REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.
TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com
IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice
FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD
Patient Dignity (Formerly: Patient Modesty): Volume 92
"Modesty is Not About Hiding Your Body. It's About Revealing Your Dignity"
What I wrote in Volume 91 detailing this expression:
In other words "hiding your body" is a component of "dignity", a concept that is worthy of reminding those in the medical profession who simply consider physical modesty as a matter of personal "shame" for which the goal of correct diagnosis and treatment should trump. How's that??
And now..let the discussion continue with the goal of how we all, patients as well as members of the medical profession (who one day will be patients) rehabilitate and change the medical system to be the supporters of patient dignity in all of its various contents and expressions. ..Maurice.
Graphic: From Google Images and Pinterest.com
https://www.pinterest.com/
BEGINNING NOVEMBER 22 2018 NO FURTHER COMMENTS WILL BE PUBLISHED ON VOLUME 92. COMMENTS CAN CONTINUE ON
VOLUME 93.
183 Comments:
Maurice
You said “ hiding your body is a component of dignity, a concept that is worthy of reminding those in the medical profession who simply consider physical modesty as a matter of personal shame for which the goal of correct diagnosis should trump.”
Really! Let’s see, there are about 4.5 million nurses in this country of which about 4.1 million are female. I doubt they share your view since they have ensured they don’t fall into this category, ie mammo, L&D, high influx of women into gyn services. Additionally, take into account the numbers of female physicians of which they too seek the same personal care as nursing does, mammo, outpatient women’s services and finally I know for a fact many male physicians are selective as to whom they seek their medical services.
Therefore “ those in the medical profession” opinions have you vastly outnumbered. They have almost guaranteed that while seeking medical care that they never have to worry about being “shamed”. Let’s delve into this concept of being “shamed”. Why do people feel this way, is it that in reflection they are being judged? But, we are told the medical industry dosen’t judge patients in this regard from a sexual standpoint. If not then why are there so many Dr Nasser’s, Dr . Sparks, nurses like the Denver 5, etc.
If you notice, public sentiment and opinion are what changes industries and the medical industry is no exception. The manner in which care is distributed as well as men in nursing will eventually reach an equilibrium. There are many many dinosaurs in our healthcare system and ever so slowly they will eventually become extinct and no one will ever remember their name. Why then should the ill be shamed, is it a prerequisite? I know most of this “shaming” is unnecessary and unwarranted and does it make for a better patient, mind and soul. Is it all worth the big black eye on the medical industry.
PT
Posting #1
One of the last posts in Volume 11 was an excellent presentation of the history of nudity and bodily modesty issues as written by our visitor MER. I thought it would be appropriate to start out this Volume by re-posting his writing here. ..Maurice.
Saturday, March 21, 2009 2:05:00 PM, MER said...
One point I’ve tried to consistently make in my past posts is – how we feel about nakedness is contextual, depends upon the situation. The same person who may frequent nudist events may be embarrassed or even humiliated being naked in other contexts. The same is true for those who are extremely embarrassed being naked in front of a female nurse or doctor. In other contexts, in front of a male doctor or nurse, they may not be embarrassed.
I’ve been trying to study the change in attitudes toward nakedness in Western culture, especially the US, within the last 100 years or so. This is a complex subject and I don’t pretend to have “the” answer. But I do have a few suggestions. In the late 19th century, early 20th century, interest in Greek culture with the start of the Olympics, reminded us that these Greek athletes competed in the nude, and often trained in the nude. The Greek perfection of the unity of mind and body became visible in statues of the “perfect” athletic body. I think the early Olympics had some influence on attitude changes. This about the time we begin to see the growth of modern nudism and males swimming nude in public swimming pools.
About the 1890’s, when Boy’s Clubs, YMCA’s, (the scout movement, etc.) became popular, attitudes toward masculinity changed. The notion was that we were becoming weak as a culture, especially males, with the closing of the frontier. These male bonding institutions in connection with exercise and wilderness experiences helped shape our attitudes toward nudity. In UK, as the empire was declining, a similar attitude developed about the decline of masculinity and the traits associated with it. Early indoor swimming pools started being built. They had filtering systems that were sensitive. For that reason among others, males were required to swim naked. It started in the YMCA’s and Boy’s Clubs and later came into some of the college and high school systems. But, and this is a big BUT – it seems to me that there was always an understood, tacit agreement – no females were allowed. This would be strictly for men and men felt safe in these situations.
I don’t think naked military induction exams really became standard until WW1. That’s not to say it didn’t occur during the Crimean War, the American Civil War or the Franco-Prussian War. We’d have to research that. But before “modern” warfare, governments were more interested in bodies in any condition to man the front lines. Doctor’s examining naked bodies didn’t really begin seriously until after the French Revolution secularized the hospital system and doctors from all around the world headed to Paris to study and get access to real bodies. Read George Eliot’s “Middlemarch” to see how one of the main characters, a British doctor, brings back modern medicine to England from his Paris studies. There’s a revealing chapter in Tolstoy’s “Anna Karenina” where Kitty is ill and must go through a complete examination with one of the “new” thinking doctors who insists that he examine her entire naked body. Very revealing. It shows the arrogance of that doctor, how the modesty of the patient is completely ignored. If ever there’s a literary example of Foucault’s medical “gaze” it’s there in Tolstoy. Kitty was simply an object for this doctor to examine. My point in all this is that the modern medical examination of the complete naked body doesn’t start until the mid to late 19th century.
To be continued on Posting #2
Posting #2
We occasionally see photos of naked soldiers from WW1 and WW2 being examined. This was standard. But I would argue that there was a strict, assumed, tacit agreement that there would be no women present. The question is often asked as to why these men felt comfortable swimming nude together, or being examined naked during military inductions. I would argue it was because of this understanding that this was a male ritual that excluded women.
Now – something begins to change after WW2 and comes into being in the 1960’s. It has many sources, but I argue that it’s closely connected to what we call the “sexual revolution” and the growing feminist movement. As more women enter male occupations, as this process gets embedded in legal doctrine, that is, giving rights to the same access for women as for men – we see things change. As more women want access to these indoor pools the policy about men swimming naked changes. As gay rights becomes an issue and as more gays come out of the closet, some men show more homophobic tendencies and become less comfortable being naked around other men. As sexual abuse, predation and crimes become more publicized, people become more wary with exposing their bodies in more and more situations.
How does this relate to what we’re talking about? Before we get to medicine – we see one example with the military induction during the Vietnam War. With more women becoming doctors and joining the military, we find many anecdotal examples of naked male inductees facing female doctors and nurses. In fact, there are a significant number of anecdotes of female clerks and other non medical personal having access to these naked men. Here’s where we see the old understood, tacit, agreement breaking down. In the past, it was understood that there would be no females present for these nude male rituals. Things now change. I would argue that during WW1 and WW2, as a general rule males in the military (unless seriously wounded – again, I’m not referring to extreme examples) were not subject to intimate examinations by female doctors or nurses. I grant the exception of the USSR and some other European countries. But remember, medicine wasn’t opened to women in the early USSR because the Soviets were concerned with gender equity. I suggested more women became doctors than men because being a doctor didn’t have the social status it did in other countries. It wasn’t considered the highest, most honorable calling for men.
Combine all this with the dominance of post modern philosophy – the concept of gender doesn’t exist, it’s only a cultural construct – and we see this attitude enter the medical system. Exempting emergency situations, it wasn’t that long ago that male orderlies or nurses or doctors handled intimate procedures with male patients. Even the “older” retired nurses today will tell you that. As more women entered medicine, it was just expected that gender didn’t matter and that they would have access to males just as the male doctors over the years had had access to females. Although attitudes are changing, this world view is still significantly embedded with the medical culture. These attitudes changes that now claim gender neutrality have come relatively quickly and without an open, honest discussion which includes patients at the table.
I don’t claim this is the whole story. I’ve probably missed some important elements and movements. I present this summary, my opinion, for discussion and criticism. I believe it’s relevant to what we’re discussing here.
Good Morning:
Mer was correct about one thing.
without an open, honest discussion which includes patients at the table men will continue to be denied their right to equal healthcare.
The issue has to get into the public domain or the healthcare industry and the federal government will just ignore it.
Men that are needlessly dying because they chose their dignity over being some nurses lewd entertainment will just be spun as another man not taking care of himself.
Men have to get past the fear that they might be seen as being a weakling.
It's time to show the skirts we're human beings not animals or objects for their entertainment.
We're men. We have medical needs the American healthcare system WILL address even if that means hiring back the male orderlies they dumped back in the 60's and early 70's in favor of these so-called female nurses and female ancillary staff.
The needs of BOTH genders outweigh the needs of either one gender and it time the US government and the United States healthcare industry stepped up and fulfilled their ethical obligations to the people they serve.
Guys, put your fears aside & lets ride the tide to change things for the better.
Have a great day all.
Regards,
NTT
MER's comments are very well stated. Interestingly while the female dominance of healthcare trend continues to grow, at the same time most young men now grow up not being exposed in even same-gender scenarios let alone opposite gender. The days of mandatory swimming in the buff that some of us experienced are long over but now boys are not mandated to take showers after gym in middle & high school anymore.
Growing up as I did I'm not shy around other men. Today's young men are. I see it at the fitness club I go to. Most of the young guys don't shower there after exercising. Many don't even change there. Those that do go to great lengths to make sure nobody sees them whereas the older guys change and shower w/o caring who sees them. These young guys are going to be in for a tremendous shock when they enter the healthcare system and find it is almost exclusively female-staffed when it comes to any kind of intimate exposure.
As the doctor shortage grows, even finding a male doctor may prove difficult for many. It is mostly female NP's and PA's filling the void for primary care and they are starting to find their way into specialties too, including urology and dermatology.
Maurice,et al,
I very humbly thank ALL of you for the discourse since I stopped lurking and started posting back in Volume 70-something. The latest change to the title of the thread was something I initiated back in Volume 80-something. Maurice gave heed to the evidence that I presented to support my assertion in Volume 91, "What are we talking about?" The discourse continued and I continued to defend my assertion with scientific support.
All those who have posted and even those who just read Volume 91 contributed to the debate. Even those who remained silent, expressed their views, BY their silence (such that they either so strongly agreed or disagreed as to cause them to speak up).
In the end, logic, scientific reasoning, ethical debate, and the academic quest for knowledge, and the divine virtue to seek perfection as a reflection of our Creator as we are made "in His image," has prevailed.
Again, I HUMBLY thank EVERYONE for allowing me to bring up this topic up for debate, and taking the time to examine and discuss it.
I HUMBLY thank you Maurice for your integrity to accept this change that on the surface is significant (despite the thread subject matter remaining the same). I also say this in all honesty, YOU have lived up to the expectations of all those who post here imagine you to be as a physician, AND what we wish ALL physicians and providers WOULD be.
After our conversation of why you never experienced the pushback from your patients that have been talked about here, for the reasons that you presented fall in line with you being the physician we wish ALL physicians WOULD be. That physician, who you are, also would have the courage and integrity to change the title when presented with the evidence that supported my assertion that it needed to be changed.
This forum is also a microcosm of medicine. Change here gives us hope for the profession.
Even though I believe that the entire profession should be torn down and rebuilt by (and for the benefit of the patients), I still hold hope that what we have now will miraculously change.
-- Banterings
Hey, you all should go to the 2009 Volume 12, from where I copied MER's presentation and read all the most interesting responses from a host of visitors perhaps you will not know except PT. Read also Suzy's postings there and comments of them by others. Has expressions of the dignity-modesty issues changed in these 9 years?
While I appreciate all the contributors to our more recent Volumes, I am looking forward for new participants, including those from outside the United States on the important issues within the entire medical system. ..Maurice.
Hey Banterings, thank you for your kind words.
You all know that "miracles" (unexpected but "hoped for" beneficence) can happen in medicine. But many, when later re-considered, are found to have a patho-therapeutic explanation. This means that "miraculous change" may be related to the medical process and not simply to "miracles". This should give us hope that dealing with the disasters of medical behavior which affects patient dignity in many ways described here have the potential to be prevented through the directed reactions of the patients themselves. Contributing to the discussions here may provide needed stimulus and direction for attempts at such system directed actions. ..Maurice.
Even in the UK, men are discriminated against in healthcare:
Anger at hospital's ban on men in breast screening clinic waiting area
- Banterings
A. Banterings
Let me say those male patients in the UK were visiting with female patients, but here in the US male patients awaiting a mammogram are treated the same! They are NOT allowed to wait in the same waiting room with other female patients. This is how ridiculous this entire issue truly is and the absurd level of discrimination it is at.
I have a lot of respect for MER and I agree with his assertions in the cultural regards that Maurice posted, however, in no way should it be looked at as an excuse in the way male patients are treated. I try to stay out of the politics that involves Brett Kavanaugh and his nomination to the Supreme Court but it just astounds me that the National Nurses Union ( NNU) wrote extensive letters to congress along with extensive petitions of nurses nationwide asking that his approval to be blocked.
One would think the NNU would have enough problems on their plate regarding the nursing industry with staffing ratios, licensing, image and ethical issues but rather they use their platform to pursue political ambitions in an arena outside of the medical nursing industry. THIS IS JUST ONE OF MANY REASONS WHY I HATE NURSES AND THE NURSING INDUSTRY WITH A PASSION TO THE EXTENT THAT NONE OF YOU CAN TRULY APPRECIATE.
PT
Dr. Bernstein, I looked at Volume 12. There were more women participating back then and that was an excellent discussion about the pelvic exams in exchange for birth control. I hope that isn't still as mandatory as it was then.
The discussion was as well a bit more focused on patients simply being modest and/or uncomfortable with opposite gender intimate care without going into staff misbehavior or unprofessional behavior as being the source of that modesty and discomfort. Some of us are now more clear on how we came to start speaking up after having had inappropriate experiences.
Otherwise, the problem is the same, or perhaps worse as female NP's and PA's flood the market and women slowly achieve parity at the physician level. It is becoming harder for men to even get a male physician. Meanwhile political correctness has reached absurd levels where we celebrate female-only caregivers for women and call men sexist if they want male caregivers.
A female nurse in Montana was arrested for having child pornography on her computer. She was sentenced to 6 years in prison and once released had to be registered as a sex offender. The hospital where she previously worked hired her back despite protests by families refusing to bring their children to the hospital if they employed her.
This article was published in Becker’s hospital review. Now I will say that no male nurse, cna, Lpn is going to get a job anywhere in healthcare if they are a convicted sex offender, no way in hell. They don’t even prefer to hire men in pediatric units as it is let alone some poor guy who can’t even get a job with a perfect record and he tried for 10 years until being told your best chance is to join the navy and get a job as a medic. That’s right, on a submarine a thousand feet below the surface.
The CEO at the hospital stood by her position to rehire this female convicted sex offender, despite protests. This female nurse has many good job prospects, she can do no wrong because she is a female. I’ll bet the Denver Hospital will hire her no problem. Yet a male patient that needs a mammogram has to be ushered through a side door, get his exam and then sent away here in this country. If you are in the UK you are not allowed to sit in the waiting room as a companion because as the article mentioned, some women waiting for their exam could feel a loss of DIGNITY even though they are fully clothed.
A Urology clinic I went to once had the clinic divided up into two sides, one side said in big letters on the wall “ The prostate Center “ with a picture of a prostate in the middle. Of course it’s only females that work at that center and one could only imagine if they had a breast center that said in big letters on the wall “ the breast center “ with pictures of breasts in the middle. One can only imagine the protests this would bring about.
PT
Good Afternoon:
With the current political environment, women may get a taste how we feel should something happen with reproductive rights.
They're yelling up a storm. Something the guys should have been doing since they replaced the male orderlies with skirts.
Regards,
NTT
There is a gynecologist office someplace that looks like a woman in stirrups. You could probably Google the picture up.
Not me NTT. I voted for Hillary but really I was just voting AGAINST TRUMP! I HATE abortion! I'd take a baby in and raise it now if it came up, and I'm in my 50's.
ABCnews.go.com/Health/North-Carolina-man-denied
This male patient was denied a mammogram through a program through the center for disease control and prevention despite his father had breast cancer and now he has symptoms. Only women are allowed to have mammograms approved.
1) men are not allowed to work in mammography
2) men are not allowed to accompany their partners in the waiting rooms for mammography
3)As a male you will not qualify for health programs that allow you to get a mammogram
4) if you can get a mammogram you will be ushered through a side door and not be allowed to wait in the lobby.
Is this how an industry that rakes in $4 Trillion dollars annually treats their patients, like lepers.
PT
PT can you provide a link to that mammography article that works? I can't get the file with your posted address. Thanks. By the way, mammograms in male patients are more accurate than in females in view of the comparative more limited amount of breast tissues. ..Maurice.
Good Afternoon:
Here's the link Dr. Bernstein.
https://abcnews.go.com/Health/north-carolina-man-denied-free-screening-suspected-male/story?id=10313188
Regards,
NTT
Maurice
Here is one link. The patient, David Mudd of Florida was refused amammogram from 6 different organizations because he is male.
www.Dailymail.co.uk/news/article-2451436man
Then this male patient, Mr Cunningham from North Carolina was refused a mammogram as well.
www.abcnews.go.com/North-Carolina-man-denied-a-mammogram
Would you like a full listing of all men who are refused a mammogram? I’ve got truckloads
PT
Maurice
With advanced equipment like the new breast tomosynthesis utilizing 3D imaging this new technology takes mammography to a whole new level wether the patient has limited tissue or not. Nonetheless, if you are a male patient, forget it. You won’t be approved.
PT
Confirming a suspicion of breast cancer in a male patient by non-surgical technique should never be prevented because of gender since breast cancer in a male is not a theoretical occurrence but one that occurs. I had one male breast cancer patient in my entire medical career who was worked up properly and treated appropriately. Nobody in medicine is asking for screening of males like is done for females. But when suspicious symptoms (nipple bleeding) or suspicious physical findings are present, any rejection of attention to working up (including equal gender opportunity for diagnosis) is a discredit to any concept of ethical or legal justice or dignity of one's gender. The medical system will never go bankrupt by diagnosing suspicious breast physical findings or symptoms in the male patient. What political, economic or legal craziness is responsible for these stories of diagnostic neglect?
By the way, for what purpose are we teaching medical students to also palpate male breasts if there is a medical system concept to reject equal gender workup for appropriate clinical findings? ..Maurice.
