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.
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Patient Dignity (Formerly: Patient Modesty): Volume 95
Ray B. said in Volume 94:
If you believe Steven Miles, M.D. (“Oath Betrayed: Torture, Medical Complicity and the War of Terror”) the answer is, “All of them.” That’s hardly evidence of outliers. At the same time, however, there is reason to believe, from Milgram’s study, that the people who commit evil acts may, in fact, be outliers – it depends on the situation.
And so where are we, as patients and our dignity, within the medical system? ..Maurice.
Graphic: From Google Images and modified by me with Art Rage.
As of March 21 2019, no further Comments will be published on
this Volume. Comments will continue on Volume 96.
192 Comments:
JF, I had my own experience similar to your scrub nurse story. Back when I was scheduled for a vasectomy we lived in a neighborhood full of people our age and with kids of similar age to ours. There were lots of social gatherings in the neighborhood. One of the women was an OR nurse at the small community hospital where it was going to occur. The other women were quite clear they wanted her in the room for my vasectomy and they wanted a full report afterwards. I figured odds are it wouldn't be her in the room and quite honestly I didn't think she would broach my privacy even if she was. I never heard her talk about patients and she struck me as being a true professional. The real issue for me was that the sisterhood in the neighborhood thought this was something they were entitled to given the opportunity they saw. Curiosity is a powerful incentive and so I don't doubt but that some healthcare staff let their curiosity override what they know is wrong. The Denver 5 anyone?
A side question this prompts is does standard hospital or medical practice protocol say that staff should not have people they know as patients? Maybe not an issue in urban areas where everyone is seemingly anonymous, but in small town & rural areas it is all but impossible to be anonymous.
Ray, the Twana Sparks (ENT, not dermatologist) grouping to me are the predators who purposely sexually abuse patients. It might be for their own gratification or maybe it is an acting out of a power fantasy. Given Dr. Sparks was a lesbian her abuse likely wasn't that of personal gratification but perhaps a power over men fantasy of some sort. In her case I find more fault with those who worked with her and knew for years what she was doing than I do with her. In her case had she not been a woman and thus subject to prosecution she might have had a psychological impairment defense. The rest of the folks at that hospital wouldn't have had any defense.
What you described about your research makes abundant sense. I could see myself in it but having found my voice and no longer being afraid of what they will think or say I am speaking up and demanding my privacy be respected. I am not a confrontational person by nature and do not look forward to conflict, but it is liberating to no longer be afraid and suffering their dehumanization in silence as a result.
Biker
You don’t have to go very far to answer your question. “ Does standard hospital or medical practice protocol say that staff should not have people they know as patients ? “ No, there is no protocol in any hospital or medical practice.
But now you know why hospital staff go elsewhere for treatment, to have their child etc.
PT
I have great news for you all. Covr Medical has started selling their modesty garments directly to patients who want their genitals covered for certain procedures such as hip replacement surgery, cardiac catheterization, etc. You can see more information at this link.
I appreciate that those modesty garments were invented by a surgeon who was sensitive to patient modesty.
Misty
Biker
Twana Sparks was a lesbian and wouldn't have gotten sexual gratification from her male patients if it would have been just her and him/them. However she could have gotten MUCH sexual gratification from exposing those male patients to a roomful of nurses.
Thanks NTT and MS KS for the information re. contact with those who produced the film re. knee surgery prep.
I've gathered questionnaire data and interviewed hundreds of people over the years about their experiences. Some have had humiliating experiences involving people they know. It was not uncommon in the home of osteopathy (Kirksville, MO -- population 17,000)for nursing students (and in one case a business student)to use their professors as teaching subjects without consent, in spite of the fact that they learned in their legal/ethics course that consent was an ethical requirement. One professor expressed his humiliation with, "I had no choice but to see her in my class three times a week. It really affected my teaching." In an even smaller community where there was a hospital that served a large area gave nicknames to local men based on he size, shape, and condition of their penises. I found this out from the brother of "Big Balls." There was "Right Angle," "Upright,"Smelly Sam," "Smegma something or other," "Little Fella," and the like. "Big Balls" knew the CEO of the hospital personally and complained to him. The CEO, in effect, called him a liar. Not exactly, though. He did claim that the nurses at his hospital were all professional and treated patients with dignity and compassion. When I hear such malarkey, I run as fast in the other direction as I do when I find out that a car salesperson names himself "Honest . -- Ray
As Moderator, I want to state that though I don't accept advertisements anywhere on my blog, I am accepting the direct link displayed by Misty because the resource described is unique and strictly pertinent to the privacy concerns expressed on this blog thread. As a physician, I think it is important to emphasize what caution was written in the advertisement: "...Medical garments must be brought to your medical or surgical procedure in its original, unopened packaging. Do not try them on at home prior to your procedure." ..Maurice.
Dr. Bernstein, thank you for posting the link. Of course, my purpose for listing the link was to let everyone here know that they can buy those modesty garments if they wish for future procedures that may involve their groins, hips, etc. I think it is very exciting that a surgeon invented them. This shows that there are doctors who actually care about patient modesty. There is a lot of negativity on this blog about doctors and nurses who are insensitive to patient modesty. I think it is important to recognize medical professionals who are sensitive to patient modesty.
Misty
I wanted to mention that the orthopedic surgeon, Dr. Bruce Levy who invented those modesty garments was interviewed the other day and was on the news. Here’s the link: Mayo Clinic surgeon goes beyond operating room for patient care. We need more surgeons like him who are sensitive to patient modesty.
Misty
Have my appt with state rep. Am seeing about ggetting a mtg with US Senator Regional Director. If anyone has facts and figures I can include please feel free to send them to me. I also want to show her some of the videos that I have seen the links posted to on this site. JR
Good evening:
JR, I read the article about the ease app. The google play store description says its HIPPA compliant.
My take is that it’s a good idea however, if you want someone communicating from an OR or any other patient area with a cell phone, that cell phone must NOT have a camera on it. If defense contractors can equip their employees with camera less cell phones, then the healthcare industry can do the same if they want them to have them while on duty. Plain and simple.
HIPPA compliant my patootie.
Biker, as far as cardiac catheterization goes, the patient is awake throughout the procedure as s/he may be asked to cough or take a deep breath at times during the procedure. You do get I.V. meds for anxiety and pain as needed. I suspect valium or versed to make you forget and light dose of fentanyl for any pain. They use lidocaine at insertion point to dull the insertion.
That friends is all I have for now.
Regards,
NTT
NTT,
I have done a lot of research about what happened that night to my husband. Reviewing several drugs sites, I found that these of some of the side effects fentanyl can have:
decreased awareness/responsiveness
difficult or labored breathing
slow breathing rate
chills
chest pain
tightness of chest
irregular heartbeat
fast/slow heartbeat
unusual tiredness/weakness
lethargy
confusion
nausea
pale skin
seeing, hearing, feeling things that are not there
severe sleepiness
thinking abnormalities
trembling
trouble concentrating
lack/loss of strength
hypotension
sweating
He has had all of these in the past with less strong drugs than fentanyl. He remembers having some of these that night along with what I have found in his medical records. However, the hospital from hell did not record his vitals prior to their cath lab ambush. Not even when they were doing the not really conscious sedation evaluation--trange? Eventually he went into shock although it is stated that he was not in cardiogenic shock at the start of the PCI but there is a pattern after the administration of the fentanyls (he received 100mcg more and 3mg Versed). When asked by the transferring hospital, we both told them how ultra sensitive he is painkillers and he did not want any. He eventually agreed to 4 mg of morphine and it with nitro made his pain go away. I could tell it was affecting him as he became very quiet, tired, and his breathing changed. He told them no more painkillers. We told them all what painkillers do to him. He told them he did not want Versed or any other drug in that class as it severely affected him for weeks and caused extreme long term memory issues. We saw them making notes so we thought they were making a note of this. He agreed to morphine and once he did along w/ the nitro his pain went away. However, unknown to him, the ambulance personnel gave him fentanyl. The fentanyl made him totally out of it. In doing my research as to why they would give a man that wasn't in pain 100mcg of fentanyl after they were told it has severe consequences, I found several EMT sites that state that cath labs want STEMI patients to arrive w/ fentanyl in them as they are less likely to question and resist treatment thus is why I say they use it to make patients compliant. They also may use Versed in route if the fentanyl doesn't achieve the required results. Giving a STEMI patient this drug knowing how it affected him under healthy circumstances is negligent and downright criminal to me. However, since we had only agreed to go to the hospital from hell for evaluation to see what his options were, they felt they had the right to decide his course of treatment for him as he was being "difficult" and not okaying what they wanted. It is no wonder this country had an opiate crises as the medical field seems are little too eager to give opiates out even to people who don't want or have problems with them. JR
Here is a great JAMA article: Patients and Physicians in the Era of Modern Cancer Care. The most important line is:
"In this context, social skills are often as important as medical knowledge."
This also leads me to comment on COVR garment. This was an angle that I did not see coming. COVR stands to make millions (or billions) off this product. So how do they create the desire? They throw the rest of the surgical community. The OR theater is filled with sexual predators, either insist on these garments or buy them yourself.
-- Banterings
Thanks NTT, lidocaine at the insertion site is just fine. The only purpose of versed and its counterparts that I can glean is to wipe the patient's memory of the event. That includes being exposed needlessly or otherwise not being treated in a respectful manner.
I refuse those drugs so as to avoid being sick & vomiting or dry heaves for the rest of the day, but not having my memory wiped is a definite upside. I can't explain it but sedation/anesthesia type drugs somehow trigger my vertigo and extreme motion sickness, even if they add anti-nausea stuff to it. I've learned to just say no and go elsewhere if they insist on sedating me up for minor procedures (colonoscopies, upper endoscopy, transesophageal echocardiogram thus far).
I am perfectly capable of following directions and managing mild pain without being drugged up. Hopefully I'll never need a cardiac cath but I was just curious is all given cardiac caths have come up in conversation here.
Why should any patient have to have some CEO belittle his or her complaints about being disrespected by staff? Let the asshole CEO hide a tape recorder in the break area's. Or wherever the staff clusters around. That DOESN'T mean he should confront them about every wrong thing he learns that way but the blantonly ignoring abusive behavior has to stop. Hire male staff. Eliminate unnecessary exposure or being exposed to more people than necessary.
Biker,
No, you don't have to be given anything but it is sop in the US. Having done my research, I have found a lot of other countries don't require "conscious sedation." We all know that "conscious sedation" is more or less a zombie state that enables them to control you w/o you remembering much of what happened. There is really not pain but rather pressure from the insertion of the different devices such as sheaths. They say they use painkillers as they don't want the patient to feel any pain but that was a lie in this case. I'll explain later. They used lidocaine to numb one of his groins but not the other. Here is my husband's story as he was allowed to remember:
He began feeling funny during his ambulance transport. Once they landed, he felt as though he was floating above and watching what was going on. He remembers that no one from the hospital from hell was there to greet him the captive and his jailers. They finally flagged down a nurse getting into her car in a parking lot and she badged them in. They wondered the hall until they finally found some people who directed them to the cath lab. The ambulance jailers (I call them this as they gave him fentanyl w/o his knowledge and against what he had stated he wanted done) transferred him directly to the cold, metal cath lab table. The 4 women heifers started readying him for what he didn't know. They stripped him of his clothes w/o asking or even giving him the chance. They stuffed them into a pink garbage bag (pink is kind of symbolic of the abuse of power by these female heifers). They left him naked w/o a gown or blanket, exposed to a room of people. He remembers seeing people standing around (the 3 ambulance jailer stayed and watched for awhile) and others coming and going. He remembers hearing some of them talking but he doesn't remember anyone talking to him. He remembers one female voice in a mask telling him she was going to shave him. She shaved his whole pubic region and thighs not the little area as described in most cath lab sites. They also state they respect the patient's privacy but this also was not the case. He stay exposed until they finally draped him 30 minutes for the procedure. He remembers how cold he was and how upset he was that he was exposed without thought to his bodily privacy. He felt humiliated. However, the fentanyl had done its job and rendered his thoughts just that--he was unable to find his voice or the energy to resist. He remembers the pressure but says it did not hurt although the bruises on both groins and his thighs said otherwise as I have never seen such blackness and the area was about 12 in in diameter on both groins w/ hard lumps that are still present months afterwards. He said he was scared, alone, and wondering why and what was happening. No one communicated or comforted him. The put 2 more IVs in him so he had a total of 4--2 in each bend of his elbows. Hospital from hell did not note their IV insertions but the perverted nurse signed that she was present at the original hospital when they inserted it (no--just another lie from her). He remember wondering if I had okayed what was happening to him but I hadn't. He remembers wanting to see me but couldn't form the words to ask. He remembers being scared and cold until he finally started trembling violently. He remembers seeing the screen of his heart and wondering what was going on. Cont. JR
He remembers after the dr. was gone still laying on the cath table (he laid there for about 50 minutes after the procedure ended according to MRs). He remembers once again that he was laying there naked, exposed, and cold. He remembers a female heifer voice telling him they were going to do some suturing and he would hurt a lot. (Remember their reasoning for conscious sedation is for the patient to feel no pain--well that's a big lie.) He remembers even in his fog, how badly the suturing of 3 areas hurt. He remembers eventually being transferred, still naked, to a gurney. He remembers them throwing a gown and then a blanket over him. He remembers them telling him he would get to see his family shortly. That too was a lie as it wasn't until well over 2 hours later that we finally flagged down someone so we could find out what had happened to him. They apparently didn't care about his mental well being either. By the way heifer is the nicest term I can consistently call these RNs. Because of the Versed and fentanyl, his memories are limited. He did hypnosis sessions that helped him regain these. They were very traumatic for him and me but he and I needed answers. The hypnotist was very careful as to not suggest things to him but rather let him tell his story at his own pace.
Now I know that some may have issues with this story. We have issues with this story as it is what happened to my husband. This story should never have happened to him. I want to tell this story to others because I want them to be aware of what can happen. This may be the exception to the rule or this may happen more than what we realize. I don't know but I do know it can and did happen so everyone should be aware. We weren't and this is the result. Mistreatment, abuse, and the lack of Informed Consent. Everytime I think or tell this story, I cry because these medical things were so cruel, abusive, and violating to especially my husband. What I suffered pales in comparison. The drugs weren't necessary as he is a big boy and if he had been allowed to exercise his basic human right to freedom to choose his treatment, he would have been okay w/o the drugs. However, he will never be okay again for what they did to him.
Here is a link to a site talking about the differences in use of fentanyl here and elsewhere: https://www.medscape.com/viewarticle/885560. I have read having your music would be helpful if you feel stressed which I can attest to lately that my music has helped me a lot. After seeing what some others have to say and what my husband experienced, I will stand by my statement that cath labs are cesspools of abuse, control and violative behaviors by the staff. The actual interventionalist may not have been present during the abuse but ultimately he is responsible for the actions of his team. JR
My agenda for my meeting w/ the state rep is to educate her about:
1. Inequality of care between the sexes (lack of respect/personal dignity)
a. I will offer examples such as stories and web links.
-I will offer solutions such as having your chosen advocate present
-The state offering incentives for more male nurses, techs to staff areas where it
is mainly female
2. Lack of Informed Consent
a. Many times if you have an issue w/ what is on the consent form, they tell you
it cannot be changed
b. Many times it is difficult to read on the little screens they use or you have to
become very obvious you are a problem child and stand in the waiting room on
reading the copy on the wall
c. They have you pre-drugged and have you sign it or say you have verbally given
consent w/o you having a witness totally on your side
d. Some areas need to be separated out of the consent form such as sedation, filming,
who can be present, etc.
e. If consent cannot be signed by patient or their family, then a recording of
procedure, risks, etc must be recorded when given to patient if they term
care is emergent but they have no consent signature
3. Drug usage needs to be studied and corrected
a. Patients have the right to refuse drugs and this should be required notations
in records
b. Use of opiates by medical staff should be carefully monitored as they seem to
use these way too often
c. Use of Versed, other benzos, and other memory altering drugs need to curbed and
if used fully explained. Alternatives should be readily on hand.
4. It should be understood that patients are ultimately in charge of their healthcare
decisions that medical staff are just advisors and carryout the orders
5. Medical records should be accurate and reflect everything done to a patient. If there
has been an issue with care, that must also be noted.
6. If there is any video of the patient, that video must also be given to the patient.
7. Before any patient information is given out to any data registry group that is not gov.
mandated, it must be approved by the patient and not by a blanket consent form.
Any additions? JR
JF, your list is all good stuff but I suggest you approach this from the perspective that she has a line of people every day with their own lists of things they want her to do. There aren't enough hours in the day for her to personally take on every issue presented to her and if she has any staff, she doesn't have enough staff for that either.
She needs to get a general statement of the nature of the problem you are looking to solve, and then a request specifically saying what you are asking her to do. By that I mean you are asking her to review modifications and additions to the State's current Patient Privacy regulations, that you have prepared suggested changes in the same format they currently use to debate wording changes, and that you have prepared background notes explaining the intent of and need for those changes. Then she has something actionable that she can take with her vs a vague "fix healthcare" kind of problem. To the extent your list concerns more than one regulation, then the same is needed for each change you are seeking. Even with a very specific list, your chances of getting any help from her are lessened if you expect her to go research current patient privacy regulations and figure out where to change wording to address your concerns.
Doing it this way would convey that you have done your homework and that you know what it is you are looking for. It's also OK if you are not ready to bring this down to something actionable for her when you meet. In that case you are presenting the general problem and asking her if she would entertain beefing up the pertinent regulations that you could follow-up with her on when you have your documentation ready.
Whatever you do, do not allow your time with her to become an angry rant. That'll elicit a smile, nod of the head, maybe a sympathetic look or a few kind words, and then no effort whatsoever on her part to help you. You need to come across as a calm rational person with reasonable requests. Whatever you do, do not exaggerate any point as it'll detract from the whole. Don't interpret the intentions of the healthcare staff unless you could prove it but instead focus on the actions themselves and their effect. Make the current protocols the problem, not the staff. You want her to help solve a systemic problem, not get in the middle of your beef with specific staff at a single hospital.
Good luck.
Biker,
The first area I am tackling are the consent forms. I am including for her viewing actual consent forms to show her where the issues are and what might be done to correct them. I think the forms need to be broken down in different signature areas and with the ability for patients to exclude and add. I feel that since we live in a computer age that procedures, risks, sedation, who's involved, etc. should be tailored for each patient's specific situation.
Another area I want to cover is the difference between how male and female patients are treated. This is a tricky area. I am including news articles and different websites if she wants further details. I think one solution is to have incentives to have more male medical staff in area that especially serve male patients. The state could help in this. I also think that having mandatory courses that really teach about patient dignity in all aspects should be considered. This would include having patients advised beforehand about chaperones being present and would also enable patients to have their advocate present during procedures.
I also want to enlighten her about medical records. I think that verbal recordings of all procedures should be done as it would serve as a memo of what occurred. I want to remind her that 2 people seeing the same thing oftentimes have different points of view and that many times records are dictated long after the encounter. I also want to remind her that there has to be greater protection and training of staff in handling all types of medical records. Medical records have all your information for anyone to see and hear. HIPAA violations of the smaller variety are likely to go unpunished by fines but really these are the ones that are most likely occurring on a more frequent basis. There also needs to be notification and approval by the patient before any of your information is used for other than government purposes. You should be aware of who has your info.
I do not intend to make this a rant and rave session about what happened to us but rather use our experience to know what we are looking to change. I have my own blog for that along with our court case. I also vent here as there are others who unfortunately have shared in their own way, our suffering. I am going to tell her that I have other areas and will give her a paper to read and would like to help if she feels this is something is interested in taking on. JR
That was JR. I'm JF.
JR
I think in the end you are going to win, why do I say that? Because you are very very persistent and that is what these people don’t like. They have to see, hear or deal with you every day or they find out that you go over their head which is even better because to the person over them it appears they could not or was not willing to rectify the problem to your satisfaction. I Love It!
PT
TORONTO — A Toronto doctor has had her licence revoked after an intimate relationship with her cancer patient that included having sex while he was receiving treatment in hospital.
https://nationalpost.com/news/canada/doctors-licence-revoked-after-admitting-to-sexual-affair-with-cancer-patient.
Well, to be fair I might as well get into the contributing references, even as statistical outliers, regarding published "bad girls of medicine" and their "damaged male patients". ..Maurice.
You're correct Biker; Sparks is an ENT. Must have had a lapse. If I recall, there were jokes about her "work" going around the hospital -- "Hey Doc; that's a long way from the throat." "ENT stands for Ears, Nuts and Testicles.
I did some probing a couple years back and found out more "dirty" things she reportedly did but fear to broadcast it because of a frivolous suit. It was also reported to me that there were people fired other than the nurse who reported Sparks. It's telling that the latter was fired because of a HIPAA violation but apparently Sparks behavior did not rise to that level, as far as the authorities at the hospital were concerned. -- Ray
I emailed Covrmedical almost two weeks ago asking if the company sold anything to cover the genitals when receiving cancer radiation therapy called Varian RapidArc radiation. The coverings the company sells would interfere with tattoos placed around the pelvis. I never received a reply. I sent another message recently but again received no reply. I find no responses to be the most frequent "response" to queries, but in Covr's case it surprises me given its interest in profits. -- Ray
JR: Your story is a very distressing one. There seems to be no end to similar stories told to me over the years and published in the popular media. My blood pressure soars each time I hear or read about one. Also, each of those times I think of what George Annas wrote in "Judging Medicine" back in 1988 (read about him here: https://en.wikipedia.org/wiki/George_Annas). He dubbed the hospital a "human rights wasteland" and added, "Civil libertarians have little difficulty appreciating the plight of prisoners or mental patients. But tell the average civil libertarian that there are significant and unnecessary restrictions on the individual rights and liberties of patients in general hospitals, and you are likely to encounter a blank stare. There are a number of reasons for this. One is the general misconception that the problems are minor, or that certain temporary restrictions on individual liberty are essential if hospitals are to treat sick people properly. An unconscious desire not to perceive ourselves at risk may be another reason; we seldom seriously think we will ever be either prisoners or mental patients. But almost all of us have been hospital patients at least once, and each of us will be a hospital patient an average of seven times during our life. By not dealing with the issue, perhaps we are seeking to avoid thinking about our own future hospitalization, an event which is almost always traumatic and undesired." Annas goes on to give examples that are not as egregious as yours and the many examples people have contributed to this blog and which have been reported by the media. Today, a pattern of systematic violations of civil rights also extends to healthcare organizations in addition to hospitals. Some healthcare organizations, I believe, can now be classified as human rights abattoirs (such as Gila Regional Medical Center in Silver City, NM and NY Presbyterian Hospital) this in spite of HIPAA's and the Joint Commission's efforts.
Out of curiosity, How do you plan to approach the issue of differential treatment of males/females? I hope you keep us apprised of your efforts and progress (or lack thereof).
