Bioethics Discussion Blog: Patient Modesty: Volume 81

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Saturday, August 26, 2017

Patient Modesty: Volume 81






To make the necessary changes in the medical system's duty to provide gender equality to the personal and intimate concerns of all patients, perhaps what is needed is that both genders stand together to achieve that goal. ..Maurice.

Graphic: Google Images and Clipart Panda

66 Comments:

At Saturday, August 26, 2017 8:13:00 AM, Blogger Maurice Bernstein, M.D. said...

I strongly feel that for all patients to be provided by the medical system the gender of their caregiver, it is essential that both genders work together to get this goal accomplished. Do my visitors think that the female gender has achieved the goal and have no interest in the concerns of some of the male patient population? ..Maurice.

 
At Saturday, August 26, 2017 11:32:00 AM, Anonymous Anonymous said...

But men weren't for the women's movement? Seriously. Maybe from a politics stand point you might achieve a unified liberL effort to make a change like this in the healthcare system, but in doing so you will change it to a healthcare that is not based on merit but equality. So what I'm saying is that I don't hear women or other men complaining of these things in general. The younger generation is going to care less until it effects them and the older generations will have to have a passion an unified force for a change like this. There are all female clinics because they were in demand. Is there a law that requires them? If there is I'm not aware of it. I say that's an achievement but I didn't battle for it or demand it. Probably feminist Women did. But they don't even have to have been feminists. This is an intimate issue and I think woman are better equipped to be intimate with one another than men are to be intimate with one another.

Renee

 
At Saturday, August 26, 2017 8:55:00 PM, Blogger Biker in Vermont said...

Dr. Bernstein, generally speaking I don't think the majority of women care that men face a sea of women at every turn when it comes to intimate care. To change it might erode some of the advantages women have currently, and that is antithetical to feminism in its current form.

Women are suspect of any man that wants to be an L&D nurse but don't see anything odd about women that want to be urology nurses. This should speak volumes. They really do think men have no modesty and that men should not have any expectation of privacy in this regard. They don't see that there is a problem to solve.

My daughter-in-law's niece is in nursing school as is her nephew's girlfriend. Both aspire to work in pediatrics. It really begs the question as to what drives female CNA's, Medical Assts, RN's, NP's, and PA's to specialize in male urology. If lots of women weren't looking to work in urology, the industry would be seeking out men for those roles, but they can fill 100% of the need with women. Women are not going to want to change a system that would deny them apparently coveted careers.

At the end of the day however, Renee is right. Women band together and demand changes that they want. Men are more solitary creatures, and in this case the cultural expectation of no modesty, suffer silently etc is deeply ingrained from a young age. Not having their privacy respected is also deeply ingrained from a young age.

I was at a cookout this afternoon. I have known most of the guys that were there for 30 - 40 years socially and in work and civic settings. I've been naked in locker rooms with some of them. They've all been patients and so a discussion on this topic wouldn't be theoretical, yet it would be incredibly difficult to get a discussion going given the risk of ridicule of whoever starts the conversation. Even worse is the risk that one or more of the women would chime in embarrassing the guy that spoke up. Societal norms are hard to breech.

 
At Saturday, August 26, 2017 9:32:00 PM, Anonymous Anonymous said...

Renee

Female patients never ever banded together as you say to ensure that they were provided privacy in many intimate settings such as mammo, L&D, women's health centers etc. Team Vagina is responsible for that! Who is Team Vagina you ask? Team Vagina encompasses all the female nursing directors of all L&D suites, female directors of medical imaging, countless nursing directors of hospitals, outpatient surgery directors. It's been discrimination from the gitgo for the last 5 decades. With their phoney propaganda core measures which no one even knows what it represents or where it's posted. Pathetic!

In the 1950's when mammography first entered as a viable imaging modality and hospitals first purchased mammography equipment are you suggesting women marched with big signs to hospitals proclaiming on female mammographers must be hired. Were hospitals torched, businesses burned and rioting. Really!!! Of course not. Most radiographers were women as were the directors and thus only female techs were trained to perform mammography. It's the same to this day, not one male mammographer works, it is the only occupation in the United States that employs only females.

Now, Team Vagina has worked very very hard to push out all male orderlies in the past and replace them with something called a cna and medical assistants. Have you looked at the cna forums where male cna's and medical assistants don't get hired anywhere. Common sense might suggest that some of these people might get hired at urology clinic. Visit any urology clinic on the prostate side and look at the gender of the staff, exclusively female medical assistants. These people are soo highly trained, they can't even perform a correct blood pressure.

What is the point of having your blood pressure performed at you physician's office if they don't perform it correctly. That's about as Stupid as calling your physician's office to make an appointment when hearing that Stupid recording that says" if you are having a medical emergency, hang up and call 911". No, really. Now you expect the patients to be as dumb as the medical assistants they hire!

PT



 
At Saturday, August 26, 2017 10:09:00 PM, Blogger Maurice Bernstein, M.D. said...

Am I correct in what I have been reading above that there is no logical nor experiential rationale for the consideration, leading off this Volume, regarding both genders working together to promote changes in the medical system with regard to the discordance (if that is the right word) between how each gender is treated? Is my hope at the top of this Volume truly hopeless? Does each gender have to pull in opposite directions when a "common good" (patient gender selection) in the medical system is being attempted to be established? Or is it because, what has been discussed here all these years is some anomaly in terms of the real interest of most all patients, their concern being only one thing: "get well"? ..Maurice.

 
At Saturday, August 26, 2017 11:44:00 PM, Anonymous Anonymous said...

Maurice

Do you like ice cream? Do you ever take your family to an ice cream parlor on a hot summer day? You expect to get good ice cream since you are paying for it am I right. You wouldn't expect to get diet ice cream as that is crappy ice cream, bulimics love that kind. What if every ice cream parlor you went to discriminated against you because you are Jewish. Now discrimination is discrimination wether you are male, female, white, black, Eskimo or whatever. Ice cream is not free, it costs money and you are paying for it. But would you like the ice cream each and every time despite the discrimination you received.

In regards to your response, how do you define " get well" Getting well involves many components, mind, body and the notion that you were advocated for and that you were treated the same as everyone else, that you were not looked upon differently, treated differently or given any special differential treatment because of your race, ethnicity or gender. Why should the gender of those rendering medical care be be altered based on the notion that one half of the human population are all considered perverts by the other gender thus altering almost the entire medical industry makeup? Are all male patients automatically discriminated against based on perceptions that half the human race can't be trusted?

PT

 
At Sunday, August 27, 2017 4:05:00 AM, Blogger Biker in Vermont said...

What I'm saying Dr. Bernstein is that both women and men recognize female modesty, women don't recognize male modesty, and modest men are too embarrassed to say they are modest for fear of ridicule.

Throw in women controlling the majority of healthcare hiring and we have the system we do. It makes sense from their perspective given the open recognition of female modesty and their underlying assumption that men aren't modest.

There are degrees of modesty of course ranging from men whose modesty limits the extent to which they will go to the doctor to men who have no modesty. I posit that most men are somewhere in-between the two extremes. These are men that are somewhere between uncomfortable and embarrassed but endure it in silence because that is what society expects.

The missing element is society acknowledging that most men have some degree of modesty. If that could be acknowledged I suspect women would be receptive to making change in support of their fathers, brothers, sons, husbands, boyfriends etc. The question then is how do we get that acknowledgement.


 
At Sunday, August 27, 2017 8:16:00 AM, Blogger Biker in Vermont said...

The Men's Health Network now has it's first ever (as best I have been able to determine) guest article about male modesty. http://www.talkingaboutmenshealth.com/ The allowable word count was very limited and so what got said is limited but hopefully the message can be reinforced with some comments. You have to be logged in to comment, and as yet I have not found where I can register so as to comment. If someone figures that out, I'd appreciate hearing it. I would add that the search feature they have does not seem very robust either.

Even if articles can't say everything that you would like to say or can't say it forcefully enough, the more articles that get out there the more awareness and acceptance there will be. Each small addition helps.