Here is how REAL MEN deal with the disparity in healthcare: WE AVOID HEALTHCARE if we can NOT find care that WE find DIGNIFIED and ACCEPTABLE to us. We will DIE with DIGNITY. That is OUR CHOICE.
I myself, have avoided ANY kind of CA screening ALL my life. I had an incredible doctor growing up who realized that him watching over me, giving me immunizations, and signing school forms was much better THAN me having NO care what so ever.
If we are wronged and cannot get justice through our legal system, REAL MEN will exact the justice that they deserve.
Before anybody gives me that PC BS of being around for families, pressuring us with the upcoming Movember BS to accept substandard or abusive healthcare, my family came to this country and worked in the Pennsylvania coal mines. My grandfather died in his 50's from black lung.
My wife's father was crushed in a coal mine cave in and thought dead. He described the doctor's diagnosis as "breaking every bone in his body." He spent months on the couch, in excruciating pain, his bones not healing correctly only to return to the mines to take care and support his family.
These are real men.
As previously mentioned, Boy Scouts, YMCA, etc. was a response to world communism because boys were not masculine enough. Now, society is creating "girly men". Under our President, there is a revival of real men (the rejection of feminism), and the women who support men being men.
There is also a wholesale rejection of the whole Medical-Industrial Complex. This is evident in the anti vax movement.
So, when we are gone, who is going to get that spider out of the shower?
Who is going to run into the next building and carry people out when the next terrorist plane hits?
-- Banterings
A. Banterings
Amen to that brother, if there is ever another titanic you can be sure the lifeboats will be more diversied and furthermore I go way out of my way NOT to hold doors open for women. I always find it amusing when I’m walking into an establishment through the right door some female, rather then go out her right door will cross over to try to go through my door, blocking my entrance. They’ye Expecting you to hold the door open which I do not do but rather, immediately switch over to the other door. They can open their own damn door!
PT
Maurice
You said “ What political, economic or legal craziness is responsible for these stories of diagnostic neglect? “
Now as you know Maurice in my posts I use a lot of sarcasm and ridicule. I’m not doing that right now with you but honestly, where have you been? There are hundreds of documented cases of men being refused a mammogram. I’m not talking about cases of screening but rather a medical reason, ie lump, pain and tenderness. I have said a number of times before that I know of one mammo clinic specifically that female patients are given a pink robe to wait for their mammo and it is for this reason that they don’t want male patients there. Male patients were turned away despite the fact that they had an order from their physician.
I have but one thing to say about all this.............WTF!
PT
PT, Maybe you should get on psyc meds. Before you become a serial killer, killing nursing hags.
JF
Nope,no reason to. If the cigarettes don’t get them first, obesity, diabetes and heart disease will.
PT
First, let's keep this blog thread free of ad hominem remarks. We want to read the opinions of all, consider and then accept or not but lets keep the responses pertinent to the issue and not to the character of the participants.
I think the issues of failure of patient dignity maintenance and acceptance by the medical system of patient dignity has been well documented here. What is only rarely noted and what should be the main discussion here for the future comments is practical approaches to at least some beginning solution and what our readers and participants will do to change the behavior of the medical system. I have written this before but "moaning and groaning" should not have to continue here but what should be written is practical approaches to create change. Can't there be some patient group action which has the potential to gain momentum and pressure the system to make the changes in all the dignity issues for all males and females and all the genders "in between"? There must be some ideas which can be presented here and hopefully initiated into action here. SO LET'S GET "AT IT"! ..Maurice.
TV commercials showing the offensive ways of doing examinations and proceedures. Vs. The hospitals/ clinics where exams and proceedures are done in an acceptable way ( to us ) Maybe a series of commercials that covers what has been brought out on this blog. Advertising the clinics and hospitals that do it the right way.
Good Morning Everyone:
Dr. Bernstein you ask what group action can be taken.
The only action available to us is our voice and our vote.
Women are not going to stand with us as from speaking with many of them, they are afraid if we are given dignity and privacy they will have to lose some benefit in return.
Most women don't know and don't care about the indignities men have to suffer as long as they don't lose what they have.
If this injustice is going to be corrected, men everywhere will have to stop wining and start talking and pushing back.
Otherwise them, their sons, and their grandsons will continue to be assaulted by a system that doesn't give a rats a** about male dignity & privacy.
I've talked with elected officials and even tried using letters to the editor in the local papers. They won't publish the letters because they don't want to ruffle the feathers of the local hospital officials.
We have to keep talking and pushing back until someone give us a chance to get this into the court of public opinion.
Have a great day & week all.
Regards,
NTT
Here is a positive step forward for patient modesty. https://www.postbulletin.com/news/business/doctor-creates-garment-for-patients-dignity/article_4188dc6c-b1e2-11e8-bdec-732782b994e8.html
I don't know if it is the same as what was described in this article but my wife had foot surgery a couple weeks ago and was given a pair of disposable underwear to wear during the surgery.
Kudos to this doc and his wife for caring about his patients.
A short article “The Case for Medical Chaperones” was just published. Have a look:
https://www.aafp.org/fpm/2018/0900/p6.html
I applaud this young physician for encouraging a discussion. However the use of chaperones is more problematic than physicians realize.
At my old institution we never had any training program for “chaperones”. I doubt many, if any medical centers, have well defined chaperone training programs that teach appropriate behavior, appropriate exams, gender issues, how to report inappropriate activity (and the time frame for reporting), documenting chaperone attendance/observation, etc. This is problematic, one a plaintiffs lawyer would easily seize on. “How do you know what an appropriate exam is, what is your training for conducting this exam?” “Do you stay in the room the entire time or are you asked to leave for various reasons?” “Who do you report suspicions too, what is the policy for reporting and to whom do you report?” “Do you document your observation or does the provider do that?” etc.
Certainly small practices will not be able to or bother with providing chaperone training and having staff of both genders trained and available at all times for patients of both genders.
Additionally we all know many assaults go unreported. A “chaperone”, fearing for their job, will be less likely to report what may have been an inappropriate exam. They may rationalize they just don’t understand the medicine, which of course is likely the case anyway because of lack of training. But if patents are unlikely to report, chaperones who fear for their job will be even less likely to report.
All in all just throwing another untrained incorrect gender person in the room does little to protect the patient and has less value to the physician/NP/PA than they may realize. It may protect the provider from inappropriate behavior BY they patient, but is of limited value for the opposite as currently haphazardly implemented. The US medical system needs to think much harder about this problem. — AB in NW
Hello,
Biker, thanks for the article re the Covr medical garment. I discovered this garment about a year ago and posted their site on this blog. No one seemed to care at the time. The article that you referenced is a bit flawed. It states that the hip patient had the doctor buy the garment for him. Actually, I showed the doctor Covr's website and the doctor found no problem with it. I then contacted the sales manager, Aaron Miller, attempting to buy the garment (at the time they were only considering hospital sales). Mr. Miller mentioned that, due to my prompting, there were embarking on a sales strategy for individual clients and, he sent me the garment gratis. I wore the prototype from pre-op through post-op with no problems. Before the operation I communicated with the ortho nursing staff and had the doctor sign a "Conditions for Treatment" note stating that the garment was not to be removed. The ortho nursing manager was also able to fulfill my request for an all-male surgical team. The greatest obstacle was anesthesia. Although the doctor indicated that he performed the operation with a spinal and no catheter, apparently, the head of anesthesia over-ruled him. I was offered, by the "head", either spinal with cath or general w/o cath. I chose the general w/o cath. After jumping through all the required hoops (walking, urinating and climbing stairs) I was able to leave the hospital the same day. The doctor agreed to the same day discharge during our pre-op visit. I really don't think he expected me to be able to do it, since the one-day procedure is usually reserved for patients 65 and younger. I'm 74 but, in great shape. The only potential problem throughout the procedure came at the beginning when the intake nurse gave me the gown and told me to take everything off. My son indicated that I'd be wearing the Garment that the doctor had OKed. She shrugged and left. With all my e-mails and communications with the doctor and ortho nursing staff, there was still a bit of a lack of communication. This is another reason to have an advocate with you to reaffirm your case. Incidentally, the operation took 3 hours, instead of the anticipated 90 minutes. I had quite a bit of arthritis in the hip. Certainly, a genital covering could be used in most surgeries with no compromise to the procedure. Getting the doctor and nursing staff on board is the key. Unfortunately, I had to divulge to them my situation of prior sexual abuse as a minor. This was private info that I had only divulged to my wife. I'm still saddened that I divulged this but, I wasn't sure that the modesty/ dignity approach would be successful by itself. This was the first time that this garment was being used; and, I wasn't sure how well a novel approach would be accepted by hospital personnel. Possibly, I was the topic of discussions, protocol meetings or jokes. I don't know. Throughout the entire process I was not hostile nor belligerent. I tried to politely "nail everything down" before the operation day. Nevertheless, my son and I were ready to pull the iv and walk (hobble) in the event of a last minute refusal. I sincerely encourage everyone to TALK FRANKLY to your doctor and/ or hospital personnel re your modesty/ dignity concerns. Although there are "bad apples", I don't view them as voyeuristic monsters. This was St. Joseph Hospital in Orange, CA. There were very compassionate and I would recommend them to anyone for any procedure.
Reginald
Reginald, thanks for your personal "speaking up" story.
What is needed now is a "speaking up" to the nation and to those who can facilitate change in the medical system.
Isn't it possible for those participating on this dignity thread to provide a list of all the other websites on the internet which are discussing the same issues we are here? Of course, I am aware of Misty's site but I bet many of our writers and others here know of more and perhaps the first things we can do is see if we can develop a consortium of these sites, working together, to more effectively promote change of the system beyond "speaking up" one to one to the healthcare provider. How about first developing this "working together" consortium? I bet most of our participants here do know much more than me what is going on internet-wise on this subject. Here in Southern California, we have a consortium of the ethics committees from the many local hospitals which I think is an important way to "spread the word" and "do things". How about an internet consortium of websites with the aim of making the medical system fair to the personal dignity of every patient? Anyone want to first start that listing here? I just think 13 years of "moaning and groaning" on this thread really doesn't do much except spread the word that there are other potential patients with the same experience and fears. ..Maurice.
Hello,
Perhaps it’s time to found the Association (or Organization) For Dignified Patient Care whose major goals are concordant-gender care and patient genital privacy. Proximate goals would be placing male nurse assistants in urology offices and promoting the use of Covr-type and/ or Digni medical garments. These proximate goals would be accomplished by (1) contacting urological offices in, or around, major cities to inquire of their need for nurse assistants and providing names of available male nurses; and, (2) by placing ads (possibly on buses, subways, TV or benches) encouraging people to request that their doctors and/ or hospitals provide dignity garments for them (the patients). The ultimate goal would be to have society thoroughly embrace the concept of concordant-gender care and genital privacy for all patients. Funding could come from membership dues and/ or government grants. My limited internet search found no comparable organization. What say all of you?
Reginald
Reginald,
The problem is that we need to deal with the issue of ANY exposure. Physicians are taught that they MUST do COMPLETE exams. Yet after the science is examined, we find that the intimate exams for cancer are unnecessary. Only after years of practice and/or lawsuits they realize that being thorough does not equate to good health.
Physicians should be taught (while the patient is fully dressed) this is what I propose, this is why then the patient can accept, reject, or modify the proposal. The physician must then accept the patient's answer and NOT penalize the patient.
Look at the digital rectal exam (DRE) in trauma. For years the mantra was "a finger or tube in every orifice" or "reasons to omit digital rectal exam in trauma patients: no fingers, no rectum". Now it is "reasons to omit digital rectal exam in trauma patients: no fingers, no rectum, no useful additional information".
The problem with the conservation here (especially recently) has been gender concurrent care. What is missing is the necessity of the exam/treatment, the patient acceptance/rejection/modification, earning patient trust (as opposed to paternalism). Gender concurrent care, covering garments, etc. can be used either as options in proposed treatment or in negotiating after rejection/modification.
The proposed exam/treatment should ALWAYS be guided by the virtue of the patient's human dignity.
In too many of these conversations I hear patient defeat and blindly accepting the procedure is necessary. They then panhandle for crumbs.
Here is the solution, request modifications then sure for PTSD as a side effect of treatment which could have been avoided.
-- Banterings
Good Evening All:
Men in this country are faced with shorter life spans compared to women.
Feminism in America, has led to women's health issues being privileged at the expense of male healthcare.
Our healthcare community refuses to acknowledge the known fact that there is a significant segment of the male population here in the United States that like their female counterparts, have modesty concerns and, like women and girls, want the our medical community to start respecting their dignity and protecting their privacy much the same way the system has done for over a half a century where women are concerned.
Today, when a man with modesty concerns goes for a male specific intimate exam, test, or procedure, he is faced with the real possibility of being intimately exposed and handled by a gauntlet of women he neither knows, nor wants to be exposed in front of.
To a modest man, this kind of exposure being forced upon him can have devastating results. Effects that some gentlemen never recover from.
Men don't go around making fun of women for wanting a female nurse or aid for their intimate issues.
Makes one wonder why women in today’s society, lead the way and always poke fun at men when they request same gender care for male intimate issues.
Physicians and hospital institutions are responsible for maintaining a patient’s personal privacy and dignity. The healthcare industry should be ashamed at the way they treat men and boys.
Back in the late 1950’s female nurses took care of a female gender specific, intimate related issues. At the same time, male orderlies took care of the male gender specific intimate related issues.
Back then most orderlies were male. They were in effect the nurse’s assistant and helped them out whenever and wherever they could.
From the 1960’s into the early 70’s, women became disenchanted with the healthcare system in place at the time.
In the beginning, there was resistance from the healthcare industry. They had a system in place and it worked for them.
Then the voices kept getting louder. After a while, the healthcare decided if we want to keep our self-rule intact, we better listen otherwise, the federal government might intervene. So, they listened.
So, after listening, the industry concocted a diabolical plan that if implemented would solve their woman issues.
Industry executives, physicians and nurses at the time came together and decided they would better protect a woman’s dignity and privacy, at the expense of their male patients.
At that time society’s view of the female stereotypical role was she was loving, compassionate, caring, and nurturing. Someone who should be protected.
At the same time the view of the male stereotypical role was to be assertive, competitive, independent, courageous; hold his emotions in check at all times.
It was that male stereotype that the industry cleverly used against men back then as they do still today.
The plan evolved by using what is called a BFOQ hiring exception, the industry could save $$$$$ by replacing their male orderlies with female nurses.
Once the nurses were sold on the plan, the deal was done. Men, would never realize until it was too late, the great miscarriage of justice that was done upon them by their fellow human beings.
Hence, our great healthcare system began trading men’s lives for the almighty dollar.
That then begs the question.
What right did they have to decide that men were no longer worthy of basic human respect, and, who gave them the right to make that choice, for another human being?
So, as male orderlies were systematically replaced by female nurses and the nightmare for male patients began.
As far as healthcare was concerned back then as it is today, men don’t have dignity so they don’t need privacy either. Men are just “objects” to the medical community.
Put up, shut up, do as your told, or, don’t seek medical assistance.
That ladies and gentlemen, bring us to where we are today where men’s healthcare needs be damned in favor of feminism.
Regards,
NTT
NTT Why couldn't it work for BOTH genders. We aren't your enemies. We don't want you humiliated. Male doctors are as much the problem as anybody because they set the stage for all this indignanty. The female staff kisses their tail.
About the doctors who won't do vasectomies without another staff member present, firstly that staff person should be male. He should be sitting at a desk with his back to the patients and a screen between them. If ( as so rarely happens) the patients are bleeding, he could then rush to the physicans aide. I wonder who votes these laws in place. Is the public made aware that these laws are being passed or do the medical staff vote and the public is unaware?
NTT
You made many very positive comments and I want to add to it. Repeatedly, I’ve said it’s not the fact that female staff perform intimate procedures on male patients, it’s how they perform them. As a male patient you don’t get a private environment to even change into a gown without people ( female staff) walking in on you. Once in a gown not only are you unnecessarily exposed, but for an unnecessarily prolonged period of time.
Not only are you gossiped about with all the shop talk but if you are unconscious you will be unnecessarily exposed and by that I mean in the manner of Denver 5, nurse Johnson in New York, the hospital in Penn. and Dr Sparks. People say “ oh but these are such isolated incidents. That’s what they say and that’s what they want the public to think, notice that whenever there is an incident a hospital spokesperson says “ in no way is this reflective of how patients are treated by our staff.” Well it just happened, what a ridiculous comment to make, pathetic damage control.
PT
Good Morning Everyone:
Hi JF:
You my friend are a dying breed.
Most females in today’s healthcare look to humiliate their patient whenever they think they can get away with it. Most of the time they do get away with it because everybody that knows about is afraid to say something for fear they may be drawn in and have to face the music or they don’t say anything because they thought it was “fun”.
Last night’s essay I posted was but a tiny piece of my nine-page dissertation to America on the male healthcare crisis. I had to condense it due to the 4K character limit.
You are correct in that many doctors (both male and female), set the table for their underlings to misbehave and do nothing about it afterwards. Many times, they set the table for themselves thinking they won’t get caught. They’re thinking patients won’t turn them in because they don’t want to be publicly humiliated in the process.
Healthcare’s number one rule. What the public don’t know is good for business, and that means, business as usual.
If something bad gets out into the public domain, they turn around & spin it so as to not make them look bad.
Move the perpetrator(s) to other areas. Give them time off for good behavior. Then quietly bring them back into the fold to carry on.
The medical community relies on self-rule to get away with what they do. Transparency to them is like a death sentence.
Until the public demand’s full accountability and transparency, they will not change.
You asked who votes on these things. You have other medical people with their Phd’s, health & human services people, and members of congress screw the people with this crap.
Without proper input from the public they serve, healthcare feels they and they alone knows what’s good for the people.
Until the PEOPLE (not the gov't. or medical community) have more of a say in healthcare nothing will change.
Regards,
NTT
NTT, agree, but how do the "people" do that in this generation?
Maurice,
The answer is civil lawsuits, filling criminal charges, and naming names on social media.
- Banterings
Good Afternoon:
Dr. Bernstein, a good place to start is your elected officials. The buffoons in Washington are doing nothing to clean up this mess. All they keep doing is appointing yes men and women to positions of influence.
It’s time to tell ALL local and federally elected officials WE the public want REAL change in healthcare. WE want a LARGER say in policy.
We want total and complete transparency within the system from the CEO right down the line to the janitor and everywhere in between.
