another experience at an adjoining facility). I, like Al, have excellent health and have mostly been able to avoid doctors altogether (I am in my late 50s). There have been a few times when I saw a male doctor but only when I knew it would not involve a state of undress. Otherwise, I always choose women doctors and always will when it comes to any issues involving "private" areas. My experience involved a sedated screening exam (colonoscopy) and even though I had a woman doctor I ended up with a male anesthesiologist. That was before I found this blog so I had no idea that I could attempt to request otherwise and discovered as an after fact how much it bothered me. By the way, I would never have had the colonoscopy had I not had symptoms (which turned out to be nothing serious). I just don't do those recommended screenings because they are usually so embarrassing and cause me a lot of anxiety. Just not worth it. And, Al, I feel the same as you. In the future I will definitely voice my needs and I am thankful that this blog has helped me feel more empowered to do so. I also am grateful to know that I am not the only person who feels this way as that is what I used to feel. Jean
First I'd like to tell Anne,Charlotte, and Jean I'm sorry to hear about your modesty violations.It proves they come from both sides.Some might think what does Al know since he still has good health.How about a 1 year journey with my wife's fight with lymphoma.I was there for every doctor visit and hospital stay.During that year she had 2 surgeries and a hip replacement(do to a fall that broke the ball off)The surgeries were for a port placement and lymph node and bone marrow biopsy.Later they placed a filter thru her heart to keep the blood clots in her legs from causing a stroke.Her first 8 chemo treatments failed to stop the cancer.Your last hope was with a stem cell transplant.Off to another hospital for that.As the disease progressed it started to block off her right kidney. Another procedure to have a stent put in.That hospital's female urologist was to busy with prostate research(it took 20 minutes)We left and had it done at another hospital.Everything but the hip replacement was done by a total female staff.Even with the hip replacement the doctor was female.She did say she had help by a male doctor.Upon her return the male lymphoma doctor over dosed her on chemo.She was totally delusional for 4 days.Crying and wailing.As she started to go delusional the nurse said lets catheterize her before the crowds come.I assisted the nurse.The nurses that took care of her were more that wonderful.I sincerely thank you from the bottom of my heart.I wish I could tell you this has a happy ending.It doesn't.She died 3 years ago in my arms.With her final breath she whispered ( I LOVE YOU )and passed.Do I need counseling.Probably.But men are taught to suck it up.I've been to HELL,but every day I claw my way alittle further out of that hole.I HAVE PAYED MY DUE'S.Now quit bickering about who has it worse and lets all come togather and start to fix this.Someday we will all be weak and feeble.Who will fight for you then.Hopefully if we all are sincere it will be fixed by then.I'm sorry for the long post.Keep the faith and GOD BLESS. AL P.S to Jean. Stick with your values and don't let them boss you around.Maybe in another post I will tell you how 3 of her female doctor stood by her bed and hugged her as she cryed because she was afraid.Sorry.There I go again AL
Recently I had a Prostate Biopsy. This was at the urgent request of my Urologist. When I rang to enquire about the staffing I was told it would involve "at least one female nurse". I said no it won't. I told them I was prepared to delay the urgent biopsy for as long as necessary to ensure an all male team. When they realised I meant what i was saying, they gave in at once. It was possible, it was doable in the time frame, they just didn't want to do this for me without putting up a fight. What does that say to you about the professionalism of our so called "medical professionals"? I know I was taking a risk by digging my heels in but it was important to me. The Ultrasound scan part of the process (TRUS Biopsy) was very painful and undignified. The biopsy part was no problem at all. I did in no way "enjoy" the experience, I can however only begin to imagine how I would be feeling now if any females had been present. PTSD would not begin to describe how humiliating I would have found it. If you feel uncomfortable with opposite gender involvement in intimate situations, do yourself a favour and stand by your feelings, DO NOT GIVE IN.