 
At Sunday, August 27, 2017 8:26:00 AM, Anonymous Anonymous said...

When commenters on this blog use the word modesty it presents the issues as benign, it's far from that. Read any nursing text, all patients are to be treated the same wether male or female regarding any procedure that involves intimate care, draping and privacy are expected. But that's not the outcome. Female patients are given more privacy, proper draping etc. An example of this are the manner in which trauma level 1 male patients are treated vs female level 1 trauma patients. Female trauma patients are covered up quickly vs male trauma patients theft exposed long after the trauma has been called.

I don't write the rules, state boards of nursing wrote the rules and the rule says any nurse that does not use appropriate draping, leaving the patient unnecessarily exposed is guilty of sexual misconduct and is considered to be unprofessional and can be subject to license revocation. Yet the contention is that female staff assume men have no modesty and thus are treated unprofessionally. This is the contention, that the thought process is that female nurses step out of bounds in their nursing care and treat all men the same because all men do not care about their privacy.

If this is the case and I believe it is the case because it's true and I've be seeing this for decades then any female nurse who cares for male patients is unprofessional and guilty of sexual misconduct. I rest my case.

PT




 
At Monday, August 28, 2017 4:09:00 AM, Anonymous Anonymous said...

Biker -- your article is first-rate. Captures every major issue clearly and concisely and reasonably. Thank you!

RG

 
At Monday, August 28, 2017 1:00:00 PM, Blogger NTT said...

Good Afternoon:

Congratulations Biker on another well written article. I’ve been going back & forth with the website owner as to how to login to make comments. If I get something that works, I’ll pass it along here.

Gender equality to the personal and intimate concerns of all patients will not happen unless and until men drop the preconceived notion that you have to have female nurses for caregivers in all aspects of medical care.

We cannot move forward until men start thinking the correct way and that way is WE HAVE A CHOICE.

Dr. Bernstein you said it was essential that both genders work together to get this goal accomplished. Yes there has to be cooperation from both sides but I see two major road blocks to getting on the road that will balance the scales.

First one in men themselves. Too many men won’t speak up for themselves and tell the healthcare industry enough is enough give us a choice. They’ve been brow beaten for so long by the system, they’re brainwashed on the idea they will be completely exposed and humiliated and that’s the way it is. The other group of guys are the ones that haven’t had to use the system yet. They naively believe the healthcare system is going to protect their privacy and respect their dignity. Then they go in for an exam or test & come out of the encounter shell shocked when they see what we were saying is how it is.

The other road block is that most facilities have women in positions to do the hiring As long as that’s the case, an equally qualified male will rarely get hired. The only real ways to stop this illegal practice is with a court challenge or legislation out of Washington. I’ve written many a letter to Washington about our plight only to be completely ignored to this point.

As far as all patients are to be treated the same whether male or female regarding any procedure that involves intimate care, draping and privacy are expected. You’re right PT it’s not the outcome. The reason the outcome is the way it is, is because the female nurses know they can get away with exposing their male patients because they know men are not going to speak up about it & stop it. Put up, shut up, and just get it over with is the current way most men think about medical interactions.

We are our own worst enemies.

As far as getting help breaking out of this quagmire men are in, I see little to no help coming from the medical community. They like things just the way they are thank you.

The immediate family can be there for moral support but that’s about it.

I agree with Biker in that I really don’t think women care one way or another if males are exposed intimately in front of female nurses and techs as long as their privacy and dignity are protected and respected.

If guys want change, it’s up to us to get off those couches & spread the word as to what’s happening and demand the system change.

Women are up at arms right now about possible changes to their healthcare under the proposed new healthcare legislation coming out of Washington. They’re banding together & standing up for themselves.

Take notice guys. This is what WE should be doing also.

Until we can prove to the powers that be in Washington and the medical community that we want equality, they have no reason to take us serious.

Get busy guys.

Regards,
NTT

 
At Monday, August 28, 2017 2:52:00 PM, Anonymous Anonymous said...

Responding to Biker from last week on the previous volume (sorry, I was offline for a bit). First, you mentioned all your cystoscopies where handled by an NP. Not sure what that completely meant. In most urology practices now the patient is prepped by the MA. And, (if the state allows this, most do, some do not) the MA injects the anesthetic into the urethra. Then the physician or NP comes in a few minutes later and does the exam, with the MA present assisting. Sometimes if one is particularly “fortunate/unfortunate” there may be two additional women present in addition to the MD/NP depending on how the practice is organized. For women I’ll bet the MA’s drape/cover the women will she waits for the anesthetic agent to take effect in the urethra. For men that doesn’t seem to be the case and its especially annoying since the room door is opened and closed multiple times.

Many of the other in-office Urology tests, like urodynamics, bladder volume scans, etc. are done by the minimally trained/qualified MA too. Nurses and above must be used when medical discussions, test interpretations, diagnoses, etc. are needed because MA’s are not licensed medical providers. So practices reserve them for such activities (not cost effective for the grunt work anymore & they are needed to generate income not prep penises).

I also read your article - great job Biker. I applaud you for pursuing opportunities to publish articles that force some thinking about the double standard/discrimination pervasive in medicine. - AB

 
At Monday, August 28, 2017 3:01:00 PM, Blogger Biker in Vermont said...

NTT, I would note that The Men's Health Network which appears to be well connected and well funded has not done anything in this regard. They encourage men to go to the doctor and they advocate for funding for things like prostate and testicular cancer, but my small article is apparently the very first mention of this issue in their history.

It has not even been on their radar, or if it has, they've not been willing to take a stand bucking the female-centric status quo, or perhaps the women who hold key roles in the organization. This is why I hoped that there would be some good dialog in comments. Very few of their articles get any comments. Maybe they're not really interested in having a dialog with men. Or maybe the key men there haven't had the full intimate care experience and are clueless.

 
At Monday, August 28, 2017 7:45:00 PM, Blogger Biker in Vermont said...

Thanks AB. I appreciate learning about the use of MA's in urology. It is not good news. If I am going to be exposed to a woman I at least want it to be someone who has a license at risk if she misbehaves.

Prior to this year all of my bladder related matters were at one large practice at one of the major hospitals in Boston. An NP did all of my BCG/Interferon treatments. My couple dozen cystoscopies were all handled identically despite numerous individuals doing the prep. I had the same doctor throughout. It was always just me and one female for the prep and then only the doctor joining us. Nobody ever entered the room once I was in it except for the doctor.

I always assumed the prep person was an RN but last year I asked her specifically if she was an RN and she said she was an NP and that the practice was in process of converting to all NP's. It could be she meant only NP's for bladder cancer matters, though I'm not sure why cystocopy prep would require someone at that level. They don't wear name tags that make their licensing level clear.

Never did I see a male there other than the physicians.

As I said, the prep was done in identical fashion no matter who did it, and it was done in a very respectful fashion that minimized my exposure to literally only the penis as I was otherwise kept fully covered. As soon as my gown was raised a cloth with an opening for only the penis was put down and then the rest of me was covered. I was always told what each step was before she did it and asked if it was OK to proceed. If the doctor was delayed, she either maintained eye contact with me or otherwise was not staring at my penis while we waited. Clearly they were very well trained. I was always very self conscious but none of them ever did anything that specifically embarrassed me.

This year I switched to a large teaching hospital in NH which is far closer than Boston and for the 1st time had a male nurse (RN... they wear clear name tags there). It was only he and I for the prep and then only the doctor coming in. Going forward there may be a Resident with him but that is my choice. Urology takes two Residents a year, one female and one male. I will allow male Residents to participate but not female. I just have to tell them when I schedule my appt. Truth be told the RN's prep process left me a bit more exposed than I was used to but I didn't care because I at long last had a male nurse and was totally relaxed. I will ask for a male nurse when I schedule my next cysto and will then ask again when I arrive for the appt.

Thanks again for the warning about MA's. That's something I didn't know.

 
At Wednesday, August 30, 2017 7:56:00 PM, Anonymous Anonymous said...