By way of the power of the vote you tell these buffoons if they want to stay in their cushy jobs, then it’s time to listen to the people that put you there or you will be voted out in favor of someone who will listen and get the job done right.
On a local level people can start getting more involved in the working of their local hospitals. If the hospital is short on say males in a male patient critical area, start making inquiries as to why the shortage & what are they doing to correct it? Get the names of the CEO & board members and ask them why males aren’t treated equally.
Hospitals and doctors don’t like negative publicity so if they don’t act on an issue keep the pressure on until they do. If a patient has a negative experience and passes the word on & it continues to be passed on eventually the negativity will come back to bite them. At the same time if they do something positive for everyone, spread the word on that too.
Healthcare employees have an obligation to themselves, their colleagues, and more importantly to their patients that they are supposed to be advocating for to report any and all wrong doing by anyone they work with. It’s important to report what you saw to the police if warranted because reporting it just to your boss may result in a coverup.
It’s important for patients to NOT let medical institutions cover up their wrong doing. DON’T be bought off. Force the issue out into the public’s eye so they can get a good look at what’s going on at their medical institution.
Find out how your state medical boards work. Who gets on the boards and how do they get there. Next, Find out if these boards have civilian representation on them. If not, why not? Push for change if no civilian representation.
Healthcare likes to do their “thing” in the shadows. The more light you shine on them the less comfortable they will become but at the same time, the more cooperative they will be to talking and compromising.
Right now, our hands are tied until we can find a way to get the male dignity issue out in the wild where healthcare can’t spin it and send it back into the shadows.
There are doctors out there that are unhappy that their patients are being needlessly exposed. What are you doing about it? Join us and lets bring the issues out into the public’s eye so everybody knows about it and we can start a dialogue and come up with a solution everyone can live with.
Our medical community doesn’t like change. That’s why changes in the system move at a snail’s pace. It’s time to move like an avalanche and roll over anything that gets in the way of change.
This isn’t rocket science. Your system is broke. Everyone knows it so stop hiding and let’s come together as Americans do in times of trouble and working together WE can create a healthcare system that’s the envy of the world.
Regards,
NTT
Attempting to make changes in the way society accepts or rejects issues of human dignity is frankly complex: political, legal, religious, business and other viewpoints and arguments all can appear to those who propose changes. I recommend our participants here read this brief essay October 17 2018 in "Public Discourse" (Journal of Witherspoon Institute) titled "Respect for the Dignity of Every Human Person: The First Pillar of a Decent Society".
What I am getting at is that, as you can see from the essay, making changes in viewpoint and behavior with regard to patient dignity including males can be an uphill battle. However, I agree with the consensus here that such changes in the medical system ..Maurice.
Last sentence correction of my posting:
"I agree with the consensus here that such changes in the medical system is necessary"
..Maurice.
NTT
I personally believe the only way to effect change is airing healthcare’s dirty laundry. It needs to be presented in such a fashion to reach a fair amount of mainstream America, but the real audience is the healthcare industry. As you know the laundry is of course the Denver 5, Dr Sparks, nurse Johnson, the incident at a Penn. hospital etc. The public in general don’t think there are issues for male patients, that only female patients face these kinds of behaviors.
Along with the presentation it needs to be made clear that soo many concessions have been made for female patients, mammo, L&D, lack of male ma’s in physicians offices etc. Furthermore, mammography is such an entrenched modality for female patients aside not only the fact that it is a 100% female occupation but that male spouses are often turned away from the waiting room. So entrenched in fact that even male patients with a valid physicians order are turned away because they don’t want Male patients at all in their waiting rooms.
If you can find a medium, outlet to present all the issues, proof then the healthcare industry has to take notice because it’s been placed in the public’s eye. No agency, state, government or any organization for that matter will do anything to act. This must be somehow presented to the public in such a matter to capitalize on discrimination and the emphasis that male patients too are treated unprofessionally.
PT
A few things. First I don't think female nurses are purposely embarrassing their male patients. Yes of course it happens but it is not representative of the norm. I think the vast majority instead just don't care if their male patients are embarrassed. They see it as they are just doing their job and if the men are embarrassed so be it. That's not good but it is different than purposely trying to embarrass men. At the same time I do believe many choose specialties because of the intimate access it gives them to male patients. What else would explain why some seek careers working for OB-GYN's whereas others seek careers in urology.
On how to fix the system, I still see discrimination based lawsuits as having the best chance. In the current environment, no politician is going to commit carer suicide advocating for men to have equal rights in healthcare settings. Women's groups and their media supporters will not allow it. Modern feminism is all about dominance and control, not equality. Any legislative attempt would be characterized as trying to push women backwards in their career options. As it is we see a constant stream of articles written by female medical students, residents, and young physicians screaming about how tough they have it vs men. At the same time those medical students and young physicians have no concerns whatsoever for male patients in the overwhelmingly female nursing and other non-physician ranks. Medicine is gender neutral and all that.
The solitary legislative action in favor of men I am aware of is that observed urine sampling for DOT exams require same-gender observers. Maybe that can somehow be a springboard for general patient rights, but I don't know how one would go about that.
Lawsuits to date have almost always favored women's employment rights (reporters in locker rooms and staffing in prisons, halfway houses, and adolescent detention facilities). The only exception I am aware of is that psych patients have been deemed to have some same gender intimate exam rights, but I think that has generally been geared towards female patients. Nonetheless, all it would take is the right case getting before the right judge to establish a precedent that would make healthcare start to fall in line respecting male patient dignity. This is why I think lawsuits have a better chance than legislative action.
One last comment is that of terminology that I think the healthcare system has purposely twisted the word "professional". Being a professional is not the same as acting in a professional manner. Anyone can be trained to act in a professional manner but to be a professional requires certain credentials. What those credentials are is fair game for debate, but training and/or expecting employees to behave in a professional manner does not automatically make them a professional. Simply having a license to do something does not make one a professional. Certainly giving someone scrubs to wear does not automatically convey professional status. This is why I strongly object to being told everyone who works in healthcare is a professional. I would rather a more honest statement to the effect that they have been trained to behave in a professional manner.
I think it would rock their boat if somebody printed up some bogas consent forms ( of course that person better leave as quickly as he passes out those consent forms) The forms speak of ambush and blindsiding and says " We at such and such clinical don't practice these unethical methods. If you want a same gender support staff just ask!" Also plant some magazines in their office with attention getting covers on them and print up some of what is found on this blog. As well as the address and phone number of who to complain to.
Like I have mentioned before, I have lots of revenge fantasies about this issue. Here's one of them. Male doctor is doing an intimidate exam on a male patient and the doctors secretary comes in to speak to the doctor about something that could have waited.
The doctor obviously allowed her to do that. The male patient puts his clothes on immediately after she leaves and follows her out. " THANKS FOR INVADING MY PRIVACY YOU #@;%÷! I WOULDN'T DO THAT TO YOU!" A young black woman speaks up " O NO YOU DIDN'T. F#$&: YOU DIDN'T! " Before another second can laptz she has ripped the secretaries shirt off and grabbed a big handful of her hair. And of course she cuts off a big clump of Secretaries hair with some scizzers.
A few miles away at another clinic another similar scene unfolds, only now the significant other is a gay male. Instead of attacking the secretary however he runs outside and bustes up her car. ( of course the avengers would need to be prison bound already cause they'd likely go to prison for their actions.) But it would bring attention to the issue.
Good Afternoon:
For the AMA, and everyone else involved to decide that men were no longer worthy of basic human respect says volumes about the character of the people who work in our healthcare industry.
Their inaction to correct the problem they themselves created, while men who need care are forced to walk away or be humiliated speaks volumes to their personal integrity.
For an industry that forces people to use our legal system as the only way to fix a problem THEY created speaks volumes about the total lack of honor and professionalism in the industry.
It just doesn't seem right that it will take nothing less than a major lawsuit again the industry to make them see they were wrong.
I was wrong. Maybe we don't have some of the brightest minds in the country working in healthcare after all.
Regards,
NTT
JF et al, in my opinion, your observed facts are more constructive to this discussion than
fantasies. What we are dealing here is about REALITY within the medical system with regard to patient dignity. And it is the REALITY which needs important changes if patient dignity for all genders is to be maintained.
..Maurice.
I’d encourage everyone to take a look at the cell phone violations posted on Propublica.org, titled policing patient privacy. It goes on to say from 2012-2015 there were 47 known reported cell phone violations of cna’s posting to Snapchat of their patients sitting on the commode, in the shower and other areas in nursing homes and LTC facilities. The site further states that there were double the violations from 2015-2018,
yet no one thinks the discussion is worthy.
PT
I’ve been working a lot lately, and have wanted to comment on some of the regular contributors’ information in Volume 91. First, I’d like to note that PT has given us some really great info on the extent of sexual abuse/voyeurism that occurs in hospitals, and of course this is always the female hags violating the male customers. Now, we knew that gaggles of nursing hags run about enjoying their moments of voyeurism on hapless male customers, but now we know that non-medical female hags as well are doing exactly the same. Yes, an unconscious, intubated (and always younger male!) really needs that female speech pathologist to view his bath or catheter care – last time I noticed, unconscious humans can’t respond to help with language skills. And of course the female dietitians are really needed for intubated male customers! So, what we’ve got here in the current collapsing makemsick industry are covens of females literally running about hospitals, eagerly viewing unconscious males for sexual thrills.
This aside, of course, from the female nursing hags routinely violating conscious male customers for sexual thrills. Interesting, is it not, that these hags find their greatest enjoyment in the voyeurism of the male customer who is embarrassed and humiliated, rather than the minority of male customers who enjoy exposing themselves – it’s a SIGNIFICANTLY greater thrill to expose the embarrassed male customer, and this action readily acquaints with present and historical accounts of sexual thrills being found in human torture. Not much healing goin’ on...
I find this most alarming, though not unexpected. If one is open to it, one can feel the prurient energy of these female covens the nano second one walks through the front doors of a hospital, and of course most makemsick offices/clinics. HOW LOW HAS THE MAKEMSICK INDUSTRY, AND OUR CULTURE, FALLEN THAT MALES SEEKING MEDICAL CARE ARE VERY LIKELY TO BE SEXUALLY ABUSED AND HAVE LEGIONS OF FEMALE HAGS OF ALL LEVELS/POSTIONS ACTIVELY PURSING VOYEURISTIC OPPORTUNITIES UPON THEM? CAN FELLOW CONTRIBUTORS SEE HOW SICK THIS SITUATION IS? But, of course, even a casual student of history can attest that sexual abuse in many arenas is part and parcel of collapsing societies. And that nursing haps complain of being overworked – well, we know that is a crock of pure, unadulterated S*&% as they have time to leave their customers to run about and voyeur, even disrespecting the deceased male customer!
EO cont.
Some contributors have pointed out religious grounds for the sanctity of the body within a sexual/romantic relationship, and how such sanctity applies to medical care, and most atheists would agree with this viewpoint as many of us see the sacred everywhere, and are appalled at how it is routinely violated by female hags against male customers throughout the ugly, dying web of the makemsick industry. Rather ironic that such criminal behavior is most readily practiced in the makemsick industry (which falsely purports to support health), but of course many of us know that this industry PROMOTES ILL HEALTH, FROM BIRTH TO DEATH. It’s how they make the big bucks. Yet, as seen from the fascist states of america’s ugly political climate, unfortunately a huge portion of citizens are essentially morons who eagerly suck up negative, incorrect info because it appeals to their lower emotions, especially the primary, foundational emotion of fear. These idiots vote for the current lords of the planet who are busily constructing underground bunkers for when the s*&^ hits the fan as pension funds collapse, welfare checks are greatly reduced/stopped, and martial law overtakes us. Hopefully, my hide should be gone by that time. As a child of the 60s, I awake every day to rather an underlying base of future shock. I can find no comfort in trying to return to an accustomed, human normalcy bias. Nothing left there, because I find no comfort ignoring the growing restrictions upon my freedom and seeking some sort of temporary refuge in idiocy. Doesn’t work for me… and the makemsick industry is a prime example of political/medical fascism. BTW, a bill is being introduced that would repeal the free pass given to the Vaccine Cartel and permit customers to sue directly. Look for that senator to suddenly die from an “accident” or early “heart attack.” Only 1-2% of all vaccine reactions, including death, are reported to VAERS, and it has been deliberately constructed so as to be almost impossible to qualify for a VAERS settlement. Look it up! That 4 billion paid out should be more like 400 billion, and the largest payment is a mere $250,000. Yeah, that will really take care of a vaccine damaged individual for life!
EO cont.
And thanks, JF, for previously assuming that I, EO, am male. I’ll take that as a compliment! A majority of my friends are men, and I avoid all covens of females, even as a child I did so. Can’t abide their C*#*! As PT said, “Female Starfish are already advocated for and sometimes just sometimes to get the train headed on the right side of the tracks you have to steer it on the wrong side of the tracks.” All female customers when entering the makemsick industry need to be treated as male customers are, basically no choice of gender and humiliated and mocked when they request same gender care! Perhaps a law suit from a female customer re refusal of same gender care could be taken up by a very smart lawyer who can then turn the tables over and start a group lawsuit for male customers. The clowns in Congress have their platinum health plans and don’t give a C%$* about the rest of US men because their platinum plans and position in society assure them of respectful, same gender care. A group lawsuit seems the only way to end the discrimination against male customers as most in the makemsick industry really only care about their oversized paychecks for being the number one cause of death here in the good ole’ fascist states of you know what! These medical critters only understand cha ching! But I’d like to add that the female nursing hags who are screaming so loudly against male customers who demand same gender care are protesting for another reason – THEY DON’T WANT THEIR OPPORTUNITIES FOR VOYEURISM CUT OFF OR SEVERLELY RESTRICTED! I’m glad JF agrees with me that MODESTY VIOLATIONS ARE SEXUAL ABUSE!
And thanks, Banterings, for posting the link to the 5 medics that were fired for dancing around a naked male customer on the OR table. I posted the link many months ago and was hoping someone would comment on this disgusting scenario. Notice, it’s always the female makemsick hags sexually abusing the male customer. And, as a former entertainer/front man and fabulous dancer, I think they should be put in prison just for some of the most disgusting “dance” moves I’ve ever seen. As a dancer, one can be sexy but not lewd, as those makemsick critters were. Yes, men going into hospitals need a spouse or friend TO BE WITH THEM, PROTECTING THEM, FROM THE MOMENT THEY SET FOOT INTO SAID INSTITUTION, INCLUDING ORs. Considering the sloppy job they do re sterilizing procedures and their filthy cell phones they are carrying in their filthy hands, the makemsick argument that protectors would violate the cleanliness of ORs is a bloody sham- the makemsick critters just want to be as sloppy as they feel that day AND get their jollies at male customers’ expense as well. Beckers has had some interesting stories such as the
https://www.beckershospitalreview.com/quality/bone-blood-bugs-found-on-instruments-at-denver-hospital-after-surgical-breach-report-says.html exposing customers to just little infections such as Hepatitis B, C and HIV! Nothing to worry about, we’re professionals! Returning to customer modesty, when the customer is a male, as PT has informed us, “It seems that people are figuring ways of presenting themselves into the exam room with the physician and the patient. I’ve seen the physician’s secretary, medical assistant barge in.” WE KNOW WHY THESE FEMALES ARE BARGING IN, THEY’RE HOPING FOR A SEXUAL THRILL FROM VIEWING AN EXPOSED MALE CUSTOMER! And of course, the physician/provider is equally guilty for allowing this kind of S^*# to occur! PT, you stated if we want examples of female hags running wild in hospitals practicing voyeurism on male customers, you would give us some specific examples. I am requesting that you present us with some specific examples out of all the modesty violations you have witnessed in your long career. I can’t even begin to imagine the C*^* you’ve seen! Thank you. From the general scenarios you have already provided, I can see why being young, male, and unconscious in a hospital is such a dangerous combination!
EO cont.
And I agree 100% with Banterings that EMRs are a part of big brother. A medical record should be something that is entered into by both customer and provider, with customer having the last word when an arrogant, ignorant provider tries to inject a comment such as “overly modest male, needs psych exam” or “drug seeker.” Let’s recall that the current ridiculous backlash against prescribing narcotics is an overreaction (putting it mildly)to a problem that was created in the first place by the makemsick industry, which is trained to treat symptoms but has no real idea of what true health is. How can they, since they are not particularly intelligent, and are brainwashed during med school by Big Pharma? Like PT, I would probably even avoid “care” by such critters even in the event of a fatal illness, as I don’t want to be just another victim in their ugly system of disrespect and poisoning. I’d rather go a bit early with my dignity and reasoning power intact!
Thanks for the forum, Maurice. You are one of the very few physicians that possesses any real analytical, reasoning abilities.
Considering the flu “shot”? Think again: https://www.healthnutnews.com/british-medical-journal-flu-vaccines-seem-to-be-modifying-influenza-into-a-dangerous-dengue-like-disease/
My health has been compromised by catching the new vaccine produced pertussis which put me in a coma for 2.5 days and left me with permanent injuries. Yes, vaccinated individuals shed dangerous new and fatal forms of the diseases they were vaccinated for; often these “shedders” have no symptoms. The 2 most compensated for vaccine injuries are from the flu vaccine and MMR. But oh, the cha ching down the line: makemsick early with vaccines (which actually severely harm the immune system) and you've got a customer/sheeple for life!
EO
What you just said is true. I wouldn't do what I described that girlfriend / gay lover as doing. At the same time , do you think Rodney King would have been awarded $10 MILLION dollars if it weren't for the criminal elements acting out? My guess is he wouldn't have gotten ANYTHING!
Cellphones and videos can be used in a wrong way or a right way. Glossing through the different volumes , I saw a post by Dr B that was similar to one of mine. What I was talking about was intimate exams using videos instead of chaperones. Then everybody talked about the flaws and dangers of doing that.
I have another thought about that. Patients being given a choice about whether to use a video as a chaperone or a human chaperone. The videod exams would be in certain rooms. After an accusation has been made, create doubt in the medical staffers minds. Create some real stress that certain questionable exams have been secretly videod when they actually weren't. Give staff the opportunity to save themselves from job loss and legal consequences if they turn in coworkers. Then when they are being separately interviewed, hook them up to lie detecters.