I'll be happy to contribute to your efforts if I am able. -- Ray
Telling somebody " You have nothing I haven't already seen!" is kinda ignorant. I think probably just about anybody has seen nude bodies before, male and female. Even kids.
PT,
Thanks for your comments! I am nothing if not persistent. We won't ever give up and become their victims again nor are we going to just let it ride having been their victims.
Banterings,
I took your advice and we wrote them requesting them remove his records from all their voluntary data registries. Thanks for the info!
Ray,
Thanks for your comments. You have a lot of information and your latest on the hospitals being like prisons really hit home with us. That is exactly how we felt. I felt like I had a warden and my husband felt punished and subjected to torture from those RNs. Moreover, he feels like his right to decide his own treatment was violated as they had decided for him. He was just an object to them and statistics. Perhaps they shouldn't use either terms of discharged or dismissed but rather paroled or executed. Those may be more descriptive. Both of us felt like he was in solitary confinement when other families were seeing their loved ones, he was being isolated for no reason (not a justified medical reason). The care excellence person said we should get use to this type of encounter as we are aging and the older we get, the more we will be hospitalized. But then as I told her, she is aging too so there is always hope that she will receive the same treatment they gave my husband. Actually, she is no longer there. I had sent a copy of her letter to the legal dept. when we wanted his medical records and couldn't get them in a prompt manner as stated in HIPAA.
If anyone has anything that they would like to send to me as I do my research for my meetings' agendas, I asked Dr. B. and he said I could post my website URL so I could get materials. If anyone has any stories they would like to contribute, just let me know.
Issues4Thought.com is my blog.
Another area I want to hit is that I don't think medical staff should have their own private cell phone on them while on duty whether it be in an office or hospital. What happens to the content after they leave employment even if the material was gotten with approval? JR
This switch in titling this blog thread to "Patient Dignity" has really opened the opportunity for me to present links to thread topics in the past. One such topic (in which BJTNT even participated) in 2014 was "Instead of Handshake Hazard: Namaste, Salaam Gestures or Bumping Elbows?" Check it out. ..Maurice.
JR,
Great job on the blog!
Now let us get down to the nitty-gritty.
A February 2019 JAMA article, Addressing the Psychological Symptoms of Critical Illness, addresses PTSD after a critical illness.
The intensive care unit (ICU) is the focal point for identifying critical illness surviving patients plus the ICU experience is a traumatic one (just as reported on this blog). The most important lines in the article are:
...In terms of the targeted symptoms, it is essential to ensure that among the broad array of psychological symptoms that can be caused or exacerbated by critical illness, the specific symptoms most likely to be improved by a specific intervention have been identified. The term postintensive care syndrome includes a combination of many different types of psychological symptoms and effects. This concept helps raise awareness of the bundle of interrelated symptoms that patients can experience after critical illness....
This gives grounds for lawsuits for side effects NOT mitigated by the provider or discussed with the patient. To leave a patient exposed in the manner that JR describes which lead to her husband's PTSD is malpractice. If they had protected his dignity, he would not be suffering these effects or they would be less severe.
A second February 2019 JAMA article, Effect of a Nurse-Led Preventive Psychological Intervention on Symptoms of Posttraumatic Stress Disorder Among Critically Ill Patients, further supports critical illness/ICU experience being sufficiently traumatic to cause PTSD. It states:
...Among patients admitted to the intensive care unit (ICU), a meta-analysis of outcomes for survivors, during the first 6 months after ICU discharge, indicated a pooled prevalence for clinically important posttraumatic stress disorder (PTSD) symptoms of 25%. Acute stress while in the ICU and early memories of frightening ICU experiences (eg, hallucinations, paranoid delusions, and nightmares)1 have been identified as independent risk factors for longer-term psychological morbidity, including PTSD symptom severity. Evidence suggests that addressing these risk factors early, commencing while in the ICU, might prevent longer-term consequences4 and that addressing such factors after discharge may be too late...
Another February 2019 JAMA article that supports the concept of Patient Dignity is Medical Scribes, Productivity, and Satisfaction. This article states:
The physical environment may also affect satisfaction. A 2018 study at an urban safety net health clinic found that the proportion of patients comfortable with the number of people in the room during a visit declined when scribes were present. Interestingly, comfort levels with the scribes themselves remained high. This suggests the physical implications of another person in the examination room will be increasingly important as scribes become more common, even if patients are comfortable with the idea of scribes.
It is important to realize (FOR PROVIDERS) that simply treating/curing a condition may NOT be the patient's primary goal. Avoiding complications such as PTSD may be a primary goal, being that PTSD interferes with quality of life.
Finally, the graphic in this article expresses how many of perceive healthcare...
-- Banterings
Maurice, Ray, et al,
This goes to my original point for coming out of the shadows and posting on this blog. The 2016 article is Physical Examination and the Physician-patient Relationship: A Literature Review. The article supports empathetic common sense (which med school crushes in physicians) that myself and others here have been saying for years:
Invasiveness of physical examination
However, in contrast to the above reports, physical proximity can also negatively influence the doctor-patient relationship, and a number of publications address this issue. In his ethnographic fieldwork at a hospital in London, Rice focused on the negative aspect of intimacy caused by auscultation. He reports that some female patients in particular felt the examination was invasive (9). Further, Rice references current medical discourse that regards auscultation as an opportunity for contagion spread (9). A study on the relationship between doctors and pediatric patients reveals that a physician’s intrusiveness (i.e. approaching a child suddenly or in an uninvited way) during a physical examination is related to concurrent child uneasiness and lasts through the postexamination phase of the consultation (28).
A number of studies also focus on the anxiety and discomfort felt by female patients during physical examination. For example, Gabbard and Nadelson (29) reported that a female patient with a sore throat receiving a breast examination without knowing its purpose felt like she was being molested. Another female patient described her gynecologist as “nosy and intrusive” when he asked her about her sexual history during a pelvic examination...
Physician-patient relationship in physical examination education...
...While it is important for students to have the hands-on experience of physical examination with patients, Rice suggests, through the example of a teaching session of auscultation with real patients at a university hospital, that repeated physical examination by students is experienced negatively by patients, who felt as if they were “reduced to clinically interesting acoustic ‘things’” (49)....
...During the sessions, students learn how to conduct a physical examination by role-playing physician and patient. In this “peer physical examination” (PPE) process (53), students, when playing the role of a patient and being examined by their classmates, learn to appreciate the patient’s perspective...
...The medical articles, mostly composed of anecdotes, could be regarded as clinicians’ paternalistic discourses on the physician-patient relationship, since doctors are in a privileged role as caregivers to patients. In contrast, medical anthropology and sociology critically address the asymmetry between medical professionals and patients, as well as the unequal power balance between men and women in society...
-- Banterings
So here is another example of physicians lacking common sense and empathy: Syracuse cops push St. Joe’s to probe man’s rectum for drugs; ‘What country are we living in?’
.
Syracuse, NY -- Syracuse police, a city court judge and St. Joseph’s Hospital Health Center worked together last year to conduct a highly unusual drug search.
They collaborated to sedate a suspect and thread an 8-inch flexible tube into his rectum in a search for illegal drugs. The suspect, who police said had taunted them that he’d hidden drugs there, refused consent for the procedure.
At least two doctors resisted the police request. An X-ray already had indicated no drugs. They saw no medical need to perform an invasive procedure on someone against his will...
So we should be thankful that only 1/3 of physicians are sociopaths?
This person should never be allowed to practice medicine again.
-- Banterings
As I have stated before, being thorough is for the benefit of the physician and NOT for the patient. Granted some patients want that thorough exam, MOST DO NOT. (Reference)
Study: Many Invasive Medical Procedures are the Result of Uncertainty, Not Evidence
This is what we need to be teaching new physicians; FINDING OUT WHAT THE PATIENT WANTS!
-- Banterings
A. Banterings
We must not forget that as patients we are paying for the salary of the scribe in the room. From a PTSD standpoint noise is a very high contributing factor on nursing floors and intensive care units.
PT
Good Evening:
JR, on the subject of cell phones with cameras, if the US government can mandate that defense contractor employees working in sensitive areas are not allowed to carry cellphones with cameras on their person during their shift, then they can also mandate that all healthcare workers without exception are not allowed to carry on their person a camera equipped cell phone during their shift.
Get caught with one and its immediate termination no exceptions.
Like defense sensitive areas, patents have sensitive areas too and it's about time congress mandated protections for patients.
Regards,
NTT
Dr. B.,
I really don't want a dr. shaking hands w/ me or any other useless gestures as it doesn't mean anything. A simple I am Dr. So-and-so and I will say I am Ms. So-and-so. It's polite and we aren't best buds. What means something is their overall tone and their actions. If they arrive in the room w/ a glove on, I don't want to touch them bc I don't know where that glove has been and then I would have to ask for a glove too or tell them to wash and change the glove ( and I have told them to do this in the past as I am interested in protecting myself from the germs they carry with them). If I am in a gown or piece of paper, then it is certainly not the time for social fluff pleasantries. Drs., nurses, and techs calling me by my first name is a sign of disrespect. If I get called by my first name, then I will in turn call them by their first name or pointedly act them what their first name since we have skipped formalities. If my title of Ms. So-and-so is not respected then I will not respect their Dr. So-and-so. I have an education too and I happen to be contracting for their services so the level of respect that I should receive should top theirs. My husband never understood my hard line with medical people until he suffered this abuse from them.
NTT,
Agreed. Cell phones are not that difficult to control and punishment should be swift and tough. Ill and vulnerable people should not have the additional worry of the possibility of someone acting inappropriate with a cell phone.
Banterings,
Good info. Do you mind if I use some of it? In the case of my husband's PTSD, it is also the not knowing what happened in the times when the drugs completely erased his memory. What he remembers was bad enough but what about the times he doesn't remember? Also, how can you seek treatment when treatment is given by the very profession that abused, violated, and utterly destroyed trust and faith? I have long said that medical students need to practice exams and certain procedures on each other so that may have an idea of what is it like to be the object in the room. It wouldn't be completely the same as in real life bc you don't get to strip the drs and nurses, drug them to erase memories of what you do, nor are they showing their naked bodies to you bc it would make no difference so they say since everyone has the same body parts. However, it does make a difference and they know it. It really isn't having to show your private body part if it is necessary. The issue is more about their lack of concern when a private body part is exposed, how they expose it, and to whom it is exposed to. It is also about the control and power they think they have over patients which goes hand in hand with providing a lack of dignity for the patient.
So, Dr. B., this goes back to what I talked about before. If I am addressed by my first name then I make the judgment that medical person will also take other liberties. This, for me, is a red flag for me. In school, kids had to address me as MS.______. It was a show of respect. When nametags came into being, we wore them turned around bc the kids wanted to know our first names bc they would use them. The cafeteria and recess ladies let them call them by their first names and generally they had issues keeping order and discipline with the kids. Have you noticed that many nurses also wear their badges turned around so you can't see their last names? It is funny because they know everything about you! JR
If a doctor or anyone else offers to shake my hand I will politely reciprocate, though my druthers are really not to. If they look to do fist bumps or any other faddish greeting they'll likely just get an odd look from me and know to drop it and move on. I have not experienced any of that stuff however.
With the exception of the person who calls me from the waiting room (who is protecting my privacy by using my 1st name rather than last name), I expect to be Mr. Biker to everyone else. Without fail I call doctors "Dr.". I am not comfortable using 1st names for NP's, PA's, or anyone else that I don't know personally, and so in healthcare settings I try to avoid using any name at all and just speak directly.
I know that a number of the tests or procedures I have had in recent years have been due to uncertainty, and that's OK with me. The doctors have been trying to rule something in or rule something out and have been clear on that being the reason when seeking my consent. Physical exams are just another aspect of ruling possibilities in or out, and in the absence of symptoms just assessing general health. I'm OK with all that but if the exam goes beyond the routine listening to lungs and heart, auscultating the abdomen, checking reflexes etc, I do appreciate being told in advance what he is going to do, and if it isn't generally obvious why it's being done.
All in all I see myself as a pretty compliant patient who generally defers to recommendations being made. I only become the patient that pushes back when they want to include sedation or if I feel they are not respecting my privacy (female staff when male staff can be an option and/or women in the room that don't need to be in the room when I am exposed). I don't see such push back as being unreasonable.
JR,
Please feel free to use all my info. Also, here is my blog: Banterings of a Mad Man and my Twitter account. (I gave your blog a shout out).
-- Banterings
I have been recently following three high profile cases of female nurses in the news. One nurse gave her patient the wrong medication, did not follow the five patient rights to receiving medication, her patient died an agonizing death.
The nurse currently has her nursing license and is still working.
A nurse in Missouri poisoned her husband, he died. She burned the house down in an attempt to cover up the murder all because she wanted to marry a murdurer in a men’s prison where she works.
The nurse still currently has her license and is still working.
A nurse in Idaho assisted a man who murdered his fiancée by hiding her cell phone after the murder.
The nurse still currently has her license and is still working.
My point is if a nurse can kill her patient by administering the wrong medication, murder her husband and burn the house down, assist her secret lover in murdering his finance and still maintain her nursing license and stay employed. I doubt anything else they do in regards to the issues of this blog will ever matter. Remember, they are the most trusted profession.
PT
Good Morning:
PT those nurses still have those licenses because licensing boards are made up of mostly females and, society in general still won't grasp the reality that a woman can and is just as mean & viscous when she want to be as a man.
JR, another area where you can counter the medical community's reasoning is male intimate care.
They claim there are not enough male nurses available. Somewhat true. However, there is NO GOOD reason hospitals cannot use a male hospitalists to handle male intimate care needs. They're already there. They don't need to do extra hiring.
The other area you can debunk is male ultrasounds. They can cross-train male radiologists to handle intimate male ultrasounds.
These actions may offend the female healthcare workers but WHO CARES.
The needs of the patient, out weight what the healthcare workers wants in a patient-centered healthcare system.
Take away their excuses, and they will have to act for the good of the patient or the government will step in and MANDATE IT.
Regards,
NTT
NTT, the two largest excuses they have are pretty tough to fight.
One is nursing and its allied fields, despite paying more than what the average man earns, are still culturally viewed as women's jobs and few men pursue those careers. The result is "we don't get applications from men". Men not being adequately represented in nursing is deemed to be something of their own choosing rather than something in need of affirmative action.
Two is few men will ask for male staff or complain about the way they are treated. That in turn feeds the mantra that men are OK with the status quo. Those who do speak up are few enough in number to be relegated to outlier status. Said another way, the cultural norm is still that men have no modesty and as such it is OK for women to provide all of their intimate care.
Until such point as large numbers of men either pursue nursing careers or speak up as to their caregiver gender preferences and/or speak up as to having been treated poorly, these two excuses are going to continue framing the nature of healthcare.
Biker,
...or until a man suffering postintensive care syndrome and/or PTSD sues a facility for malpractice and wins because a facility failed to protect him by NOT leaving him exposed for hours in front of femle staff....
-- Banterings
Good afternoon:
They can only frame it if men allow it. I for one won't. Other countries knowing men won't speak up, stepped in. In Ireland male hospitalists do male catheterizations.
There is no reason whatsoever why our medical community knowing men aren't going to speak up when they should can't have the compassion to speak up for them and just ask, would you be more comfortable with a male attendant. Then get them a male nurse or hospitalist.
The United States medical community has lost its humanity when it comes to male patient care and its up to the American male population to push back at them and congress with a ton of bricks and show those individuals the error of their way.
Regards,
NTT
NTT,
Some good points that I didn't think of and that I have included.
Biker,
That's true. That is why I am suggesting that there be a concentrated effort by the state to actively recruit men into the nursing and related fields by offering incentives. Sometimes they don't complain at the time because they are drugged or maybe in disbelief over what had happened. I know that once my husband was home where he felt safe from them and coming out of the drugged state, he complained. I know that they didn't care. They offered no apology but rather said that's the way it is. They used that same argument that he has nothing that has not been seen before. Apparently he did as they exposed him way more and longer than necessary. We also know that the lower private areas do not need to be exposed at all for a cath. but they do because they can. The chest area needs to be exposed for lead placement but there are falsies women could have to cover their areas. But hospitals simply don't care until they are made to care. That is what I am working on so my husband doesn't have to be victimized again and that my son doesn't become one too. JR
Banterings: Here's an article about a man in England who did not have a BM for 47 days as cops waited for him to poop out the drugs he had swallowed. https://www.newsweek.com/police-free-man-accused-swallowing-drugs-after-he-refused-poop-47-days-834558
A few years back, Deming police suspected a man of swallowing drugs and got an illegal court order which allowed police to cajole physicians at the local hospital to give the man a colonoscopy. Physicians there refused so the cops brought him to Gila hospital in Silver City where the physicians and nurses were more than happy to comply. They found nothing. The victim was awarded 1.6 million.
https://www.cnn.com/2014/01/16/justice/new-mexico-search-settlement/index.html You'll recall, Gila Hospital is where Twana Sparks does her dirty deeds. In both the Silver City and Syracuse cases the victims were sent bills from the hospitals for the procedures done. The hospitals in both cases were not sued as far as I know because they were conforming to a court order. In the Syracuse case the hospital's attorney told resisting physicians that they were legally required to perform the procedure. He either lied or was persuaded by the judge, to whom he spoke, that this was true. In both cases, the court orders were not legal.-- Ray
And, and, and.. the maltreatment of patients in many ways could, I could also assume from the study below, from the maltreatment by hospital staff in relation to other staff members.
Extracted From MDedge Feb 19 2019
A work culture in which disruptive behavior is tolerated can have consequences. Research on this topic has linked disruptive behavior by staff in the health care setting to increased frequency of medical errors and lower quality of care (Am J Med Qual. 2011 Sep-Oct;26(5):372-9; J Caring Sci. 2016 Sep 1;5(3):241-9). This new study, based on a workplace culture survey of 7,923 health care workers and 325 work settings at 16 hospitals in a large West Coast health care system, found higher rates of depression and burnout among staff where disruptive behavior is prevalent, researchers found. The paper was presented by study lead Allison Hadley, MD, of Duke Children’s Hospital, Durham, N.C., at the Critical Care Congress sponsored by the Society of Critical Care Medicine.
The investigators developed a novel survey scale for evaluating disruptive behaviors in the health care setting. The objective was to look at the associations between disruptive behavior, teamwork, safety culture, burnout, and depression. Disruptive behaviors included turning backs or hanging up the phone before a conversation is over, bullying or trying to publicly humiliate other staff, making inappropriate comments (with sexual, racial, religious, or ethnic slurs), and physical aggression (such as throwing, hitting, and pushing).
So.. what else is new to explain why patients could be mistreated in the medical system. It could be that the unprofessional interaction between members of the system may lead to such mistreatment. ..Maurice.
Ray,
If the hospital is going to seek protection behind the court order then they are acting as agents of the state and can then be held to a higher standard. They are potentially liable for violation of civil rights and due process. Any first year lawyer can break this veil and the assertion that the facility was "legally required to perform the procedure" is total BS. Did the court order name the facility, the procedure, and the participants?
Were the members of the care team deputized? Was the facility or procedure room commandeered? If not, then they may not have sovereign immunity.
This would fall under the Common Law and Constitutional concepts of (civil) conscription. Still, most lawyers take a hostile view of (civil) conscription.
Furthermore, the court order only compels the suspect to submit to these procedures, it does not compel any person to perform them. Lack of compassion, lack of empathy, lack of conscience, masochistic tendencies, greed, and megalomania lead one to voluntarily do this to another human being.
This is classic Milgram and Zimbardo: the SS made them do it. So what does this say about modern medicine? There is the potential for physicians to be complicit in another Holocaust?
...and physicians wonder why the public has lost trust and compassion for them...
Physician, heal thy self.
-- Banterings
Maurice
From the article “ A work culture in which disruptive behavior is tolerated can have consequences.” Well honestly Maurice I’m way past that article. I’d like to know how nurses can kill their patients, kill their husband,participate in a murder and NOT have their nursing license revoked. What has happened to our society?
Why is it that no one in healthcare is held responsible? Why is it that nursing boards, hospital administrators appear to look the other way and i think it’s getting worse. Licensure is responsibility, accountability held to a higher level.
PT
Today, we got a visitor on two separate occasions from Merida,Yucatan, Mexico according to my counter to this blog thread Volume. If the visitor returns, I hope he or she will give us their view of their country's medical system with respect to maintaining patient dignity and modesty.
With respect to PT's last posting, what can be done to directly challenge both nursing and physician boards with these issues of individual's contempt to professionalism and law? ..Maurice.
PT, what we see with nursing and medical boards primary concern being the licensees rather than the patients is no different than teacher unions first priority are teachers rather than the interests of students and with police unions whose priority are police rather than the general public. It seems all such groups exist to protect their own rather than the public they serve. Human nature left to its own devices gravitates to an "us vs them" governance. No different than elected officials often exempt themselves from all manner of regulation and laws. Nursing and medical boards just looking the other way is par for the course.
What we discuss here concerning modesty/privacy/dignity, primarily but not exclusively as concerns males, is more rooted in societal norms than it is nursing and medical board governance. The media and courts side with the interests of female reporters in male locker rooms (including at the college level where athletes might still be teenagers), female guards in male prisons, and female counselors in male juvenile residential facilities, including supervising those teenage boys dressing and showering even. Until very recently female teachers who preyed upon male students were given a pass.
Is it any wonder that the medical system looks askance at men who want male staff for certain procedures or who don't want a female audience? The medical system isn't treating males any differently than society as a whole looks at this. Society does not yet accept the premise that men have any right to bodily privacy from females carrying a badge of authority, be that badge reporter's credentials, a badge or govt. employee ID (police, prisons, youth residential facilities), or a nursing or medical license of any sort.
Modern era politics only serve to make this issue even tougher to the extent that men who do not automatically yield to female interests and who do not favor the interests of women over men are deemed sexist.
Perhaps another reason why there are less men in health care is supply and demand.
There are now less women in the computer software field than in the good old days. Starting in the 1950s and for decades thirty percent of software professionals were women. Despite the emphasis on STEM these days, less than ten percent of students getting computer science degrees are women. The only reason given is that women prefer health care. With the availability of women, health care HR will hire women which is the easy route for them. Just another reason why it's going to be a tough slough to get more men in health care.
BJTNT
Good Morning
BJTNT,
Maybe we need to put pressure on congress then to mandate hiring quotas in the healthcare field to equalize things.
Regards,
NTT
Here in Indiana, the medical community knows that they can operate just on the fringe of crossing over into malpractice and that they are protected by the law. They have big money and lobbying to help them with status quo. Also, the boards in charge of supervising physicians, nurses, etc. are made up of those very same people so rarely do they receive any real punishment. I have been reading through the nursing board public records and I am amazed at how many nurses that do drugs, drink, or even are on record for causing patient harm and still have their licenses and these licenses are still completely intact w/o restrictions. It is indeed scary.