A Twitter tweet led me to read an article “Laughing with Cancer: How Did I get here?”. The author ultimately was diagnosed with prostate cancer. As with all articles I’ve read by prostate cancer survivors (a couple in newspapers like the NY Times, several on the web), this author also noted “Checking my dignity at the door became a rite of passage…”. That is, I’ve noticed time and again writers that describe their feelings during their prostate cancer journey comment on how one’s dignity goes out the door with a prostate cancer work up and treatment.

My question is, if as the medical profession asserts, most males have no modesty, why do so many writers of their prostate cancer journey later comment on “losing their dignity”. And, why do male patients getting worked up in a urology office for prostate cancer feel they have no dignity later? And why can’t male cancer patients be treated with dignity?

I think in fact this is another confirmation that the medical system is not addressing male dignity, is not correct in assuming males have no modesty/dignity concerns and in fact the medical profession is treating males in such a manner that it induces realization of a LOSS of dignity (even if the male patient had no modesty issues or adverse experiences in medicine before).

More specifically, the medical profession doesn’t provide robes, gowns & drapes for male patients like they usually do for the female patients. They don’t provide same gender assistants, scribes, observers, techs, etc. like they do for the female patients. The medical profession is intentionally lazy with respect to draping and covering male patients (an example of this is my experience waiting naked from the waist down in a urology procedure room for 1.25 hours for the doctor to arrive). Overall the medical profession just tends to ignore dignity/bodily privacy for male patients and they rarely if never ignore this for the female patient.

So again I ask the medical profession, an evidence based discipline, to show me the data that it is okay to treat male patients this way. Where is the data that males have no modesty and can have their bodily privacy ignored? Has anyone surveyed prostate cancer survivors to see if they felt their dignity was preserved throughout the whole ordeal? Does ignoring male privacy help or hinder the male patient and the health of the male population. Does ignoring male bodily privacy increase prostate cancer survival or hinder it? Where is the data to support how male patients are treated? - AB

 
At Wednesday, August 30, 2017 9:16:00 PM, Blogger Maurice Bernstein, M.D. said...

AB, certainly I understand the point you are making. I know I have written this before but where has our teaching of first and second year medical students "evaporated" regarding attention to modesty issues in both genders?
I guess the business men or business women in the medical system have never been taught as medical students! ..Maurice.

 
At Thursday, August 31, 2017 6:03:00 PM, Anonymous Anonymous said...

AB said

" The medical profession is intentionally lazy with respect to draping." You could call it that but sexual misconduct is more the appropriate term and I'll mention that if you have a tray, body part etc that is sterile and you want to maintain sterility you should drape it with a sterile towel. I'm referring to a prepped body part or sterile tray such as used in paracentesis, lumbar puncture, central cath ( triple lumen), Stryker hip prosthesis, laparoscopy etc. Body parts that have been prepped with betadine for a procedure should be draped, covered with a sterile towel particularly if the patient is not in any kind of sterile environment whereby laminar air flow is not used. It's just downright stupidity!

Any patient that is prepped for a medical procedure and left in that manner for 1.25 hours without a sterile drape to maintain sterility is just unprofessional. Wether that body part is prepped for sterility or not no one should be left exposed for 1.25 hours. I have been involved in thousands and thousands of surgeries and never have I ever seen any patient prepped and have to wait 1.25 hours for the procedure to begin. I'll mention that if that were the case it would be documented should the patient return for post-op, procedure infection and there would be some explaining. I assure you risk would be notified on that one and certainly anesthesia is never given until the surgery is ready to begin.

PT

 
At Thursday, August 31, 2017 6:41:00 PM, Anonymous Anonymous said...

AB

Prior to my college attendance I volunteered at an animal rescue shelter as I helped veterinarians perform procedures on dogs and cats. I'll tell you that animals were treated better than you were treated. Most minor office procedures can be prepped and draped in 30 seconds. In the surgery department having your gallbladder removed. a Cholecystectomy can be prepped and draped in under 5 minutes. There is no surgical procedure performed on female patients whereby the patient is prepped and left exposed for any period of time let alone 1.25 hours.

I believe you as I have heard of male patients in urology clinics for a vasectomy that were prepped and left exposed for nearly an hour while three female medical assistants stood in the room waiting for the urologist. In conclusion, I believe any facility that treats patients like this is acting unethically and unprofessionally. Therefore, any physician, tech, nurse, assistant whatever reading this and if you've treated your patients as such. Do the world a Hugh favor and exit the industry STAT! For you don't belong and I consider you all IDIOTS!

PT



 
At Thursday, August 31, 2017 9:18:00 PM, Anonymous Anonymous said...

Dr. B wrote “where has our teaching of first and second year medical students "evaporated" regarding attention to modesty issues in both genders?I guess the business men or business women in the medical system have never been taught as medical students!”

Are you suggesting it is the business men and women alone who are responsible for the disparity in how female and male patients are treated? There are plenty who are responsible, but in the interest of brevity let me address just the physician's complicity in this matter.

There are plenty of private medical practices (it probably is still true more physicians practice privately than are employed, although that is changing). Way greater than 95% of private physician practices hire only females. Why is that? Where did physicians learn that it is okay to design their OWN practice for the female patients and basically say to any male patients “take it or leave it” and “man up”. Where did these physicians learn is is okay for them to discriminate in the hiring process? Where did these physicians learn that in their own practices it is okay to discriminate against customers based on gender? Where did these physician learn it is okay to treat different people differently, it is okay to provide a different standard of service to one class of patient versus another? I really wonder if gender is the only category physicians discriminate on or whether race, ethnicity, etc. are also triggers but that is another matter. The point is from the start nearly every physician ENABLES and PARTICIPATES in discrimination in hiring and in services and treatment of their patients. In their OWN practices.

Now many of these private practice physicians also have privileges at and practice at hospitals and surgery centers too. There they continue to enable discrimination because they never advocate for their patients, they never call out the biased hiring of that facility (that surely they must recognize). Of course they can’t because it would make them look hypocritical and apparently that is more bothersome than simply discriminating against patients.

Most physicians practicing at hospitals argue any new implementation of anything by the Hospital until they see the *evidence* for such new practices. Want to add a time out in the OR - better prove it saves lives or surgeons won’t do it. Want to require specific documentation in the medical record - better prove why it is necessary & helps the patient and billing. Want to discriminate against half your patients - no problem - no evidence needed.

So physician play a huge roll in enabling and propagating discrimination against patients. I’m reminded of signs that existed when I was a small child that said when whites had doctors office hours and when blacks had doctors office hours (and they didn’t overlap). Health care is structured for women. Men are offered access to this system but only if they tacitly agree to the discrimination. It is not just the businessmen & women who created and propagated this system, an overwhelming majority of physicians contributed to this, and never advocated to correct it.

So again I ask - how does the medical profession, physicians in particular, justify this discrimination. Show me the evidence based medicine that this helps all the male patients. I don't think they can. - AB

 
At Friday, September 01, 2017 9:09:00 AM, Blogger Biker in Vermont said...

The article on Student Shadows has been published on the Dr. Linda site.http://drlinda-md.com/2017/09/guest-post-student-shadowing-informed-consent/

 
At Tuesday, September 05, 2017 4:03:00 PM, Blogger Biker in Vermont said...

I had an upper endoscopy today without sedation. It was easier to endure than the transesophageal echocardiogram I had w/o sedation despite the scope going down much deeper, I think perhaps because they did a good job of numbing my throat first.

There was a small surprise though despite my having read up on the procedure beforehand. The young medical asst that brought me from the waiting room takes my blood pressure, then hands me a gown and says "everything off". That startled me but I thought she must think I'm having a colonoscopy. I tell her I'm having an upper endoscopy why would I need to take more than my shirt off? She says because of the sedation. The RN comes by and agrees I only need to take off my shirt given no sedation. I had no idea that sedation meant an automatic totally nude scenario, though there clearly wouldn't be a reason for anyone to remove or otherwise lift my gown or remove the sheet that I'd of had over the gown while I was sedated.