May I add another physician, Reginald Archibald (though now deceased) whose story of past sexual misconduct with his patients is now causing pain at Rockefeller University Hospital, New York.. and you all can add today's public disclosure to your list of physicians defying patient dignity with what the hospital now calls "inappropriate conduct during patient examinations."
..Maurice.
Let’s just call it the new show “ Wheel of Misfortune” and at $4 Trillion dollars where it stops nobody knows. The latest at Rockefeller Hospital who cares at this point, it’s happened at every hospital, surgery center, nursing home and Ltc facility. Every facility has all these bones in their closets and they do everything they can to hide it, keep it from the public.
PT
I think that sometimes when we are voicing our concerns here we do so in a manner that will cause those anonymous people who work in healthcare that might read our posts to not take us seriously. I spent a lifetime as a corporate executive and in public service (as an elected or appointed official) solving problems that came my way. The first thing I did was ascertain did the person actually have a problem they wanted to solve vs their just wanting to vent, and if they wanted to solve a problem, what was that problem.
If they did want to solve a problem and that problem could be defined, next I would ascertain whether there was a realistically possible solution that would be acceptable. If nothing less than a 110 % solution was acceptable, there was no point in vesting much effort in helping them because nothing I did was going to be good enough and they'd still be unhappy. A part of this was were they willing to see the problem from the other party's perspective.
A key piece of my assessment of the person & problem being presented is how they expressed themselves. If they are calling others names vs focusing on the problem behavior or issue, it was always a sign they were more venting than trying to solve a problem. If they were going off on unrelated tangents, again it was more venting than seeking solutions. If they weren't willing to focus on the core issue that was 80% of their complaint, then again it was more venting than problem solving.
The core piece of what we discuss here is men wanting to have the same-gender choices women have for intimate exposure medical situations, and then secondary, when we must have opposite-gender exposure that it only be when necessary (vs when convenient), that it not be for longer than was necessary, and that it not be with extra observers that we did not specifically consent to.
Bringing up vaccines, hospital billing practices, revenge scenarios, the validity of protocols such as DRE's, and so forth are either going to pull those anonymous readers away from the core issues, or possibly just lead them to conclude we aren't serious about the core issues. Nobody that reads this forum is going to re-invent healthcare top to bottom but if we calmly present our same-gender and exposure complaints odds are better they'll hear what we're saying because then we're talking about something that they may be able to do something about.
Another aspect in how and what we say things is that we need to acknowledge that the female nurses and others who may be doing a procedure or prep or are just in the room are there because someone hired and directed then to do what they are doing. It is not realistic for us to expect them to refuse to provide intimate care to male patients because we think it isn't right. They're not going to quit their jobs because we don't want them doing what they were hired to do. Realistic solutions for them involve how they do their job, not whether they do it.
It falls to others above those nurses & techs who do the hiring to address the staffing mix and our complaints in that regard shouldn't be directed at the nurses assigned to our care.
The other aspect I'd look for when addressing problems brought to me was whether the person was exaggerating the problem. In our case, not every nurse is a voyeur or behaves inappropriately. Absolutely some fit that description. Been there more than once, but broad brush statements accusing all female healthcare workers of this will turn away the very people whose help we need. They know such broad brush statements are exaggerations and when we do that it makes us look like we're venting rather than seeking solutions.
Biker in Vermont
You said “ but broad brush statements accusing all female healthcare workers of this will turn away the very people whose help we need. “
So Biker, what help is it that you think they are going to give us? I don’t expect them to do anything, they are the very ones who set this all in motion. They ensured female patients recieve respectful care at the expense of male patients. Regarding your comments about exposure, those expectations are set within State board of nursings guidelines and deviations of those are considered sexual misconduct. I will never expect them to do anything, behave properly nor act professionally, sadly it’s our job. The solution to this problem will never ever come from them,ever. Only through awareness in the public opinion sector, legal or perhaps through Medicare.
PT
Biker, I fully agree. In fact, such dissection of the problem is what we teach our medical students as they develop a differential diagnosis of a clinical problem.
We emphasize the concept of heuristic errors where the appropriate consideration of the symptoms or final diagnosis is contaminated by unnecessary, not pertinent assumptions. The direction of publicized change should be directed to equality of attention to personal dignity of all patients regardless of gender. All other matters of medical system function, though some may be pertinent to this attention, should not be the primary goal to be disseminated to the system or the public. Broad brushes, like heuristic errors in medical diagnosis, broad brushes may contaminate and distract rather than cure. ..Maurice.
Hello,
I'd like to draw your attention to the following article: https://catalyst.nejm.org/patient-narratives-patient-activation/?utm_campaign=editors-picks&utm_source=hs_email&utm_medium=email&utm_content=66791001&_hsenc=p2ANqtz-8mjnzu_LzTcTXnrYHqhOCgq-v5ixuel25BjTX45o-yqbElKHb0J6P4bdGLMuFwVECk4fDijw4dUrrn3uW17EfQTsS2XA&_hsmi=66791001
The comments by
Ms O'Conner and Ms Rogers are insightful.
Reginald
They AREN'T taking us seriously. They already WEREN'T taking us seriously.
Ok. Maybe I shouldn't have written my one little revenge fantasy but I don't think this blog in general has done that.
IF the medical world had concerns about male patients not seeking care, they would compare whether or not more men saught care when the male orderlies were employed. Also not all modesty violations are opposite gender. Dr B. If you think my revenge story harmful to this issue, would you please delete it? This issue is a serious issue and in all likelihood people have died because of it. Also people have suffered with symptoms that were/are treatable because of it. I for one think that Healthcare is needed , but our issue needs resolved.
PT, there is much that an individual healthcare worker could do. They could respond in a professional manner when a male patient asks for a male staff member rather than seeking to bully or embarrass the man for asking. They could ask for permission for a student or other observer to come into the room. They could minimize the exposure in terms of how much is exposed or for how long. They could ask the patient if he'd prefer a male do his catheter. They could respect his dignity.
What I am saying is if we ask in a calm manner for things that they can do we might garner some effort on their part towards those objectives. If we instead call them a hag and a voyeur, accuse them of sexually assaulting all of their male patients, and demand (of people who have no control over who gets hired) that they change the staffing mix, or ban vaccines, or account for why that doctor in another dept does DRE's, it isn't likely they'll take us seriously.
Biker in Vermont
Should we as patients have to ask when those expectations are already extended to female patients? Were the patients of Dr. Sparks given the opportunity, oh my bad they couldn’t because they were unconscious. For years the all female staff in the operating rooms of that hospital never made any complaints, they just laughed, laughed and laughed. Advocating for patients should be an expectation and is it your position that as male patients we have to ASK and remind them to treat us respectfully.
The healthcare industry has treated all male patients with that “ Broad Brush “, I’m just giving it back in return. Respect is a two way street, it’s something that is earned and considering the $4 Trillion dollars they take, that’s a lot of money they have not earned. There really are no excuses just a lot of people who feel victimized by a reckless, greedy and arrogant industry. Gender neutral is just a fancy excuse they use to justify a means and quite frankly I can’t grasp why anyone presents, posts on this blog for no other reason than to express their “ moans and groans” as Maurice describes it which really is a process of being victimized. Posting on this blog is not going to minimize it!
PT
PT,I think this blog has already done good. RG, who wrote Ambushed by a Chaperone got some victory. You have said things like " I want everyone to stop bullying me!" You have said other useful things. Told of who to contact.
Patients can speak up and get better repect for that one visit.
I think our biggest mistake on this blog is saying most nurses this. Most MA's scribes. If we act like it happens 9 times out of 10 , they're gonna make dog meat out of us. We just need to stick to how the exposure makes us feel. Mention that the inappropriate behaviors sometimes occur.
Suzy on earlier volumes complained about what I complained about. So did an Elaine. One woman was devastated when male nurses refused to leave the room while she was giving birth.
I have repeatedly pointed out that female staff can and do check out female patients in a voyeuristic kind of way. Not as often as male patients probably. One other reason females aren't as embarrassed is unless we are spread eagled, we're not exposed in an x-rated kind of way. I hope I'm not beating a dead horse. I always thought you and some of the others saying hags and cows was just strong feelings coming through. Kinda like wearing your feelings on your sleeve. It was never offensive to me because as a CNA who only works at nursing homes or assisted living homes, the kind of behaviors you complained about is extremely unlikely to happen and I've never behaved that way and am only aware of it happening twice in all my years as a CNA. One time I turned it in myself as soon as I knew of it. The other,( the one done by a female staffer, was turned in by somebody else.
Back to Twana Sparks and her coworkers. THEY were being cowardly and probably that was.the only thing they were guilty of. You've seen many male patients treated unethically. Dix you speak up? Always? It's sometimes dangerous to do the right thing.
PT, what I am talking about is if at an individual level I want to change the behavior of those healthcare staff that I interact with or if I want to influence anonymous healthcare workers who might be reading this forum, that an approach which might actually yield some results is better than calling them hags, voyeurs, and accusing them of sexually assaulting all their patients.
No, men shouldn't have to ask for the same degree of deference given to female patients, but the fact is we have to. Acknowledging reality greatly increases the chances of solving a problem versus addressing it in theory. Cultural norms are as deeply ingrained as they are because men haven't asked for same gender care or to have their dignity respected. By their silence men have tacitly approved of the situation.
The other thing is asking someone to solve a problem that is beyond their ability to solve is wasted effort. That individual nurse cannot cause legislative solutions to happen any more than you as a healthcare worker can, so I don't blame her or you for the present state of affairs.
A year ago when I had my problem with Dermatology had I gone into Patient Relations ranting about the hags and voyeurs and saying they wanted to sexually assault me, I would not have been taken seriously and they would not have made the efforts they did to come up with a solution. I probably would have been escorted out of the building and gotten a letter suggesting I find another hospital that might meet my needs. By calming stating my complaint w/o embellishment, being clear as to what it was I wanted, and keeping what I wanted within the realm of what could be done, they proceeded to work out a satisfactory solution.
With the urology dept when I make an appt. I politely ask for a male nurse to do the prep. In theory they should ask me what my preference is but the reality is that's not going to happen. By my simply asking to be assigned a male nurse the fact that some men want same gender urological care is reinforced with that practice and by my being polite in making my request I am signalling them that ordinary men want this. If I instead ranted at them for having hags and voyeurs on staff, I am instead going to reinforce the stereotypes held by some in healthcare than men who want same gender care have some sort of problem.
Rants are a very ineffective way to effect change.
The current Presidential Administration is demonstrating no concern about human dignity:
First: The Strange Disappearance of LGBT Content From Federal Websites and today New Legal Definition of Gender
So now the question: Is each individual's personal dignity attacked if each individual's self-identity of gender is taken away by our government? ..Maurice.
Maurice
I couldn’t care less what the LGBT community complains about etc. The two primary genders are male and female and when the other half of the genders, male are respected then I’ll lend support. BTW, that goes to the female side too. I couldn’t care less.
PT
But PT, think about this. If we are talking about personal dignity of each patient, that dignity is not defined by the genitalia at birth but by the way the individual sets and looks upon and acts directly and in response regarding their current sexuality regardless of their genetic definition. Or are we discussing something about bodily anatomy and genitalia exposure and misuse of professional power and not really about intrinsic patient dignity and how it should be applied to medical professional behavior? ..Maurice.
Maurice
Medical care should not be custom tailored to any specific gender, unfortunately it is for female patients from a dignity standpoint, therefore until corrective measures and the re-education of the medical community are made no one else should get “ special treatment”. Truth be told the LGBT community are treated the worst in healthcare, I’ve seen it for years. The HIV stigma, transgender have impacted negatively those that identify as such. I’ve actually seen nursing staff get upset when a patient who presents as a male actually has female genitalia at which point the nursing staff became upset, they expected to see a penis. Really, who cares!
This is proof, a litmus test so to speak of the vastness as to how certain patients are treated indifferently. Male patients are turned away with a physicians order for a mammogram while female patients are bathed in luxurious pink robes and attended to by all female staff. There is no other litmus test that you can find, no need to go on, this settles it and it’s what you call custom tailored healthcare. You see the vast majority of the LGBT that are discriminated by healthcare are gay males and transgender males. Gay female patients don’t even register on the medical community freak scale and that may be do to many females in healthcare are actually bisexual. Yet refer to gay males and transgender males as freaks.
It would be a positive improvement for males that identify as gay or transgender if ALL males are treated respectfully, I’m not going to champion for them, I’m not here for that as you see from my explanation if I’m going to champion for males then it’s for all male patients, I don’t really care how they register.
PT
Maurice
Now that you’ve opened up a can of worms on the subject of the LGBT patient community I’ll give you more narrative for all to ponder. There is a large segment of the female nursing, cna population that are Lesbian, Bisexual, transgender and Dominatrix. Considering female nurses that are Dominatrix no other occupation gives females more “ PAID” access to males than nursing. From a perspective of getting paid well and to carry out this fetish nursing is the gig! You will probably never be able to identify which female nurses fall into this category.
From the Dominatrix perspective their fetish will override, supersede to need to advocate, deliver compassionate care. When female nurses were instructed to strike patients with an erection using a metal spoon who do you think this act most reached out to, the Dominatrix. I have read on cna forums that some cna’s could not wait to insert urinary catheters in male patients forcefully, disregarding stricture.
You want examples, I’ve got truckloads.
PT
EO. You and PT keep saying female patients should be humiliated. How did you come to that conclusion? Do you mean ALL female patients, as in you to?
How did you discover this blog? Did somebody tell you about it or did you discover it on your own?
If I saw a chance to humiliate anybody it wouldn't be the female patients! I think the staff that dishes out the humiliation would be who I would single out
JF
You said “ I think the staff that dishes out the humiliation would be who I would single out.”
Well, I guess you need to get busy. You can look on Propublica.org and see who the cna’s were, female who took cell phone pics of their clients while on the commode, in the shower, posted those pics to Facebook, Instagram etc. From there you can just pick and choose any hospital icu, there you will see they are staffed with 98-100% female nurses. Don’t forget all the Urology clinics, aside from the physicians the staff are all female. Oh and finally, when you are done with all that, stop by and say Hi to all the female staff at each State board of nursing, Good luck.
PT
Biker,
I will paint all providers with the same broad brush. Just look at Pelvic Exams Done on Anesthetized Women Without Consent: Still Happening (in 2018). If the profession can NOT get this simple piece of common sense and human dignity right, then the system as a whole has failed.
PT is also correct about the nurse/dominatrix perspective. I have heard more than once among "the guys" that nurses have no inhibitions and the sex can be "mind blowing" because due to their training, there are no boundaries. If you want to see how this is portray in society, (especially this time of year, just search for "sexy nurse Halloween costume."
-- Banterings
Here is the response from society to how healthcare is treating patients:
The New Age of Patient Autonomy
-- Banterings
PT, You forgot to mention the doctors who so nonchalantly allow their staff to mosey in and out while their patients are naked. Sometimes for reasons that have nothing to do with that patient.
Also the person(s) doing the hiring has blame in this. And what kind of woman applies for work in urology? I have lots of ideas about what should happen to some of those employees but no way to make it.happen.
It would likely land.me in prison anyway.
The point I was trying to make is why harm innocent patients? Male or female?
Maurice,
When you advocate for patients speaking up, read Seeing My Way to 'No'. Note that this is a physician who is coerced into unnecessary testing....
-- Banterings
Maurice
To conclude my dissertation on the LGBT and in all fairness if you are going to consider the sexual orientation of the patients then you need to consider the sexual orientation of the medical staff. This single sentence could derive volumes and volumes regarding the segment of our population and how they are treated, seen in healthcare. It’s not enough that straight female healthcare staff do not want males performing any kind of intimate care on them, they have essentially ensured this in every aspect of medicine.
Yet the Lesbian, bisexual and Dominatrix staff most certaining dont want men in any capacity doing anything to them in any medical setting, this I have seen many many times before. This is hypocrisy in the finest sense of the word and can be best characterized by their saying “ we most certainly cannot allow men to treat us the way we treat them”. Then there exists one kind of patient that from a dignity standpoint exists in no mans land and that is a patient that has hermaphroditism. These patients are looked upon by the healthcare industry in a freak show kind of fashion. This is what you get with a $4 Trillion dollar healthcare industry.
PT
I think I can define the orientation of what is being concluded here in one simple common expression.
"What's good for the goose is good for the gander".
For those who are not aware: "Goose applies to the female and Gander are the males. ..Maurice.
Is this what the discussion here is all about? A simplistic, within the medical system, where and what is the punctuation?
https://sassyandcheekychic.files.wordpress.com/2013/04/men-vs-women08.jpg
..Maurice.
As I have stated several times, being polite is not synonymous with being respectful. There is much overlap for sure but they are not the same. The key difference is that being respectful takes into account what the patient feels constitutes their dignity being respected. Being polite is instead just the mannerisms of the healthcare staff and their following some basic protocols (close the door etc). Being polite is a one-way interaction that focuses on what the staff member is doing while ignoring what the patient thinks. Being respectful acknowledges what the patient thinks and wants.
This is a fundamental problem that men routinely face. The CNA showering a male patient or RN catheterizing him may be the poster girls of politeness in terms of their mannerisms and following the standard protocols, but they are not respecting his dignity if he indicated he wanted a male staff member for those procedures or was otherwise uncomfortable with their doing it.
I have looked online for what the nursing industry considers to be respecting the patient's dignity and it never includes taking into account what the patient thinks. It is always just from the perspective of what the nurse or other staff member thinks. It is never more than being polite and following basic protocols.
If faced with "we respect your dignity" rhetoric when asking for a male staff member for certain procedures, responding back with "respecting my dignity includes how I feel, not just how you feel" might be a good tactic.
Good evening everyone:
Biker you are correct. The healthcare system still today does not know what it really means to respect their patients be the men or women. It isn’t about what the “system” thinks the patient needs are.
If our American healthcare system EVER hopes to be an elite healthcare system, medical institution administrators had better first learn the “real” meaning of the word respect. I can tell you it’s NOT what you currently “think” it means.
Then, after you understand the true meaning, drill it into the minds of every employee that works at your institution until they understand what it means. Then tell them to go out into their workplace and PROVE THEY KNOW IT!
Regards,
NTT
Good Afternoon:
The medical community is ALWAYS claiming there aren't enough male nurses and techs to go around.
Time to take the excuses away.
Start cross training male rad techs for male ultrasounds.
Male urologists, time to do male urodynamics and uroflow evaluation testing.
Use male hospitalists to do male urinary catheterizations.