I know my husband's cardiac care nurse was more interested in making sure the gown that fell off of him during transfer from cath gurney to the cardiac unit bed was exchanged for one of her floor's gown. She, in fact, left him naked and exposed bc the most important thing was to leave him naked and exposed and go and fetch the gown from her area. I guess hooking up the life-saving equipment that she later wasn't able to hook up is not as important as leaving a patient exposed and cold as part of their overall deviant conduct toward him that night. It was the same hospital so what did it really matter in the long run? Was he the first patient that ever came from the cath lab w/ a supposedly foreign gown on? The priorities of that woman was to abuse and neglect rather than to offer skilled and compassionate care. The level of abuse bc he was a man, a man who they thought at the time was gay (remember she didn't believe he had a wife as his paperwork said differently), an older man, where he was from, or maybe it was a mix of these things that caused such hate crimes to be committed against him and us that night. Or maybe this nurse has something against men in general or she enjoys the power and control over men in her "care". Why would a nurse not care about a man's bodily privacy and uphold her oath to protect her patient? JR
JR
Mind if I ask if the hospital you have been referring to is located in Indianapolis, ind.?
PT
Caution, avoid naming people or leads to names of institutions regarding misbehavior unless news already has generally been made public.. Maurice.
PT,
It is not the large one you alluded to in one of your posts. If you want to know exactly which one just email me from my blog site--Issues4Thought.com
We have just spent another sleepless Sat.night/early Sun. morning as we both cannot stop thinking about how we were treated especially my husband since he suffered the actual physical abuse. Somehow the pain does not lessen nor does it go away. I can't imagine why nurses choose to do harm. I can't imagine why the indignities that inflict on male patients and the mistakes they make still allow them to be nurses. But I do know the answer that most never complain and if they do, nothing is done about it as nurses are in charge of disciplining nurses and doctors for doctors. That really needs to change. We need to stop glorifying and enabling these people to be monsters. JR
Maurice
Regarding your post on Feb/13 at 2:59 pm. Just why should hospitals have more privacy than the patients they care for? My second question is, are there any ethicists in healthcare that actually get paid? I’ve never heard of any teaching medical institution, nursing school institution whereby the instructors actually teach just ethics. I know of no hospital that employs an ethicist, full or part time and I know of no medical school that employs a medical ethicist that teaches medical students just ethics. Considering the continual bad bad behaviors we read about that prompted this blog in the first place, perhaps this is the problem.
PT
JR
Was hospital administration notified of your complaint, board of nursing? Inappropriate draping by nursing in any state is considered sexual misconduct. The purpose of boards of nursing is licensure and protecting the public and enforcing rules and laws set forth. Directors of nursing boards are appointed in each state by the governor for a given term. Nursing boards have a ton of staff and a long delay in responding to patient complaints is inexcusable.
PT
PT, my posting was on Feb. 23 2:59 pm.
I am willing to have posted here individual persons names or institution names whose alleged or proven misbehavior has already been named and described "in the news media". If not "in the news", I cannot publish without those people or institutions being directly notified by the writer that the writer is about to make a "public" accusation on this blog and a response by the party or parties is requested and this statement and the individual or institutional's response to the writer is noted in the text to be submitted for publication here. Again, as been amply published here in the past, descriptions of misbehavior already described "in the news" has always been published on this blog and blog thread. All individuals or institutions should be first given an opportunity to respond here. That's ethical!
With regard to a professional ethicist employed by or working in hospitals, many major hospitals hire "clinical ethicists" to perform on their own clinical ethics consultations. While non-professional clinical ethicists (physicians, nurses, hospital social workers,administration folks and community members) are not paid to be part of a hospital ethics committee, paid formal clinical ethicists, of course are also part of the ethics committee and their cases may be discussed by the committee.
As far as medical ethicist is concerned regarding teaching ethics to medical students, I can't speak for all schools, but at our school the students are taught ethics in medicine in the Professionalism course and I also teach my first or second year group of 6 students appropriate ethics issues based on my active background having been chairman in the past of two different hospital ethics committees and still a member of one and participate on a number of medical ethics listservs and. of course, moderator for over 14 years of this and a prior ethics blog. I agree "non-ethical" behavior in medicine should be recognized and prevented. ..Maurice.
PT,
Before we received his medical records, which took a really long time, our complaint did not involve everything. At first he wouldn't talk about what happened but as time went on it was clear that bad things had happened as he was having nightmares and was stressed. We saw a hypnotist and that is when the damn broke. Since they gave him fentanyl and versed, he cannot remember everything but he has remembered enough. I had verbally then told the hospital "patient advocate" manager about some of the sexual inappropriateness as well as the medical records falsifications but she said the encounter reflects "our mission and values." Both my husband and I have filed complaints with the attorney general's office for licensing regulation overseeing. It is still in the process. We have also filed complaints with the OCR. The state board of health said they only investigate physical type of injuries and negligence and lack of informed consent is not on their list. As I said, hospital know how to dance around the fringe of our malpractice system. Do mean draping when the nurse was supposedly providing care and when he was in the cath lab before and after the procedure and was left exposed? I saw the one nurse with him exposed and she laughed as if she thought it was funny. At the time I was so in shock and overwhelmed with all that had happened that I was silent and she was the one who mentioned it, but what was she doing on her computer while he was laying there exposed? You can see why I feel so guilty.
Unless the ethicists are paid from a source not connected to the hospital then I see conflict. Maybe they should be paid from a state agency? Employers tend to control their employees especially ones who may disagree with them. JR
As a followup to my last posting, I want to note here that my experience in hospital ethics has only been with hospital clinical ethics committees. Many hospitals also have organizational/administrative ethics committees which deal with administrative/organizational issues which may have an employed ethicist as a member of that committee. I would think that this administrative committee, if present, should certainly deal with all the terrible employee misbehaviors amply written about on this thread and should be brought to that committee's attention. Patients and their families may have better listeners and responders upon dealing with such a committee rather than a single institutional executive. ..Maurice.
It just seems insane that we even have to have this discussion about protecting individual rights of patients to not be unnecessarily exposed during surgery and during care encounters. I would think understanding and compassion would be something that comes naturally. I would think medical people have families and they themselves want dignity of care. I would think any nurse who has a father in a nursing wouldn't think it proper if some 18 yr. old CNA just left her father naked on his bed, no curtain closed, and the roommate in the room while she did whatever. I am sure that nurse would be outraged. As I have said before, we all know some degree of nudity may be required but it is how it is done is the issue. If medical people did indeed possess compassion and even common sense, it would be a no brainer to realize that patient satisfaction and even patients willing to see them would increase. As it stands, medical people seem to feel they are in total control of patients once they enter their doors. However, in reality, patients are in control and need to take back that control. Medical people are our employees so to speak and we should direct our own course. Everyone should have a legal document stating what they will accept and what they won't accept. My husband's Health Directive is expanded to say what he will allow and what he won't allow such as if he has any type of painkiller then I am to be consulted for any type of decision or information. Failure to do so will result in them being sued. It is plainly stated this is due to prior abuse that has happened. We feel this is our only choice to try to protect ourselves from future abuse and violations. This document has went far beyond what is normally thought of as we wanted to be very specific. It is immensely sad and scary that we now feel we have to be protected from abuse and violations from the very people who are supposed to help and guide us in a time of extreme need. However, trust has been forever broken and their guidance will always be questioned as if they mean us harm. If we knew then what we know now so it is important for those of us who suffered their abuses to get out and make changes.
I met w/ my state rep. She seemed receptive, took notes, and even shared some stories about herself. I think she understands the need to change but is uncertain how to effect it. For instance, here in Indiana we have an opiate crisis. Many get their first taste of fentanyl through a medical encounter as I know many young people who got hooked that way. I don't really think anyone appreciates that pretty much as standard procedure, heart attack victims are shot up with fentanyl (up to 200 mcg) before arriving at a hospital where they can be shot up to 200 mcg more of fentanyl during a cath procedure (it could be more depending). She was amazed that air ambulance emts can administer fentanyl w/o prior approval or w/o patient consent or knowledge. JR
Hello,
Dr.Suneel Dhand has posted an article titled "If you’re a patient in a hospital, be on the lookout for these things…" I think he's missed a few things from a patients point of view. Contributors on this site may wish to relate a few other "details" to him. (He's very good at replying to anyone who writes him comments.) Please be gentle. He's really a good doc who's advocating for change. The url is https://suneeldhand.com/2019/02/26/if-youre-a-patient-in-a-hospital-be-on-the-lookout-for-these-things/
Reginald
Maurice
As a followup to your last post you mentioned that “many hospitals have organizational/administrative ethics committees which deal with organizational/adninistrative Issues which may have an employed ethicist as a member of that committee.”
Now Maurice as I’ve mentioned previously on this blog that I have worked at 25 hospitals in my career. I have worked closely with my hospitals administration, the CEO,COO, CNO as well as the medical executive committee. Some of the hospitals I worked at would have numerous sister hospitals in the same city.
I have never seen any facility I’ve worked at have access to an ethicist, wether it be an MD, DO, never. Furthermore, I also know that any ethical nursing considerations or questions always stop at the CNO ( chief nursing officer) which is usually a nurse rn who might have an MBA ( masters in business administration).
To be quite honest I’ve never heard of a medical ethicist until I started posting on this blog which I believe began in 2006 or 2008. Are MD’s who purse medical ethics become board certified or is it simply an interest of pursuit. I do try to read up on instances whereby major and prestigious medical facilities have bumbled through mistakes involving patients and it’s obvious no one at the medical facility ever thought it through let alone someone who might be referred to as an medical ethicist.
Finally, I am acutely aware of the highest paid medical malpractice case in Arizona history of which I know the physician personally. The major medical facility where the incident occurred did not have an ethicist on staff. I’m sure if that facility did have an ethicist he/she would have advised the physician involved “ get permission from the family FIRST.
PT
Hello:
JR, because they know the inner workings of the system, medical people already know they and/or their loved ones will more than likely be exposed more than they wish so, to keep their co-workers from gawking at them or their loved ones, medical people take their loved ones to other medical facilities for care.
The patient/provider relationship was meant to be a partnership but it was been twisted into power grab relationship by the medical community.
The medical community tout’s patient-centered healthcare but you cannot and don’t have that type of system when the provider side wants to control everything.
Patients and providers must work together in order to have any type of successful healthcare system.
Right now, providers want to dictate to patients what will and won’t happen from check-in to discharge.
Providers across healthcare have lost their compassion.
They have forgotten what it is to be human.
They currently are treating patients as objects instead of human beings and that is doing great harm to the patient/provider relationship.
That relationship, is built on trust. Without it, patients will stay away from needed healthcare and become a statistic.
The healthcare community needs to take a step back, take a deep breath, and try to remember what it was like being a human being, being a person with heart and feelings.
The system has become nothing more than an assembly line. The almighty $$ reigns over patient needs.
The healthcare community as a whole, needs to stop, sit, listen, and learn from the patient’s they serve what it is that those people want from their healthcare system.
No bureaucrats. Just plain ordinary people meeting with people to find a way forward to make the healthcare system work for both patient and provider. Like a town hall meeting in a public place away from medical facilities and politics.
A fact-finding mission so-to-speak to find out what each side needs to make it work and how together the medical people and public can together make it happen.
If that ever happens, the patient/provider relationship, has a chance to blossom into what both side think it should be.
Thanks for listening.
Regards,
NTT
NTT,
Well said. If there any ethicists around here they must have lost their sense of right and wrong. I know our local school district created advisory boards as part of their improvement plans. It had a wide variety of people on it from admin, teachers, parents, community members, etc. Everyone gave their input to improve the school system. Eventually, the suggestions were researched and an action plan put into place. This is what should happen in healthcare.
Around here, there are 3 hospitals who have overtaken all the smaller, independent hospitals in the name of providing better patient services. Actually, the service is worse since there is a monopoly and they do not have any competition or accountability.
Been doing research on why nurses abuse patients and found this interesting article:
http://www.thesmokinggun.com/documents/nurse-patient-sex-lawsuit-785643
It sounds eerily like what happened to my husband. It really shook him up when I had him watch the youtube video
https://www.bing.com/videos/search?q=nurses+abusing+male+patients+privacy&docid=608032372632062141&mid=C0A8C7636EAC53FA16A3C0A8C7636EAC53FA16A3&view=detail&FORM=VIRE
Most of the info out there is about male nurses abusing female patients. Male nurses make up such a small percentage of the nursing profession that it makes it sound like each one of them is unethical. It also makes is sound as if female nurses are saints. It is no wonder with this attitude of female nurses being saint-like that there is such an issue. It is very well hidden. Abuse by female nurses needs to be brought into the public's attention. Men can no longer be the silent victims that they are counting on them being.
JR
I went to those links and am astounded that a nurse that forces sex upon a drugged up patient only gets reprimanded rather than losing her license and facing criminal charges. Why wouldn't a nursing board think something like this is an egregious violation of the worst kind? Why wasn't this woman charged with rape by the legal authorities? Is the answer as simple as because she's a woman and the victim is a man?
I also wonder if any of her co-workers knew she was sexualizing patients but chose to not report her. It is easy to imagine her talking to her peers in a "check out the guy in Room 410" kind of way.
Yes she got fired but with her license intact she can just move and get hired at another hospital. Odds are she's in a different State working as a nurse right now.
Good evening:
Biker to answer you question, female nurses are allowed to get away with it because our society and criminal justice system won't lift the blinders from their eyes and believe that women can be just as predatory as men so rather than deal with the headache, they step back and let the healthcare system handle it.
And as we all know from years of 1st hand experience, the medical community protects their own over everything else.
Every medical board in this country is stacked with a medical majority therefore when any lay person on these boards votes, it is meaningless as majority and in this case medical, wins so the healthcare worker gets away with it.
Each and every medical board in this country should be populated with a civilian majority to stop these grievous miscarriages from continuing to happen as patients are needlessly hurt by what's being allowed to happen.
Regards,
NTT
Biker,
You can bet that if it was female patient/male nurse more would have happened. I saw the victim died about 2 years later. It just goes to prove that predator nurses will pick their victim who is more defenseless and drugged. No patient should be without an advocate during any part of their hospitalization including surgery. Crossing boundary lines and still having her license is unacceptable. Once child molesters are released from prison that must forever be registered and still away from children, schools, etc. The thought is they cured of their behavior. Why is it female nurses can be reformed from their sexual predatory behavior? In the YouTube video, the first group of female nurses murdered elderly patients who displeased them or were too much trouble and yet our society cannot grasp that women have the same bad genes that some males have. What about equality for all? Society needs to stop putting female nurses on a pedestal before that pedestal decides to fall and do harm to mostly males within striking range.
I think female nurses who purposely expose male patients are sexual molesters. That they may not actually commit the physical act doesn't lessen the crime in my mind. Since patients are vulnerable, defenseless when drugged, or afraid then it should be considered the same type of crime. There is no good reason for this type of behavior. Taking care to not expose genital areas unnecessarily is easy and doesn't much more time. For those who say it does, then they should find another job such as picking up trash. We don't need people without ethics, values, compassion, and the ability to respect taking care of ill people. I don't care that they went to school and studied hard, work long hours, etc. Everyone has their issues but those issues should not be allowed to be used against sick, vulnerable male patients. At school, no matter how rotten a student was one day, I always started the new day with that student as today is going to be a good one and I would be there to help them succeed. I didn't allow outside issues to influence the way I interacted with my students. Mostly, I had the respect of my students because they knew that. I was responsible for someone's child and they expected me to be above reproach with their child. I expect nurses to be the same with my loved ones. I don't care if they have seen a million pen-ses because if that area of my husband's doesn't need to be exposed then it should not exposed. If all pen-ses look alike why are they so busy exposing them? Keep them covered and everyone will be happier. Show some respect, consideration, and compassion. JR
NTT, I have mixed emotions on the makeup of medical and nursing boards. If the complaint is about the actual medical or nursing care given at a technical level, non-healthcare trained people may not have the requisite expertise to understand the technical specifics. Where there should be a civilian majority is when the complaint is behavioral in nature. It is almost as if there should be two boards, one for technical and the other for behavioral.
JR.......Biker
Excellent comments. My mother died in a nursing home some years ago and from what I’ve always suspected they never put her O2 ( oxygen nasal cannula on), she desated and expired. In other news the National coalition for men’s rights has successfully argued that drafting only men is illegal by a Texas judge. Therefore if there is ever a military draft which you know there will be women will be drafted
too!
State nursing boards seem to discriminate against male vs female nurses. Recently, a male nurse was arrested for impregnating a female incapacitated patient in a long term care facility, a horrific crime. Remember, he has not been proven guilty yet his nursing license was immediately revoked. Yet there have been 3 female nurses who have been arrested for murder/arson/ sexual relationship with a male prisoner. The second nurse gave her patient the wrong medication causing the patient’s death, she has been charged with negligent homicide. The third female nurse has been implicated in the murder of her lover’s fiancée. All three female nurses currently still have a valid nursing license.
Apparently, in the eyes of state nursing boards rape is a more heinous crime than murder/arson/ sex with a male prisoner. Those poor female nurses, you know they are soo overworked, underpaid.Currently, all state nursing boards are comprised of women. They too are overworked and underpaid and most likely are sympathetic with their nursing counterparts despite their 6 figure plus incomes. They are soo ashamed of the high number of boundary violations by female nurses that they no longer report it on state regulatory boards. It’s said that currently there are over 500,000 medication errors annually in this country by nursing. Really!
You know that number is much much higher, yet the spotlight seems to place a lot of blame on physicians for the opioid crisis. There will always be crackhead, methheads and drug abusers no matter what. The same should never be said about nursing medication errors.
PT
Good Morning Ladies & Gentlemen:
Hope everyone slept well.
I'm sure that on the medical/nursing boards the medical people could put the issue into words civilian adults can understand if they wanted their vote.
Right now, the goal is to protect patients better than the system currently is doing.
If in the future the medical community shows to the public that the needs of the patient come first than maybe the makeup of the boards could change but for right now the system needs to have civilian oversight.
Have a great day all.
Regards,
NTT
I have noticed that survivors of medical encounters exhibited similar symptoms/pathology as sexual abuse survivors. Now, here is a definitive look at the different aspects of torture, specifically of psychological torture. It is interesting to note that many of the techniques used in torture are also common procedures in healthcare:
- Solitary Confinement (isolation, quarantine)
- Humiliation and Shame (nakedness, exposure, voyeurs)
- Threats and Fear
- Sleep Deprivation, Sensory Deprivation and Sensory Bombardment
Here is the paper: The Worst Scars are in the Mind
Here are some highlights from the paper:
Torture is the most blatant negation of the essence of the human being…
It is the ultimate in human corruption.
Nora Sveaass, a prominent psychologist and member of the CAT, has written that psychological torture or ill-treatment is 'the process by which psychological pain is transformed into humiliation and dehumanization, where the essence of being human- namely personal agency, values, emotions, hope, relationships, and trust- is under attack'.
4. Humiliation and Shame
Humiliation is worse than death; in times of war, words of humiliation hurt more than bullets – Old Somali Proverb.
They typically tend to work because they convert the humiliation of the act perpetrated by the torturer into a deep sense of shame of the tortured. It is the feeling of shame that is invoked that produces the silencing impact of the humiliating act, so that often victims are unable to relate their experiences of humiliation for they feel so shamed.
...The CIA, in the 1960s, highlighted sexual humiliation as an interrogation tactic which could be used to strip victims of their identities and make them feel powerless.
...In recent years, US interrogators used sexual torture techniques as a method of humiliating and manipulating the emotions and weaknesses of prisoners in Iraq and Guantánamo. In the Abu Ghraib prison in Iraq, sexual humiliation not only took the form of forced nudity.
...In terms of the clinical implications of humiliation and shame, such experiences profoundly affect one's capacity to relate to others and form intimate and healthy relationships. They can destroy a person's most basic capacities, such as the capacity to trust and form secure attachments.
Moreover, the process of losing one's dignity through humiliation is a deeply destructive and devastating experience that attacks people at their cores. According to one psychologist, it is from this viewpoint that practices of humiliation once considered normal such as 'breaking the will' acquire medical labels such as victimhood or trauma.
Turning to sexual humiliation, in the opinion of one Harvard psychiatrist, the experience of forced nudity is comparable to rape since that in itself often carries an implicit threat of rape and mutilation. Psychiatrists from ETICA have argued that:
…never having been exposed to a torture situation, people from the West cannot imagine that to be exhibited naked is torture at all. Of course, it might be humiliating, but not sexually so. This is not the viewpoint of
the torture survivors. They all, independent of culture, had experienced forced nakedness as not only humiliating, but also as a sexual assault.
The same psychiatrists defined and categorised sexual torture as including mental sexual assault, that is forced nakedness, sexual humiliations, sexual threats and witnessing others being sexually tortured.
Finally, in the above situations, it is worth noting that the 'powerlessness' of the victim is always contrasted with the absolute power of the perpetrator. The relationship of torturer to victim is, in negative terms, also intimate in many of these situations. This 'shameful, unspeakable intimacy has a devastating effect on the personal, family and sexual life of the survivor'.
-- Banterings
Banterings,
The results you mentioned are spot on. They kept my husband in solitary confinement before and after as they had no justifiable reason. He was upset although he wasn't aware of the amount of time but he knew it was a long time. We, on the other hand, knew the amount of time. With the fear and worries that grew by the minute without news of what was happening, I was in total shock really unable to function like I would normally. I knew causing a scene or demanding could get me tossed out of there.
The exposure and having no control over who was able to view your nakedness is devastating to my husband. He never expected to be treated in that manner. While he knew some degree of nudity was to be expected, he never imagined it would be done in the manner in which it was done. It hadn't ever been like that in the past. I think at least for men, the older they get, the less the young female nurses respect nd protect their right to personal dignity. He and I are forever scarred from this. We trust no one now in the medical field. We now look at all of them as potential terrorists. He remembers how much he wanted to sleep but was unable because of being on display, the bright lights, and the talking in the room. Also, the drugs themselves especially Versed is formulated to prohibit deep sleep by sending impulses to the brain to startle you awake. Done my research on that evil drug. The effects for some people can last forever. To this day, because of PTSD or the drugs or a combination of all, he still startles awake constantly during the night. He gets very light deep sleep. He used to be a sound sleeper but not anymore. JR
http://www.cnn.com/2010/HEALTH/expert.q.a/04/06/medical.trauma.raison/index.html
https://www.healthline.com/health/mental-health/ptsd-after-icu-post-intensive-care-syndrome#1
Here are 2 very good articles about PTSD brought on by hospitalization. I know I am suffering from it. They wouldn't let me see my husband nor know what was happening to him for hours. Afterwards, the doctor was so hateful, rude, and uncompassionate. I also felt that I was being held prisoner by the chaplain as he refused to leave and heard information that he should not have and broadcasted into a public hallway 3 times info he should not have. I also saw the nurse exposing my husband. I reached the end of my limit that night as my husband had just had an unexpected heart attack (no prior issues) and they heaped and heaped atrocities on me. Our son is also affected. He doesn't let it out but has said to me he is bothered. I take kava kava now on a regular basis. My husband cannot sleep and is more quiet. He doesn't laugh like he used to. He is very stressed and seems to faraway in thought. He has to practice stress relieving methods before even going to medical appointment. I have to take a mega doses of kava kava. They said the heart attack might depress him but it was not the heart attack as we have dealt with major health scares before--it was how they treated him and us that gave up PTSD. Thanks to Banterings, I have a name for what is plaguing us now. P.S. We have to try to work through this on our own as we do not trust anyone in the medical field about being so violently betrayed by them. JR
JR
To bad all that rudeness wasn't recorded with your cellphone. I kinda think their higher ups wouldn't care anyway. Even though he wasn't gay , they thought he was and let him and you have it. I think I would maybe make the gay community aware of what happened. Maybe they could help you know what to do.