Anyway I thought I'd pass that along as another benefit to not being sedated. The issue hadn't come up when I had the T.E.E. being the staff I dealt with all knew I wasn't being sedated. A suggestion to those who do have these kinds of procedures w/sedation is to leave your underwear on anyway. If afterwards anyone says something about it you'd know that they did lift or remove your gown which then begs the question as to why. The procedure is through your mouth so there is no need to be going anywhere else.

 
At Tuesday, September 05, 2017 8:03:00 PM, Anonymous Anonymous said...

Hello Biker,

I read your recent post with amazement. Is it possible for you to determine the rationale for total nudity, if sedated? I'd really like to know what reasoning was involved for determining that all clothes should be removed for this type of endoscopy, sedated or otherwise. If you are able to get a response from the medical personnel, please post it.

Thanks.

Reginald

 
At Wednesday, September 06, 2017 3:58:00 PM, Anonymous Anonymous said...

I guess it's fashionable here to express the opinion that the vast majority of female nurses ate dedicated professionals and perhaps that's true; howver, it seems those I run into in medical offices are more aptly described as trailer trash. That said, this report may represent a new low: http://ktla.com/2017/09/06/5-denver-health-nurses-suspended-after-opening-body-bag-to-view-mans-genitals/
I guess none were fired which says a lot about medicine's ability to police itself.
REL

 
At Wednesday, September 06, 2017 5:03:00 PM, Blogger Maurice Bernstein, M.D. said...

To me REL's news story is a matter of humans being objects and not human subjects. And while we teach all patients are human subjects while alive in their hospital beds or in death in the dissecting room it appears that some nurses were never taught that or disregarded this philosophic ethical principle for their own sexual self-interest.

I also object to the nurse's medical institution that did not provide the news media with the names of the nurses. Why do I object? Another example of the institution allowing to present the nurses as objects and not as human subjects who violated ethical principles.

Anyway, that's how I look at this from an ethicist's point of view. ..Maurice.

 
At Wednesday, September 06, 2017 7:39:00 PM, Anonymous Anonymous said...

Yet, they are presented year after year after year as the most trusted profession. It should be noted that this mans genitals were view while he was alive and after he died.

PT

 
At Wednesday, September 06, 2017 8:28:00 PM, Anonymous Anonymous said...

Maurice

Would you expect the Colorado state board of nursing to look into this? Would you expect this subject to appear on Allnurses? Would you expect that medical facility to report the nurses names to anyone. This was investigated by the police department so I would say that a police report could be obtained and the names of the nurses would then be divulged but in the final analysis would it really matter. These faceless, nameless people who don't advocate for a human being in life let alone in death so why would it matter to anyone. This is the face of today's healthcare and male patients see these kinds of faces everyday.

I'll ask our viewers to find a YouTube video of this subject being relayed by a young gentleman who perfectly relays the point of their behavior, he's remarks what would happen if the roles were reversed. These five nurses were as I read suspended and I assure you it is with pay so no, it was just a vacation. I have seen this occur over and over and it's nothing new. I have stories I could mention on this blog but I don't because they are so bizarre that I don't because I don't think anyone would believe me. We can post comments on sites like DrLinda-Md and portray it soo nice, with icing and strawberries and be so nice and sweet about it. Do you think anyone pays attention to it. Do you think anyone cares about how male patients are treated. Then you read something like this that leaks to the press and BAM, you are brought back to reality cause folks this happens everyday at every facility all day long.

It's pathetic how it's relayed in the news and how it is so downplayed. It's even more pathetic when a few nurses will say " well I don't treat patients like this and blah blah blah" . Do you hear that " that's the voice of self- righteousness talking to you. That's the voice of one individual protecting an entire industry. It makes me sick!

PT






 
At Thursday, September 07, 2017 11:21:00 AM, Blogger Biker in Vermont said...

Reginald, I wish I had asked specifically about why no clothes when sedated but once the RN agreed I only had to take off my shirt I moved on to a couple other questions I had. Sometimes they call as a follow-up and if they do I will ask the question. My guess is it must be a precaution should there be an adverse reaction to the sedation. Clearly there isn't as much a concern with the procedure itself being I only had to remove my shirt for the endoscopy and the same earlier this summer for the T.E.E. too. If my guess is right and the sedation is riskier than the procedure, then all the more reason not to be sedated if you can tolerate a little discomfort.

 
At Thursday, September 07, 2017 11:38:00 AM, Blogger Biker in Vermont said...

Concerning the Denver nurses I am appalled that the hospital gave them a slap on the wrist is all. Can you imagine going to that hospital for a procedure and wondering if your OR nurse is one of them? Or your floor nurse that needs to tend you in some intimate matter?

The reaction of the hospital to not fire them on the spot tells me that such behavior is an accepted part of the culture. I read comments on a different forum that ranged from totally appalled and thinking they should have been fired to those who thought it wasn't such a big deal because the patient was a guy. Yes you heard me right.

Apparently much of our society is not yet ready to accept that men are entitled to dignified and respectful treatment as regards their intimate privacy.

I sent a message to Denver Health expressing my thoughts on their having effectively condoned what the nurses did. This is something that we can do.

 
At Thursday, September 07, 2017 1:24:00 PM, Anonymous Anonymous said...

Colorado board of nursing
1560 Broadway, suite 1350
Denver, Colo
80202


I'm asking our readers to write to this nursing board regarding the incident. In my state their actions are considered sexual misconduct. I'll mention that the director of the board of nursing answers to the governor of Colorado. After reading the article on numerous sites I have come to the conclusion that the floor this patient was either the emergency room or the intensive care. Denver health on their site says they have a non-discrimination policy and they do not discriminate on the basis of gender. For a hospital this size 5 nurses would essentially entail the majority of their staff be it the er or Icu. From what I've read their have a new CEO who is a female. From from I've read the incident occurred from late March till early April but was not reported till May.
Typically, when a patient expires in an intensive care unit the patient is transferred to the morgue in fairly short order so the room can be ready and prepared. A deceased person will never occupy an Icu bed for very long. Within the emergency room a deceased person will be moved to a room adjacent within the er for some time allowing next of kin for perhaps a number of hours prior to transferring the patient to the morgue. I believe this patient was in the Icu prior to his demise and it's very disturbing the culture that exists and as I mentioned the 5 nurses very well could have been the entire Icu staff for that day. A typical Icu nurse will be assigned no more than 2 patients at any one time.

PT

 
At Friday, September 08, 2017 4:07:00 PM, Anonymous Anonymous said...

Hello,

I sent the following note to Karen Jackson at CMS and received an immediate reply (see below). Medicare is BIG business for the health care industry. When it speaks EVERYBODY listens. Possibly, suggesting same-gender care to one caring individual at CMS may propel our concerns mainstream. Incidentally, I applaud Ms Jackson for being the only member of CMS Leadership to post her CMS e-mail address. You don't have to be a Medicare participant to offer suggestions. You may wish to research another CMS official to spread the word.

Reginald


Sent: Friday, September 8, 2017 2:38 PM
To: Jackson, Karen E. (CMS/OA)
Subject: Need for Change

Denver Health nurses suspended after opening body bag to see man's genitals

Hello Ms Jackson,

As a handicapped Medicare participant and as a human being, I find this headline appalling. I'm wondering if this is how I'll be treated when I'm hospitalized. Will my Medicare payments be given for this? Please consider what Medicare can do to prevent this from happening to me when I'm hospitalized. Will my care and safety be jeopardized because medical staff are viewing my genitals instead of caring for my injury/ illness? Creating new rules which are not respected or enforced obviously does not work. Medicare must insist that same-gender care be provided to anyone upon request. The shortage of male nurses must be addressed by aggressive recruiting.
Medicare has done a great job with bundled payments. This has forced medical facilities to improve care and efficiency. This must also be done with same-gender care so that incidents like the above are "never events".