These are viable workarounds to the issues you claim exist.
I ask ANY lurking healthcare executive or worker, what's the excuse for NOT using these people.
Patient-centered means what will it take for the medical community to get the patient the best possible outcome from their visit.
By not giving same gender care to those that want it, you are lessening their outcome from their visit.
Regards,
NTT
On Twitter yesterday there was a trending hashtag, #DoctorsAreDickheads. I read maybe 50 - 75 of the tweets by different ppl. Roughly 95% of them from patients were females complaining about their experiences. I bring this up because it echoes what I saw in my position in healthcare for decades - women are good about complaining about their healthcare experiences and men - not so much. And there is no reason to expect men have BETTER health care experiences than women, in fact I would argue they probably have a worse experience overall because of health care’s design (dick head doctors not withstanding).
Complaints change behavior, at least at larger medical centers (who are subject to far more regulations and regulatory scrutiny than little physician outpatient offices/clinics). It’s really a shame men don’t appreciate their rights more and speak up and complain. Women are doing it frequently, it’s not “wimpy” or “unmanly” to complain - it is your right.
At my institution I dealt with any of the serious complaints. By “serious” I mean complaints that went to the Attorney General’s Office, the Health Department, the Office for Civil Rights, CMS, the Joint Commission, occasionally the Medical Board and Board of Nursing, etc. Yes - patients (mostly women) complain to all of these places in addition to the medical center personnel. There is no reason why MEN can’t complain to these places also, but they just don’t with the frequency that women do.
Patient rights, including the right to respectful, dignified care, and the right to the same level of care, apply to men as well as women. A medical center that purposely provides only same gender care to female patients is discriminating against their male patients if they, when requested, do not provide similar ACCOMMODATIONS and SERVICES to the male patients. Complaints should be filed about experiences like this. (Two thirds of States have discrimination laws that require similar “accommodations and services” in public places, which includes hospitals, regardless of sex). Complaints don’t cost you anything really and those in a position to change how an institution operates will not make changes unless they understand the deficiencies.
In addition to filing complaints with the institution, and with external regulatory agencies, remember to comment on adverse treatment when you are surveyed. Chances are if you get regular care at a medical center you will be surveyed periodically. Usually the surveys provide an opportunity for written comments, in addition to answering the CMS required questions. The comment boxes are a good place to point out the unbalanced staffing issues you observed, gender discrimination, possible sexual harassment or abuse, etc. You should use every opportunity to document unsuitable care if you want to help change the system. — AB in NW
NTT, you mention urodynamics/uroflow evaluation. I've never had that type of testing and have never spoken to anyone that has but I am curious as to whether it is like the rest of urology that only hires female staff.
Folks
We need to brainstorm and come up with solutions to this entire predicament. AB in NW points are all valid but not enough to change the system. Most patients don’t know about the complaint process and don’t follow through.
PT
From the current October 26, 2018 issue of the New England Journal of Medicine:
"We are calling on our fellow leaders in academic medicine to commit to a systemwide change in culture and climate aimed at stopping sexual harassment before it occurs."
The subjects of the harassment are the female professionals. I am attempting to insert a Comment in the website presentation regarding a "systemwide change in the culture and climate aimed at stopping sexual harassment before occurring" for male patients. ..Maurice.
Hopefully they'll accept your comment Dr. Bernstein. There is a steady stream of similar articles being published on KevinMD and elsewhere, all pointing to the statistical shortfall of female medical school and hospital leadership. I suspect there is an organized effort behind those articles given their similarity. The #metoo movement offered the perfect backdrop to demand more leadership positions.
I have responded to a few of them but never a response from the authors or their supporters. I have pointed out that if the statistical shortfall of leadership positions is evidence of discrimination, then what do they have to say about the 90% female ratio below the physician level, and the effect it has on male patients who may avoid healthcare as a result.
The people who write these articles come from the same camp that celebrates as empowerment women being able to have all-female care, including in urology now, and then call men sexist if they don't want a female urologist. A year or two ago there was a study done on gender preferences in urology by a female resident at the urology practice I go to. The conclusion included that men who do not want a female urologist need to be disabused of such notions. I sent the author a (polite) email but didn't get a response.
It is a one way street that women in medicine travel.
Good Morning Everyone:
Biker, alas urodynamics and uroflow evaluation testing areas are infested with female healthcare workers like the rest of urology. :(
PT is correct we are not getting out ahead of this and we must and soon.
Regards,
NTT
Good Morning:
ABinNW is correct. Most of the complaining is being done by women. I may be wrong and if I am I sincerely apologize but I think most of their complaints are against MD’s not the supporting staff.
I for one truly believe if men would speak up, the entire healthcare landscape would begin to change overnight.
Men are too fixated on that “Macho” image. They are using the excuse “it is what it is” to justify being humiliated by a system that just doesn’t care.
There is absolutely NO shame in just saying NO when a healthcare worker wants to do something that is gender specific and intimate in nature that you are not comfortable having them do.
Over half a century ago, the healthcare industry took men’s respect away and left them with no dignity or respect.
They’re not going to just hand it back to us. If we don’t start opening our mouths and speak up, they will never change.
Being a man doesn’t mean being macho 24/7/365.
Part of being a man means putting your family first.
If you have son’s and grandson’s you know the misery they will face should they one day require medical care. Do you really want them to have to go through what we are being put through today?
How many times have you been left in a compromising situation by healthcare workers and kept your mouth shut because you didn’t want to upset anyone?
Being quiet, ONLY HURTS YOU.
The healthcare system will only change if we the people force it to change and the way we do that is by SPEAKING UP when things aren’t right.
There is NO shame, NO dishonor, NO weakness, in speaking up be thee a man or a woman.
Shame will only silence us IF WE LET IT.
In the legal field they have a principal “equal justice under the law”. “No one is above the law, and no one should be treated differently or disproportionately,” regardless of “who he or she is or who he or she was.”
Take that principal and apply it to healthcare.
“Gender EQUALITY in healthcare” means.
NO gender is better than another.
No woman shall be treated any differently or disproportionately than any man,” regardless of “who he or she is or was.”
I’ve written to everyone on the Health and Human Services Committee in congress, the Health and Human Services Dept., the JC, and the Centers for Medicare & Medicaid Services about how male patients are treated.
I’ve heard absolutely NOTHING back from any of them.
Maybe its time to go on a letter writing campaign to the White House. We know they’re pro male there and maybe get some answers.
None of my letters to the editors have been posted either.
Very discouraging.
We need a reporter to do a story on lack of dignity and respect afforded male patients by the American healthcare system.
We must get this story out into the wild.
Regards,
NTT
Biker,
Urodynamics involves more of the poking and prodding. Urodynamic studies (UDS) test how well the bladder, sphincters, and urethra hold and release urine. These tests can show how well the bladder works and why there could be leaks or blockages.
There are many types of urodynamic tests. A health care provider may recommend one or more based on your symptoms, but they are typically performed together as one test.
Most of this involves catheters (most likely placed by females).
You can read, Urodynamic studies in the evaluation of the older man with lower urinary tract symptoms: when, which ones, and what to do with the results, to see if this may be of a benefit to you.
-- Banterings
Maurice,
As to "Ending Sexual Harassment in Academic Medicine," this is just another example of the profession doing what is best for itself. It only mentions patients as a source of harassment. The belief is that as long as one wears a magic white coat or has a magic stethoscope around their neck, they can NOT commit sexual assault against someone in a gown.
Medicine can NOT even figure out that pelvic exams anesthetized women without consent is WRONG.
Now I am going to address physician burnout and suicide from one of the root causes that has NEVER been discussed ANYWHERE else: cognitive dissonance theory.
Let us look at the study, It did not mean anything (about me) Cognitive dissonance theory and the cognitive and affective consequences of romantic infidelity. Note that:
...Participants who received unfaithful feedback reported higher levels of self-concept discrepancy, psychological discomfort, and poor affect and trivialized to a greater extent the importance of their ostensive infidelities. Experiment 4 further showed that trivialization significantly reduced self-concept discrepancy and psychological discomfort but not poor affect. These results are generally consistent with the view that infidelity is a dissonance arousing behavior and that perpetrators of infidelity respond in ways that reduce cognitive dissonance.
When applied to healthcare, providers (especially students) know what they are doing to patients is WRONG. They would not want to be treated in such a manner. This is evident in the abolishment of the Peer Physical Examination (PPE) in medical school. (We even discussed that here and Maurice said the psychological toll that would take on the students.)
Just as in the infidelity study, perpetrators trivialized the offense. (...you have nothing I haven't seen before...)
Another great resource is Dehumanizing just makes you feel better: The role of cognitive dissonance in dehumanization. (a review of Less Than Human: Why We Demean, Enslave, and Exterminate Others, By David Livingstone Smith. New York, NY: St. Martin’s Press, 2011; ISBN: 978-031253272).
For example, the military teaches soldiers that killing the enemy is a good thing but those same soldiers have a deeply ingrained belief that “thou shalt not kill.” The ambivalence owing to these conflicting ideas and the resulting emotional state are nicely captured by Smith in chapter 8 of his book where killing is shown to be a difficult task with ramifications such as post-traumatic stress disorder.
This leads to burnout and suicide in providers. This is the penance they pay for their crimes against the humanity of patients.
-- Banterings
AB in NW,
Please contact me off list. I have questions about some of the instances that you have dealt with (that I don't to post here).
-- Banterings
PT,
Here is the solution: we need to create a booklet that details the complaint process for patients both within the healthcare system and outside (criminal and civil complaints).
Then we can share it among patients via social media.
I will compile the booklet if anyone wants to send me suggestions.
-- Banterings
A. Banterings
I’ve been having trouble logging into my e-mail but I will try to contact you offline once I get it resolved. What you’ve mentioned is a good idea and it’s basically an education process. A large segment of the population is completely unaware of many of the issues, double standard, discrimination and unethical behavior. Your idea is certainly a start.
PT
PT,
I hope so. I have sent you a number of emails (previously) to which you have never responded. I was wondering if I some how offended you.
I look forward to conversing with you.
-- Banterings
A.Banterings
No No of course not. I rarely check my e-mail but currently I’m trying to figure out my password. The only thing that offends me is our health care system!
PT
THE STORY
After perusing this site for a few weeks or
so I finally decided to post. Like a lot or possibly most people who post here I am doing so because I had a negative experience regarding medicine specifically in a hospital. Prior to this experience the biggest problems I had were bad teeth, minor skin problems and other relatively minor things. Despite being on the cusp of 60 I had never even been an inpatient before and had none of the issues that people write about so much here. That all changed when I had a relatively minor heart issue and ended up being sent to the hospital for the Cardiac Catheterization procedure. The procedure per se was not really a problem. It was the pre op that was the issue.
Before going into the CC I was told to take everything off and then change into a gown. So I do and the nurse in my room hides behind a curtain so I can change in private. So anyway I get wheeled into the Cardiac Cath "lobby" and am greeted by some cheerful enough woman who eventually tells me I have to change into another gown. I ask her if she can leave the small room that had a small bed of sorts on it. "Sure" she says and leaves so I can change. So I do and then call out that she can come in. Some time after that some plump ,middle aged, unexceptional woman comes up to me and without saying a word lifts my gown and begins shaving. I immediately maneuvered my gown to cover myself and she ignores that and just keeps shaving. She never says a word to me throughout. It wasn't really that big of a deal but I definitely felt that I deserved to have her give me a heads up. It was one of those thing though that you don't forget. That wasn't the worst of it though.
So anyway after waiting for something like 45 minutes I finally am wheeled into the CC "lab". I am immediately asked to move onto a table of sorts which I do. There are two nurses or whatnot there who I only see briefly. They first tape my right hand to something then the left. A short time passes. Suddenly, out of nowhere someone, presumably one or both of the nurses takes off my gown leaving me to the best that I can gather lying on my back wearing nothing. I was so shocked by what they did that I screamed for something like 10 to 15 seconds. I would not have thought that I would have reacted like that. Something else happened but I will leave that for now. Very shortly after that I was put to sleep and after what seemed like a second or two I woke up and was dressed and the procedure was over. Later that day I went home. But it doesn't end there.
In the military people are sometimes referred to by their state or so they say so I will refer to myself as Pennsylvania or PA. PA
Pennsylvania
Cardiac Catheter suites are staffed by a Cardiac Cath tech ( radiologic technologist) often 2 of them, they do not perform any kind of patient prepping. Then then will be 2 nurses assigned to cardiac cath and maybe on some days the radiology nurse but not usually. Most often the normal approach to a Cardiac Cath is through the femoral artery although it can be achieved via the upper arm but can be more difficult.
The prepping involves creating a sterile site at the region of the femoral artery. That area is about 3-4 inches to the right of the groin and that’s just a fair approximation. I’m not going to get fancy with anatomical jargon to describe the prep but suffice it to say 1) there is not reason to remove the patient gown 2) yes the genitals could be covered for the prep.
Finally I’ll say this. Cardiac Cath staff are a very unhappy lot of people, they hate their jobs and often take it out on patients. I believe the nurse used her little authority to punish you when you asked for privacy to change. There is an expectation of privacy when you are changing, this is so stated in State board of nursing rules. Unless you were very ill, medicated and needed assistance changing there is no need for anyone to be present.
Based on what I’ve said you could make a complaint to the hospital, start your complaint with administration. Did the staff introduce themselves to you? That’s the first problem. This happened of course in a hospital as I’ve never heard of a Cardiac Cath outpatient facility. You need an intensive care unit nearby for complications and yes I’ve seen many complications, code arrest etc.
PT
Good Afternoon:
On behalf of the group, welcome to the blog PA.
I'm sorry you had such a hard time at the hospital.
You were treated the way all male patients are treated by female healthcare staff. They're taught that male patients have no dignity therefore they need not be respected.
May I ask. Did you file a complaint against the personnel and the hospital? If not, you should. I'd even send a letter to the editor of the local paper about how they treat male patients.
The more and sooner the public knows about what they are doing, the sooner they will be stopped.
This type of behavior will never end until more men stand up for themselves and speak up against an unjust system.
Again, welcome to the group and hope you have better luck in the future.
Regards,
NTT
PA,
Hello my fellow Pennsylvanian (Philly here).
So sorry that this happened to you. Par for the course.
May God bless all those in healthcare that they may experience the same compassionate care that they provide patients.
Because you did not mention any experience (yet) that leads me to believe that you were in a teaching hospital, I am guessing that you were in a hospital in the northeast.
At one time (1990's-early 2000's), the northeast hospitals were leading in the whole US for cardiac issues. That was due to the region having the 3rd largest elderly population in the nation (behind Miami/Dade and Pheonix) and the large blue collar workforce (especially the coal mining).
Even the Philly teaching hospitals acknowledged that the northeast was the best place to have a myocardial infarction (heart attack).
Unfortunately, they have not advanced the dignity of the patient with the technology. Because patient dignity is just STARTING to be given more than just lip service, we are only just at the BEGINNING of coming out of the DARK AGES of MEDICINE...
-- Banterings
PA. I'm sorry that happened to you. We on this blog want the opposite gender exposure to come to a screeching halt unless advanced permission has been granted. Me, personally. I think ALL exposure should be warned of in advance so the patient can say yes or no!
Pennsylvania, thank you for sharing your story. As others have mentioned there was no need to expose your genitals to prep for the femoral artery. The dignified way to have done this would have been a) for the prep person to introduce herself and her title, b) tell you what was about to happen, and c) use a drape to push aside your gown to your groin to expose the area of the femoral artery only (and keep your genitals covered). The femoral artery does NOT run through the testicles and penis. There is ZERO reason to expose your genitals for this prep.
What happened to you is called “sexual misconduct”. You should file a complaint with the Medical Center/Hospital and factually tell you story like you did here and assert sexual misconduct by this person who exposed you needlessly. The facility needs to explain why it was medically necessary to expose your genitalia (it wasn’t), why their practice was consistent with dignified patient care (it wasn’t). Further, if the prep was being done by a male on a female patient he would not throw the gown up and expose a woman’s vagina while he prepped her. That would lead to a complaint about “sexual misconduct”. And that would be the last time he worked in the Cath Lab. You are entitled to the same level of care, the same respect, dignity and bodily privacy as women, and this institution failed you. They have a process where men routinely as sexually abused (“sexual misconduct”).
You should address your complaint to the President/CEO and to Patient Relations. You also should locate the licensing entity for the Medical Center/Hospital and send the same complaint to the licensing entity (usually its an agency of the State Department of Health Services). Sexual assault and sexual misconduct always trigger actions. Do complain. And if you don’t get satisfactory WRITTEN responses you can complain to CMS and other entities we can tell you about. Finally, they CANNOT retaliate against you for complaints, that is against the regs/law and plenty of patients (usually women) complain all the time. Good luck. — AB in NW
THE STORY2
First off I thank you for your responses. I will try to explain some things so that it will clarify the issue. The incision was done through my wrist. Also the two young female nurses who prepped me in the lab were not the same nurses or what have you that were in the CC waiting area. When I was wheeled in they never greeted me. The woman who wheeled me in there goes "Here's the lab" but the two never said a word. Throughout the process they said a grand total of something like ten words.
Continuing with the story. Anyway, so I get home and think back on what happened. I think to myself "Just let it go." At least I didn't come out of it disabled or something. But I couldn't let it go. So I spent just over two weeks thinking about what it was that I would do. There were times where I was wondering if I was imagining all of this but it sure seemed real. Finally the plan I came up with was to contact the hospital and have a notepad document of what happened prepared. So I call the hospital and say I have a complaint against an employee and they switch me to the Patient Advocate. After talking to her briefly I send her the email with the notepad attachment.
I wait three days to see what will happen. I'm thinking ahead that maybe somebody will call me and say "It's all over. They confessed. You weren't delusional after all." Finally the phone rings and some lady who I would later find out was the director of the CC lab introduces herself. Her interpretation of this series of events could best be described in two words: It's good. "You were covered" she assures me. How does she know that? Was she there? She says that they put something under my gown before they took it off. She also says that the two nurses said that they "explained everything". I say that that just isn't true but she says that it's my word against theirs so regarding that there's really nothing left to say. Then she goes on to explain against the arguments in my email wondering why they needed to do this that they needed to prep my groin in the CC lab because even though they went through my wrist there could have been an emergency and the doctor would have needed to go through my groin. We talked for about 10 to 15 minutes actually. It doesn't seem to dawn on this lady that if these two women "explained everything" how is it that I didn't know that?