JR made an interesting comment that might be worth further discussion. She said:
"I think at least for men, the older they get, the less the young female nurses respect and protect their right to personal dignity."
I'm not in a position to know whether that is true or not but it does make some sense. They perhaps don't see older men as sexual beings for whom exposure matters. This could in part be reinforced by older guys having perfected their game face making believe it doesn't matter. Young women may not be able to read the body language of older guys to see their embarrassment.
Young guys are certainly the primary target of staff of all ages in healthcare settings, but older guys don't necessarily get a pass from the older staff. Been there. The particulars may change as we age, but the lack of respect for male patient privacy and dignity manifests itself throughout our lifetimes.
Good Evening:
The number one reason for male patient disrespect within the medical community is that female nurses are exposed to a culture created by healthcare management that condones the humiliation and embarrassment of male patients especially the more mature men.
New female nurses are taught this by their peers from the day they start their careers. They in turn not knowing any different turn around and teach the next graduating class of students and so on and so forth.
The nursing industry splits male patients into three groups.
Teenage boys who they want to expose just to embarrass because they get a charge out of it.
Young gentlemen who have something they definitely want to see if at all possible then tell as many other ladies as they can about it.
And you have the mature gentlemen. Some of these gents have goods they want to see and spread the word about but, all of the mature gents are open game to be embarrassed and humiliated whenever possible. The more females in he area at the time of the embarrassment, the bigger the charge they get out of it.
This perverse culture is allowed to grow and prosper because more and more women are being hired into management positions from which they can and do protect their female underlings.
The only way this culture is going to be stopped is if men stop going along with something, they know isn’t right and speak up loud and often enough so that our blinded society can have their blindfolds removed knowing this is a serious issue that must be dealt with in a public forum where healthcare doesn’t have the upper hand.
The public must be made aware of the FACT that due to the direct effect of behavior of medical staff towards male patients in this country, families are seeing their male loved ones scarred for life or even die when it need not be happening.
Regards,
NTT
Biker,
What led me to say what I was the Service UNexcellence Director from the hospital told me that being an aging patient, my husband should adjust to being exposed since he is aging and the encounters become more frequent. I told her no one should have to adjust to unnecessary exposure. I am sure that most staff members do not care about male patient exposure. Why would they with an attitude like that from the head of supposed patient advocacy? However, looking back, it is clear to see that male patients have been treated this way for many years and with each passing year, the female nursing staff feels more emboldened as they are protected especially in the age of MeTOO as all men are bad especially older men. It is funny that some of the people who label themselves to be unbias thinkers are actually the ones committing the most bias acts. The nurse who abused and violated my husband is one as we have done our research to what in her background would point to why she did what she did for our lawsuit.
NTT,
You hit the nail spot on in your post. I think you defined why the groups are treated as such. I think they do feel the more who are witness to the humiliation makes it more of a charge for them. I think there is a culture that discriminates against older men making them a more fun target. I think also when they are ill, vulnerable, drugged, and isolated from their family it makes their torture of them even more fun. I believe that having more women in higher positions protect this atmosphere of abuse as witnessed by us from what the hospital from hell director said. They weren't even willing to investigate.
They count on men being ashamed or not remembering from the drugs they give. We had given what we are doing a lot of thought as we know how stressful it will be. It has already been extremely stressful just living with their abuse and violations. We know not everyone thinks it is a big deal to have suffered sexual abuse from hospital staff but it is a big deal. We put our lives in the hands of these people. If they are not willing to do the right thing with something so simple as to allow us to retain our personal dignity then are they doing the right thing with more complex matters that involve the quality of life and death? I would say no because if they are willing to abuse and violate in one area that is easily done than chances are they will neglect patient care in more complex aspects. We know the one nurse not only abused him but was neglectful in hooking up his heart stress saving equipment in a timely manner as she was too preoccupied with him having on the correct gown so she could have him exposed while she went to fetch one. We know she did not perform her educational duties as she lied in his medical records over 30 times. We know she lied about witnessing whether the IVs were inserted correctly as she said she was at the facility 35 minutes away when they inserted them. She never mentioned about the other 2 IVs that no one has taken credit for inserting. She lied about us being able to visit him. What else did she lie about and what physical harm did she cause to him? We know she added to his PTSD by her inappropriate sexual conduct. JR
Good Afternoon:
This all begs the question, is the #meetoo movement and pressures in the work place, contributing to all the bad behavior by female healthcare workers towards male patients or is it something else?
We know that management everywhere is asking employees to do more with less every day. Could they be taking out that added pressure from the top on their patients by cutting corners (like not covering the patient or closing drapes or doors), to get things done faster and ease the pressures?
Then you have peer pressure from other nurses and technicians. They do it and get away with it so I better follow suit so I’m not an outcast.
The #meetoo movement is all about feminism. Since its rise in the 60’s healthcare for males has suffered. Are these women getting even with men for all the bad things powerful men have done to women over the years?
Has nursing, technical schools and medical facilities failed to weed out the unstable candidates? Or do they even care to weed them out?
How many more men have to be abused or forced away from needed care before our society opens their eyes to this problem and takes a stand against it?
If men won’t speak up for themselves or their family, then we have to find another way to get this out of the shadows.
Regards,
NTT
NTT, I think #metoo contributes to the problem only in that the more radical feminists have used it to push the all women are victims and all men are bad meme. In healthcare you can see its manifestations in the constant stream of articles in KevinMD and Medpage written by female medical students and physicians bemoaning their victimhood in the oppressive healthcare patriarchy.
The day to day problems men face in healthcare have been there for far longer than #metoo and modern day feminism. I think the reality is that males are treated better now than they were decades ago. Things I was subjected to growing up would be lawsuit fodder today. Schools would never dream of doing things the old way. I also think healthcare staff are trained to a higher degree of professionalism today than was the case decades ago. That's not saying its good, just that its better.
The problem remains that society does not recognize male modesty as a valid concern nor male intimate privacy as a priority. Also, the "medicine is gender neutral" proponents are in control of what is an increasingly female-centric healthcare system. Nothing will change until men speak up or someone presses the precedent setting lawsuit.
Something that would help would be healthcare staff and patients both admitting that donning scrubs does not somehow mute normal human sexual feelings and reactions. Of course staff are going to be attracted to certain patients, or in some cases enjoy the view. It's not realistic to think that's not the case. Its just being human. The problem is acting on those feelings or attractions which most of the time isn't going to be actual physical assault but rather exposing more than is needed or for longer than is needed or to more people than is needed.
I have said it before most nurses gravitate to the part of healthcare that appeals to them, many to places that rarely if ever would have opposite gender intimate exposure and others to where they get that exposure constantly.
I think too that female nurses take out some of their hostility on male patients because of their feelings of being abused and unappreciated by the male doctors. The majority of doctors have a godlike attitude and think that everyone else is beneath them. I think the nurses resent this and the only thing available to show their control and power over is the male patient.
I disagree. I think that unnecessary exposure is assault and battery. If it were to happen on the street then that is what it would be considered. They do not get a get out of jail free card because they are nurses. Males patients do not have to be subjected to this under any set of circumstances even though it is true that society does not recognize that men should have the right to privacy or dignity.
I was reading on AllNurses about the entertaining things people do when under the influence of Versed. It appears that the staff find this quite entertaining. I still cannot figure out why US medicine insists that patient cannot handle remembering a medical procedure. I think the use of drugs used primarily to erase memory should be stopped immediately. I think these drugs allow them to abuse and violate and then hide their actions because of the drugs. JR
Hello,
Please note the comments to the following article. Both comments were by women responding to the "minimal" exposure of a female patient. ("minimal", in my estimation, relative to male exposure - i.e. no genital exposure) Again, one wonders if these female commenters would be concerned, if a male patient was pictured. http://www.outpatientsurgery.net/surgical-facility-administration/patient-safety/a-weighty-problem--02-19
Reginald
Self policing is the policy:
Tennessee health officials decided against professional discipline for the Vanderbilt nurse whose now-famous medication error killed a patient. RaDonda Vaught, RN, still faces criminal prosecution, however; she pleaded not guilty to charges of reckless homicide and impaired adult abuse.
Source: Nashville Tennessean
Really?
-- Banterings
A. Banterings
She violated not 6, but 12 patient rights to safe medication administration. The hospital she worked for concealed the fact for almost a year, yet many nurses side with her. Why? They don’t want to be held accountable for the mistakes they make for costing human lives. Look, dispensing medication is the most critical aspect of nursing and if they are not paying attention to that do you think they care about other aspects of nursing, your privacy?
I hope many of these reports that people post here are cause for an awakening among our readers, these are NOT sentinel events. They represent mainstream America and how care is delivered to people seeking healthcare. We, the victims are considered OUTLIERS, we are the ones paying for the disgusting care delivered in the most disrespectful way. We are now seeing state nursing boards look the other way and I’ve posted the behavior just recently on this blog in high profile murder cases involving nurses. Their nursing license remains active after committing murder, arson, accessory to murder and negligent homicide. Go figure!
PT
" State nursing boards looking the other way!" That jogged a memory for me. One nursing home I worked at in 2007 and 2008. An office worker.( I think a social worker had her office upstairs in the Alzheimer's unit. She left her office but left her window OPEN. One of our exit seekers went into her office and climbed and fell out the second story window. The state inspectors were in the building at the time. The social worker didn't get any discipline out of it. Just us CNA's. Even us on different units.
Different nursing homes I've worked af , I've had no idea how they passed inspection.
I have spent some time looking through the cases on the Indiana State Nursing Board. It is amazing that the majority of them walk away with nothing done. The only ones who seem to get a slap on their hand are the ones who don't show up for the hearing. Apparently, that is more offensive that they disrespect the board rather than the wrongdoings they actually commit. I suppose their philosophy is a bad nurse is better than no nurse. Of course, the board is made up by mostly females. I have been keeping an eye on the board as we have filed charges against several nurses. It is strange these proceedings don't hear from the victims or affected parties. I guess only one side of the story is enough. Truly, this is not a fair proceeding for the victims. That don't get to present their stories in person. That needs to change.
There is no way to know if nurses are truly dispensing meds especially the pain relieving type. It is too easy for them to scan it & put it in their pocket for their own use. If a nurse has a drug problem then more serious consequences should happen. Kicking an opiate addiction is one of the most difficult to overcome. Many have times it takes 3 or more attempts at rehab. to get it under control & then it remains an issue. How can someone who is dealing with an opiate addiction ever return to work around where opiates are freely flowing and easy to get? These boards need to be held accountable for their decisions when they put or keep these nurses in patient care roles.
It makes us wonder if the really bad nurse from that night, the one who didn't know how to hook up his equipment, didn't know what "all the wires" were for, left him exposed for the fun of it, & made over 30 false entries into his medical records had some sort of addiction issue? JR
Due to length, I must do this in 2 parts:
Part I
PT,
This latest article adds insult to injury:
Patients and Modesty in a Healthcare or Medical Setting, by Trisha Torrey. This article was updated September 10, 2018 (not sure of the original posting date), which was after the beginning of my focussed effort to change the title of this thread to Patient Dignity: Volume 90 (formerly Patient Modesty)on Wednesday, August 29, 2018.
This article is very disturbing because of the number of incorrect facts and inaccuracies that it presents as factual such as:
Modesty would not exist if we weren't afraid of judgment. It's that feeling that someone will judge us to be more or less than someone else, or in some way failing to adhere to our cultural beliefs that embarrass us, and makes us afraid of exposing those parts of our bodies that we are afraid will cause negative judgment.
If it were all about people feeling judged, we would not have obscenity laws and indecent exposure and open lewdness laws. These laws actually have a social purpose, and that is protecting societal order and morality. This topic is too in-depth for me to go int, but the link should suffice for a deeper explanation.
In each case, body embarrassment is set aside for the bigger goal of body knowledge.
The article fails to mention that protecting one's self from psychological trauma (PTSD, postintensive care syndrome) is just as valid a reason as screening from disease. It also fails to recognize the reasons that trauma informed care is becoming the standard in healthcare.
At an extreme, a patient's death could be blamed on modesty as easily as it could be blamed on the disease or condition that caused his or her body to die.
What about the side effects of PTSD, postintensive care syndrome, etc. that lead patients to depression, addiction, suicide, and other pathologies that destroy their lives?
Let's use the analogy of auto care to explain why some doctors just don't understand patient modesty well....
...Can you picture your car mechanic being concerned about exposing your car's engine or choosing not to fool with the controls because he's worried that your car will be embarrassed?
Cars do NOT possess human dignity.
Patient Modesty Is Not Addressed in Medical Training
Unfortunately, through medical school, residency and the example of other physicians, not all doctors have been schooled in the finer points of taking care of human beings.
Basically doctors are not properly trained and this amounts to malpractice.
Patient Modesty May Cost Time and Money
That lack of respect for a person's emotions and feelings may be the fault of the individual doctor, the fault of the training he or she has received, a bad approach to patients developed over time, or a combination of all three.
...so patients should just accept this?
End Part I
-- Banterings
Part II
Modesty is a problem for patients but is not really the fault of the healthcare system. A fear of being judged is something society, in general, imposes, making us patients feel embarrassed.
BLAME THE VICTIM!!! (even though she just admitted that physicians are not properly trained to deal with the issue).
You May Have a Phobia
GASLIGHTING!!! It is your fault, blame the victim!
Some people believe that, as patients, they are "owed" this extra step by providers to be sure modesty is addressed. But no, they are not.
It is not modesty, it is PATIENT DIGNITY.
There is no patient right stated anywhere that modesty must be addressed by any provider.
The Federal Patient Bill of Rights guarantees the right to be treated with dignity and respect. This means that patients have the right to be treated humanely and never be subjected to degrading treatment by any healthcare professional.
But respect is subjective, and from the point of view of any provider, addressing a patient's modesty issues isn't their first thought.
Trauma informed care.
This article shows that person is a paternalistic dinosaur, lacks empathy and common sense, and this applies to the "institution" that hosts the site.
-- Banterings
I am going to recount what was a very different experience for me which affirmed something I have read many times that nurses say but which I didn’t believe. This is that patients are often so sick that they don’t care about their exposure.
I slipped on ice the other day while shoveling snow and managed to land hard on the shovel itself. I was sore afterwards but OK. Yesterday morning when I woke up I felt something snap in that sore spot and was instantly in excruciating pain, like a Charlie horse that wouldn’t end. I could barely speak or move it hurt so much. My wife calls 911 and it was two female EMTs that came for me. All I had on was pajama bottoms, a tee shirt, and slippers. If they had wanted to strip me in the ambulance on the way to the hospital I wouldn’t have cared given how much pain I was in. She instead just tried keeping me immobile.
The local hospital ER has private rooms with doors and I was quickly placed in one. The two EMT’s and a couple female nurses then worked to move me from the stretcher to a bed. Again if one of them had said let’s get him out of his clothes 1st I wouldn’t have cared given my pain level. They didn’t and once in bed all left except one nurse. After getting my history she asks if it is OK to remove my shirt so that she could place pads for a heart monitor and checks my lungs. When she was done she got a gown to put on me. It was too warm in there for me and I said it wasn’t necessary but she insisted on covering my bare chest.
I was there for 9 hours and everyone that came in to do something always knocked 1st and then waited before entering rather than open the door as they knocked. Everyone explained what they were going to do and why and asked if it was OK before proceeding. The gown was taken off for X-rays but then promptly put back on, though I’d of preferred to lie there bare chested given how warm it was.
Clearly a broken rib in my back wouldn’t have warranted taking my pajama bottoms off, but I suspect some ER’s have a standard “get them undressed before we figure out what the problem is” protocol. Instead they were more focused on protecting my modesty than I’d of been given the level of pain I was in. Now here a day later it surprises me that I wouldn’t have cared, when absolutely I do care under normal circumstances. Then again I have never experienced pain like that before.
Hooray! The California of Public Health just posted this advice to California physicians, which represents an "inch" acceptance of the concept of male patients who are having sex with men, applying the testing tools for rectal or pharyngeal STDs THEMSELVES instead of having the application performed by a physician or nurse. Hooray..maybe more self-clinical examinations of men can be done with that type of "male privacy" Maybe, as noted in the posting " Having patients collect their own specimens could overcome
potential barriers to screening such as time constraints and patient/provider communication and
discomfort, which might limit provider collection of specimens from extragenital sites."
Get the picture I am trying to express? A little more opportunity to self-care by patients would improve the patient's maintenance of self-dignity? What do you think? ..Maurice.
Biker, I published my last comment before I read and published yours Sorry to read about your accident but pleased to read about your medical treatment professional behavior. Where I live in Southern California at 900 feet no ice except in the refrigerator. .. Maurice.
Maurice
What good does the Californica of pubic health ( deliberate spelling) matter to me. I don’t live in Californica, nor am I gay. I think this is perhaps an excuse for healthcare providers who are deathly afraid of contracting HIV from collecting specimens to defer it to those patients.
Why is it just for homosexuals and why not for heterosexuals?
A.Banterings
I will tell you that many have had heated exchanges with Trisha Torrey, including myself. I believe she has stepped back and gave a lot of thought to what she posted. She claimed to be a patient advocate. I’d like to see her resume and just what qualifies her to be a patient advocate.
PT
Biker,
I am glad you are okay and that your treatment was good. However, that is not always the case.
They took my husband's shirt off of him at the first ER. They never drew the curtain or closed the sliding glass doors. He laid there bare chested. I wonder what they would have done for a woman? Everyone in the vicinity knew he had had a heart attack and everyone who walked by looked in the room. He had no blanket or gown. They offered neither. The first ER was associated with a large teaching program.
At the hospital from hell, they stripped his clothes off without his permission and without any regard to his privacy. They place his clothes in a garbage bag. They left him naked and exposed for all to see. Even though he had just had a heart attack, was drugged, and not feeling so great, he did care that he was left exposed for all to see. He cared that the exposure was repeated again and again. Now he is left with having to try to deal with the abuse as I am too. He made him feel helpless, victimized, belittled, and sick to his stomach thinking about what happened. It doesn't really matter if the patient really cares at that point because of the pain or the injury if they are exposed, care not to expose should always be done. As my husband was drugged and defenseless, it was up to the staff to take care of him in a humane and compassionate manner as Banterings stated in the Patient Bill of Rights. My husband is a prostate cancer survivor and he didn't need the additional trauma of this procedure that really didn't need the genital exposure like during his prostate related encounters. Neither my husband and I should have been left with the feeling that he had been sexually abused. He never wants to be alone again with another female medical staff member. He doesn't trust them especially since they abused him when he was so sick and drugged. He is afraid that it will happen again. He doesn't ever want to be hospitalized again and may fail to get medical treatment at a hospital because of what they did and I feel the same.
You were lucky that the hospital you were at acted with compassionate and ethical. Unfortunately, it is not always like that.
Continuing with the story that I had discussed with this site I had previously stated that I was planning on emailing the Director once again. I have since done that. For those who are unfamiliar with my story you can read the premise on October 30 of 2018. Here is bulk of the letter. The parentheses are where I added or (left out) something.
The last time that I spoke to you over the phone I thought would be the final time we spoke. The letter that you spoke of over the phone that you stated you sent the day before did not arrive until early the following week. For your reference the letter is dated (left out). At long last I am responding to your letter. Specifically I am responding to the part in paragraph three which reads "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." From what I remember that is not what you said over the phone. As I recall you seemed to say in no uncertain terms that during this prep procedure there were no exposure issues. If what you stated in this passage was procedure then that would have been very much in doubt. (The first time that I spoke to the Director she said "you were covered" whereas the way she described it here that seemed an iffy proposition. She did mention a cloth but I was not under the impression that there was any brief exposure) You did say something about sterile draping during our final phone conversation but I don't remember this and I think I would have. In this paragraph you seem to imply that the sterile towel cannot touch the gown because the gown is not sterile. If that is the case then how can it touch the private areas which are also not sterile? (The Director did not respond to this) If the sterile towel cannot touch anything not sterile then the private areas would have to be exposed and scrubbed and sterilized before putting the sterile towel on top of it thereby negating your assertion that there were no exposure issues. (She did not respond to this).
Beyond this I investigated this procedure online and was in contact with someone who works in a hospital and described himself as a patient's advocate. He said that he was credentialed in numerous areas and was well acquainted with the cardiac catheterization prep procedure. He mentioned that the groin punctures that you described involved inserting an "introducer" which is a needle like device. He said that the sterile towel normally has roughly a three inch window through which the introducer is inserted and that the sterile towel is normally sticky and sticks to the skin. He said that it is not a problem if the sterile towel touches the gown. (She did not respond to this) He stated that typically the gown is just pulled away from the groin area and sometimes taped but covers the private area. (She said nothing about this)
Continued next post PA
Continued from the last post. This is part 3 of 3.
In retrospect I'm not really sure that writing to the Director was such a great idea. I had optimistically thought that she would see the truth in what I was saying. That didn't turn out to be the case. PT you were right. The Director overlooks certain things that are obvious to anyone who just thinks about it a little. On the first email I sent I spent several paragraphs trying to figure out why they took off or lifted my gown. It was only after talking to the Director over the phone that she explained what was going on. It was so obvious I didn't know. Yet it doesn't seem to occur to her that if these two people "explained everything" why didn't I know that? Yet she sides with her techs' version of events.
The second reason that is obvious is the question that the Director can't think to ask which is why would I lie? I wrote three substantive emails plus engaged in two roughly 15 minute phone calls where I asked her numerous questions all on behalf of what? A hoax? And beyond. As far as where she says there will be no further conversation after thinking about it I actually agreed. There was really nothing left to say.