PS Below I have included the URL for the story and a few brief excerpts. These should appall anyone with a sense of human dignity.
http://www.thedenverchannel.com/news/local-news/denver-health-nurses-suspended-after-opening-body-bag-to-see-mans-genitals
Five nurses at Denver Health Medical Center were suspended for three weeks after they inappropriately viewed a deceased patient’s body and talked about it, a hospital spokesman confirmed to Denver7 Investigates Tuesday.
A tip to Denver7 said the nurses disciplined admired the size of the deceased patient’s genitals and at one point opened a body bag to view parts of the body. A hospital spokesman confirmed details of the incident.
“Multiple staff members viewed the victim while he was incapacitated, including after he was deceased,” a Denver Police report says. .”
The report says the incidents occurred between March 31 and April 3, 2017, but weren’t reported until May 8.
Rasmussen said although the nurses received discipline considered “serious,” four nurses ultimately returned to work.

From K. Jackson

– thank you for your note and for reaching out to me. And thank you for your positive feedback on the bundled payment programs that CMS has worked with many health care providers to implement in the Medicare program. We are working hard to improve health care outcomes with innovative programs like the one you refer to. I will share your note with agency staff who are more expert than I am in health services staffing and recruitment.

Best regards,

Karen Jackson
Deputy Chief Operating Officer
Centers for Medicare & Medicaid Services
Karen.jackson1@cms.hhs.gov
410-786-0079


Reginald

 
At Friday, September 08, 2017 6:24:00 PM, Anonymous Anonymous said...

Reginald

Thank you for your advocacy as I've said that CMS holds the key in much of this discussion. Based on her response I don't see much success as its business as usual. Some states have laws regarding necrophilia and Colorado is one of them and if I interpret the laws correctly it is a class 2 misdemeanor at least it should have been for the 5 nurses. I do not understand why they were not terminated or in the very least reprimanded by the board of nursing. It just may be the nursing board may or may not know of the situation and I encourage everyone to write them. Don't expect respectful care when you are alive and don't expect it after you die.

PT

 
At Friday, September 08, 2017 6:56:00 PM, Anonymous Anonymous said...

Reginald

I want to mention that those 5 nurses were actually rewarded, not punished. They were put on administrative leave with the pending investigation. The hospital spokesperson said the punishment was serious, how do you call being three weeks of free vacation serious and he goes on to say a letter was put in their personnel file. Do you know how worthless that comment is? I have much experience in human resources and those letters mean nothing. Those letters grow legs and disappear after several months. The fifth nurse probably got another job and couldn't care less.

Administrative leave is always with full pay, They were rewarded after violating the nurse practice act, violating the core values of the hospital, violating the patients trust both when he was alive and after he died and violating rules set forth by the Colorado state board of nursing. Probably violating laws enacted by the state of Colorado regarding necrophilia and after all was said and done they got three weeks of vacation and returned to their job.

What would happen to you if you committed the same act and create any scenario you want and after all was said and done would you like to be rewarded with 3 weeks of paid vacation and then return to your job? They were rewarded because they are female and the hospital CEO, Risk, CNO and their nursing director is female. Three weeks of paid vacation?

PT



 
At Saturday, September 09, 2017 8:14:00 AM, Blogger NTT said...

Good Morning.

What a sad state of affairs we are in.

What I find most disgusting and distressing about the "Denver 5" episode is most people view it as being funny.

What should have been a wake up call to the public is just a joke.

Sad.

I understand the next of kin was notified of the episode. I hope they sue the pants of the hospital & the 5 degenerates.

Regards,
NTT

 
At Saturday, September 09, 2017 9:09:00 AM, Anonymous Anonymous said...

Hello again,

In my original note to Ms Jackson, I yellow highlighted the "3 weeks" and "return to work". Unfortunately, this site doesn't seem to support highlighting; thus, it did not appear in my original post. I presumed that, as an intelligent individual, she didn't need to have me explicate. Yes, it may still be business as usual at CMS. However, maybe once, just once, the seed will fall on fertile ground and produce one hundred fold. We live for hope and spreading the word can't hurt.

Reginald

 
At Saturday, September 09, 2017 11:05:00 AM, Anonymous Anonymous said...

I'm going to step outside of my bounds here regarding people who view what the Denver 5 did was funny. I personally know of perhaps between 20 and 30 patients who died of medical malpractice and the family was never told the truth. Same kind of story, same channel but different day so to speak. Patient on a ventilator ( breathing machine), nurse and anesthiologist leave the vented patient unattended and go to the cafeteria for coffee and donuts. They return 15 minutes to find the ventilator had malfunctioned and patient had expired. Not necessarily the anesthiologists fault, rather the nurses fault, No one around to hear the alarm going off on the ventilator. Family told their loved one died of natural causes, not told the truth.

The above is an example of a lack of advocacy and those who might see the Denver 5 behavior as funny do not see this is advocacy gone bad and it comes in many flavors and many scenarios. As I always say bad Karma is a bit$h and it goes around, particularly if it's funny in that they don't see the true meaning of the implications. I'm sure at one time or another they or their loved ones will experience it. There is a good probability that one of them took a cell phone pic of this patient in the body bag. Once a patient goes to the morgue only security has access to this locked unit and I'm sure only the hospital knows the truth as to how these nurses gained entry.

PT

 
At Saturday, September 09, 2017 2:28:00 PM, Anonymous Anonymous said...

Three brief observations on the Denver 5 case:

(1) Science uses abstraction when it's helpful. But, like Hollywood's depiction of a shooting (bang, the victim falls dead), abstraction can obscure events rather than help. I fail to see the utility of a subject/object abstraction in the Denver 5 case.

(2) I have absolutely no desire to see a dead woman's genitals regardless of how she looked in life. This probably makes it very hard for me to relate in any way to the body bag opening at Denver Health. I can only view it as perverted behavior.

(3) Humiliation of men in medical settings by females who hate men probably occurs every single day. Medicine gives them the opportunity and they seize it. What strikes me as different about the Denver 5 case is the group aspect. I believe the counterculture facilitated the descent of the Manson family girls into extraordinary depravity. Makes me wonder about the culture at Denver Health and how conducive it may be to development of similar group behavior. Also makes me fearful of who else may be on medicine's payroll with apparently so very little to do.

REL

 
At Saturday, September 09, 2017 3:52:00 PM, Blogger Biker in Vermont said...

PT was right. No discussion of the Denver 5 on AllNurses. My guess is any thread started is quickly deleted.

 
At Sunday, September 10, 2017 5:58:00 PM, Anonymous Anonymous said...

Biker

Or maybe it was never placed there because this is a subject female nurses don't want to see discussed. This incident blows the gender neutral theory all to hell.

PT

 
At Monday, September 11, 2017 8:25:00 PM, Blogger Maurice Bernstein, M.D. said...

Although what follows is my recent posting to ethicists on a ethics listserv and though not dealing strickly with physical modesty, it does deal with the issue of a form of "verbal modesty" between a physician and the patient.

I wrote:

A simple question: Should physicians feel comfortable if their patients consistently call their physicians by the physician's first name? That includes dropping the title "doctor" which is allowing this communication. to go from "Doctor Smith" to "Don" (the physician's first name). Is this really unprofessional communication and the physician should somehow correct the patient? Is the allowance that the physician may call the patient by their first name a valid argument for patient permission to do the same toward naming their physician? Or is the current seemingly unequal behavior in communication between patient and their physician an ethical "good" which should be preserved?


So to my blog thread readers: Is there some inequality here on the part of the medical providers? When first names are used to identify either party is this a form of verbal "undress"? How do you as patients "name" your doctor or nurse and how do you want or insist to be named by your doctor or nurse when they speak to you? ..Maurice.

 
At Tuesday, September 12, 2017 5:02:00 AM, Blogger Biker in Vermont said...

Dr. Bernstein, having been raised to be polite and respectful I always refer to and speak to physicians as "Dr. so-and-so". It has never occurred to me to do otherwise, nor do I have any expectations or desire that this should change. In turn in the absence of being asked what I would like to be called I prefer to be called "Mr. so-and-so" by them. If they ask me how would I like to be addressed I'll tell them my nickname. The difference is being asked by them. I would never say anything if a physician called me by my first name or by the standard nickname that goes with it without 1st asking me but it would strike me as the taking of a liberty I didn't grant them. Nothing that rises to the level of complaining about however.