Anyway so I think about it for a week or so thinking maybe they were right. Maybe they really did cover me. I accepted the necessity of the groin prep. I wanted to believe they covered me but the more I thought about it what it always came back to is I just don't remember that. I remember how they taped my right hand first and then the left hand. I remember the few things they said. I remember them taking my gown off. But I don't remember them pushing something up my gown. I especially don't remember them saying anything about it.
PA
AB in NW, thanks for your explanation as to that prep process and advice to PA as to what he can do to pursue his grievance. A question for you on the rest of the process after the hair clipping is complete. Once moved to the lab itself, does the patient's genitals have to be exposed for the antiseptic application or other remaining aspects of the prep, or for the cleanup when the procedure is done? It would seem that if the genitals are not directly involved that they don't have to be exposed yet I suspect staff convenience will cause total exposure once the patient is sedated. Part of my question comes from my having resolved that if I ever need this procedure that I would not want to be sedated. Sedation makes me ill and I have come to realize that it is way over used. I've had 2 colonoscopies, an upper endoscopy and a TEE without sedation and none were a big deal.
Part of what this discussion points out (again) is that patients rarely know ahead of time what is actually involved in medical procedures. You can find hundreds of websites that talk about cardiac caths but none mention anything about whether it involves genital exposure or not.
THE STORY3
After the weekend of I wrote a second email that was mostly in response to our phone conversation. The Director had said that perhaps the nurses involved needed to better explain the procedure. I wrote in my email that that isn't really the immediate issue. The main issue is if they need to take off the gown or something along those lines they need to tell the patient beforehand.
The Director was off for a week the week after the phone call so I wait. But then another week after that passes. I make several phone calls leaving messages and whatnot. Finally after chasing after her for over a week I finally get her to call me back. We talked about a number of things. She had sent a letter to me which stated that she would hold a meeting with CC staff and discuss this. I ask her if this meeting took place. She says that it did and corroborated it to at least some extent. She talks about how it was discussed that all the nurses or techs or what have you were to explain every part of the procedure as it takes place. I restate what I wrote about in the email that they really need to mostly focus on the important things. At some point she apologizes for it all and I thank her for that.
I ask her if the two nurses made a statement. "You certainly have my statement." I say "What is theirs?" She pauses for a second or two then says. "They explained every procedure." That's it? Their statement consists of one four word sentence? I say to her "If that is true why are we talking about this?" She doesn't have an answer. Finally she says something about she "wants to be sure that this never happens again." I appreciate the sentiment. One thing though is that statement seems to be an indication she believes something happened.
I complained. At least the two nurses and others know that this has been brought out in public. Also the director has said that all the CC nurses were directed to explain to the patients what they were going to do. So the phone call ends and I hang up. That's where it stands as of today.
When I think back on it I can't go back in time and say what I would have done but if I had been told by these two ladies the necessity of the groin prep and that they would keep my crotch covered I think that I would have probably gone along with it. If on the other hand they had said that they could not even have kept my crotch covered I would told them to forget it. They could wheel me back to my room. They should have told me this beforehand.
I complained to the Director that nobody told me about the groin prep beforehand. She was unsympathetic to it. It was not in the two page literature I was given. Neither the cardiologist the day before nor the day of who did the operation spoke of it. The nurses in my room never spoke of it nor did they in the CC waiting room. In fact they never spoke of it at any point in time not even to the last second. They just grabbed. I felt that I should have been told. Like I said I probably would have gone along with it. But if I had known about this going in I might have chit chatted with these two women making sure we were on the same wavelength in terms of having my crotch covered instead of going in there and being shanghaied.
PA
It feels like to me that everything needs tape recorded. All these encounters. I believe the ladies who attended to you are LYING!
The lady who was unsympathetic, she should have been tape recorded! I have murder in my heart for people who abuse patients in this kind of way!
Pennsylvania, you are remembering your experiences correctly. Such treatment is not uncommon, but that doesn’t make it appropriate. There is a correct way to process patients and maintain their bodily privacy and dignity/modesty and there is a sloppy incorrect way and/or an intentional sexually improper way.
I want to correct my other post slightly (since I now took the time to look at Pennsylvania rules and regs). In PA intentionally exposing genitals when not necessary is not legally defined as “sexual misconduct”, the PA Board of Nursing calls it “Sexual Impropriety.” It’s legally the same offense (some States call it sexual misconduct, some call it sexual impropriety). Here is their text:
Sexual impropriety—The term includes the following offenses:
(i) Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient’s body or undergarments.
(ii) Unnecessarily exposing a patient’s body or watching a patient dress or undress, unless for therapeutic purposes or the patient specifically requests assistance.
Let’s be clear:
The reputation of the physicians does not give anyone a license to treat you with disrespect and ignore your patient rights.
The reputation of the hospital/medical center does not given anyone a license to treat you with disrespect and ignore your patient rights.
Consenting to a medical procedure does not give anyone a license to treat you with disrespect and ignore your patient rights, including your right to bodily privacy.
Consenting to general nursing care does not give anyone a license to treat you with disrespect and ignore you patient rights.
Each patient has the right and expectation to professional treatment that preserves their dignity and privacy consistent with the medical procedure they consented too.
In your case PA the nurse/tech that prepped you “just in case” did it unprofessionally and perhaps intentionally by needlessly exposing your genitals. Hospitals need to get feedback about this. btw, you are entitled to a written response for your complaint (which under CMS regs is known as a “grievance”). If you do not feel your grievance was satisfactorily addressed you should file a written complaint with their accrediting entity (the Joint Commission?) and with CMS (Center for Medicaid and Medicare Services, the Federal Agency that allows the Hospital to receive any federal dollars, i.e., stay in business). It raises the cost to the hospital and raises awareness higher up the food chain. It might affect change in the Cath Lab.
If you need further info just let us know. — AB in NW
PA
I can assure you there is no reason ever to completely remove a patient’s gone in Cardiac Cath. The director of CC units is usually the same director of the intensive care unit, a nurse. When accessing the femoral artery a small area is prepped and a needle called an introducer is placed into the artery. I would pursue this follow up with a complaint to the state board of nursing. The director has already admitted to the fact that “ something “ was placed under the gown. WHAT?
I have never heard of placing something under the gown as she mentioned. Personally, I’d like to know because I have been present in many CC cases and never seen that done.
PT
How about this from KevinMD?
Would this physician's approach to a patient do anything to comfort you? ..Maurice.
A female nurse on Allnurses, general discussion does not feel comfortable with the fact that due to her health insurance she must get her care from the sister hospitals where she works or pay high out of pocket costs. During one of her doctor visits a male doctor examined in her words he saw her ( partially nude) and now she feels awkward because he is now a co-worker at the same hospital she now works at.
Due to the circumstances what should occur?
1) The male doctor should recuse himself from working where she works cause he has seen her partially nude.
2) The female nurse should get another job somewhere that he dosen’t work at.
3) The female nurse should buy a dictionary and look up the word “hypocrite.
4) The female nurse should not worry cause she dosen’t have anything he hadn’t already seen.
5) Visit Bioethicsdiscussion.blogspot.com/modesty1-91 and then post moans and groans.
6) Write her own script for a psych evaluation ( outside the scope of her license)
PT
This comment has been removed by the author.
That's funny PT. I thought that was you posting.
I read that article Dr. Bernstein and like the doctor's honesty and attitude. It seems she is talking more to her female patients on the apology piece but her matter of fact approach is something I'd like. Whether I'd actually be comfortable undressing for such a female physician is an unanswered question. Allowing for a moment that I was, it would only work if she didn't bring a female chaperone, scribe, or assistant into the room.
PT, I found that thread and interestingly nobody responded to that poster specifically though there were a couple other comments about lack of confidentiality when they sought healthcare within their own systems.
The concern that one person expressed however is the reality for rural communities. I personally have all my regular care at a teaching hospital 1.75 hours away, but if something caused me to end up in the ER of the small local hospital and possibly the OR as a result or as an in-patient there, the odds of there being staff who know me or otherwise have connections to me is great. Been there. HIPAA does not get in the way of hospital staff spreading the news when there's good gossip to be had. Small town life is wonderful at so many levels, but it is all but impossible to be anonymous.
Biker in Vermont
I’d like to make this post an addendum to my earlier post regarding the female nurse seeking care within her own organization. As you know I have worked at 25 hospitals or so and with the ever increasing restrictions placed on hospitals employees by their health insurance as to where they can get care has became an issue. I know because I have heard this very complaint while sitting in employee forums at some hospitals where I’ve worked. I’m talking about a forum with hundreds of female nurses present and maybe there were 5 males in the entire forum.
During this forum the CEO say “ ok you don’t want to get care at the same facility where you work, I get that. But would you refer family and friends to get their care here. “
On Allnurses the nurse who expressed concerns about receiving care at the hospital where she works said “ People talk, like someone else said, Hipaa, people talk, word can get around and things can get very awkward.
That is the culture at hospitals. Who creates the culture, the staff, not Administration, not the maintanence dept, not the security department, not the lab, but who. Who creates the culture whereby the female nursing staff prefer to get their care somewhere at else besides where they work where no one knows them. The nursing staff! Why? Because of the gossip?
What does this say about patients who don’t work in healthcare yet come to recieve care, male and female patients alike. Is Gossip gender neutral? Apparently not. If a female nurse who works at a hospital came to recieve care at the same hospital where she works who are the staff that will provide that care to her? Predominantly the 95% of the staff, females.
Now how does this all relate to male patients and what are the implications to male patients when female nurses don’t even feel safe among other female nurses taking care of them. They feel they will be judged, talked about, gossiped about, made to feel awkward.
Finally to add what Biker in Vermont mentioned about small rural communities yes it’s impossible to avoid gossiping when you need care but it’s the same in the big city as well. Hospital institutions owe it to patients that they recieve care in a culture free of gossip, ridicule. As you have seen even their own staff don’t feel comfortable and we are talking about female nurses as patients in a female dominated industry.
PT
PT's comments about nurses not wanting to receive care where they work is consistent with what has been written many times on AllNurses. To me this speaks volumes because if the female nurses are correct when they say that they don't judge (and they say this every time the topic of patient modesty comes up) and if they are correct when they say there is nothing even remotely sexual about patient exposure (which they say every time the topic of patient modesty comes up), then why would they care if their co-workers see their bodies during medical procedures? They say nobody judges and there is nothing sexual about it, so why would they care? The reality has to be that they do judge and they do view patients through a sexual lens. They can't have it both ways.
For 20 some odd years I exercised during my lunch hour at work as did a bunch of other guys. We routinely saw each other dressing and showering afterwards. Some of these guys were also my buddies outside of work while others were just co-workers. These guys ranged from their 20's to their 60's. Some were fit and some flabby. The full range of what mother nature bestows was present. Never once did I hear anyone comment on someone else's body while in the locker room or outside it, not to someone directly or behind their back. The cultural norm if you will was non-judgmental and there truly was nothing sexual about changing or showering in front of people we worked with.
Why then would female nurses whose jobs involve patient exposure on a regular basis not have a similar non-judgmental, non-sexual culture such as us guys had? Clearly they don't if they fear their co-workers seeing them exposed for medical reasons.
PT, one additional comment. When I say it is very hard to remain anonymous in a small community, I mean it literally. I'm not talking about the hospital staff gossiping just amongst themselves about patients they recognize or know from the community, I mean they also share that insider info with people who don't work at the hospital.
Once I cut my finger badly and had to go to the ER for stitches. It was a careless mistake on my part and I was embarrassed over it. I didn't recognize anyone in the ER and the next day at work did my best to not draw attention to my hand. The only people who knew what happened were the ER staff I dealt with. A friend at work then comes up to me laughing about what I had done. Clearly someone in the ER knew who I was and had a connection to my friend who they proceeded to tell what happened. Makes one wonder what else the ladies at the hospital are sharing out in the community. HIPAA is great on paper but in practice not so much.
It is hard to feel bad for the hospital staff that don't want their co-workers knowing their business when they don't think twice about sharing patient private info.
This is an interesting article. I do not think that this inhumane treatment is confined to certain races, this is how all patients are treated.
The doctor is in, but please check your bias at the door
-- Banterings
Biker , I guess it was groomed into guys to shower in front of other guys.
In early childhood me and my sisters and brothers all took baths with each other and thought nothing of it because my parents had lots of kids close together and that's how they bathed us/ let us bathe.
When we got older though, I never undressed in front of anybody. Not my mom or my sisters. My sisters were somewhat the same way. A couple of my brothers were not at all modest.
I only had one phys ed teacher, as a kid who mandated that we all get naked and shower together. She would come into the shower room to watch and ensure that we did.
I refused to do it and I'm not the only one who refused either.
For me, being intimately examined in a medical circumstance HAS to be a stranger. I couldn't tolerate it from a coworker.
JF, you are helping to make the point. You work in healthcare in a role that routinely deals with naked patients, yet your own feelings about being exposed to co-workers would seem to indicate an expectation of being judged. Nothing wrong with feeling as you do, but it does support the premise that healthcare staff do judge patients and for some the interest is not always purely clinical.
I forgot to say a few things in my last three posts that I will mention here. Yes I am male. It was that obvious huh? Also I never did tell either the hospital or the Director about the woman who lifted my gown in the CC waiting area. Enough was enough. It wasn't the main point of contention anyway.
PT you said in an earlier post that you weren't aware of any case of someone putting something under the patient's gown in a CC procedure. If that is the case then how is it done because you also say that for this procedure the patient should be unequivocally covered? How do you know this? What is your job title anyway?
The Director sent me a letter which she said in our final phone call she had sent the day before but I did not receive until a few days afterwards. She writes: "The preparation prior to you entering the procedure area does not require sterile but clean conditions. That is why when staff was shaving your groin, we can allow the groin and your private area to be covered either with your gown of linens. Once you are taken to the procedure area and placed on the special X-ray table, we now have to make your areas of puncture and work environment is sterile. That means, the gown has to be pulled above the pelvic and hip area since the gown is not sterile; at the same time we are using a sterile towel to cover your private areas so the tech can perform a surgical scrub. This occurs on every patient and is explained to each patient as we are performing."
As far as the last sentence is concerned where she says this is explained to every patient how does she know that? She doesn't know that. A better statement would be to add to the end "if procedure is followed". Leaving that aside as compared to when we talked on the phone where she said without a doubt I was covered this seems much more ambiguous. She seems to say that the sterile towel cannot touch the gown. But isn't the patient's skin also not sterile?
I thusly looked to the internet to get a straight answer from websites that discussed the CC prep procedure. The question that I wanted to know was is the patient involved in this covered or not? Yes or no? I couldn't get a really good answer. The best that I could come up with comes from tabbheart.org which states under Cardiac Catheterization that "Before the procedure, the are that was shaved will be scrubbed with an antiseptic agent." This seems to indicate that no you don't need to fully uncover the patient.
From other sources I was to learn that the patient is to be draped from the neck down in a sterile draping of some sort. I still cannot see how this is applied. One way to do that would be to take off the gown, then scrub the patient in antiseptic from head to toe then put on draping. But nobody talks of this and the Director indicated otherwise. Any assistance would be appreciated. Thanks
PA
Biker.
My point is that embarrassment about being exposed is not automatically thinking the other person is being sexually gratified. Somebody being repelled is embarrassing also and all these feelings are instinctive , some people have more modesty than others.
Of course I'm gonna make your point.
I believe that male patients are disregarded more than female patients are. I just don't get why you guys think we are never unnecessarily exposed/embarrassed in a medical setting.
Intimate care when family. friends and coworkers are present? That isn't a problem? Doors being opened at wrong moments with no privacy screens or curtains blocking the veiw? That's not a problem?
Some of are " accommodation" isn't accommodation at all. It's just the fact that more women go to school to be nurses than men do. More females become CNA's than guys.
And for the staff who does get sexual gratification from seeing naked patients, the ratio of them wanting to see nude males will be higher than those who wanna see nude females.
PA
If you would like I can get very technical with all the appropriate medical jargon to describe the process by which a cardiac cath is performed under fluoroscopy. For now I will use basic terminology or layman’s terms. The area of the groin, inguinal is to inset a needle so that a small wire can be fed up through the abdominal aortic artery towards the heart.
The area that needs to be prepped is often referred to as the gutter or the inguinal area. That area that needs to be prepped is an area perhaps 3 by 5 inches. A large sterile drape with a small hole or circle is placed on the thr prepped area. The hole or circle has a diameter of approximately 3 inches. The side of the sterile drape that touches the body is adhesive, and one the adhesive touches the body or area that adhesive further ensures sterility of that area prepped. Thus the patient’s gown is of no consequence, it can remain and cover the genitals. Are you with me at this point. The drape is often a large drape that folds open.
An example, take a tablecloth say 6 feet long and 5 feet wide. In the very center cut a 3 inch diameter hole in it. Then the side that touches the body make that area around the hole sticky with adhesive and then sterilize the whole thing, now you have a sterile drape.
The patient’s gown is move away from the groin but still covering the genitals. An area to the right of the genitals is cleaned and prepped. The surgical drape is laid down on the prepped area with the 3 inch diameter hole touching and centered on the prepped area which is directly over the femoral artery. The drape is then unfolded to cover the entire patient with the patient’s gown still on. Are u still with me.
Ok let’s do the procedure from the brachial artery approach or the inside of the arm. Again, the patient’s gown is still not removed. The area inside the arm is cleaned and prepped. The drape is placed again on the prepped area with the gown still on the patient.
Let’s do another procedure called a PICC insertion, same prep and gown does not need to be removed. I’ll say again and again in Cardiac Cath or in interventional radiology for vascular approach utilizing the Femoral artery on the right or left side the gown does not need to be removed and the genitals can stay covered with the gown.
I’m not going to divuldge my job titles and all the state and national licenses that I hold, which are many. I’ll only say that I’ve worked in just about every department of a hospital that delivers patient care and properly licensed to do so as well as working in management capacity in administration. Im an advocate for patients as that is my identifier PT ( patient).
Let’s do a little thought experiment here. If I clean and prep an area on the body and then cover that area with a sterile drape that’s adhesive around the hole so that the prepped area is secure. Of what consequence is it if there is a patient’s gown near but separate from the surgical site. The gown cannot contaminate the prepped area because the drape is adhesive and secures the prepped area.