There were some accomplishments for lack of a better word in all of this. I complained which means that if nothing else these people will probably be less likely to do this again. I did receive a pro form apology in the Director's first letter and she apologized over the phone. I would have appreciated an apology from the two surgery prep staff members which I did not receive. I got the impression in the second phone call that the Director kind of knew that my story was at least largely true but she wouldn't admit to it in her letters. The emergency room hospital staff fixed the rapid heart beat issue which I couldn't stop. After they did a test they felt that I should go to the other hospital for further tests. If I had to do it again I would not go...for the further tests. It all goes back to what a lot of people have said that if you go to a hospital beware. PA
Good Afternoon:
PA, for cath lab related tests, there's a company called Covr Medical that makes what they call a Bilateral Medical Garment that will protect a patients privacy while giving medical personnel access to the groin area.
http://covrmedical.com/
They now sell to the general public so individuals that know they have a test coming up & want their privacy protected can buy the garment direct from the company. Just bring the garment unopened to the test and put it on there.
If they have a beef with it, then they need to look at their policy.
Regards,
NTT
Reading this website this morning it appears the second post of the three from yesterday did not get through. It was a little long and went beyond the 4096 count so I cut out a part to get it through but apparently it didn't work. I will try it in two parts. Here is the last part of the letter I sent.
When I first entered the emergency room at (left out) on the evening of (left out) after going to the acute care room or whatever it is called I was only asked to take off my shirt. At that time I was given a "shirt gown" with no instructions as to when to put it on. At that time I was intubated and also had electrodes put on my chest. The rapid heart beat situation that I previously described stopped relatively shortly thereafter but I continued to be intubated almost continuously from that time at approximately (left out) on the night of the incident on (left out) until I left (left out) around (left out) on (left out). At no time did anyone say that there was any problem with wearing the "shirt gown" over the tubes. There were at least two doctors and three RNs who knew that I wore the "shirt gown" over the tubes. After arriving at (left out) I was instructed in the early morning hours of (left out) by an RN to put on the shirt-gown. (The Director did not respond to this paragraph at all)
You also state at the end of paragraph three "This occurs on every patient and is explained as we are performing." How do you know that? A better way or putting it would be "explained...as we are performing...if procedure is followed."
I don't know how to say this so I will just come out and say it. If I don't get a straight answer from you in a reasonable period of time I will be contacting you again. (I wrote this because back in October it took the better part of a month emailing and calling her on the phone before I finally got a hold of her. As it turned out I sent this email originally on January 29 and did not receive a reply until after I emailed her on February 27 where she said the first email might have gotten deleted as spam even though the second email had the same web address.) I am not nearly as upset about this as I was in September or October of last year but nonetheless. Assuming you are I thank you for reading this. I will await your reply.
PA
This is the last part of the "second post" which are posted out of order. You have to read it all to understand. Anyway this is her reply.
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." From what I remember that is not what you said over the phone. As I recall you seemed to say in no uncertain terms that during this prep procedure there were no exposure issues.
I remember clearly discussing this on the last call and the call before. As the staff is pulling up the gown the tech placed a sterile towel over your private part so there is no exposure. (There is unless this part was perfectly synchronized. As I told the Director on the second phone call I don't remember feeling any towel. I remember feeling them tying down my hands but not any towel.) Both groins have to be exposed to do the sterile scrub. Once the scrub is complete a sterile drape is applied that has holes that over lie each groin that was just cleaned. This drape has sticky material so the drape adheres to the skin (that is correct.) (her parentheses) I don't know if I got that specific in the description of the sterile drape.
In reading this letter, this is dealing with the same information that we have been over before. My staff does this on a daily basis, I also watch and work with this staff in the procedure room. I have true confidence that my staff performs and explains all tasks that are being done with patients and prevents exposure of patients private area. (She can have all the confidence she wants. They didn't explain this and I was there and she wasn't. Failing to explain something or tell somebody something is not a terribly uncommon thing. Hopefully after this incident though they will be sure to explain this to patients every time.)
This compliant is closed and I will not be addressing any further emails or calls.
(Her grammar)
Late last year I looked into what was said online by patients about the CC prep procedure. What I found was although there was no situation quite like mine there were still a number of complaints all with the treatment of male patients by female hospital staff although none of them said anything about filing a complaint with the hospital. That does it with this email and her response. The first post is first. The two posts on today March 7 are second and the post (3 of 3) is last. Hopefully you will be able to make sense of these four posts. PA
PA,
When I talked to the cath. lab and the hospital, they had a different story of what should have happened. Belongings are to be put into a clear bag with Patient Belongings printed on it and a patient label adhered to it. However, his belongings were put into a pinkish garbage/trash bag. They denied this could have happened but fact remains this is what happened. Finally, they said if his items were soiled then they would have maybe used a haz mat bag. His items were not soiled. It was like pulling teeth to get any type of answer. They at first acted like it was all a big mystery until I told them I still have the garbage bag with the label on it. So many lies or evading the truth.
As for the exposure, they said it doesn't happen. However, he remembers the exposure. No gown or blanket when they stripped off his clothes. They said this doesn't happen but it did. If they even would ask the ones involved it would beof no benefit as they wouldn't admit to wrongdoing. Also, they couldn't remember 2 minutes after the procedure ended what they have done. Also, after the procedure ended, he was once again exposed as they were doing cleanup of blood and suturing. No towel. No gown. No blanket. He remembers the exposure. They also performed bedpan duties during this time as the contrast and the IVs make you have to go or they threaten you with a Foley cath. They will only tell how it should have been handled; not as it was really handled. Even if they tell you, you probably won't know for sure. My husband's team of 4 female nurses did not care about needless exposure. I have found in doing my research of cath labs that exposure for men is fairly routine. It was very traumatizing to know that as a human being with feelings and wanting to be treated with dignity, they simply did not care but seemed to go out of their way to dehumanize and belittle him. They also did this cath w/o his permission as we thought he was only going to be given options for treatment. Hence that is why they drugged him so they could do what they wanted so he couldn't resist or most likely remember. The Versed is used as their accomplice to enable them to commit their atrocities. On my website, Issues4Thought.com I am telling our story. JR
As I have written here previously, I accept that the personal ventilation on this blog thread of one's experiences is proper and worthy. But in order to obtain executive action throughout the country to help prevent these experiences from happening again to my posters and others something more is needed than descriptions here or, if you have one, on your blog. What is necessary as a beginning (and I have noted this previously) that someone like Banterings to begin, for example, by writing a commentary to the New York Times.
Start something on a national level!
You all can continue to ventilate here but here isn't enough! ..Maurice.
Maurice,
I would welcome venting on my website as the more who vent, the more it is likely to become an issue that the medical providers have to address. Also, it is not everyone's cup of tea to publicly address their sexual assault and battery. Rape victims have the right to remain unnamed. It is a very big decision to have everyone knowing that you have been a victim of sexual assault. It was a big decision on our part to go ahead and talk with legislative members. It was a big decision to pursue our lawsuit and make it all public. Not everyone can do this. I am new at this but I am being proactive now and not being a victim doormat but it is hard. The stress both of us suffer from the abuses and torture we endured cannot be put into words. I appreciate that you have this blog but I don't think you really can grasp what being a victim of this feels like. For many this blog is therapy and their stories can help ethicists like you see that change needs to be made. As for my blog, I am just getting started and still learning the workings of a blog. The way I am starting is by telling our story because I feel many can relate. That has been a very difficult process and it is a very long story. I do intend to add more content but I have not been doing this for years but rather months. Thanks for letting me vent. JR
JR what happened with your husband was much worse than the situation I went through. This also goes to show that hospitals largely protect their own as do boards. As I told the Director this was an elective procedure. When I was at the first hospital I was told by the doctor there when I asked that my chances of survival in the immediate future were "excellent". He said that the test that I took there said that there was a chance that I might have had a minor heart attack and that they wanted me to go to another hospital to have further tests. As I said before although I would go back to a hospital to get rid of a rapid heart situation if necessary (no doubt) under a similar situation if told to have further tests I would very probably pass.
I am repeating myself but as I have written before at no point was I told there would be some exposure of sort, whether in the literature I was given, whether by a medical professional in my room, whether by someone in the CC waiting area or by the prep staff.
Was it really necessary for them to lift the gown? I could not say for sure because I am not a medical expert. In contrast to what the Director said I did have new info about the necessity of the gown lift which she did not answer. PA
PA,
That is what I am working to change. They don't tell us the truth. The US medical community thinks we are "babies" and cannot tolerate knowing what a medical procedure entails. They also don't want us to know how they treat us like the lack of dignity respect. No, exposure during a cardiac cath. procedure is not necessary in the lower genital region. If they had the Covr garments or they could have the patient gloved if necessary to place a towel. For the upper region on women, the could give falsies to cover the appropriate area as they would not interfere with the EKG leads. Could but don't care because it is not them. They use drugs to purposely make patients unable to resist or form actions to resist such as fentanyl and versed (benzo) drugs to erase the memories of how they go about doing their disrespect. They may provide a service but what is the ultimate cost to the patient? For us, the procedure was costly in terms that my husband may never have another procedure. For me, I will never have a procedure.
I want to educate people. I want everyone to know what happens in these secretive procedures. Everyone should know and the medical community should no longer be able to essentially operate under a veil of secrecy. Once everything is out in the open, then true informed consent is given.
I have sent to Dept. of Human Services, the HHS secretary, and the CMS director what I think needs to be done. I have a lot of issues with informed consent. Informed consent is informed for only the medical staff. It is too vague and doesn't allow the patient input. I will address these some on this blog will be going into more on my own blog where there is no limit on my character usage. I am also going to be going into the use of opiates and benzos. I think versed is an evil drug. To use drugs primarily to erase memory is something that the Nazis would have done and it is beyond horrific that US medicine uses versed (benzos) like water. Is it ethical for them to decide what memories you are "allowed" to have? I am also going to talk more about PTSD from medical trauma. There are many issues that need to be addressed. I am formulating my plans. Would encourage all to give your input or stories. JR
I have recently placed a number of excellent resources on my Twitter page (@MadmanBantering).
The 2 most recent posts deal with PTSD in healthcare settings. There is also a post on non-medical students shadowing doctors.
Please check them out.
-- Banterings
Banterings,
Thanks--some great articles! Will use them. Am following you now. I am new to Twitter but I am learning. I think I will take Maurice's advice and contact some papers about our story. Need to get it out there what they did. Maybe others will come forward. JR
Time with your Attorney is priviledged, you are given a private conversation with every consultation. Why is that no longer the case with your physician. You can’t have a private consultation with your physician without one of the medical assistants barging in looking for supplies. You can’t have that private visit without some stupid scribe tagging along. The same goes when you are in the hospital, your hospitalist visiting you in your room and the nurse or nurses, cna have to barge in and stand there. No one invited them, who the Fu&k invited them in to invade your privacy.
The emergency room is just as bad if not worse. You should be able to speak with the emergency room physician at least in a private manner but nope, they have to drag a scribe in or your nurse has to waltz in. You would think your nurse has other patients to tend too. They are always complaining about nurse to patient ratios, they are always complaining about no time to pee or eat. They sure have to to surf the web at the nurses station or with their cell phones at the cab ( computer on wheels) with all your information on there.
Here we are 50 years after the Apollo moon landing and they don’t have a system that records EMR without paying some scribe $15-17 an hour to violate the privacy, that priviledged consult you are paying the physician. You can’t tell me that technology has not evolved to that point yet, despite $4 Trillion bucks pumped in annually, to fill in the EMR. You will never see a scribe at the gyn or the physicians office during a pelvic, no do they allow then in the pelvic exam room in the ER. Yet they will drag one in for a male patient for a rectal or exam in the ER.
PT
I tried to be precise in what I have written. Going back to the original post I had stated that when the techs or whatnot lifted the gown or whatnot I screamed but there was something else that happened at that time. That something else I now state was that I lifted my legs to try and cover myself.
In response to the Director saying that her staff does this every day like as if that's the end of the conversation what exactly does that mean? Because her staff does this every day they never make mistakes? I mean we're not talking a first class major mistake here. They just failed to inform me is mostly the issue. Hospital staff in general do this every day of the year. Does that mean they never make mistakes? I could just see it. Over the past year they are a hundred odd patients nationwide who complain all the way to the hospital CEO for the hospital they were at. In each case after the CEO has listened to the patient for about a minute or two finally responds with their staff does this every day so apparently no staff member ever does anything wrong. He or she says this like it's a conversation stopper. It's not a conversation stopper. Saying that you have a video or even audio recording that disputes the complainant's story is a conversation stopper. I stand by my story that this is what happened. I was there.
Dealing with the Director I had to be like Columbo and explain the obvious because she has no interest in that. The first time I emailed her I asked her to interview the techs separately and ask them: what their story is, did I scream? If they explained everything then what did I say when they told me they were going to lift the gown? It doesn't appear she did this. I have never said the techs had any sort of untoward motive. Perhaps they just forgot or didn't feel comfortable bringing up the subject. But you have to tell the patient this. I won't go into it again but they really should have explained this in my room. I would agree with JR after finally reading it that Bantering's twitter page is an excellent resource. PA
I find it a little perplexing that when nurses and physicians take cell phone pics of their patient’s genitals and distribute them that they are not arrested for revenge porn. The statue does not say the victim and perpetrator have to be in any intimate relationship. In many state the fine ranges from $30,000 to $50,000 fine and anywhere from 3-5 years in prison. Is it that people just have not realized that these are the dots that need to be connected.
PT
PA
You mentioned in your post that she said “ This complaint is closed and I will not be addressing any more e-mails or phone calls “. Have you taken the matter up higher in the organization?
PT
" You will never see a scribe for a pelvic exam in the ER!" WRONG! Not only in the room but looking on from the foot end of the exam table!
Anonymous said
“ You will never see a scribe for a pelvic exam in the ER! WRONG! Not only in the room but looking on from the foot end of the table! “
Nope, Nope! Scribes cannot be utilized as a chaperone. Physician assistants can perform pelvic exams in the emergency room, however, they are not assigned scribes. Scribes are only assigned to MD, DO’s. Yes, physician assistants are pissed off about this. A male physician is not going to drag a nurse and a scribe to perform a pelvic in the gyn room. Dosen’t happen!
PT
Nasty things written by patients to the internet and seen by others about how they were cared for by the medical profession and how the professional should react is an issue currently published by Medscape.
Here is the link and hopefully you can access it:
https://www.medscape.com/viewarticle/909173?src=WNL_bom_190310_MSCPEDIT&uac=215853DX&impID=1902328&faf=1
If you were the professional and read something written by your patient about YOU and, well, it wasn't so "nice"..what would be your reaction and response, if any? Think of yourself as that medical professional. Consider the possibilities mentioned in the article.
..Maurice.
First off, I don't write nasty comments but rather I write about the truth. Also, I do not blame the doctor for a receptionist with a bad attitude but rather the receptionist. I put the blame where the blame needs to be put.
As far as what I would think, I hope that I would be mature enough to be able tor realize that customers that have had a bad experience have the right to their opinions and to tell their story. I would try to find out what went wrong and seek to change it. Every business is subject to having someone who has a bad opinion of them. That is how it works. Doctors and medical related businesses have for too long thought they are immune to receiving criticism for their actions. They are not immune as they deal with the most important service, the service of our bodies therefore, there should be a higher level of standards.
Also, I as a consumer, read reviews and make my own judgment. This all leads back to medical people not believing that us non-medical people can make good decisions on our own. They patronize us and seem to believe they should make all of our medical decisions for us. I believe that medical providers need to be aware of what their customers are saying and if they truly care about proving compassionate and skilled care, they will explore what has been said and try to change. I know most businesses do but it does not seem that the medical community thinks they need to change.
And yes, my husband and I are one of those dissatisfied patients who wrote "nasty" but true remarks. We want other potential patients to be better informed and more aware than what we were. They can sue but it would bring them more bad press than just a random rating that has limited access. A lawsuit would bring it out in the public eye. Also, many patients may bring their issue up to the medical community but are dismissed as the medical entity does not feel they need to address the issue. This is what causes so much dissatisfaction. If our issues had been addressed properly, then we would not have had to travel the route we are now on. It is the superior attitude and the unwillingness to change or even admit there are issues, that cause a lot of the dissatisfaction. Until the medical community can grasp they do not have the right to do whatever they want, to whoever they want, however they want, and wherever they want; there will continue to dissatisfied customers. People are not put in for medical people to control and abuse and then expect them to be happy with the outcome. At least for people like my husband and I who have feelings, pride, autonomy, intelligence, etc. and realize we are actually in the driver's seat for our own healthcare decisions and quality of care. Medical people are just our employees who carry out what we need to have done. Therefore, they should be providing better customer service as we are the boss. JR
Is it legal for hospitals to put a camera over the bed in a normal hospital room? I recently spent a few days in the hospital with pneumonia and there was something on the ceiling over my bed I couldn't figure out. Every time I tried to sneak out of bed to go into the bathroom without asking the teenage girls permission first they walked in to check on me. It wasn't ICU. That can't be legal, can it? DM
I have only ever written one review, and that one was to praise a PA who I found to be extraordinary.
When seeking a new physician I will read reviews that have actual comments and not rely so much on those simple star ratings. This is because I want to know what prompts the # of stars given. Some comments I dismiss if the writer's complaint is about something I don't particularly care about or if the review comes across as angry venting vs being an objective review.
I would not write a negative review unless I first tried to address the issue directly, and even then I would try to make the review constructive rather than angry.
DM, it might not be a camera but rather a weight-triggered bed alarm signalling them you've gotten up. A friend ran into that when he was in a rehab facility for guillan-barre syndrome. The purpose is to reduce patient injuries from falls when they think the patient is too weak to move around on their own.
A few years back, I called the same hellish hospital to praise a male nurse who was helping my mother in ER. The male nurse never touched her unless he first asked for permission and always told her why and what he was going to do. He was very attentive and helpful. He did not have her undress unnecessarily and gave her privacy to provide a urine sample. That is a lot different from the controlling and sexually abusive female nurses my husband encountered. There is a very marked difference in the way this male nurse interacted with a female patient. Part of my PTSD is my guilt in not defending my husband when I came face to face with what I now realize was the one nurse sexually abusing my husband. If only I could go back and change how I had already let their torture of me affect my ability to react. By torture, I mean having a warden who gave me no information about my husband for hours thus isolating him and me, and then afterward the procedure, the rude and abrupt doctor who told about a procedure he had done to my husband without any prior knowledge or consent, and then the isolation of my husband for hours again without any word.
We did not leave ratings at first because we were too angry and did not have all the facts yet. I agree with what Biker said that ratings that appear as ranting or too subjective are ones that I don't pay much attention to unless there are others to back them up. I tell the facts then state what is my opinion and make sure to emphasize it is my opinion. In fact, I often say "it is of my opinion ...."
Like in the case of the one hospital who failed to make note of issues with painkillers and versed causing serious side effects and later that same hospital crossing off the same concerns after writing it on the form, you bet their review contains this important piece of information. To me, in my opinion, this blatantly shows negligence on their part as they don't seem to care about serious complications that these types of meds have. Rather they want the ability to use these meds on patients to control and erase their memories. That aspect seems more important than the overall safety of these meds to the patient. If they would like to sue and make this a more public event then it would harm them more as we do have the proof to back up our claims and eventually this will become public knowledge. JR
Maurice,
I was thinking about your post on the California Department of Public Health self-collected exams letter, WHY ARE WE CELEBRATING THIS?
How backwards-stupid is the profession that they do not realize that having the provider collect the specimens are barriers to screening?
Why has it taken so long?
Albert Einstein was critical or our education system in that it did NOT teach critical thinking, but memorization.
The value of an education in a liberal arts college is not the learning of many facts but the training of the mind to think something that cannot be learned from textbooks
Students are NOT taught in medical school to have patients self collect specimens as an alternative, and physicians are not suggesting this. Why is this concept so revolutionary?
Self-Collected Specimens for Infectious Disease Testing
Diagnostic accuracy of self collected vaginal specimens for human papillomavirus compared to clinician collected human papillomavirus specimens: a meta-analysis.
Safety and acceptability of human papillomavirus testing of self-collected specimens: A methodologic study of the impact of collection devices and HPV assays on sensitivity for cervical cancer and high-grade lesions.
UNC Study Finds Self-Collected Specimens Comparable to Physician-Collected Specimens for STI Screening Accuracy
Self-collected vaginal swab specimens (UR Labs)
ESwab for Surveillance Cultures
Reluctantly, medicine heralds these announcements as they have made a great advancement for patients. The truth be told, these protocols are pushed by regulatory authorities that have low screening rates due to people avoiding this inhumane treatment.
This is predicated with providers saying "I need to" and believing that draping makes a difference.
-- Banterings
Good Afternoon Everyone:
As far as writing online reviews go, if it's a doctors office, I'll try working with the doctor and/or office mgr. first to get corrective action. In a hospital, I'll work with a patient advocate first.
If the problem doesn't get resolved, then I'll write a review to make others aware there might be a problem using their services.
Regards,
NTT
Maurice: The following is all I could find at the site to which you sent us – “Harassment from Patients Prevalent, Poll Shows.” The survey found that physicians and nurses reported high rates of harassment by patients. https://www.medscape.com/viewarticle/892006 We don’t know from the study what forms the harassment took or what precipitated it.
I harassed a dermatologist once. I was in my underwear when he exited the examination room and left the door open. (I got up and closed it.) It was in the beginning of the examination when a woman (a scribe, I guess) entered the room without knocking, introducing herself, and explaining why she was there. I told her that I deserved privacy and if her presence was not a medical necessity, she should leave. She left.
After she left, I scolded the physician for the two violations as I would a wayward child. He was surprised and said, “Don’t you dress like that when you go to the beach”? (I had put my running shorts back on after he left the room and I closed the door.) I replied, “Yes I do, but I don’t get medical examinations on beaches.” (Analogies always break down at some point. That’s why they are called analogies.) He said, he treated everyone the same way and never got a complaint before; he wondered out loud why I should be treated as though I were special. I replied that I wasn’t demanding that I be treated as though I were special; I was demanding that he treat all his patients as though they were special – with respect.
He asked me if I had lost trust in him. I told him that I would trust him if he treated me with the respect any patient deserved. Within five minutes, he had me stand to check the back of my legs (I thought). Without saying a word, he jerked my shorts down and inspected my genitals. I said nothing, just left and vowed never to return and to file a complaint with the state’s medical board. Three days later, I received a letter from the physician telling me that I was no longer welcome there. Fine with me.
I filed a complaint with the medical board. An investigation was done. One of his defenses was that I harassed him. He was given a written reprimand for terminating me as a patient without following protocol. That really wasn’t part of my complaint but the board’s response reinforced my belief that complaints will only be taken seriously when one has definitive evidence to back them up. Otherwise, complaints amount to no more than a “he said-she said” situation. Had the physician not sent me the letter, he never would have been written up.
So, what are we to do, bring recorders into examination rooms with us? Maybe so. Legislators passed laws in some states against unauthorized recordings to protect the deviant behavior of the privileged (called “elite deviance” by David Simon in a book by that title). In other states it is legal as long as one person in an exchange between 2 or more people approves of it. That would, of course, be the person doing to videoing.