My thinking here is similar to the modesty issue. I want to be asked if it is OK to lift the gown for example rather than someone just lifting it as their right. There I might complain though.

I as well expect any other medical staff including the receptionist to call me "Mr. so-and-so" unless I have told them it is OK to do otherwise. Of course for privacy reasons when being called from a waiting area they use 1st names only which makes sense and is OK with me. I do expect them to shift to Mr. so-and-so once we leave the waiting area however.

Where I don't know what to do is what to call a PA or NP. Using their 1st name seems a bit disrespectful. Calling them Mr. or Ms. so-and-so doesn't seem right either but is better than using their 1st name, yet saying Physician Assistant or Nurse Practitioner so-and-so strikes me as odd. That leaves me with using Mr. or Ms. so-and-so until someone tells me better. Is there a right answer?

With RN's or below, I will defer to Mr. or Ms. so-and-so if their last name is displayed where I can read it, unless they first tell me to use their 1st name. If all I have is the 1st name that is what I use. If they don't have a name tag or the tag is turned around as often is the case I just go with Sir or Mam.

 
At Tuesday, September 12, 2017 10:53:00 AM, Blogger Biker in Vermont said...

Just an observation which may not hold elsewhere in the country but in this region at least there seems to be a feminization of primary care underway.

After more than a year of a couple symptoms going undiagnosed and my primary care physician not doing anything more than having given me a couple referrals I decided it is in my interest to find a new primary care doctor, much as I like him on a personal level.

I looked locally (hospital and non-hospital), at a regional hospital an hour from here in VT, and at the large teaching hospital in NH that I been to for urology and gastroenterology matters. What I have seen is that there are more female internists and family physicians than male and that practices have more NP's, APRN's, and PA's than they do MD's. The ranks of the NP's and APRN's are almost exclusively female. Things are a bit more balanced with PA's, though there are more females than males there too. What is telling about the future is that on average the male MD's who are already fewer in number than the females, are also older on average. I extrapolate that to mean that at some point in the future male internists and family practice physicians will be few and far between. Primary care will have become the domain of women except for a few male PA's, though the question can be posed as to whether those female MD's will continue to hire male PA's once they have more fully taken over the system.

I also saw that some internists, NP's, and APRN's specialize in women's health. None specialize in men's health.

The other observation is that demand has outstripped supply. I could not find a single internist, male or female, that is accepting new patients locally or at either hospital. Even most of the NP's and APRN's are not accepting new patients. Note that there is no population growth in the region served by any of these hospitals over the last decade but rather a small decrease, yet there are no internists taking patients.

I decided my best bet was going with anybody I could find over in NH that was taking new patients so as to then have my primary care within their system. I plan to switch my cardiology over to there too and at that point 100% of my medical care will be within their system where hopefully coordination and oversight (by the primary care) will work better. Over in NH I found 2 male PA's who just started last year and who are still accepting new patients, and I've made an initial appt. with one of them. Having found an entrance point into in their internist system perhaps I'll be able to get an MD at some point as my primary care.

Most of what I learned here came as a surprise. A week ago I'd of told you no way would I go to a PA or NP for primary care. At least I found a male PA.



 
At Tuesday, September 12, 2017 2:36:00 PM, Blogger Maurice Bernstein, M.D. said...

How about a lesbian physician or other lesbian healthcare provider for you heterosexual males with worries about modesty issues written to this thread? Did you know I have an active thread on this blog titled "Would You Accept a Gay or Lesbian Physician as Your Doctor?" You might go to
http://bioethicsdiscussion.blogspot.com/2010/08/would-you-accept-gay-or-lesbian.html
check it out and then return and respond here or respond there since you will see a Comment by Dr V from Canada referring to our Patient Modesty thread here.

I don't recall whether we have discussed here the sexuality of the males writing here who are complaining about the female healthcare providers which I assumed in the first paragraph "heterosexual".

Or do you all agree with some writers to that other thread who state they really don't care about the sexual direction held by their physicians? ..Maurice.



 
At Tuesday, September 12, 2017 4:13:00 PM, Blogger Biker in Vermont said...

I have never thought about the sexuality of any medical staff I interact with nor do I care. As has been discussed I grew up in the age of mandatory showers in school, nude swim class for guys, and generally having to grow accustomed to same gender nudity. For most of my adult life I have been in locker rooms where guys shower together. Surely some of those guys have been gay, and to that I say who cares. Doesn't bother me in the least as for me there is no sexual context to locker room settings or interactions.

I had been in mixed gender nude beach or swimming hole settings a few times in my younger adult years and quickly became comfortable with it being we were all exposed and thus on equal ground. Being naked with women who are fully clothed in a medical setting is something entirely different. That is not equal ground. Even knowing that it is most likely not perceived in a sexual way by the doctor or nurse, the best I can hope for is that I merely feel self-conscious. I am in a position of weakness relative to them and it is not comfortable. Knowing that there will be times that the caregiver may have a prurient interest just adds to the discomfort.

 
At Tuesday, September 12, 2017 4:39:00 PM, Blogger Dany said...

Dr Bernstein,

When meeting a physician for the first time, I'll always give him or her their title. They worked pretty darn hard for it, so it's only respectful to use it. At least until the relationship is well established. That being said, if a doctor starts to use my first name, this implies he or she is okay with me doing the same. Any issue with this and we'll go back to "Mr " in a hurry.

In my neck of the woods, there aren't many PAs (not all provinces in Canada recognizes them) but the few I come across through the military seem to be fine with first name basis. I have noticed a more prevalent familiarity ("chummyness"?) coming from PAs and NPs than from doctors. This could be explained by a cultural difference.

At the regular clinic I go to, there's a family doctor (woman) as well as a PA (man). The doc is oh so prime and proper (formal) nearly all the time but that PA... Man is he is casual. Not that I mind, but the contrast is very apparent. I prefer dealing with the PA myself but, sometimes can't avoid having the doc "crowding in" (typically it will be for some confirmation or consult-type situation).

As far as sexual orientation goes, finding out (or realizing/discovering) that my physician is homosexual (or even transgendered) wouldn't bother me at all. It's not something that comes up casually in medical appointments so, it most likely would have very little impact on my interactions.

Dany

 
At Tuesday, September 12, 2017 5:07:00 PM, Blogger NTT said...

Hi Dr. Bernstein:

As far as the doctor goes, I don't think sexual preference plays as much a role in choosing the MD as much as their professional ethics.

I think what upsets both male and female patients is the way the MD not thinking a minute all the sudden ambushes their patient in certain situations.

That causes the patient to only want to seek out same gender care.

If in their first meeting the doctor and patient took the time to explain themselves to each out so both knew what to expect from the other, I don't think sexual preference as far as the MD goes would be an issue.

If female MD's want to have male patients, they will have to think about male related scenarios and how they would handle them before they start seeing male patients. One can't start a male physical then at the intimate part step out for a second & bring a female chaperone in announced.

I guarantee you'll never see that male patient again if he has modesty issues. And he will spread the word to others as to how you handled the situation which may in turn further erode your patient base.

Just my take.

Regards to all,
NTT

 
At Friday, September 15, 2017 3:41:00 PM, Blogger Biker in Vermont said...

As a follow-up to the discussion about how do you address a doctor, I had a 1st visit today with the PA who will serve as my new primary care provider. As noted before there is not a single internist within 1.5+ hours of here that is accepting new patients, nor are most of the NP's and PA's. This guy has only been practicing since last year which is probably why he hasn't been fully booked yet.

The Medical Asst bringing me from the waiting area referred to him as "Dr. so and so". However when he came into the room he introduced himself simply by his 1st and last name and referred to me as "Mr so-and-so". My wife says where she goes the PA's are referred to as Mr. or Ms so-and-so.

I did learn that if he needed to bump me up to the MD, he is paired with one of the female MD's. That's fine with me being he's the one that'll do basic physicals.