My points about France's wanting to deny Muslim females choices of doctor gender are:
1. Once governments get into health care, this is what can happen. On the other hand, the opposite can happen, too. But with governments it will all come down money. I'm not necessarily opposed to Obamacare. Just making an observation. But if we go to a national health care system, those interested may want to start fighting for gender choices.
2. If a government rejects religious grounds for gender choice in medicine, there are not many other grounds, if any, left to argue.
Doug/MER
I absolutely agree that modesty issues are just as important for men. However, women have two sexual parts of their bodies,their chest area and genitals so it makes it harder for women to achieve modesty in a medical setting. Any respiratory tech, ekg tech, etc, with little training, can expose our breasts in the name of medicine. Doctors are usually more sensitive to not doing this, its the techs that are the problem. And in the US women's breasts aren't respected as a private part like they are in Europe. I don't understand why this is. Anne
alan: Thanx for the encouraging words for everyone...and the update on your proactive scholarship. Can you tell us (not asking for personal info) if any males have taken advantage of the offer?
Anon 4:22:
Excellent job standing by your convictions and mitigating your own circumstances in seeking care.
I absolutely agree that everyone must first be their own advocate in protecting their convictions about their body. Usually we are our own best and strongest advocate. I continue to be concerned, however, for the patient/client/customer who is at a disadvantage when fighting for their own dignity needs. Many people find themselves groggy after surgery, and whatever disorientation is wearing off is replaced by pain. In these cases, they are more easily coerced into "accepting" intimate care that they would ordinarily rally against. After one or two rounds of caregivers justifications, 20 minutes of pain, confusion, and fear can easily pass before no resolution seems eminent. The patient/client/customer could give in to the tactics, later to find that the damage of coerced care has taken an ethical toll. As we all know, this coercion is often cited as "consent" and the catch 22 begins.
Actus me invito factus non est meus actus.. the act done by me against my will is not my act.
Coerced consent is not consent at all.
As far as I'm concerned, once coersive tactics begin, ethical questions will follow, and another more appropriate caregiver should be found.
swf/Suzy
This is in responce to Doug/MER posts.That is just one example as to why it's important to know who your voting for.Personally,if your a Christian and you vote for a candidate thats for abortion,your a hippocrate.Same goes for a gun owner that votes for a candidate thats for gun control.Do you think if God was standing in front of you he would say it's ok to kill that baby?For those that think Obamacare is the answer.Just remember.The same people who run the VA,Post Office,and FEMA WIll BE IN CHARGE OF YOUR HEALTH CARE.Remember katina.New Oleans.No one can say what a good job they did.Read.Understand.Educate yourself.It's hard for people to blind side you when you know whats coming. AL
Anne here. Here's what happened to me:I was poor and had county health coverage.I had a lump in my breast but the mammogram was useless so the lady tech said doc said to have a breast sonogram. Lady X ray tech said tech was a "he!" I immediately asked for a woman, but was told, "Oh, it would take weeks to get an appt. with the female tech, and don't worry, you'll like "him." I was too scared of cancer to wait, also scared to complain because it was county. But I assumed there would be a female present. No: he was alone,and he was very nervous, told me his name 3 times. He asked me where the lump was and I didn't know if I was supposed to show him or what? I lay on that table,alone with a strange man squirting cold gel on my naked exposed breast and I felt TOTALLY violated and humiliated. You could feel the sexual tension in an awful way;he didn't look at or speak to me. I am Catholic and celibate but that day I felt I was being forced to be intimate with that man...My breasts are my sexual organs and it was traumatic. I went home and showered,crying. I sought out a sex counselor because I felt so violated in that way. It was four years ago but I have not complained; how could I? It is county and they will say he did nothing wrong but that's not the point: point is I was traumatized sexually and emotionally.He SHOULD have asked me if I wanted a female present. I would like to write a letter but am afraid of using my name, and if I write it annymously they will not listen.Counselor did educate me that from now on,ALWAYS ask for same gender care. However, I have tried that only to be laughed at. Thankfully lump was nothing but I will never have any breast tests done again. And no tests involving my chest area, either; too many other bad experiences with male techs seeing my breasts. Too bad I couldn't get the county to pay for the therapy!