By the way, the physician advertises himself as providing “compassionate skin care.” Maybe he loves skin better than the people who occupy it. – Ray B
Thanks Biker. A weight-triggered bed alarm makes sense. DM
PT short answer no I presently have no plans on taking this further to either a medical board or the hospital CEO. I feel like I am likely to get a similar response as before. Also this is not an easy subject to discuss. PA
Ray B.,
Some good points. I don't consider what you did as harassment but rather explaining your actions when questioned. It is sad this doctor thought you defending your basic rights was harassing him. Maybe he should consider not "harassing" a waitress because the cook was slow in getting his order ready. I am sure that medical people tell other professional people when they think something is not done correctly. Pulling down your underwear without your permission should be considered assault. It is clear this doctor did not understand the concept of patient respect/dignity. It is also clear that the system that regulates their behavior does not understand the concept of patient respect/dignity especially if the patient is male. It is my thought that medical people think we need to respect them but they don't need to respect us. Many seem to have the attitude that they are doing us a favor by giving us treatment even though they are being well paid for their services. Many don't feel we, as mere mortals, have the right to question them. Most of the articles I have found on patient dignity/respect have come from other countries. The US seems to be very far behind on patient respect/dignity issues.
Going back to original posts about complaints, I think most of us try to direct our issues to the doctor's office or hospital patient "advocacy". We did and were told they did nothing wrong and he should get used to being treated as such because he was getting older and would have more encounters. I was told they have the right to have whoever they want involved and they never have had a complaint. So according to that hospital, sexual assault on male patients is acceptable, medical record's falsification is acceptable, you don't have the right to have someone removed from your care is how they operate, keeping the patient and family uninformed and isolated is acceptable, doing procedures without consent is acceptable, giving drugs that harm patients is acceptable, invasion of privacy with HIPAA violations are acceptable. It may be acceptable to them how they mistreat patients and their families but it was not acceptable to us. Hence, we file complaints with the various government agencies, left bad ratings, and are pursuing a lawsuit with both hospitals. As I have said, the medical community has been able to exist under a veil of secrecy for too long. It must be exposed to others can receive better treatment and compassion. The hospital said no one else has complained. So in other words, abuse and mistreatment is okay because no one has complained. That is a scary philosophy for a business that is supposedly in the business of providing skilled, compassionate care to have. We complained but they didn't care so I guess they are back to no one has complained. However, I have seen other complaints about the same thing. It is like with other things, sometimes following the chain of command doesn't work. Sometimes you need to go to the top. JR
PT: On March 8 you wrote, “. . . they don’t have a system that records EMR without paying some scribe. . .” In fact, the technology is available and marketed by several companies. Here’s one http://www.physiciansangels.com/virtual-scribes/ . The company markets virtual scribes and the scribes are called angels. I don’t know why all providers don’t use this option; maybe cost, maybe loss of control.
You may be correct regarding never seeing a scribe in GYN clinics. ScribeAmerica has certainly made an effort to persuade physicians in OB/GYN clinics to use their scribes. You can probably be 100% certain that they will all be female. The courts have consistently ruled (e.g., Backus v. Baptist Health, EEOC v. Mercy Health, Jones v. Hinds Hospital) that gender is a bone fide occupational qualification (BFOQ), given certain conditions are met, when intimate/intrusive procedures are involved. You can also be 100% certain that the overwhelming majority of scribes in urology clinics will be females primarily because of institutionalized gender discrimination. Furthermore I’ve not seen any studies that have been conducted on the effects of scribes in OB/GYN. I’ve read two studies conducted in urology clinics. – Ray B.
Ray B, that the doctor left the door open and the scribe later entered without knocking tells you all you need to know. Patient privacy is not even remotely a consideration in that practice. They probably think being polite is synonymous with being respectful.
A couple years back I went to the local dermatology practice and while in the waiting room I could see the doctor going into rooms with patients in them without ever knocking or announcing himself. I saw the staff doing the same thing. I was only there for a cyst removal on a finger but I saw enough to know that practice was not especially professional in their protocols and knew I wouldn't go back there again.
Ray B
I agree, I’m certain they could and would have an electronic system to replace scribes.
PA
I believe you should take this issue up the food chain for a number of reasons. You are letting the director have the last say and if you take this matter up to the CEO the director will know as she will be asked about the incident. This will put the director under the spotlight, especially if someone else complains. It will appear that there is something amiss in that department. Now, if you don’t complain about this further you may regret it later. Complain, complain and complain some more.
PT
Ray B
The Joint Commission ( an agency that I have grown to despise) have said that medical scribes are unlicensed medical personnel and furthermore the physicians that hire them are responsible for their actions and behavior. That scribes cannot enter orders, ask patients medical questions etc.
In my opinion they compromise the patient-physician relationship, inhibit the trusted communication that can transpire. I seriously doubt that a busy OBGYN physician who already pays among the highest malpractice insurance out there among physicians, is constantly on call most of the time and takes on high risk pregnancies. In particular, if the OBGYN is a male would he want to drag into the exam room a chaperone, and a scribe? I seriously doubt it. It’s been said that scribes must not be utilized as a chaperone and considering they have zero knowledge in medical procedures I doubt their testimony would even stand up to scrutiny should their be an accusation against the physician.
There is much fake documentation out there regarding the use of scribes and this fake information about patient satisfaction is being pushed by large companies that provide scribes. I’m hopeful that this scribe phenomenon will be temporary as technology will replace these useless nosey busybodies.
PT
Good Evening:
I'm attempting to get this 2 part letter published in the "Letters to the Editor" section of all my local towns.
Men’s Healthcare
Ladies, has the man in your life gotten his annual check-up lately or has he gotten one but not followed up on it? Is he having male related medical issues, but doesn’t seem to want to address them?
Have you sat down and talked to him about it only to have him tell you what you want to hear not what he’s really feeling?
The reason he tells you what you want to hear and not wat he really knows is two-fold.
One he doesn’t want to worry you and two, he doesn’t want to look like a weakling in front of you.
You see, long ago our society stereotyped men as being assertive, competitive, independent, courageous; one who holds his emotions in check at all times.
It’s that stereotype that our society (and more importantly our American healthcare system), won’t let go of, that has gotten men in trouble as far as medical issues go.
Since the rise of feminism in America back in the 1960’s, women's health issues have become privileged at the expense of male healthcare.
Case-in-point.
Have you looked at the dollars spent each year on breast cancer research compared to prostate cancer? The numbers are by far in favor of breast cancer. Why?
Look at the thousands of all-female clinics that have sprouted up all over the country. Men have nothing anywhere near that number in all-male clinics. Why?
In September of 1990, the Office of Research on Women's Health was created in the federal government. Twenty-eight years later and there is still no Office of Research on Men’s Health. Why?
Why, because women's health issues have become privileged at the expense of male healthcare for over 50 years now.
That privilege, has led to the discrimination of male radiologists, nurses, and patients by the healthcare industry.
It is also, a major reason why men are dying on average 7 years sooner than women but our healthcare industry never tells you that reason because they are responsible for a big part of it.
When a woman needs medical attention, she’s automatically given Choice, Privacy, and Respect (CPR) by the American medical community. If she has an intimate related exam, test, or procedure, she has a Choice of same gender caregivers if she so chooses so as to respect her dignity and protect her privacy.
The same cannot be said for a male.
If a man needs medical attention, he’s told to leave his dignity, honor, privacy, and respect at the door or don’t seek medical attention.
He has to endure intimately invasive exams, tests, and procedures done in the presence of and by female healthcare workers while being told “we have no modesty here”, or “you don’t have anything we haven’t seen already”, and “we don’t have any male nurses so I’m it”.
What’s wrong with a male hospitalist stepping in and taking over? Other countries use them all the time.
Some men have no problem with being exposed in front of and handled by female healthcare workers. That is their choice and it should be respected by everyone. By the same token those men that choose same gender caregivers should have their choice respected by all and honored by the healthcare system.
Ladies, your male loved ones are being embarrassed and humiliated on a daily basis all over this country by the same system that protects you. Is that okay with you?
(end part 1)
NTT
Part 2.
Men get NO Choice, Privacy, and Respect (CPR) from the American medical community.
That ladies, is why your man has walked away from needed healthcare. They’d rather let nature take her course and die an early death rather than go back to a compassionless medical system for more embarrassment and humiliation.
Why aren’t men be afforded the same right to Choice, Privacy, and Respect (CPR) from the American medical community that women have gotten for over 50 years now?
It’s time the American public woke up before its too late and more of your loved ones die a needless death ladies.
Ladies and gentlemen, it’s time to force a dialogue between patients and a compassionless healthcare system.
The veil of secrecy that our healthcare system has been allowed to operate under for decades must now, be lifted off for good in favor of total and complete transparency with the public they serve.
It’s time to tell congress to mandate needed changes to the system.
Patient modesty isn’t confined to male patients. It’s just easier and more fun for the female healthcare workers to do it to them.
The American public pays a great amount of money each year for healthcare premiums. Women for the most part, have gotten their money’s worth from the system over the years.
It’s time now the system stopped short-changing men and give them their due.
That's it.
Regards,
NTT
NTT, great! Let us know if your writings are published. ..Maurice.
NTT,
Great job! Doing this is also on my list of things to do.
I am busy cleaning up an Informed Consent form that I have sent to several legislators, CMS, HHS, and a couple of others. I need to delete the name of the hospital before I post it along with my suggestions on my website. I think the informed consent should be broken down into sections with more explanations and signatures. The informed consent should be more tailored as we do live in an electronic age. One size does not fit all well. I have also sent a 20+ page document to HHS and our insurance investigative unit. I know the document is long but so is the list of abuses and violations that happened.
I am also in contact with a man who does staff training on patient issues with local hospitals. Hopefully, I will be able to get what not to do to a patient as part of his training.
PA,
I can't remember if I have already said it but sometimes there is a recording of the actual catheterization session as they use the video in round table discussions. They probably won't admit to you if there is one but an attorney could probably get ahold of it.
DM,
They do have the bed alarms thing on the ceiling but if you read your informed consent, it says they may film in your room. At least the one from where my husband was at said that. Again, having them admit to that would be next to impossible.
It is kind of funny that the hospital that refused my husband's request to let me be present during his stress EKG also had the cubicles in front of the double doors and when the doors opened, you could see the male patients in various states of undress. No females were in view from where I was sitting. This same lab also had a clerk come into the waiting room calling an older lady by her full name and then proceeded to tell all within hearing distance about her scheduled appointment such as time and what they were for. And yet I wasn't allowed to be with him as I would compromised patient privacy? We left and found another hospital who had no issue with me being present. They listened to our story and said they weren't surprised by it. If we could only go back and change where we went on heart attack night. JR
Maurice: You write, “What is necessary as a beginning (and I have noted this previously) that someone like Banterings to begin, for example, by writing a commentary to the New York Times. Start something on a national level! You all can continue to ventilate here but here isn't enough!” ..Maurice.
I agree with you. As I’ve written in the past, the research is clear; it takes collective action to foster institutional change. Successful social movements begin with a collective sense of dissatisfaction that usually takes the form of relative deprivation. This and other sites provide evidence of dissatisfaction.
What comes next is communicating that dissatisfaction using public media such as the New York Times.
Several weeks ago, I wrote and posted to this blog the first part of a paper I plan to submit to “Men’s Health.” I requested that readers give me feedback – a critical analysis of what I wrote coupled with recommendations would have been apropos and welcome. I expressed my plan to include the second part of the proposed paper. However, Biker was the only one who responded. He wrote, “What you described about your research makes abundant sense.” Does anyone else have something to add?
Were my paper to be accepted and published, it would be challenged from all sides. It would be helpful if those challenges came from those on this blog in advance of submitting the paper. That way I could address them in the paper or be ready to parry them as they come.
PT gave me some valuable, albeit ad hominem, feedback awhile back but it was not a response to the first part of the paper I intend to submit to Men’s Health. It was valuable to the extent that it challenged what I induced from data I had gathered. I still believe that my induction was largely correct but PT’s input made me skeptical about at least one of my “findings.” I’ll address that later.
In graduate school, there was a professor who frequently reminded us that “no data is a datum.” What he meant was that if some people do not respond to, say, a question or questions on a questionnaire, there is some reason for it. The researcher’s quandary is to find out why or the meaning behind the no responses. One explanation for the no responses in the present case is that most contributors to this blog are indeed interested only in airing their grievances. It appears now, though, that NTT plans to start the ball rolling. I’ll hope to find some time to give you feedback, for whatever it’s worth, NTT. -- Ray B.
I wanted to let everyone know that we have put up a new video, Problems With Medicine Being Gender Neutral on YouTube.
Misty
Ray,
Do you remember which blog number your articles was in? I would like to take a look at it. Would USA Today be another one to submit articles to since it is a national paper. It has been so long since I have read an actual newspaper that I don't know. JR
Ray,
Here is another (quantifiable) result of feminism on men:
The Atlantic; Why Men Are the New College Minority
Huffington Post; Why Are Boys Falling Behind the Girls in K-12 and College Achievement?
Here is more (quantifiable) research from Athena Health about the preferences of men for healthcare:
Why male patients may not want medical chaperones
Some male patients may prefer male doctors, research shows
Feel free to add these to your letter.
I also have a Twitter account with links to some great research.
- Banterings
If medical overcharging could be done away with , there wouldn't be a need for Health insurance. Just let there be a monthly bill. Insurance companies are just extra people to be paid and make the cost higher in the long run
Excellent video Misty!
JR, your comments on the stress test reminded me of the one I had a few years back at the local cardiology practice (rural/small town, there is only one practice in the area). It has 3 doctors and though owned by the hospital, it is in a separate standalone facility.
It was in a large room in which two patients could be there at the same time. I wore shorts and sneakers and did the test bare chested. I was OK with that except staff was coming and going the entire time doing things in there that had nothing to do with me and it seemed rather unprofessional. It was even odder that a female patient was having a stress test while they were going over some other stuff with me. She was fully covered of course, but again it struck me odd that patient privacy was not even a consideration and that maybe she would of preferred I not be there.
Misty,
Great video! It seems odd that Maggie got saddled with men in a hospital where it was mostly staffed by women in that dept. and that she had requested all women. Could it have been that the surgeon/hospital done this out of spite? Good points about Versed and what it is used for. It is true that Versed (benzo) makes abuse and mistreatment so much easier to happen. Sadly, the medical community know it too. I really feel for Maggie to have been abused this way. It is indeed a beyond horrible feeling. I am sure, she like we, wonders if she should have left or done something differently. Versed (benzos) is an evil drug. It is used to control and erase memories. It needs to be outlawed for usage along with other drugs in its class. It renders patients incapable, vulnerable, etc. I think everyone has the right to know beforehand who will be involved and their qualifications. This is our life and our bodies so we have the right to know.
Would like to see a video that addresses the issue of personal dignity for men. Most men will get a female nurse. Most prep for men are done by female nurses/techs. Most intimate care done to men is done by female nurses/techs. That they don't even hide the fact the men don't matter because at the urologist's office the nurses/techs are female drives home the point that men don't matter.
When I had my first child, I went to a hospital in Indy that was a women's hospital. The practice was all women except one male. Wouldn't you know it that he was the one at the hospital? However, to their credit, they asked me if it was okay that he be involved until my doctor came and that she was on her way. I said yes and she was there very shortly. Sadly, enough that hospital was overtaken by a large Catholic hospital (not the one from hell) and their philosophy is much different now. In fact, the practice left and went to another hospital.
Biker,
You would have thought that even a small practice could afford to buy a curtain or divider if it truly cared about the privacy of their patients? It just illustrates that the medical community doesn't take into account patient dignity once you enter their doors. I wonder how they would handle the stress test with the transducer where they have to immediately perform it once you dismount from the treadmill?
We gave up the HIPAA part of our business because 1.) we can no longer tolerate being around medical personal in such great doses since our experience and the PTSD2.) it was worse than pulling teeth to get many of the medical practices to spend less $1000 to know if they were compliant w/ HIPAA 3.) and the ones who did have the scan usually did nothing to remedy their issues. What this says is that most medical practices don't really care if patient info is secure and safe.
What I will go on to say is if they don't care about your info being safe and secure, wouldn't it make sense that they also don't care about your overall well-being and personal dignity? Yes, I have painted in broad strokes but they also paint in broad strokes that us mere mortals need to be drugged because we are so immature that we cannot tolerate knowing about our medical procedures. For about every 25 we talked to that didn't have any HIPAA compliance procedures in place only about 1 or 2 would have a HIPAA assessment done. It is mandated by law but unless there is an issue or they are chosen for an audit (which is in their favor not to be chosen) most chose to ignore. How outraged are they when we ignore their mandates? JR
I have worked at a couple of county homes through the years. Until I actually worked at them I wondered why they had such bad reputations.
One major problem was no privacy curtains ANYWHERE. Not in the bedrooms that they shared with one or two people. Not in the bathrooms that multiple people used at the same time.
I learned at a staff meeting at one of them that county homes used to be homeless shelters and became nursing homes when somebody thought to get them Medicaid/Medicare approved. We were told we we the stepchildren of nursing homes because the commissioners didn't make any money off of us!
A. Banterings
The articles you referenced
The Atlantic: Why men are the new college minority
Men typically don’t ask their parents to bribe their way into college.
Why male patients may not want chaperones
Not mentioned in the article. Scribes are the new tool of ambush.
PT
Here is what we have
Female non-medical staff observing male medical induction exams
Female news reporters in male lockers after the game
Female scribes during male urology exams
Female physicians, with a female chaperone and a female scribe in male intimate exams
Female fans at sports games who don’t want to stand in line to the women’s restroom barging in to male restrooms
Finally, we knew this was coming, girls joining the Boy Scouts.
Anyone want to add to the list, be my guest
PT
NTT: Here’s my input re. your “letter to the editor.” Hope it’s at least somewhat useful.
Paragraph 3 under “Men’s Healthcare”: “what” rather than “wat.”
Paragrphs 3 through 6, you suggest two reasons why a man tells his “lady” what she wants to hear. You suggest that the second reason is that “he doesn’t want to look like a weakling in front of you.” In the next two paragraphs, you suggest that stereotypes are behind the fear of appearing weak.
U.S. citizens tend to attribute social problems to individual defects. So, they may misunderstand what you’ve written; to wit, they may think you believe that men have internalized the stereotypes and, consequently, have images of themselves as strong, assertive, competitive, independent, and courageous (as least, as compared to women). However, your intention seems to be to point the finger at society when you write, “he doesn’t want to look like a weakling.” To get your point across, you might put more stress on the man’s reasonable fear that people will view him as weak, passive, dependent, etc. So, the man’s reticence not to “come clean” is due more to his reasonable fear of stigma because of not fitting the stereotype than to a self–image that fits the stereotype. This moves the discussion from what C. Wright Mills calls a “personal problem” (a problem the sources of which lie in individuals – e.g., character defects) to a social issue or social problem (e.g., a problem the sources of which lie in society).
Your 7th paragraph after “Men’s Healthcare” attributes men’s hesitancy to share the truth with their “ladies” to the rise of feminism. This is probably not a good political move. I’d recommend, “Following the rise of the feminist movement in the 1960’s, women’s health issues have become a priority” (or “gained ascendancy over men’s health issues”). That takes away the implication of cause-effect.
You then list what appear to be 3 “cases-in-point? (or indicators or examples) of women’s health issues dominating men’s health issues. 1) More dollars are spent on breast cancer research than on prostate cancer research. Here you might briefly point to the gap in spending – Funding for breast cancer research is more than 200% greater than for prostate cancer. With a bit of searching you might find that the gap has increased over the years. E.g., you might find that in 2010 the gap was 200 % and in 2017 it was 300%.
Your next case-in-point (indicator, or example) is the gap in the number of all-female clinics versus all-male clinics and your third indicator is that the feds have an office dedicated to research on women’s health but not one dedicated to men’s health. You then ask “Why?” and answer “Because women’s health issues have become [I’d use ‘a priority’ rather than ‘privileged’] at the expense of male healthcare for over 50 years now.” You’ve two problems here. First, you’ve “committed” a tautology. If the 3 things you’ve listed are “cases-in-point,” indicators of, or examples of the “privilege” of “women’s health issues . . . at the expense of male healthcare” and you attribute the 3 things to “women’s health issues [having] become privileged at the expense of male healthcare,” then you, in effect, are suggesting that “women’s health issues have become privileged at the expense of male healthcare” because “women’s health issues have become privileged at the expense of male healthcare” – a truism or true by definition statement. -- Ray B.
End Part 1
Beginning Part 2
Evidence for the second problem can be found in Sociology of Health and Medical Sociology textbooks from 2005 (I’ve not looked at them since about that time) going back to when the first books in this sub-discipline were published. The evidence presented in the textbooks that addressed it was that discrimination in healthcare tended to be against women not men, including the funding of research. Since I’ve not studied in the area for some years, I can’t speak authoritatively on the subject anymore. It may be that in general discrimination in healthcare still favors males. If so, then you could be accused of cherry picking examples of the reverse. That means avoiding statements that are overly broad and by using words such as “tends to” or “may” or “it appears” or “assuming that” rather than using absolutes. Your “cherry picked” examples (cases-in-points) seem to carry the stamp of validity and may, cumulatively, affect men’s health in a negative manner but those effects, in large measure, are empirical questions that have not been answered yet. I don’t know what else to say on the matter; just be circumspect in your choice of words and scope.
Next, you assert that the privilege of women’s health issues “has led to the discrimination of male radiologists, nurses, and patients.” Yet, I understand that radiology from residency on up is one practice that has been and still is dominated by males. Discrimination against male nurses does exist but it preceded any contemporary focus on female health issues. And, the percent of nurses who are males has remained stable at around 10% more or less for many years thereby suggesting that, to the extent that the domination of women’s health issues have supplanted the domination of men’s health issues, it is unrelated to changes in the percent of nurses who are males. And, I’ve not seen any study that shows a causal relationship between an ascendency of female health issues over male health issues and discrimination against male patients. I also have not seen a study that shows a relationship between the privilege of women’s health issues and the gap between men and women’s life expectancy that you posit. Indeed, the gap between the life expectancy of men and women diminished until 2017 at which time it stagnated. We’ll have to wait to see if that change is a statistical quirk.
I hope you find something in this post you can use. I’ll continue in this vein later, if you like, NTT. Just post your preference. -- Ray
JR,
Thanks for your feedback on the video, Problems With Medicine Being Gender Neutral. I think the hospital that Maggie had her surgery at does not care about modesty and think modest patients are crazy. I personally think Versed should be banned.
I am planning on putting up another video, Surgery and Your Modesty in the future. It discusses male patients some.
In the meantime, you can see some articles we have about male patient modesty on our web site. Look at the bottom of the web page and you will notice there is a video about male patient modesty by another man.