Lastly on an unrelated note to what we discuss here, this was my 1st real encounter with a PA and I was totally blown away. Never have I had a PCP or a specialist for that matter who explained things as well as he did or was as thorough as he was in asking questions. He was also able to preliminarily diagnose and then test to confirm a recurring problem I have dealt with and been pursuing a diagnosis on for over a year. I went into this skeptical about seeing a young PA but my doubts proved unfounded.

 
At Saturday, September 16, 2017 10:23:00 AM, Blogger NTT said...

Good Afternoon Everyone:

Came across an article that told the Denver 5 story but also included another incident that happened to a gentleman last December at the University of Pittsburgh Medical Center in Pittsburgh. Here's a link to the article.

http://www.nbcmontana.com/news/health/workers-at-2-hospitals-disciplined-for-violations-involving-patients-genitals/621418563

A "crowd" of UPMC Bedford nurses and doctors "lined up at the door" of the operating room to take photos and videos of the man's genitals while he was under anesthesia, according to the report.

The material taken on personal cell phones "had no clinical justification," and staffers "shared those videos and photographs to others uninvolved with the patient's care," the report says.

It's open season on male patients.

As per the Denver 5, nobody in Pittsburgh lost their jobs either.

There has to someone with the power to stop these animals that we can contact.

If these animals were lined up to take pics of a female patient, EVERY LAST ONE OF THEM would have been fired.

This can't be allowed to continue.

I am thoroughly ashamed of the United States healthcare system for it's total lack of any good judgement and their complete disrespect for their male patient's privacy and dignity.

These were sick people that only wanted their help. They didn't go there to be put on show.

Every one of those animals in Pittsburgh should have been fired.

Regards to all,
NTT

 
At Saturday, September 16, 2017 5:51:00 PM, Anonymous Anonymous said...

NTT

A story was relayed in discussion regarding the Denver 5 whereby an overhead code would be announced when a male patients genitals should be viewed by nursing staff. This occurred in a post surgical recovery unit which typically receives patients that are still under the effects of anesthesia. The article did not say where this occurred, however, I have read this happening before so I believe there is validity to the story. As I have said before and I'll reiterate it again, these behaviors happen every day at every medical facility. Once in a while the events make it to the news and you read about it.

PT

 
At Saturday, September 16, 2017 6:30:00 PM, Anonymous Anonymous said...

NTT: Thanks for posting the link. I agree with your "animals" characterization and don't see additional HIPAA training as beneficial. Surely most decent individuals from many walks of life would have recognized the behavior as inappropriate -- HIPAA or not. Unfortunately, it appears probable that medicine is attracting more "animals" than other industries and appears to not really care. Notice how the administrators were so elated to be bragging about how they'd taken action. If medicine is unwilling to curb such behavior through consequences, then it will be difficult and time-consuming to change it from the outside. A strategy is desperately needed along with conviction for the long haul. REL

 
At Saturday, September 16, 2017 8:43:00 PM, Blogger NTT said...

PT.

If this behavior happens everyday then the facility mgmt. should be held responsible for the behavior of their employees and as such should be prosecuted and sent to prison along with animals.

There has to be a federal agency that men can complain to.

Regulators must be take the camera phones away from all healthcare employees during working hours. Get caught with one, mandatory termination. Caught with patient pics on it, automatic loss of license and your turned over to the cops for prosecution.

All decent people have to take a stand on this & put these animals where they belong. In cages.

Regards,
NTT

 
At Sunday, September 17, 2017 11:29:00 AM, Anonymous Anonymous said...

NTT

Genitals photographed, shared by hospital employees, a common violation in the healthcare industry. This is the headline in an article written on Penn. state news. I agree with it because I know of it happening at " Every " hospital I've ever worked at. The cell phone issue I agree should be banned in patient areas but they are not. Hipaa laws in my opinion don't have enough teeth, fines should be heavy yet not enforced. More and more people enter the healthcare industry only for a paying job.

There should be extensive training in medical schools and nursing programs regarding patient privacy but there is not. Hipaa laws are only mentioned once staff begin working at medical facilities and the implications are poor in the presentation. Nothing is going to change, it's just business as usual. Millennials cannot be separated from their cellphone these days for more then 5 minutes, it's a must have as its a tool for those lacking any self esteem and personality. Every operating room staff have their cell phones on them and are playing on them as well during cases. No one enforces the policy and there are no policies regarding cell phone use anywhere in patient care areas.

Is it a modesty issue when an unauthorized cellphone pic of a patient's genitals are taken and shared? In the Denver 5 case the family was notified of the incident. I can't but wonder what those people must have thought. " What, they opened his body bag to gawk at his genitals, " It's a crime if you take a cellphone pic of your patients genitals according to laws, however, is it still a crime to bring in an observer to view your patients genitals when that person is not involved in your patients care. It should be a crime in that you could have shown that person the cellphone pic but rather just bring them in and have them take a peek in real time.

The case in the Pen. hospital actually touched on this when state regulators investigated the incident. The description was that the onlookers were described as a pyramid of cheerleaders gawking in the or case at the patients genitals with most of them taking cell phone pics. The regulators determined that staff should not have allowed people not involved in the patients care into the operating room.
Now, this is the first time I have actually read where this issue was addressed. I have to say I'm actually surprised in that I've never ever seen this enforced in any surgical suite.

PT






 
At Sunday, September 17, 2017 1:56:00 PM, Blogger Biker in Vermont said...

The culture and ethics of any organization starts at the top. If the top mgt at a hospital truly disapproved of the Denver 5 type behavior that behavior would stop. They wouldn't have to fire very many nurses or doctors before the message sank in. Fire a manager or two and managers as a group will get the message and they will make sure the rank and file know the rules.

It wasn't a healthcare setting but where I worked being dishonest or unethical would get you fired very quickly, far more quickly than if you were just bad at your job. I was the Chief Operating officer and then the Chief Financial Officer and can assure you that any Payroll Clerk that divulged someone's salary would be fired pronto. Same for anyone in Human Resources that divulged that which they shouldn't divulge. The CEO fired his Executive Secretary for talking out of school so to speak. I fired the IT Director for getting a freebie laptop for himself buried in a very large technology order. I fired a production manager for including a case of oil for himself in a large parts purchase. People knew we would not tolerate inappropriate or unethical behavior and guess what? It rarely ever happened and it helped attract quality long term people who wanted to work for a company with a high ethical base.

Hospitals could do the same if they chose to.

 
At Sunday, September 17, 2017 4:21:00 PM, Blogger Biker in Vermont said...

Here is an article from Men's Health that more or less says it is OK for medical staff to look at and discuss amongst themselves patient "unusual" genitalia. This is partly why it is tolerated. Many people just don't see a problem with it. They do agree that doing it to a dead person such as the Denver 5 did is going too far.

http://www.menshealth.com/health/colorado-nurses-suspended-for-mocking-dead-patients-penis

 
At Sunday, September 17, 2017 9:27:00 PM, Anonymous Anonymous said...

Biker

If you read in particular rules set forth by state boards of nursing, it is not ok to discuss patients genitalia with anyone not involved in their care and it has to be for a reason, as always the np basically covers for them by making excuses.

PT

 
At Sunday, September 17, 2017 9:30:00 PM, Anonymous Anonymous said...

Biker

Now if male nurses discussed between each other large female breasts than I'm sure that np would be having a cow right now and would want those male nurses fired.

PT

 
At Tuesday, September 19, 2017 9:04:00 AM, Anonymous Anonymous said...

Hello,

On a more positive note, please read the comments below from Jeremy Zoch, CEO of St. Joseph Hospital, Orange, CA. "Some patients request male nurses specifically, particularly in a hospital like St. Joseph that serves a wide diverse population. To be the trusted source of care in our community, we have to meet the cultural demands of our patients." At St. Joseph Hospital about 13 percent of the nursing staff is male. Zoch says men can be compassionate, empathetic and caring at a patient's bedside. He began his career in healthcare as a bedside nurse assistant. Below I've attached the general e-mail and the address of St. Joseph Hospital, Orange, CA. Sending a complimentary e-mail or note to Mr. Zoch might further motivate him; and, he might encourage his fellow hospital CEO's to hire more male nurses to fill a, heretofore, unnoticed need.