Ok, so take the gown away, then what do you have. Is the genitals sterile, of course not. So it dosen’t matter if you keep the gown covering the genitals or not. Because you have established a sterile area by prepping the area and securing the prepped area with a large sterile drape that cover most of the patient and the hole in the drape is secured by adhesive to the body.
Another thought. It’s always a good idea when doing a CC to keep the patient’s genitals covered with the gown for two reasons 1) to main the patient’s dignity, no unnecessary exposure. 2) Should the patient have to void which the patient may or may not know, the gown will absorb the urine and at least protect the sterile site from contamination.
PT
JF, I know that women also get disrespected in healthcare settings. The only point I am trying to make is that if healthcare staff fear being judged by their co-workers it is because healthcare workers know that their co-workers in fact judge patients. Certainly there is more opportunity for good gossip when it involves a co-worker than an anonymous patient and perhaps healthcare workers would get closer scrutiny than anonymous patients, but the basic fact of the matter is that it is more the norm that healthcare staff judge patients than not. Those judgments may be fleeting for those who are not extraordinary in any way and healthcare staff may typically maintain a proper gameface when interacting with patients who fall outside norms, but that doesn't mean they aren't judging them or gossiping about them behind the scenes.
Those who work in healthcare know what really goes on which is part of the reason they don't want to be patients in their own facilities.
PA, I too find it very unclear as to how cardiac caths are done as concerns patient exposure. The literature don't explain it.
Thanks for the explanation PT. What confuses me now is what is the small towel over the genitals for that I have read about if the genitals aren't exposed during the hair clipping, cleaning of the groin area, or the cleanup after the procedure is done?
Pt Thanks for your reply. I think I understand what you were trying to say. When to the best that I could gather the nurses involved took off my gown I was in a position where I couldn't see anything. I could only hear and feel things. Still I was able to feel them tie my wrists even though I couldn't see it and they said certain things. It seemed like they took off my gown but I can't be completely sure although I'm virtually certain they said nothing about it. The Director says everything was explained but if that were the case why did I have to ask her so many questions? What did you think of the Director's letter anyway? If the two nurses had explained that they wanted to lift my gown a little but I would be covered I would probably have gone along with it but in regards to this they explained nothing.
PA
Biker in Vermont
Most surgical packs or in separate packs are what’s called sterile towels. They are blue and measure about 2 feet long and 16 inches wide. They double duty as sterile drapes etc as well as soaking up blood although sterile 4 by 4 are more suited for that job. There is a shaving kit that includes a square piece of tape to pickup loose hair after the shaving of a site. I really don’t know about a small towel being left on the site, Again, there is no reason to remove a patient’s gown in CC unless the gown is soaked in urine or some excessive body fluid.
PT
PA
I have to disagree with the letter you recieved from the director as they will attempt to dismiss any complaint from patients full well knowing their staff may act unprofessionally etc, its called damage control. There are many aspects of a procedure that are not fully explained to the patient. There are many reasons why we post on this blog and I’ll just say that in the future you will feel better about the event if you complain about it now rather than let it haunt you.
The procedure was not properly explained to you and in particular about the level of exposure you would experience. I have tried in detail to explain at least in layman’s terms how a CC is performed and the proper drapes that are utilized. First I’ll mention that if you are a Medicare patient you are allowed to file a complaint online at Medicare.gov. Additionally, file a complaint online with the state Board of nursing. You don’t need to know the names of those involved. The BON will investigate and request all of your records from the facility.
Additionally, I would complain to the state dept of health, on line. Finally, I want to say a few things about hospital directors, particularly hospital nursing directors. I’ve never knew one I could trust nor had any kind of moral integrity. I’ve known a hospital nursing director who knew one of her nurses was a meth user but did nothing about it because the nurse was her friend. That 98% of all female nursing directors are female, they discriminate against males and only pretend that they care about patients.
There are things I know about nursing directors that could fill an entire set of Encyclopedias and that would just be a prelude but suffice it to say I place hospital nursing directors on a plane equal with ISIS terrorist commanders, I absolutely despise them, I hate them with a passion. My only recommendation is that you take your complaints to the organizations that I’ve mentioned. I assure you that director that wrote you that letter will have her hands full for weeks to come.
PT
Good Morning:
Hospitals across the country should be required to have privacy garments on hand at all times to protect patient privacy and dignity. I don't mean just johnny gowns.
There is NO reason not to do this for the patient. I suspect we have a bunch of voyeurs in the testing & OR areas of every imaging center, clinic, and hospital in this country.
They've gotten away with looking for so long they don't want rule changes that might take away their viewing pleasure.
In the case of the Cardiac Cath Lab, the Covr Medical bilateral Medical Garment would have been just what the doctor ordered.
Regards,
NTT
As PT knows and has been amply exemplified as content Volume after Volume on this thread, there is ventilation of personal experience and emotional consequence. And certainly, as a physician, I hold no prejudice against such ventilation leading to clinical benefit. However, I also appreciate directions in these Volumes toward methodology of making the medical system aware of these unhealthy personal experiences and the defects within the system that do the creations and persistence of these defects. ..Maurice.
As everybody knows, women have a tendency to sit around talking about their men to other women. What he does that makes her SO ANGRY!
How many of them want to deck those guys because they have family coverage and the asshole loser STILL won't go to the doctors or the hospital?
Maybe those ladies flapping their jaws might be how those men could be located. Maybe at a staff meeting at work ASK these ladies how many of them have men who avoid care.
Once the men avoiding care are located, bring up our topic. It might be useful to request an interview with the Chief of Staff at a hospital ( maybe a lawyer ) Lawyer gives Chief of staff a big stack of papers with names and phone numbers of males requesting accommodations with comments about how long they have avoided care and why.
The men able to do so should donate a certain amount of money towards putting males through nurses training and CNA classes. Of course a paper would need to be signed holding that Chief of Staff to his word. With all this being said ,.I sure don't know how to get something like that started.
A. Banterings, Biker in Vermont, NTT, EO, JF, PA, Reginald, AB in NW, and all the anonymous lerkers as well as anyone I’ve forgot,sorry. It’s time to do something about this. Give me ideas, I want help and lots of it. Think about how we can change the system. No excuses. It’s time to get off your A$$es and not only do I want ideas but we need to get organized. Maurice is getting tired of preaching to our A$$es to do something about this.
PT
PT . I must be one of those anonymous lerkers you speak of , although I'm not new to this site . I've followed and posted here for over 10 years . I've also asked many of those same question but have come to the conclusion that most people want someone else to ask the questions and do the work . How many times have people here given Misty flack for trying to help . She is only one person running her site and trying to assist the people that come to her for help yet some prefer to beat her up for her comments .
As far as idea's , I don't think the medical field will listen until they are forced , either by a drop in revenue or with a lawsuit . I've stated in past posts that if they won't accommodate to take your business elsewhere , but most people won't go out of their way for that . They go in blind and get ambushed then come on here and complain . I would be willing to assist with changes but I don't have much faith I will see much change .
One thing the medical field could do is just ask if you have a gender preference . That one question would resolve a large amount of the negative comments you read on here . Good luck with your endeavor .
AL
PT
If as you stated in a previous post you could write an entire encyclopedia about the nefarious activities of hospitals why not write a book instead? You could include other insiders as well. Just a recommendation but I would want a second opinion from another person outside of this website. I looked for such a book on Amazon and all I could find from hospital insiders were "sales pitch" type books.
Years ago I had a late aunt who the only time she went on a rant did so on this subject. She didn't like doctors and she didn't like hospitals. She once told me "I could tell you stories about hospitals. I worked in a hospital once." I vaguely remember her telling me "Don't ever go into a hospital unless you really have to." In retrospect I wish I had thought of that before becoming an in patient. When I asked the ER doctor what were my chances of surviving all of this his response was "Excellent". Two days and two tests for something that was only a notch above observation.
As far as your recommendation that I continue my case beyond the CC Director it remains to be seen but I don't think so. I formally complained which is more than other people have done. Enough is enough.
PA
Good Morning:
We need policy changes within the system. Other than calling & writing people, voicing our displeasure with the current broken system I don't know what else we can do.
In my work in progress letter I've written some antidotes to the issues.
So how can the American healthcare system fix what they broke.
This whole mess started with the rise of feminism in this country. There is NO room for feminism in healthcare. It hurts patient and staff alike. Bury it forever.
Next, find the humanity you lost years ago.
Offer incentives to young men looking for a career to enter the nursing industry. Once in nursing school, offer them more incentives to go into areas where male patients need them the most. Urology and oncology are key areas.
Offer incentives to men to become male ultrasound technicians.
Short-Term answers.
To give back the respect you took from men, hire some male “orderlies” to assist with male related intimate medical issues until such time as there are enough male nurses in the workforce to take over the job.
If money is the issue, do what Ireland does. Use male hospitalists to care for male related intimate medical issues. Unless the patient specifically asks for opposite gender care there’s no reason for women to make a man’s hospital stay worse than it already is.
In ALL exam and testing areas, provide medical garments to all patients that will keep a patient’s private parts private for their entire visit. There is NO medical reason for the genitalia to be exposed if that area is not the focus point of the procedure. Johnny gowns are like the Chevy Corvair, a thing of the past. There are companies out there that make very good hospital clothing and gowns for testing and procedures. Look into and make it happen.
In all hospitals, clinics, imaging centers, and doctor’s offices, make sure you have the necessary staff on hand so if you have a male patient that needs prepping for an exam or procedure he is asked first if he prefers same gender care for the prepping and if he says yes you give it to him.
Cross-train more male radiologists in ultrasound so males have their privacy and dignity respected.
On any intake paperwork, have a question asking if the person prefers same gender care. If so, make it happen.
Create penalties with teeth for any healthcare worker that violates a patient’s privacy.
Healthcare took men out of female intimate private medical issues over 50 years ago.
They have an obligation now to take women out of men’s private intimate medical affairs.
There is NO SUCH THING as gender-neutral ANYMORE.
Regards,
NTT
PA
It’s not how you complain, it’s who you complain to! I’m not going to write a book about the issue, I just want 5o raise awareness and solve some problems. It sounds like you have already given up or have you? You brought your concerns to this blog, we listened and gave you options on what to do. The very best advice you will ever get is from us, otherwise from anywhere else outside of this bog you would get a bunch of dumbfounded stupid stares. What do you expect from the uninitiated clueless. I’m hoping you will help.
This blog has gone on long enough for people to read moaning and groaning. It’s time to do something, raise awareness etc. I have a goal and that goal has a timeline of 3 months to get everyone on this blog motivated.
PT
NTT
I absolutely agree on the issues you’ve mentioned and we all can add our own ancedotes as well. At this point we need to make a concerted group effort. I’ve always respected your comments and I’m going to be asking you for help. I’m putting together some methods that will be very economical for all of us to reach out and communicate with the right people to effect change. Thank you
PT
Al
Yes, I remember you now. I believe we can effect change, true we are a small group but as a concerted effort and bringing these issues to the right number of people we can make change. Currently, I’m putting a plan together and when I have all the contacts in place I will call on you from this site. Thank you for your support.
PT
A. Banterings
I will be reaching out to you via private e-mail on our ideas that I’ve compiled. Currently, I’m researching a very large list of those I want our group to make contact with on a concerted effort.
PT
Good Evening:
Another guideline for a better healthcare system would be stricter rules for the use of chaperones and scribes.
Patient must be asked 1st and if approved chaperone/scribe must be same gender of the patient at all times. If healthcare feels the need to have them then they need BOTH genders available at all times not just females.
Chaperone/scribe must be in opposite corner of the room behind a blind or facing wall at all times while in room.
To start this snowball rolling into a landslide, maybe we need a story in the newspaper or magazine about how when the feminism movement of the 1960's & 70's caused healthcare executives to unilaterally decide that men were no longer worthy of basic human respect so they started using the BFOQ exception to hire female nurses then terminate the male orderlies that were taking care of male intimate medical needs at the time whereby forcing men to put up, shut up, & do as your told or don't seek out medical care.
That is when they started trading men's lives for the almighty dollar.
Once the story is in the open, people will start talking about and maybe, just maybe will see changes to a broken down system.
Regards,
NTT
I was under the impression the laws were in place already but were/are being ignored.
PT, My ideas that are LEGAL I post all the time. My CRIMINAL ideas, I shouldn't be entertaining at all , but I'd be lying if I said I don't ever think that way.
Responding to BIKER from 10/31 on questions about what happens in the Cath Lab. PT did a nice job of covering most of this. Be aware that depending on the needed heart procedure you might have multiple caths involved, that could enter from the arm, neck, or the groin area. If the physicians needs access to arteries/veins on both sides of the groin, you will be prepped on both sides. In this case a drape should be placed over your genitals and left there (and thus the gown will be lifted). However, many procedures are done by accessing an artery in the arm now. So it depends on the exact procedure one is having.
Be aware that monitoring leads may be attached to various places on your chest. This would require either lowering the gown or raising all the way up or removing it. You may even need a grounding pad affixed to your skin, depending on the procedure.
Be aware that when access is made to an artery there will be blood that is spilled. This may soil the gown requiring a gown change at some point.
The cleansing/antiseptic agent applied may also get on the gown, requiring a change of gown at some point.
All of this, with the exception of the initial prep, is done under conscious sedation (so you won’t remember what they did after the drugs take effect) or general anesthesia (so you won’t remember what they did).
Please don’t deny yourself necessary heart care because of the fear of a gown change. The large medical center you go to Biker would have a quite busy cath lab. Time is money. Money is king. Rarely is there any time to stand around and gawk. The cardiologist is waiting. You’ll be prepped quickly and out of there as quickly as possible.
Now the “just in case” femoral artery prep that PA got was done poorly. The nurse doing the prep either subscribes to the medical myth that men don’t need bodily privacy or something more sinister, but she used inappropriate technique. It takes no more time to move the qown to the side maintaining genital privacy than to lift it up. So doing this is not to save money, it is intentional exposure of the genitals for no medical purpose. Personally if I experienced that “sloppy” technique I would claim sexual abuse to the Board of Nursing and the licensing agency and make the institution and the nurse squirm (including doing documented staff training on proper techniques and maintaining bodily privacy). I say this again, just because a patient has consented to a medical procedure they have NOT waived the expectation and right to appropriate bodily privacy.
About removing the entire gown right away that PA experienced. Hmm, probably is a hospital nursing policy - the patient will leave with a clean gown. Doing it immediately, while the patient is still alert is bad form. All in all I think this particular cath lab needs scrutiny for their processes. It all comes down to training. If bad technique and medical myths keep getting passed down these things will continue. That is why its valuable to complain. More in later posts. — AB in NW
PT et al, more of my analogy of what is going on here: presenting the symptoms is first. Next is dissecting the symptoms in the context of the situation and with exercise of further analysis a diagnosis is created. But for all that is accomplished, the finality becomes effective treatment. It is now the time and need to develop an approach to effective treatment and to carry out that treatment with intention to treat and cure.
That is our daily professional duty in medicine and I am pleased that the current orientation of the thread discussion here is and will continue to that goal. ..Maurice.
Good Evening Everyone:
AB in NW.
Cardiac prep. "All of this, with the exception of the initial prep, is done under conscious sedation (so you won’t remember what they did after the drugs take effect) or general anesthesia (so you won’t remember what they did)."
If during prep I'm violated and want to report it then they feed me their conscious sedation cocktail which in turn wipes out my short term memory of the violation, they get away with it.
Can a cardiac cath procedure be done without the use of any memory effecting drugs?
Otherwise they'll violate patients knowing that have their drug cocktail to cause you to forget what they did to you.
Seems like this is one test the patient needs somebody they choose in the room with them to protect their interests.
Cardiac cath labs should have the bilateral medical garment available for all patients to wear due to its retractable front panel for patient preparation and procedural access. Women should also be allowed to wear a sports bra for privacy.
That way if they splash something on the gown and have to replace it, the patient still keeps their dignity intact.
When they prep the groin area they have to learn to be careful not to get the garment so the patient can continue to wear it after the procedure until it's time for them to change in private & go home.
Thanks.
Regards,
NTT
I just want to follow up a bit more on the the treatment of PA in the cath lab as it’s instructive. Valid, factual complaints, when done properly, can be a real headache for the institution and for the clinical staff involved. In some cases it can threaten licenses and thus their job. Claims that use the terms “abuse”, “sexual abuse” and “discrimination” normally get high scrutiny.
Either a tech (under a nurse supervision) or a nurse prepped PA for his cath procedure. In either instance a NURSE is responsible (and the nursing chain of command is also). In Pennsylvania (like ALL other states) the Board of Nursing has these statements (amongst many others) in their regs:
Sexual impropriety—The term includes the following offenses:
(i) Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient’s body or undergarments.
(ii) Unnecessarily exposing a patient’s body or watching a patient dress or undress, unless for therapeutic purposes or the patient specifically requests assistance.
Also;
(b) The registered nurse is fully responsible for ALL actions as a licensed nurse and is ACCOUNTABLE to clients for the quality of care delivered.
Also;
(b) A registered nurse may NOT: …(9) Engage in conduct DEFINED AS a sexual violation or sexual impropriety in the course of a professional relationship.
(d) The [Nursing] Board may, in addition to any other disciplinary or corrective measure set forth in this section, LEVY appropriate civil penalties as authorized by section 13(b) of the act (63 P.S. § 223(b)) upon a nurse found to have engaged in conduct constituting a sexual IMPROPRIETY or sexual violation.
So the practice of exposing males genitalia unnecessarily, to prep the femoral artery, “just in case”, or for any other situation (unnecessarily) in medicine is an example of a sexual impropriety. A complaint to the Board of Nursing about this sexual impropriety would then involve the Board of Nursing asking for the patient’s medical record and contacting the hospital Nurse Executive to ask about policy, practices, etc. The nurse involved in the action would have to answer Board questions. The nurse’ director may have to answer questions. This can be very stressful because of the potential penalties. Of course the nurse could deny the behavior but there are other team members the Board can interview. They are not all going to lie, and jeopardize their license and job.
Once a nurse experiences a Board complaint about her inappropriate treatment of patients “word gets around”. Behavior changes or else.
So I would advocate medical center patients who are victims of clearly unnecessary exposure by nurses or of staff a nurse is supervising to report this to the Board of Nursing. Unfortunately male patients get this a lot because of medical myths that males have no modesty and they can be treated without the same level of dignity. Complaints to Boards are one way to change this behavior quickly. (Later I’ll post other avenues for complaints that cost the Hospital).