Misty
I wanted to let everyone here know that Outpatient Surgery Magazine published an excellent article about how surgery patients can have modesty at this link. I thought it was well-written.
Misty
Good evening Ladies and Gentlemen:
Ray, please keep the comments coming as this has to be as factual as it can be if we want people to start talking about it.
My letter to my local paper here was rejected for publication as being to controversial for a small town. In other words they didn't want to offend anyone at the town hospital.
Hog wash.
Will keep trying.
Regards to all.
NTT
NTT, your guess is probably right that the local paper didn't want to draw the ire of the hospital. I don't know the nature of where you live, but in rural areas the hospital may be one of the primary economic drivers of the community and certainly one of the major advertisers in the local paper. That's very much the case where I live.
Perhaps a shorter version that focuses on the sea of women men face for virtually all intimate healthcare being one of the primary reasons many men avoid healthcare, but are too embarrassed to admit. It can be stated that the issue isn't the training or professionalism of the women but rather a simple matter of modesty that the medical community ignores by focusing on it from their perspective rather than the patient's. Healthcare may be gender neutral for those who work in it but it isn't for many patients.
NTT,
I am not surprised your letter was not published. I imagine the amount of advertising dollars your local newspaper receives from them is the reason why they won't print your article. Our local tv stations here have hospitals that sponsor (advertising dollars) on sport segments, etc. I am sure they too would not broadcast opposing pieces either. Today's society has become a place where dissenting views are not allowed. However, different views is what made America the best nation in years past. Sadly, that is no more. I am thinking about a billboard. I am going to check into the price. The hospital from hell viewable from a very busy interstate. In fact, the heart center faces the interstate. That is where I want my billboard.
Misty,
Thanks for the info. I visited the link you listed. I think it is scary that the use of smartphones are allowed in patient care areas. That is one of the things that I have talked to some of my local politicians about. They should be outlawed in any patient care area.
I have posted a new articled about hospital sanctioned sexual abuse on my blog--Issues4Thought. Let me know what you think. It is my opinion of how I now see the medical community. JR
I have to agree with Banterings that I don't like the term of modesty being used. I think of modesty as I don't wear low cut blouses because I don't want to show cleavage or too tight jeans because I don't want things showing like how great the big divide is. I think of not wanting unnecessary exposure whether it be to male or female staff as an issue of dignity. I don't think people should have to be naked and exposed to others unnecessarily. It all is a matter of respect for their customers and also a concern for their overall health including keeping patients warm and their mental status. Unnecessary exposure is a traumatic experience and can leave the victims with PTSD. It can also affect their family. It is more than just modesty. It is how the medical community views their patient, the client. Are they just an object that is there for their services and it doesn't matter how those services are delivered or do they care really care about the overall well-being of their client. Do they recognize their client as a person like they hopefully are or do they think their client is beneath them and therefore are entitle to show that client a lack of respect. I live a modest life but I live it with dignity. There is a difference. JR
The article regarding the link Misty provided to Outpatient Surgery Magazine “ how surgery patients can have modesty “
I believe for the most part the article will fall on deaf ears. If you notice the pictures of the two female patients originally published
by Outpatient surgery magazine caused an uproar. Quite a number of female readers who were female nurses within the industry
complained about the lack of respect shown. I assure you had the patients been male nothing would have been said. Outpatient
surgery magazine and it’s nursing followers could not and would not comprise such an article addressing privacy or modesty, it’s
just not in their vocabulary. I’ve no doubt Misty contributed the article and perhaps wanting to alleviate any anger that Outpatient
surgery may have caused its readers in the past, this articles addresses those concerns.
I believe Misty did an excellent job in an attempt to bring this issue to the forefront, however, it does little or nothing for male patients
in an industry dominated by female nurses and surgical techs with a feministic approach that has shown no respect for male patients.
Dr Twana Sparks and her OR staff in New Mexico as well as the hospital in Penn. attests to this fact! Furthermore, no article of
clothing or contraption designed for the purpose of respecting patient’s privacy or modesty will ever be purchased by any surgical
facility in a hospital or outpatient facility. In conclusion, I want to give our readers some very important tips regarding surgery.
1) Never ever agree to have a surgical procedure done in an outpatient facility. Should something go wrong the only recourse will be
for them to call 911 and have you transported by ambulance to a hospital.
2) Outpatient surgical facilities don’t follow strict oversight regulations as do hospital facilities, surgical infection etc.
3) Should you have a complaint there is essentially no one to arc your complaint up to comparable to hospitals.
4) Outpatient surgical facilities tend to have more unnecessary staff present during surgeries.
5) As previously mentioned, if a life threatening complication arises, bleeding, code arrest etc. There are no present rapid response,
code blue teams etc that can rush to your aid as hospitals do.
6) Pick your poison!
PT
Maybe publishing a view based on what has been discussed on this blog thread in a small town newspaper is, as has been suggested, open to rejection. That is why I suggest a carefully crafted description of the issue, consequences and needed constructive changes and submitted to a major newspaper like the New York Times might be a more reasonable site for publication. ..Maurice.
You know, another concept appeared in my mind which I don't think we have strictly written about here. We have repeatedly written about the patient "speaking up" to the physician (or their "others") but I think the connotation is "speaking up" as the patient (and with regard to the desires and needs of the one "speaking up". But, in contrast, what do you think about "speaking up" not as the patient of the moment but as "the physician's MENTOR". A teacher, teaching not just about yourself but educating the healthcare provider about what you understand the majority of patients expect when they are subjected to care by the professional. It could well be that the professional is looking toward "cure" and not specifically "care" and it would take the education by a mentor to provide the education, of value not just for yourself but for other patients. Or do you feel that any patient in a physician's office or in the hospital is more interested in directing attention to how the professionals treat them as the "patient of the moment" than becoming an educator in the form of a mentor? We have professional mentors in medical school for the students, how about patient mentors beyond medical school who will be YOU? What do you expect would be the reaction of the professional to this needed education? Should patients always "look UP" to their professional caretaker or there is merit for the patient to become their own professional's mentor? Any ideas about my attempt to provide another approach to improving the medical system? ..Maurice.
I don't know if it could get somebody in trouble or not but if nobody has any success in getting anything our issue in the newspaper, how about a person distributing newspapers planting our issue in the papers they pass out?
Dr. Bernstein, I like your thought on mentoring the doctor from the patient's perspective. It's all in the way the message is conveyed. Doing it in an "I'm OK, you're OK, but there is an issue that needs to be addressed" manner is the least threatening way of conveying something. It puts it in a way most likely to be heard vs a personal attack where the defensive shields go up instantly and nothing gets resolved. Easier said than done in the heat of the moment perhaps but a worthy goal nonetheless.
On the small town newspaper issue, for sure the hospital is the largest single advertiser here, perhaps only surpassed in total by the auto dealerships collectively. The hospital is also one of the four primary employers in this nearly thousand square mile county of only fifty some thousand people. None of the other three are heavy advertisers.
Two questions here for those who work in healthcare or who are otherwise in a position to know:
It has been said that many female nurses & other staff don't go to the hospital they work at for surgeries and certain other procedures, presumably for their privacy in not wanting their co-workers to see them exposed. Do female physicians do the same thing?
Do male physicians, nurses, techs etc also not have their surgeries and certain other procedures at the hospital they work at?
I will note that doing so doesn't prove patients aren't being respected or treated in a dignified manner given there is a difference between seeing someone you know intimately exposed vs seeing a stranger. It could be a piece of it however. What it does prove is that exposure in a medical setting does have a sexual component to it even when the staff maintains their gameface and treats the patient in a respectful and dignified manner.
Biker
As you may well know I’ve commented on this subject matter in previous post and since you’ve asked, I’ll go into detail. There was a time that mammography suites were primarily located in hospitals, they have since made their way into outpatient facilities. Hospital employed
nurses never came to have their mammos at the hospital where they worked. They never opted to have their children delivered at the L&D suites of the hospital either, I know because I would ask them, the answer would always be at another facility. In fact, I asked a nurse once who happened to be 6 months pregnant, “ would you ever want to have your child delivered here? “ her response was no, I don’t want every one gossiping about my business.
Furthermore, at all the hospitals that I’ve worked at which numbers about 25, never did I ever see a patient that I recognized as a physician and from what I know their insurance plans are much different than your typical hospital employee in that they have more freedom on where they can go without being considered out-of-network. I’ve never seen any nurse who was employed in our emergency
rooms come in as a patient. I once heard a female trauma nurse exclaim “ if I’m ever brought in here ya’ll need to cover me up” which I
thought was redundant in that they are the ones who cuts and removes clothing from trauma patients.
In conclusion, the general consensus is always heard from staff when the subject would come up about would you be willing to be treated
here at this facility ( where you work) the response was that they would not because the gossip and the concern everyone would know and perhaps nose into the electronic medical records.
PT
Biker,
However, it does prove that nakedness/exposure does matter and totally disproves them saying to us mere mortals it doesn't matter cause they have seen it all before. It proves it only matters when it is their private body parts being exposed. The exposure of our body parts don't matter. If exposure doesn't matter because all are professional then they too should be okay for their nursing or doctor buddy seeing them naked as it is part of their job.
On the other hand, my ob/gyn was pregnant the same time I was and also due the same time. She asked me who I wanted to see in case she went first. I asked her who she was seeing. She was seeing another woman in the practice so I said if she was good enough for her, she was good enough for me. She asked me if I wanted to start seeing the other and I said no. I didn't meet the other doctor until the C-section which by the way there was no prep, the epidural didn't work as I could still fully move and felt the cutting and nothing bad happened. They had given me choices of what the alternatives were and in even in such an emergency situation they didn't ignore my right to choose my own destiny as well as my baby's. I asked what they would do and went with that as that was what we(my husband was ALLOWED in there too) were leaning to anyhow. The guy in charge of the epidural said to hold his hand squeeze it as hard as I needed if the pain was unbearable but it wasn't. They were all very nice, respectful, and professional. We have never had any regrets or bad feelings as how they treated us was like we were people and mattered. It makes a difference.
By printing a letter to the editor that merely makes people aware that hospitals may have an issue with personal dignity especially for male patients does not and is not intended to put the hospital out of business. It is to educate people and hopefully the hospital will review how they deliver their service and seek to improve it. Are your small hospitals being swallowed up by larger ones? That is what has happened here in Indiana. Quite frankly, I think that is why our service level has sunk past the sewer. The larger they are, the less they care. The hospital we are taking action against is self-insured which should tell you something.
Maurice,
One of the doctors we were interviewing said he didn't care about our bad experience as we were trying to nicely explain why my husband no longer felt comfortable with female staff and why he wanted to know how intimate exams are done. He said he does things his way so we said our way is out the door. So much for trying to explain our point of view as to why we are now insisting on personal dignity and respect. Clearly, that doctor was not interested in a patient's point of view. The doctor he has been seeing is better although the hospital is not but my husband won't go to that hospital for treatment. He will go to another hospital even though this doctor is not part of it. In this way, my husband can control what info. the doctors gets as w/ EHR every doctor in the hospital system has access to your info even if they don't need it. Since his records from the hospital from hell are full of false information and such downright lies to cover their -sses, he has only given limited info. He was also put on his paper that no more info from that hospital may be accessed. Some of the info we had to make corrections to like the number of stents as the hospital from hell didn't know how many they had put in during their assault and battery session. In theory, it would be great if doctors would take info like being aware of personal dignity and respect but then didn't they already learn about that in med. school? Isn't that part of the nursing oath too? It is not that they don't know about that but they choose to ignore it for whatever reasons? JR
JR,
In response to your sentence below:
I have posted a new articled about hospital sanctioned sexual abuse on my blog--Issues4Thought. Let me know what you think. It is my opinion of how I now see the medical community. JR
Can you please give me the exact link to your blog? I’d love to see it.
NTT,
I think it is great that you tried to publish an article in your local newspaper about patient modesty. Sadly, I am not surprised they rejected it. I think hospitals in small towns have a lot of power. They may consider publishing it if it came from a bigger city newspaper or a national newspaper.
Misty
On Feb. 14th, PT responded to one of my earlier posts. I had written that a MSN nurse-educator informed me that “typically, patients are left naked en masse while being prepped for surgery.” (These words are mine, a paraphrasing of what the nurse said.) I recalled that she reported having seen as many as a dozen naked patients being prepped at one time. I followed this with the story of a female college student who before being prepped for surgery said she saw “a bunch of naked anesthetized men, one of whom was getting his pubic hair shaved” (my words, as written).
PT responded, “No, no and no. Patients are not left naked in masse (sic) while being prepped for surgery. That’s just fodder for people to read who have a fetish about that kind of thing. Consider the logistics of a surgical center, not all patients have their surgeries at the same time. You can only have so many surgeons, anesthiologists (sic) at one time. Each patient has to be prepped differently, not all patients are the same. Some patients will be intubated while some may have an epidural. . . Honestly, that is one of the most ridiculous assertions I’ve ever read on this blog. Appreciate that I have over 40 years in healthcare with much experience in the OR. There are so many factors as to why this dosen’t (sic) happen and it would take pages and pages for me to explain why, so it’s not worth it.”
PT appears to be questioning only the use of “en masse” (“in” rather than “en” was originally my error) and not my more important point, viz., the genitals of patients being prepped may be (and have reportedly been) exposed within sight of people (including other patients) whose presence is unnecessary for the health/healthcare of the exposed patient. I assume, then, that, from PT’s point of view, my error was in using the expression “en masse” which refers to everyone in a particular cohort. I understood the cohort to which my source was referring to be the aggregate of patients scheduled for surgery whose prep occurred in the same location within the same time period. PT’s input suggests that he thought I was using en masse to refer to an aggregate of patients who had surgery beginning and ending at the same time.
Technically, “en masse” refers to two or more people. I don’t recall my source using the term “en masse” (that was my invention); I do recall her using “dozen” which I took to mean “as many as a dozen” patients at any particular time may be seen undergoing surgery preps together, some at the same and some at alternate but overlapping times. I know she didn’t intend that I imagine twelve patients starting and finishing their preps at exactly the same time. – Ray B.
End Part 1
Beginning Part 2
To get a better grasp of what tends to transpire between prep and surgery, I found three retired nurses who said they could speak authoritatively on the matter. The responses of all three were more tempered than PT’s, but they did think it was highly unlikely (rather than impossible) that one would find a hospital in the U.S. that could accommodate 12 patients being prepped for surgery at any particular moment. They guessed they may have seen or known of upwards to six or eight patients being prepped in the same location at any given moment. For each type of surgery, I was told, standard of care criteria required the use of pre-packaged kits the contents of which were used to prep patients and varied somewhat depending on the type of surgery done. Consequently, they took exception to PT’s assertion, “Each patient has to be prepped differently.” PT probably didn’t mean what he wrote here because he contradicts himself when he writes, “not all patients are the same. Some patients will be intubated while some may have an epidural.” He’s suggesting that, in fact, some patients are the same and must be prepped in the same way, an observation which is consistent with the three nurses.
The nurses reported that over the years, they had worked in between three and seven hospitals with between one and three operating rooms. However, they also reported that there were sometimes more patients being prepped at any particular time than there were operating rooms. This differential tended to be the result of prepping patients who did not require the presence of an anesthesiologist and nurses trained specifically to be surgical or rotating/circulating nurses. Some of these patients were prepped in the same areas as other patients who were to use OR rooms.
One ex-nurse said that in the U.S., she could conceive of at least two scenarios where there might be as many as a dozen patients being prepped for surgery at the same time. The first was in an emergency or disaster situation. The second was in hospitals were surgeons operated on an assembly-line model. Before she retired, she visited a hospital in Seattle where the OR operated on a production-line model developed from practices in India and China. She believed that large hospitals in the U.S. would increasingly be adopting this model in the future and that they would conceivably be able to accommodate a dozen patients being prepped at the same time. Since my original source of information came from an interview near the turn of the century, I had to concede that either the figure “12” was probably hyperbole or, more likely, a consequence of my failing memory. Unfortunately I’ve not been able to find the interview I did with the nurse who I recall spoke of the twelve patients being prepped, but I did find the interview I had with the college student who reported seeing a male patient being prepped for surgery. – Ray B.
Misty,
My site is:
Issues4Thought.com
I will be doing a lot of writing especially telling our story of abuse. It was really horrible and unbelievable but it did happen. And yes, I believe that sexual abuse is hospital sanctioned as they know that patients are exposed unnecessarily and do nothing to change it. It is also a crime to abuse people who are vulnerable, defenseless, and at their mercy of which they seem to have none.
Ray B.
We went to another state to have my husband's prostate surgery as we had time and choice. At that facility where they were famous for prostate issues as well as being a regular hospital, there was a large room where they prepped many patients at one time. There were curtains but some curtain were not drawn. My husband's were drawn as they allowed me to be present during his prep. I made sure he had his privacy. His prep was done by a male tech. The tech kept his genital area covered as best as he could given the circumstances. I held the curtains together. I was also allowed in the PACU and it was also a big room with patients laying in various states of undress. Both rooms had male and females patients. There were 6 to 8 patients in each area. I was also allowed to go from PACU to his assigned patient room while they transferred him. I was not allowed in the OR. I really don't know why because a C-section requires a sterile field and they allow men to attend. I really don't know why other procedures cannot be as flexible. I guess because there have been enough lawsuits over labor and delivery these doctors have learned to be more transparent. So as far as there may be areas like you described, I can personally attest that I have been in one as a visitor to a patient being prepped. After the tech was done he covered his prepped area with a blue drape from a cart he had rolled into the cubicle with him. We have always been conscious of having personal dignity respected as is our right of being human. We choose this hospital after talking to many and their standards of treatment. The hospital from hell was one we turned away from in 2006 because the doctor told us and everyone else in the waiting room about my husband's cancer diagnosis. We not only had to deal with the diagnosis but the fact they others were privy to his private information and our pain at learning of his diagnosis. JR
Though I can readily understand and am willing to provide more than sympathy to JR's descriptions regarding her husband's experiences and her own in dealing with the medical profession, I would suspect that any description to the public through presentation in a major newspaper of the "bad behavior" in the system would require more generalized population documentation along with generalized approaches toward changes and improvements. Unfortunately, change will require more detail than in reference to but one patient. The descriptions published should reflect widely publicized "other case" examples of professional mistreatment and misbehavior and evidence that what I previously described as "statistical outlier" events are not "outliers" but acts of common and publicly unaccepted practice. ..Maurice.
"
Well, there is hope and not all practices have decided to ignore patient modesty and dignity. I say this after a recent visit to a new doctor for a male issue.
The female MA who took my vitals also took the time to explain to me in detail what my examination would involve. She also added that the doctor would be in shortly and that she would be assisting.
My reply was that I appreciated her explanation and that I was a modest individual and did not want her in the room during the examination. She told me that the doctor would require assistance and she was sorry if this would be an inconvenience. I said, to be clear that I did not "consent" to having anyone else in the room. She immediately said that she would inform the doctor and left the room. Later, the doctor came in alone, did the examination and left without mention of my encounter with the MA.
First, I really appreciated the fact that the MA explained everything in detail ahead of time, including the fact that she would be in the room. It gave me a chance to respond without the embarrassment of the typical patient ambush. Second, apparently the magic word was "consent" as in "I do not consent to an additional person in the room". In all, a very civilized encounter.
Ed T.
JR,
Thank you for the link to your blog! It was very informative. I am so sorry to hear about what happened to your husband. Sadly, this is not surprising because of the callous attitude that many female nurses hold.
I've added a link to your article, Hospital Sanctioned Sexual Abuse to two web page on Medical Patient Modesty's web site.
The article is under links page.
I also added your article under Sources on Male Patient Modesty page.
Misty
I wanted to let everyone know that we have several other videos on Youtube that you can check out in addition to the “Problems With Medicine Being Gender Neutral” video. You can see more videos by going to this link.
Misty
Maurice,
I think you are misunderstanding about the presentation of my information. I don't believe I have said I would be sending an account of our story and our story alone to any news media outlet for the purpose of what NTT is doing. As far as my website, it uses our story because it is a place to vent and for others to vent and feel safe. What I have said are facts but there are no works to cite except his medical records. I wish that I had recorded the entire episode so there would be undeniable proof but I never expected such abuse to happen although I am told I would still not be able to play it publicly as with my other interactions with the hospital from hell. I would like to at sometime have others vent and tell their stories too. Since the website is new, it is only ours. As far a bunch of facts and footnotes, for our story and my opinions, at least for now, that is not my style. People can be overwhelmed with footnotes and cited works to support their opinion. I have don't remember ever saying what I intended to send to an editorial column. The writing of an editorial is not my first rodeo and many times an editorial is very subjective in nature without the benefit of works cited. An editorial is meant to get to the heart of the matter through persuasive argument usually done in a manner to make you identify with what they are saying. Of course, you can cite works to back up what you are saying but shouldn't overwhelm or distract the reader from your heartfelt opinion. If there were to be a series of news articles on the subject then I would agree that cited works should be used to back up the claims. I, too, have done that in the past as I used to have my own newspaper column. I also had an editorial column where I gave my opinion. If an articles is not relatable to the targeted audience, then it is just a big waste of time. As for men not having equal access to same gender care, it doesn't take a mountain of cited works to make that argument--they just need to think about all their encounters over the years. I appreciate you letting me explain. I know I have vented a lot about what has happened and I really appreciate all the good thoughts and help. JR
Ray B.
I’ve never contradicted myself and I’ve always wrote what I meant. If you have indeed spoke with nurses then they obviously don’t work in this country. A surgery center be it a hospital or outpatient facility will only have an adequate number of scrub techs and circulating nurses for the schedule of surgeries.
MOST SURGICAL PATIENTS due to the type of surgeries are prepped in the surgical suite once intubated or in the event an epidural is chosen if applicable for the surgery. I’ve never known any nurse etc that would fly to Seattle to observe a surgery, why. They are done the same EVERYWHERE!
For that matter I’ve worked at several hospitals in the Seattle-Tacoma area. Care to elaborate? They don’t do anything special there believe me. As I’ve mentioned I’ve never heard or seen in my life a room where groups of male patients are being prepped for surgery and observed by some female college student. I’ve worked at many major medical trauma facilities with 16 surgical suites and at most we only had 7 surgeries going. If a trauma patient showed up and required a laporatomy or a craniotomy, then someone’s surgery is getting bumped due to current staff levels.
As I’ve said before on this blog, I do not condone nor will I engage in any discussion where I believe people are posting for the purpose of engaging in a medical fetish. This blog is not for that purpose, fetish discussions only degrade the true topic of this blogs goal and I will not have any part of it.
PT
Ed T., I agree that the overall handling of the situation you described went well, except for one item. She used the word inconvenience which is not what it would have been. Imposition would have been a better choice for her, but to her credit she didn't go down the mocking/bullying road.
Hopefully the doctor doing his exam without her affirmed for him that she truly wasn't necessary. Convenient perhaps but not necessary. There is a difference as I have said many times.