Anne
Anne, I can give you an account that may give you a little encouragement. I had the opposite position. I discovered a lump on a testicle, was referred to a hospital for a ultra sound. They assigned a female tech, I was humliated but assumed female was all they had other wise why would they assign a woman for this. As I was signing the papers to leave the tech picked up a clip board and called the next patient. A woman stood up, the tech told her I am going on break and the only other tech is male so if would feel more comfortable and you want to wait 10 minutes I will be back and take care of you. Now I was humliliated and furious, still I did nothing but leave. That incident caused me to search the internet and found this and Dr. Sherman's blog. It took awhile but after awhile of sharing with others on these blogs I became encouraged to stand up. I emailed the patient advocate, (now over 2 years had passed)but did not get a reply. I wrote a letter and cc'd the patient relations and head of imaging. I was respectful, I just told them how much better my experience would have been if they had given me the choice. I told them becasue of the incident I didn't know if I would ever return. I pointed out if the asked patients on intimate exams, what an advantage it would give them over facilities that did not ask.....I got emails, I got letters, and I got calls from the head of nursing, imaging, and the patient advocate. I was thanked for taking the time to bring this to their attention. They were implementing a new procedure to try to ask as many patients as possible if there was a preference for a specific list of imaging procedures. They went out of their way to make me feel like I was not a freak or a problem. I can not guarentee you will have the same experience, but I will bet if you write the letter in a non condemning way, that you are just relaying an experience and making a suggestion that may help them as well as their patients. I made sure to tell them the female tech did a good job, she didn't treat me poorly and did her best, it wasn't her fault, it was just how I felt and I was sure there were others. It sounds you had a very similar experience. If you tell them the young man was trying but was obviously nervous, etc. you might be surprised. I think you will be surprised how much therapy there is in a 50 cent letter.....alan
I'm finding these political statements offensive and off point. Lest we forget that unless we're on medicare at the current time, we are all privately insured.
If you want to discuss political issues, let's just go back to coat hangers, abused unwanted children, and further degradation of our beliefs as Americans.
gd
gd -- Please be specific. What "political" statements do you find offensive? I don't see any "political" statements on this blog.
Doug/MER
Alan I was wondering the same thing as SWF. Have many men taken your scolarship? Seems like a opportunity to good to pass up these days.
I agree with gd regarding one sided political statements on a thread which deals with issues of patient modesty. I can't conceive the general modesty issue or how it is handled by the medical care system is either a Republican, Democratic or other political party issue either in terms of interest, philosophy or actions.
Let's all keep these discussion free of political rhetoric unless specific political relationships regarding any attempted resolution of the modesty issue can be specifically defined and specifically documented. ..Maurice.
I'd still request people be specific about who is being political. If you all are referring to AL's post of
Friday, April 22, 2011 6:05:00 PM -- I would agree. No one on this blog should be telling anyone else how to vote. That's too political.
If anyone's referring to my original post about the French issue with Muslim's, I would disagree. When government gets into medicine, the potential is there for any aspect of medicine to become political. Look at the problem some senior citizens on medicare are having finding primary care physicians because these doctors aren't being reimbursed enough to pay for treatment. Anyone out there telling me that's not political?
Doug/MER
I have just put the scholarship in motion and this will be the first year it is offered. I don't think I will have it ready for this years graduating class as I want to partner with a local hospital to get them involved. I think that would be beneficial if I fund the scholarship but have it offered through the hospital, that way they get free advertising and it exposes them the concept of promoting the idea of young men getting involved in nursing. I will let you know how it goes. I just found it interesting that I would meet any type of resistance at all.....alan
Doug, You are right on...I agree.
gd
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