SJO-Feedback@stjoe.org
St. Joseph Hospital
Orange County Hospital 1100 West Stewart Dr, Orange, CA 92868 (714) 633-9111

Reginald

 
At Tuesday, September 19, 2017 10:01:00 AM, Blogger A. Banterings said...

It has nothing to do with male or female, it has to be changed by making the patient the consumer. The patient pays for the service (one way or another) and has a right to make demands of the service. That is how change will occur.

We hear all the backlash from providers that patients are not the same as the person ordering a burger. The ACA has moved us closer to this paradigm. This is what all patients need to get behind, "have it YOUR way." Only then will we achieve the dignity that we demand.

Providers reject his concept because they know that they will no longer be able to say, I am a professional and this is how we have always done it.

The universe is governed by certain universal laws. One is that systems seek equilibrium. When we physicians were not meeting patient needs, patients sued them for legitimate lapses in care. These incidents would have been overlooked (in many instances) if the physician had treated the patient with more dignity.

This in turn drove up malpractice costs to the point many physicians could no longer practice on their own. They became employees of large healthcare systems that have the customer service model, just like retail and fast food.

The large healthcare systems are not at the point yet that patients demand. It is not until they have financial consequences of poor service that patients will finally receive the treatment they deserve.

--Banterings

 
At Tuesday, September 19, 2017 10:17:00 AM, Blogger NTT said...

Good Afternoon:

If mistreating men wasn't bad enough, checkout this story out of Florida as to what the so-called "Lady nurses" are doing.

https://nypost.com/2017/09/19/naval-nurses-booted-over-disturbing-pics-posts-of-mini-satan-newborns/

These people & the industry need to be STOPPED.

We need better regulations with sharper teeth.

Regards,
NTT

 
At Tuesday, September 19, 2017 10:39:00 AM, Blogger A. Banterings said...

After reading NTT's link about the Pittsburg/Denver incidents, I saw healthcare's "get out of jail free card:"

The hospital system has a strict policy against photography not intended for educational purposes or for the benefit of the patient, public relations senior manager Rick Pietzak said in a statement. Source: Workers at 2 hospitals disciplined for violations involving patients' genitals


I propose in the interest of furthering patient education, that anyone who has the ability to take pics of medical providers' exposed bodies do so and publish them to educate patients that medical providers are people just like us and there is nothing sexual about images used for educational purposes. This reenforces that assertion.

There is additional educative value if there is an anomaly with the person's body, especially the genitalia.

Before one would find any fault with my proposal, why would anyone participate let alone allow the Pittsburg and Denver incidents happen?

I think that this would solve that problem.


--Banterings

 
At Tuesday, September 19, 2017 2:42:00 PM, Blogger NTT said...

Hi AB:

They continue to do this crap because it's fun, they like to look, and most importantly they know the worst punishment the system will hand out is a suspension. More times than not with pay.

The system has no incentive to stop these animals because nobody will come down on the healthcare system and say no more. They all look at it as a joke and it will pass and things will be back to status quo.

If decent people don't take a stand here and now and demand this system be changed then we deserve what we get.

Regards,
NTT

 
At Wednesday, September 20, 2017 6:25:00 PM, Anonymous Anonymous said...

By the mid to late 60's mammography began to be used as a diagnostic tool and by the mid 70's was a modality at many hospitals. As I have said a number of times and I'll say it again the selection of gender staffing was strictly female determined by the hospital. Over the years there have been a few complaints by patients, " the mammo tech was rough with my breasts and she was rude. She will never do my mammogram again." These are type of complaints female patients have about 99% of the time if they do have a complaint.

There have never been complaints such as anyone taking a cell phone pic of their breasts, never. There have never been any complaints by mammo patients such as " I was ambushed, it was a male mammo tech" . That certainly has never happened. Neither were there ever nude pics of playboy magazine of full nude foldouts of women displaying their breasts at any mammo suite. Finally, there has never been a death after a female patients mammogram whereby she had her breasts displayed after being placed in a body bag and certainly not while she was alive while receiving said mammogram.

Now with male patients it's a different story, you can expect any of the above to happen and with frequency. The female healthcare instituted respectful care to their female patients chest anatomy but cannot institute and carry out respectful care with male patient's genital anatomy. Remember, you are a patient but it appears not in the same general capacity as a female mammogram patient as far as patient rights go. Remember all the negatives that happen to male patients everyday, never ever happens to female nurses, female cna's etc. when they receive their mammogram.

PT


 
At Wednesday, September 20, 2017 8:37:00 PM, Blogger A. Banterings said...

I want to offer some HOPE to all who are disgusted about the goings on in Pittsburg...

It is not the end of the story. There is much more to come. I can't say any more because of ongoing things. As soon as I can, I will post a follow up to this.

--Banterings

 
At Thursday, September 21, 2017 9:28:00 PM, Anonymous mitripopulos said...

In the past whenever I have had to endure an abusive doctor or nursing staff I have stated my wish to speak to either the chief of staff, in relation to doctors, or to the head of nursing services. I guarantee you that I received immediate results and direct access with profound apology hoping to avoid possible litigation. When ever this was necessary, I did it at once while in the hospital bed not after being discharged. The next step up is the CEO and you would be amazed how willing many of them are to speak with dissatisfied clients especially when a legal process could happen.

 
At Friday, September 22, 2017 12:22:00 PM, Anonymous Anonymous said...

Hello,

CMS (Medicare, Medicaid) has a questionnaire re care innovations (https://survey.max.gov/429625). This may be a great place to spread the word that same-gender male care is a concept whose time has come. The questionnaire is extremely long; but, there are opportunities to elucidate the pressing concepts appearing in this blog. Again, you do not need to be a Medicare beneficiary to complete the form. No personal data is required. You can skip any part that you wish. What better way to stop cursing the darkness? As I've stated before, when CMS talks, health care jumps. (CMS proposed 2018 budget is 737,854 Million dollars. Is there any wonder that when CMS embraces bundled care, bundled care it is?) Admittedly, CMS is a huge, seemingly impersonal bureaucracy; nevertheless, what loss is there in an attempt to sway current health care practice? A few completed questionnaires, stressing the need for same-gender male health care and encouraging males to enter nursing, may indicate to CMS that this is an avenue worth pursuing. Just pasting some of the comments made in this blog could elucidate our concerns. This is not the military. We don't have to follow the chain of command. Here's a chance to contact the mover-and-shaker of health care. Are you in?

Reginald

 
At Sunday, September 24, 2017 7:01:00 AM, Anonymous Anonymous said...

Reginald --

Thanks for the questionnaire link. I've just completed it.

RG

 
At Sunday, September 24, 2017 9:05:00 PM, Blogger Maurice Bernstein, M.D. said...

In 2 days I will be introducing my group of 6 first year medical students into the skills of performing a physical examination. The first session deals only with the category: General Appearance (which is the observations of various aspects of physical and behavioral aspects of the patient) and obtaining the Vital Signs (pulse, blood pressure, respiration, temperature and the patients estimation of pain). But, beyond these specific examinations, I will be discussing aspects of the physical examination, some of which has been the major topic of this blog.

Here is a portion of a document I created which I e-mailed to my students today in preparation of the upcoming session and which I will at the session detail further and answer the students' questions.

MODESTY AND PROPER DRAPING: Modesty varies with the patient, gender of the patient relative to your gender and the area of the body being examined. It is important to make the patient aware of what you are going to examine. Listen and watch for acknowledgment and consent. DRAPING is important for modesty issues but also to protect the patient from CHILLING which if it occurs can cause SHIVERING or unwanted increased muscular tone which may interfere with obtaining a valid physical exam. The DRAPING should be removed in SEGMENTS and only at the time that area of the body is about to be examined.

Yes, I will emphasize "communication with the patient" and that will include "listening" and "patient-oriented reaction".

Any suggestions for my teaching by my visitors here? ..Maurice.

 

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