As an aside, in Pennsylvania, under their regs, if a patient complained to the Hospital they were abused (because of unnecessary genital exposure) this should trigger reporting by the hospital to the licensing agency. This of course would lead to a survey by the licensing agency to understand what was happening. If the patient also concurrently complained to the licensing agency, and the Hospital had NOT reported it, they would have their first violation. Things could go downhill from that. Always lots of regs Hospitals and staff are not aware of that can be used to force change. - AB in NW
NTT
I can’t answer your question about no sedation in the cath lab. First, there are many procedures that are done in a cath lab, depends on what is your procedure. Secondly, that is a decision between the patient, the cardiologist, and one familiar with the sedation agents and the level of pain experienced without (usually an anesthesiologist).
For example, I do my colonoscopies without sedation and it’s easy. But the almost universal default practice is to sedate the patient and not offer the colonoscopy without sedation. It’s more convenient for the physician and staff. You don’t remember any discomfort or embarrassment so you give them high marks for care and leave happy…So it pays to discuss with your physician the use of conscious sedation, beforehand, if you can .
- AB NW
Hello,
I'd again like to propose that we form an association - Possibly, The National Association for Patient Privacy.
Reginald
NTT
Typically, CC are done with minor sedation, no more than a colonoscopy, however if it is a cardioversion or ablation then the method of anesthetic can get more complicated.
PT
Just a quick comment on conscious sedation. AB in NW is right, they say it is required for many things but if you speak up you can get certain procedures done without it. I have had 2 colonoscopies, an upper endoscopy and a transesophageal echocardiogram done w/o sedation. None were a big deal nor were they painful. I am convinced conscious sedation is mostly just a matter of convenience for the staff. They don't need to be careful with patient exposure when they know the patient won't remember any of it.
On the matter of an advocacy organization, I see two ways of effecting change, legislative/regulatory or the healthcare system voluntarily changing.
Legislative/regulatory change almost always requires either sufficient donations to enough politicians & funding of lobbyists that do the same OR the media creating the topic as a new social cause, typically as a result of deep pocket interest groups stirring the pot.
The healthcare system voluntarily changing would require society as a whole to start demanding that men be afforded the same considerations as women. Again, deep pocket interest groups are the drivers of that kind of spotlight being put on a social issue.
Women's groups have the requisite clout that drove beneficial changes they wanted both at the legislative/regulatory level and voluntary change on the part of the healthcare industry.
There aren't any powerful men's advocacy groups in this regard. Male modesty/dignity is a non-issue for the Men's Health Network, for the American Association of Male Nurses, for Men's Health Magazine, for the Prostate Cancer Foundation, the Testicular Cancer Society and so forth.
The question then is whether there is an established group that can be convinced to lend their clout on this issue.
Reginald
I’m all ears.
PT
AB in NW,
An acquaintance once told me of a situation that he felt was abusive. He complained and a representative for the facility was called in. His response to them was you can call the authorities and report this or he can call them and now we have conspiracy added to it.
He said that the criminal investigation went nowhere (as he expected), but his goal was to send the message that the facility turned their employee in rather than face conspiracy.
Historically, one can be innocent of the initial crime (the assault in this case), but found guilty of conspiracy for attempting to conceal an event that has been reported as a crime.
-- Banterings
Several years ago I related part of my story about when I started my healthcare at a new large medical center after I relocated to the NorthWest. My first visit was to their urology clinic and ultimately I had a biopsy, in a department that was staffed 100% female. I gave the medical center a warning letter about all of the issues I identified, staffing included, (as a newly retired Compliance/Regulatory Officer from another State) and gave them an opportunity to correct before complaining directly to regulatory agencies. As an institution that takes both State and Federal dollars, is not-for-profit, and an “equal opportunity employer”, they “appreciated” their self created dilemma. Their quickly appointed new male Urology Manager committed to the changes.
In addition, what this institution was doing was sending the CMS survey to 100% of their patients who came to hospital based clinics (and the hospital). So for a couple years I got several opportunities per year to complete the survey and include written comments. So each encounter I scored them poorly and in the comments sections stressed the gross disparity in staffing, the discrimination to prospective male employees, the discrimination to male patients, and the double standard of patient rights I saw and was experiencing.
I’m happy to report that not only has the urology department improved but today, at my Internal Med PCP visit ONE HALF of the Medical Assistants were male (they have a live display board of physician, MA and “time behind” so patients are informed). 4 male MAs, 4 female MAs on duty. Just perfect. Equitable.
Advocate for yourself, for others, and keep working the system. Change happens.
Banterings - I’ll respond to you via email soon. Been busy. — AB NW
Though the above Comments contain many worthy views.. they all apply to a dignity issue relative to patients who are ALIVE.
Since the title of this thread has been changed with this Volume to "Patient Dignity", does anyone want to make a comment regarding maintaining patient dignity when the patient is deceased? Yes, there has been some comments about medical staff for their own "pleasure" or "whatever" photographing private parts of the deceased.
But another topic worthy of a brief commentary is whether physicians, nurses or others in the medical community should attend their patient's funerals as part of contributing to the patient's dignity after death.
To be honest with those reading this blog, I can say that I never have attended my patients' funerals, though I was never asked to do so. Tell me, was I, by not attending, also ignoring or harming my patient's dignity after death? ..Maurice.
Dr. Bernstein, I don't expect any physician or other caregiver to attend the funerals of patients, but had someone come to the calling hours for any of my close family members I'd of been honored that they thought enough of them to come.
There is a downside that does warrant much caution in this regard. Not every family member is rational in their grief and any physician attending a funeral is at risk of an uncalled for outburst. My grandmother did that at my uncle's funeral, lashing out at his wife blaming her for his cancer. It is easy to envision such an outburst being directed at a doctor for "not doing enough" or some such.
AB in NW's post is inspiring. The change he effected now helps every male patient in those practices. Perhaps his credentials made them take him more seriously being they knew he knew how the regulatory oversight system works but it seems we are all being armed here with the correct words to use and who to complain to.
As an aside, I forgot to mention that I recently shortened my name to simply "Biker". The "in Vermont" part seemed unnecessary given there aren't any other "Bikers" here.
Good Morning:
Dr. Bernstein you did no harm by not attending a patient's funeral.
Most families don't expect their doctor to attend their patients funeral.
I've only seen it when the doctor has known the family for years. After knowing them for so long they become part of an extended family and the doctor felt a need to attend.
Regards,
NTT
Maurice,
Anthropologically and societally, funerals are for the living. They are a means for those left here to deal (grieve) with the passing of someone that they had a connection or relationship with.
Physicians and other providers have attended funerals for those patients that may have changed their lives some how or have made some great contribution to medicine.
-- Banterings
AB in NW
Unfortunately, private urology clinics can hire whomever they want and don’t answer to anyone. I’ve worked at 25 hospitals and I’ve never seen a Urology clinic in a hospital, they may have existed in the past but I’ve never seen one. The transition over the years has been that physicians have made attempts to distance themselves from hospitals. For the most part physicians are granted priviledges at hospitals and have in the past never been “ employees” of the hospital.
These days hospitalists and emergency room physicians are employed by the hospitals as group practices with the hospital having the ability to fire them at will. The same applies at level 1 hospitals that employ trauma ortho, surgery, anesthesia etc. At this point I’m somewhat surprised that hospitals have been able to maintain a mammo suite as well as a L&D without really having to utilize and or to resort to a BFOQ requirement. With the proliferation of outpatient surgery centers many surgeons and anesthiologists would rather perform their surgeries at these facilities rather than deal with hospitals. Outpatient surgery centers, private physicians offices, outpatient mammo suites and imaging centers do not answer to the Joint Commission, CMS and very little at all with the state regulatory agencies.
PT
Misty got a good article published on KevinMD.
https://www.kevinmd.com/blog/2018/11/how-urologists-can-be-more-sensitive-to-male-patients.html
I don't think that I previously remember offering as a "look back to a previous ethics thread" to this specific thread and its use as a supplement to the discussions here on "Patient Dignity".
The thread title "Violation of the Patient's Autonomy: Is that Ethical" has an interesting discussion between me and a visitor physician which leads as the final comment by a visitor "Lee" that adds to what is being written on our thread here.
Let me (us) know what you think of the arguments presented. You should write it here but there is no harm also writing to the 2009 thread itself which was read today by 5 different visitors. ..Maurice.
Good Evening:
Seems Kevin MD and his colleagues can't take the heat. There was a reply there this morning to Misty's story to a Captain Caveman a male urologist. It has since been deleted from the site. Seems Kevin only wants one side to the story. Health care's side.
They're a bunch of blowhards. If they can't take the heat, they should stay off the internet.
Regards,
NTT
NTT
Can you give any credence to anyone who goes by the handle Captain Caveman, Urologist or not. One of my posts questioned wether he was a urologist, naturally it was deleted. But you know, that’s OK. We know the game and in the end we will win. Rest assurred I am working very hard on a plan.
PT
Well, this is KevinMD's commentary policy:
"Comment policy
Comments to individual posts are encouraged. This is a moderated forum, meaning comments are reviewed before they are posted.
Respectful comments that contribute to the topic at hand will generally be accepted.
The Site will not publish comments that, in the Author’s sole opinion, fall under the following categories:
snarky, trolling, off-topic, make the same point repeatedly, ranting at doctors, ranting at patients, excessively long, libelous, defamatory, abusive, harassing, threatening, profane, pornographic, offensive, false, misleading, or which otherwise violates or encourages others to violate the Author’s sense of decorum and civility or any law, including intellectual property laws
“spam,” i.e., an attempt to advertise, solicit, or otherwise promote goods and services
contain off-topic hyperlinks"
Of course, as with our blog thread, I tend to follow the same criteria. Of course, there is "ranting" of physicians and their assistants here (though "ranting" needs to be defined) and I have not deleted such presentations. I don't want names of individuals or institutions presented here who are examples of professional misbehavior unless they are already publicly named since they deserve to be aware of the possible posting and given an opportunity to respond. I also reject ad hominem (attacks on the person, as an individual, writing rather than the content of what that person wrote.)
With all this, I have rarely, rarely rejected publishing a comment, based on the above criteria for all these 13 years even as apparently similar to KevinMD's criteria.
I would say, based on the continuity of the discussions here, my criteria for publication has been acceptable by my visitors. If not, I would certainly accept publishing comments disagreeing to this assumption statement. Thus "speak up" to me. ..Maurice.
My hat is off to Misty for again bringing this issue to the center stage. As you all know regarding some posters on Kevinmd the excuse of course is there are no male medical assistance. In one sentence he thinks it’s a “ Silly” idea but then further on he says no male has ever applied to his practice. Folks, I’ve said this over and over, I’ve researched the job market very well. Looked at cna and medical assistant forums. Men are simply not hired for these positions. There are males who have looked for jobs for 10 years without success.
PT
My regular visitors, please excuse my occasional requests for input on the issues discussed on this thread by my non-USA visitors. I just think that understanding how "things are done" within the medical profession in other parts of the globe is worthy information.
For example, we have had a visitor today from Selangor, Malaysia with internet resource Universiti Putra Malaysia. I hope if the visitor returns and reads this request "your comments will be welcomed".
..Maurice.
Concerning Misty's article, that urologist was pretty smug is his thinking that the staff being polite is all any patient should need. I wonder if he has ever been a patient himself being prepped for intimate procedures and/or observed by MA's.
Despite comments being quickly closed, just having the article published and the ensuing short but lively discussion focused some light on the topic, and it will be found for years to come in internet searches. Thanks Misty!
I did not have the chance to comment on that article on KevinMD. I appreciate you all contributing.
As for that urologist who argued that it would be gender discrimination to hire male nurses for his practice, this is not true. I wish I could have shared this with him.
Bona Fide Occupational Qualifications (“BFOQ”) allows employers to hire individuals based on their age, sex, race, national origin, or religion, if these specific qualifications are considered essential to the job, or considered vital to the business' operation. Bona Fide Occupational Qualification (BFOQ) can be utilized to keep from hiring male nurses in Labor & Delivery and gynecology where female patients’ private parts would be exposed due to the bodily privacy issues and potential sexual abuse. The same can be used for urology practices that need more male nurses for male patients.
Many all-female ob/gyn practices use BFOQ to hire only female doctors and nurses. Look at this example of a hospital refusing to hire a male nurse in their Labor & Delivery nurse. The same can apply to urologists. The truth is a number of urologists should start all-male urology clinics for men only. This would be for modest male patients who would never seek medical care or uncomfortable with female nurses.
I do not like the silly label that was put on modest patients. The truth is men who speak up about their wishes for modesty are heroes and brave. I’ve had the privilege of helping some male patients standing up for their rights to modesty in medical settings.
You cannot change the gender of a medical personnel no matter how compassionate, polite, professional, and experienced he/she is. The modern medicine is gender neutral and it is time for medical professionals to wake up that many patients do care about their modesty.
Urologists should actively seek out male nurses and assistants by advertising jobs for male nurses and assistants. They also should go to the local community college or college to recruit male nurses or nursing students.
Misty
Changing the gender mix in healthcare staffing below the physician level will be a slow process given each year's entries into the work pool are but a small fraction of overall staffing. Even a doubling overnight of male students in nursing school and other training programs will only slightly nudge the gender mix in the near term.
A piece of the situation that hasn't really been discussed was touched upon by that urologist who responded to Misty's article. Male nurses, MA's, and techs do gravitate to higher paid jobs in OR's, ER's and elsewhere in hospital settings rather than private outpatient practices that pay less in exchange for better hours and a far less intense work environment. There is self-selection going on and that urologist might be right that he hasn't had male applicants. That said I have no doubt but that there are many urologists, dermatologists, and others who would never hire a male even if a well qualified one applied. With 100% female staffing they never need think about a female patient objecting to a male staff member being in the room. As Misty advocated, physicians need to purposely seek male staffing if this problem is to be addressed. Waiting for men to apply is not enough.
In the meantime, having empathy for male patients (of which that urologist had none)costs nothing nor would it cost physicians anything to demand the highest standards from their female staff when it comes to minimizing patient exposure (what is exposed, for how long, and to whom) and perhaps more importantly understanding the difference between necessity and convenience.
Good Morning:
Kudos Misty for what you've managed to accomplish.
My brother found out you can't talk about "real issues" on KevinMD and expect your message to be posted. He answered your post and mentioned how they use the BFOQ exception to hire only females. It was up there for a small time before they pulled it.
Again, thanks for all you've done for the cause.
Regards,
NTT
On the other hand, the medical profession has sexual behavioral issues (or should I say "sexual misbehavior issues") as initiated by patients for which the profession should "speak up" to the patient. Here is a current example as presented currently in JAMA:
https://jamanetwork.com/journals/jama/fullarticle/2715597
By the way, at current 176 Comments we are approaching time for the creation of "Patient Dignity (Formerly: Patient Modesty): Volume 93" ..Maurice.
Dr B.
Much of the solution is what the men on this blog have moaning and groaning about already. Although I have news for them. Same gender intimate care is only PART of the problem.
Dr. Bernstein, concerning the article you posted it comes as no surprise that some attending physicians would ignore sexual harassment of interns and students by patients. It is just another facet of respect and dignity being words in policy statements more than actions to live by.
I’ve never ever seen patients misbehave sexually yet it seems that it’s always at least somewhat complained about on Allnurses. Do you notice it’s always old men that nurses complain about, Really! Honestly, I can’t count the occasions that female nurses were caught having sex in the parking with physicians when they should be taking care of their patients. There seems to be a lot of complaining about the patients misbehaving from a sexual standpoint, let’s not forget that boundary violations ( nurses carrying on sexual relationships ) with their patients is a hugh problem, physicians are reprimanded by this too.
Where are the comments on Allnurses citing that it’s a violation of the nurse practice act to engage in any relationship other than professional with a patient? You do have them posting the question “ is it ok to have a relationship with a patient”? It seems to be a common practice to always place blame on the patients. Inappropriate medical staff behavior from a sexual standpoint has and always will overshadow any behavior by patients deemed sexually inappropriate. Please don’t get me started on female physician residents complaining about sexual advances by patients.
PT
Tomorrow is Thanksgiving in the United States and so I would like to give THANKS to all my visitors and contributors who have been reading and commenting on this blog thread. A particular THANKS for Banterings and his "Banterings of a Mad Man" website. THANKS also should go to Misty who writes here but also manages her own website on the physical modesty issues. I also want to give THANKS to Dr. Joel Sherman and MER and their website on these same issues. (Both have written to our blog thread in the past.)
So there are all the THANKS I am presenting tonight for tomorrow. However, what is of special value of these contributors is the GIVING. They are all GIVING insight into a problem disorder within the medical system that should not be ignored and should be cured. Knowing a diagnosis but without a establishing a cure is not a happy condition in the practice of medicine. ..Maurice.
Happy Thanksgiving to you Dr. Bernstein! I also wanted to thank you for keeping up those blogs about patient modesty for many years. I’ve gained many great insights from the contributors to this blog.
Misty
Good Morning an Happy Thanksgiving to All.
In regards to the Solving The Silence article.
"What does the medical community need to do to end the verbal harassment and sexualization of female and male trainees? We believe that to address these deeply rooted injustices, each episode of harassment must be "addressed in real time", immediately after the offending comment is made."
What do patients need to do to stop the same verbal harassment? Especially male patients.
Each and every time a healthcare worker tells you to man up, or you don't have anything they haven't already seen, or you don't have anything special, that individual should be dragged on the carpet right then and there in front of whomever is there and made an example of by the patient.
And I don't mean a simple that's uncalled for. I'm talking "Who the h**l do you think you are telling me that. That kinda smack down.
What's good for the goose is good for the gander in this instance.
They want to teach respect to patients well maybe the patients should do the same to them especially in front of their peers and coworkers.
Few male doctors in the medical community have the gonads to really advocate for male patients.
If they did, you'd see them using the BFOQ hiring exception just like healthcare executives did for women and setup men's only health care clinics.
I realize there's a shortage of male healthcare personnel but if guys saw male doctors making a go at all male clinics they might change their mind & want to step up & join the cause.
It only takes one doctor to start a snowball effect.
Have a great holiday all & try not to eat too much.
Regards,
NTT
Beginning November 22 2018, no further Comments will be published on Volume 92. To continue the discussions go to "Patient Dignity (Formerly: Patient Modesty) Volume 93." ..Maurice.
Post a Comment
<< Home