I do give the MA and practice credit that she explained everything ahead of time rather than ambush you in a way that would have had any response be confrontational. All in all it was handled very well on your part and theirs.
Today was my annual cystoscopy. Again I asked for a male nurse and was given one without any fuss or tension. He brings me to the procedure room and I get a gown and separate adjoining room to change in. Once on the table and he's ready to start the prep, he pulls the drapes so that I would not be visible were the door to be opened, he says he needs to lift the gown, apologizes for exposing me, and says he'll cover me as quick as he can. Unlike all of the female nurses that prepped me at my former hospital, as soon as he is done he covers me with a cloth until the doctor arrives. Unlike the female nurses at my former hospital who positioned themselves adjacent to my exposed penis and stayed there for the entire procedure, the male nurses I've had these past 3 years stand away from the procedure table and busy themselves with something other than just looking at me.
This hospital is a class act. It's a 150 mile round trip through the mountains to go to this hospital but it's worth it given their professionalism. If a huge (almost 400 bed) teaching hospital like this can get it right, others could too if they wanted to. If this urology practice can find at least one or two male nurses, others could too if they wanted to.
Biker and Ed T.,
I wonder if it would be appropriate if you wrote to your respective facilities and told them how professional and respectful you felt they would to your needs? Maybe some little, positive ripples would help encourage a more respectful pool in the medical pool. Up to the point of joining this blog, truthfully I never much thought about what my husband had to go through as a male. I just thought it was normal that at an urologist office, he would have to endure having a female nurse/tech. It wasn't until the blatant sexual abuse that I thought that wasn't beyond wrong. For me, as a female, I was concerned with male nurses/techs and choose female doctors but tolerated male doctors when I had one but was more careful in what they had access to. This board has been valuable in educating me that men do not have to accept different standards of how care is delivered.
I know that what happened to my husband may not happen to such a degree at other hospitals but since it did happen, we in our minds, now assign that possibility to other hospitals. Once exposed, twice shy so to speak. However, I do believe that men still are exposed more than necessary and women too for that matter. I believe the worst crimes may happen when there are sedatives such as versed involved as it gives them free rein. Although even with versed, they can never be completely sure what the patient will remember. They usually try to dismiss whatever a versed patient remembers as part of the effects of the drug.
Misty,
Great video! I find it difficult to believe that an anesthesiologist was surprised by what happened to his mother. He should have known from the OR that anything and everything goes. It once again proves it does make a difference if it happens to you or a loved one. No one should have to be exposed to the opposite sex especially the vulnerable. It is also telling that the facility had no problem in continuing this practice on others. These videos help in letting us women know that even though we have made great strides, we still have to be on high alert for mistreatment and abuse. Unfortunately, most men don't know this for their own care.
Thanks for the link to my site. I am trying to grow it. I want others to share their stories. For men, urology and the cath lab are the 2 big places where abuse will happen. I think more men need to be aware of especially of what happens in the cath lab as it is flying under the radar. Most do not have a clue on what really happens unless they visit different Internet sites that talk about it.
I am meeting with a web designer and enhancer to help me grow my site. I will be sure to add your site to my links. I am still working on the consent form and the areas I think need to be better clarified and with more signature areas to attest the patient has seen or heard the explanation. I also think Advanced Directives need to be changed to include just a general directive for hospitalization do's and don'ts. On our list is no Versed or benzo type drugs, no female staff members for intimate care, etc. There is a whole list. Everyone should have one. It should be on file at the medical provider, on your person, on your cell phone.
Maurice,
Has anyone in your ethics group ever addressed the use of drugs like versed or benzos that are given primarily for erasing memory. I know they say it is for anxiety but I believe its main purpose is memory erasing. From firsthand experience, it does not relieve anxiety nor did it erase the pain even with 275mcg of fentanyl. It did erase some memories long before, during, and continues afterward to block/erase memories. Does the medical field have the right to erase memories of events happening to a patient that the medical field says they should not remember? Should that choice not be the choice of the patient? This fits into the patient dignity discussion as versed seems to be used to allow them to not respect patient dignity during prep and during the procedure itself. JR
Good Afternoon:
Benzodiazepines as bad as they are, do have a place in the grand scheme of things. I feel the problem is that our medical community has forgotten when and only when the benzodiazepines that have amnesic effects on the patient should be used.
Medical events are a part of life. Some people are lucky to only have experienced a few medical events in their lifetime while other are not so fortunate.
There are people that when they have a medical event, they want to be an active participate and know everything about it from start to finish. Then there is the other side of the coin that say I don’t want to know anything just fix it.
This is where the benzodiazepines should come into play.
While clear headed, the patient should sign their informed consent. Before they sign, as part of the process, the doctor and/or anesthesiologist should ask if they want their memory of the event erased or left intact. Many people don’t want to remember anything while there are some that do.
For those that don’t want to remember, doctors have at their disposal a number of different benzodiazepines they can use to erase the memory of the patient that chooses not to remember what’s happening.
Only when the patient or their advocate are asked about using the drug, should it ever be used on people.
In this day and age of medical errors so on and so forth, the medical community seems to play their ace in the hole (the benzodiazepines), a lot so that things go their way instead of what may or may not have happened.
The only way you’re going to level the playing field, is by making the patient aware that drugs with amnesic effects are being used and let the patient and/or their advocate make an informed decision to use them or not.
There should be in place severe consequences for any medical personnel who use these drugs on someone who hasn’t consented to it.
This is one genie that can be put back in the bottle and it should be.
Regards,
NTT
I find the way versed and other amnesiacs are presented to patients to be very disingenuous. They are told it is "conscious sedation to relax you" without ever mentioning the amnesiac aspect of it, nor the fact that the amnesia effect can be for more than just the elapsed time of the procedure, especially for older folks.
At the hospital I have all of my scheduled care at and at the local one where I'd most likely end up for an ER, my patient record includes "sedation" as an allergy. Allergy might not technically be the right word but it makes me ill and allergies is what they list it under. When I explain it they understand.
With that in my record I doubt anyone is just going to give it to me for their convenience.
Maurice: You write, “But, in contrast, what do you think about "speaking up" not as the patient of the moment but as "the physician's MENTOR". A teacher, teaching not just about yourself but educating the healthcare provider about what you understand the majority of patients expect when they are subjected to care by the professional.”
Been there, did that; I’m way ahead of you, Maurice. Self-reports and research on the subject suggest that an aim of physicians and the organizations in which they labor tends to be the control all aspects of patients’ lives as long as they are in a healthcare setting. These aims are codified in policies, some based on standard of care criteria and some based on extramedical criteria all of which are designed to strictly limit patients’ autonomy and all of which tend to be administered ritualistically.
Most textbooks in the sociology of health or medical sociology spend some time discussing this matter. Moreover, I’ve cited one scholarly publication after another that confirms what I’ve written. I cited, among others, John Macionis’ (2011: 102) dramaturgical analysis from which he concluded, “The overall message of a doctor’s performance is clear: ‘I will help you, but you must allow me to take charge.’” I cited Joan Emerson’s (1970) use of social constructionism to analyze exchanges among doctor, nurse, and patient during pelvic exams. According to Emerson, the three parties generally team up to balance the two vying definitions of the situation regarding the meaning of female genitals – the clinical definition and the cultural definition. She notes that it’s usually the patient who threatens the balance, a situation which mobilizes the physician and nurse to take action and regain control. And then there is Talcott Parsons (1951) who wrote about the sick role from a structural-functional point of view. In Parsons’ treatise, he too recognizes that patients must relinquish to physicians all control over their illnesses or run the risk of a deviant label being imputed to them. Finally, read the works of Erving Goffman (1961) who recognizes that control of patients is a if not the major objective those who labor in hospitals, including physicians.
Couple the on-point scholarly studies on the matter with patterns easily identified by the aggregate of anecdotes on this and other blogs, it would hardly seem reasonable to hypothesize that physicians would likely be open to patients who unilaterally take on the role of a trusted advisor or even an educator of physicians no matter how experienced they are. Patients who presume to do such a thing would most likely be seen as undercutting a physician’s legitimacy in a manner that threatens the control that they have over the circumstances of the examination or hospital room. Among the actors both inside and outside of healthcare, the role expectations associated with the status of patient does not include the role of mentor nor the role of educator of physicians. It is clear that physicians (and probably other healthcare providers too) would consider any patient who performed this role as having gone too far, as having engaged in deviant behavior. – Ray B.
End of Part 1
Beginning of Part 2
To test my “suspicions,” I conducted (and continue to conduct) an ethnomethodological breeching experiment which entails disrupting targets’ definitions of reality, recording their reactions, and then looking for patterns in these reactions. I randomly assigned myself to questioning the ethical authority of physicians to use me (and other patients) as a teaching subject without prior consent (experimental group) and to staying mum about the presence of a student and the failure to get consent (control group). When doing the former, I, in effect, played the role of what some call a standardized patient. These patients are actually pseudo-patients; they pretend to be sick while a student is “practicing” on them and behave in a prearranged manner. After the simulation has been completed, the standardized patient helps evaluate students’ social performances while a physician-educator evaluates their technical performances.
Unlike a standardized patient, however, I collected data in the process of receiving care that I needed rather than care for a health problem I really didn’t have. Sometimes I addressed the physician and student in the beginning of the visit and sometimes at the end. The protocol I intended to use (and will continue in the same vein) when the teaching opportunity arose was as follows: 1) briefly describe my background including teaching about principles of ethical healthcare delivery; 2) briefly explain why it is ethically obligatory to get patient’s consent before bringing in a student and thanking patients for the service they provided; and 3) give them a typed page that elaborates some of what I’ve told them and cites sections of the AMA’s Code of Medical Ethics that are on point. The presentation to physicians and students was structured to take under two minutes.
So far, I have collected data from 35 visits. My prior consent was obtained on three of those visits. That left 16 experimental group visits and 16 control group visits during which no consent was obtained. All physicians expressed surprise and, sometimes disbelief, both verbally and nonverbally (e.g., by raising their eyebrows, shrugging their shoulders, shaking their head “no”), about what I was saying. None of the physicians and their mentees expressed any interest in what I had to say. All interrupted me before I was 30 seconds into my explanation and directed my attention to, in one physician’s words, “matters at hand.” When I gave them the page handout and suggested they read it at their leisure if they were interested, most, both physicians and students, glanced at it and handed it back, others just handed it back without a sideways glance, and a few folded it up and put it aside. Here are some of the comments made by physicians:
1. “I owe it to my students” (to use patients as teaching subjects without consent.”
2. “I’m the doctor here.”
3. “I’ve got to get to my next patient.”
4. “I don’t have time for this.”
5. “If you didn’t want him here, you should have said so in the beginning.”
6. “I did get your consent.”
7. “Didn’t they tell you out at the desk that I had a student?”
8. “This is a teaching facility.”
9. “No one ever questioned me about this before.”
10. “This is the way we do things around here.”
Ray B.
End Part 2
Beginning Part 3
I induced the following from the patterns found in the data collected (so far) and coupled them with observations made by other researchers and theorists:
1. Patients (other than standardized patients) who attempt to perform the role of teacher (or mentor) are unlikely to be welcomed in examination rooms. When these patients offer to attending physicians and their students the same insights they offer to learners in educational settings (e.g., schools (as in my case),continuing medical education courses, as physician-educators on rounds in
teaching hospitals), their input is unlikely to be valued and they will be defined as deviating from the role of the “good” patient.
2. Physician-educators and students who shadow them or practice under their authority tend to believe that they are entitled, by virtue of their status positions and their importance to the health of the people of a nation, to use patients as teaching subjects. Patients are believed to be ethically obligated to submit to the scrutiny and ministrations of students.
3. The primary function of teaching hospitals is teaching.
4. Physicians tend not to understand the difference between a right and a privilege.
5. Among physicians, ethical considerations tend to play second fiddle to pragmatism or utilitarianism.
I’ll end (for the umpteenth time) with an anecdote written by Dr. Edward
Rosenbaum (1988: 4, 8) who, when he became a patient, was unable to sustain his status as a physician (in the very hospital in which he practiced) but was instead relegated, no matter how hard he resisted, to the social status of a dependent child.
"I had walked into the admitting room. There was no trouble with my legs; the problem was in my throat . . . I was not allowed to walk to my room; I had to be pushed in a wheelchair. Then I was subjected to the final indignity: they took away all my clothes and gave me a skimpy piece of cloth. . . When I tied that piece of cloth around my neck, it wasn’t long enough to cover the important parts. It was far too tight and hung open at the back. I felt as nude as a newborn baby and suddenly as helpless. . . Now I was [a] patient, literally stripped of my dignity. I was no longer in charge, I was being treated like a baby . . . At last it was time for the surgery. The nurse came into my room and treated me like a child. . . It was embarrassing. She wasn’t more than twenty-five year old. . . Without asking my permission, she removed the sheet covering me, ant there I lay on the bed, almost completely naked. All I had on was this hospital gown which reached only to my belly button. She wanted to help me onto the cart, but I wouldn’t let her; I wasn’t helpless yet. When I was settled on the cart, she again covered me with the thin sheet that I was sure everyone could see through, and I was wheeled down the hall to the elevator and they all looked down on me, and again I felt naked."
If Rosenbaum’s experience is typical of the experiences of physicians in general who must travel to the other side of the stethoscope, if physicians are compelled to give up the roles they perform as physicians in order to get the healthcare they need, then what is the likelihood that a teacher or mentor would be able to carry their roles into an examination room? Not too great, I’d say. – Ray B.
BIBLIOGRAPHY
Emerson, Joan. 1970. “Behavior in Private Places: Sustaining Definitions of Reality in Gynecological Examinations.” In H. P. Dreitzel ed. Recent Sociology. Vol. 2. Collier: 74-97.
Goffman, Erving. 1961. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Anchor Books, Doubleday& Co.
Macionis, John. 2011. Society. Pearson.
Parsons, Talcott (1951). The Social System. The Free Press.
Rosenbaum, Edward. The Doctor (originally, A Taste of My Own Medicine). Ivy Books.
-- Ray B.
Ray B. thank you, thank you for your excellent description and dissection of the matter regarding patients presenting themselves to their attending physician or other medical professionals as their mentor. I can understand that one can assume and it is born out that those attending to the illness of a patient consider themselves "in charge" and are not looking for such a patient presentation.
Consider the example of a pilot of an airliner in flight. The pilot would not be expected to accept a passenger to become his or her mentor providing better or best flight control information. Continuing your analogy of a physician as a patient, one would unlikely expect the airline pilot to readily accept and carry out the technical decision making during the flight provided by a passenger who, it turns out, happened to be also an aircraft pilot.
So Ray B. it seems from your observations and background knowledge, that my attempt to link the property of a physician's mentor to one who is the physician's patient is unrealistic. ..Maurice.
Biker,
At the large teaching hospital my husband went to: 1. On that fateful night, when they were told about his allergies to painkiller, Versed and other benzos. and their effects, they chose not to write it down 2. Later, during his cardiac rehab. visit, they wrote it down but crossed it out 3. The hospital from hell did not ask at all and he was too drugged to be able to form his protest. It would seem that your area is more responsible than the area in which we live. The first hospital is a large teaching hospital. They choose to ignore his allergy as they knew that the air ambulance gives fentanyl on a routine basis. Fentanyl is a common practice. The only ones not aware of being given fentanyl as standard procedure would be the patient.
Ray B.,
Great articles! You hit the nail on the head. I have seen some of those attitudes in our dealings with the medical community at large. In our experience, we have never been told in advance that a student will be present. There has not been any permission asked by a provider. We have always had to ask why the other person is in there. We have always had the added stress of having to tell them that the student has to leave. In a urology exam, this is especially upsetting to see another person tagging along to be present during an intimate exam.
Maurice,
When I take my car to the mechanic who is highly skilled, I leave instructions such as take care to use mats on the floor or I don't want my car used to run errands such as picking up kids from school, or eating in my car. I have told other professionals of my wishes on how I require something to be done. I don't think it is out of bounds to tell a medical person about personal dignity treatment and why this is important as a whole. I don't believe your original post encouraged us to tell a doctor about the technical aspects of his job but rather the patient-people skills pertaining to personal dignity. Since the issue of personal dignity offenses appear to be widespread, I do not think it is unreasonable to think of broaching the topic. I think many medical providers think that curing the patient only involves cures such as needles and pills so to speak but often forget that the manner in which they deliver the care also plays a major part in whether the cure is successful or not. Damaging a patient's mental health to the point of future rejections of medical care because of prior abusive medical treatment does not equate to having been successful at a cure but rather doing more harm than good. I think that may be part of an oath of doing no harm but it appears that is ignored when personal dignity issues become so out of control.
NTT,
I understand that benzos do have their place but the problem is the not all the medical community understand this. If you read especially about heart cath. procedures, the overwhelming majority will say something like you will be given a sedative to help you relax. There is nothing in them to suggest you have a choice. Most read that it will happen. Here are a couple articles that talk about the use of zombie sedation as I call it: https://blogs.jwatch.org/gastroenterology/index.php/sedation-free-colonoscopy-why-isnt-it-the-standard/2009/02/18/ and https://www.medscape.com/viewarticle/885560. If conscious sedation was not used as an automatic you're going to get it whether or not you want it then I would not have a problem with adults not doctors having the decision. However, it is being used to control patient's actions and memories. Ethically, this is wrong. JR
The one and only acceptable response from those doctors was the doctor who said " I have to get to my next patient." Maybe doctors just have it locked in their heads that they are already doing their jobs as well as they know how. Maybe the best time and way to plant seeds in their minds would be staff meetings discussing most common reasons people avoid needed healthcare
Good Afternoon:
JR, legally every patient has a choice.
These are the things that the medical community must be retrained on.
If the patient writes on their consent form that they don't consent to any drugs that affect memory, and they give the patient versed, they and the hospital are in violation and both can and should be sued.
The medical system is dysfunctional and it's up to the public to see there are problems and force change to fix it.
Regards,
NTT
NTT,
That is just it. Informed consent is not always done properly and suing is not that simple at least here in Indiana. If you are in the midst of an emergency and you verbally tell them when asked as they are filling out the forms, most--like us--assume they will do the right thing and write down the information. It is of vital health importance or so you would think but apparently not. We had no reason to believe they were not writing down all the info as they were asking and we were providing the information. However, they didn't and unfortunately we were not aware of their dishonesty until we got the MRs. Once we received them we could see that at the ER they simply chose not to write down his issues and refusal of painkillers, benzos, and/or versed. In a later visit, the same hospital wrote down his issues w/ painkillers, versed, and benzo and that he refused them. However, once we received an updated copy of those MRs, we saw they had hand crossed out that information. I guess is that for a cardiac patient, they will give those drugs whether or not as they are pretty much standard procedure here in the US. Yes, I wholeheartedly agree that every patient has choice but the whole point of our argument is that choice was not given. It is also too easy for informed consent to be skewed or coerced or not given like in our case. He was drugged and at that point legally unable to make decisions and they knew it. They failed to list the massive dose of fentanyl. They also failed to get my consent even though I was there and listed as his next of kin. They knew they didn't give it and tried to cover their mistake. However, in Indiana, malpractice without an actual death or extreme, extreme injury is unlikely to get past the board of doctors that review it before it is ever allowed to become a case. It appears, at least here in Indiana, the law favors the medical community. I have looked at the stats listed on the state site. Yes, I agree the system is supposed to work one way but in reality is working another way which is usually against the patient. Actually, too, my husband never saw a consent form to even make a note on. That happens to probably more patients than we know. As I have said before, he was alert so they said x3--person, place, and event. We feel very strongly about this and do not want this to happen to any other innocents victims. This s why we are making his ordeal public. What happened should not be allowed to happen again. It just is not right. I don't have all the answers or solutions but that is why I am participating in board. I am soaking up what everyone says so I too can go out and help bring about change that really should not have to be brought about if the medical systems truly was there to serve the needs of patients and not there just to line their pockets with money and stroke their ego for the need of power and control. JR
PT writes: “I’ve never contradicted myself and I’ve always wrote (sic) what I meant.” (Monday, March 18) He is referring to a statement he made in an earlier blog, viz., “Each patient has to be prepped differently, not all patients are the same. Some patients will be intubated while some may have an epidural.”
The second part of PT’s first sentence is a non sequitur; it does not follow logically from the first part of that sentence. If “each patient has to be prepped differently,” then it follows that all patients are different (in the sense that all must be prepped differently). To write, “not all patients are the same” suggests that some patients are, in fact, the same which contradicts his assertion, “Each patient has to be prepped differently.” PT’s next sentence also contradicts his “each patient” statement. If “each patient has to be prepped differently,” then it does not follow that “some [more than one] patients will be intubated while some [more than one] may have an epidural.” If what PT meant was, “Not all patients are prepped in the same way,” if it is true that he has never contradicted himself, and if his claim, “I’ve always wrote (sic) what I (sic) meant” is also true, then we have just witnessed an historical first.
PT’s next remark is, “If you have indeed spoke (sic) with nurses then they obviously don’t work in this country” followed by, “A surgery center be it a hospital or outpatient facility will only have an adequate number of scrub techs and circulating nurses for the schedule of surgeries.” PT is correct, the nurses with whom I spoke no longer work in this country; they are, as I stated in my post, retired. His next statement is a truism; as such, it proves nothing.
PT later writes, “I’ve never known any nurse etc that would fly to Seattle to observe a surgery, why. They are done the same EVERYWHERE!” First, I did not write that the nurse flew anywhere. She didn’t tell me what type of transportation she used or where she lived at the time. She may have walked to the hospital for all I know. She also did not claim to have observed a surgery and I never wrote that she made such a claim. She informed me that she had “visited a hospital in Seattle” (with, as a matter of fact, several other administrators) to study a system-wide production model that the hospital had adopted (I erred when I added “line” to production). She didn’t tell me what the name of the hospital was, but I will find out when next I see her. – Ray B.
Part 2
“I’ve never heard or seen in my life a room where groups of male patients are (sic) being prepped for surgery and observed by some female college student,” writes PT. This statement is fallacious in at least one and possibly two ways. First, it is hyperbolic. I challenge anyone to find where I wrote that a female college student saw “groups of male patients” being prepped for surgery in a room. I reported that she informed me as having seen only one man being prepped for surgery; she also saw other men who I assume were lying on gurneys. I found what I wrote when I interviewed her. What follow are some of her exact words as I originally recorded them: “As I lay there, these nurses came and took the sheet off a man and began to shave him. You know, his pubic hair. They didn’t say anything, just took the sheet off him . . . Right in front of me, they shaved him. I couldn’t believe it. I was real embarrassed.” Second, if PT intends that his readers believe that because he has neither seen nor heard of a female college student (who is a patient) observing a man or men being prepped for surgery, it could not have happened, then he is “guilty” of overgeneralization, irrespective of his credentials as a practitioner.
PT ends his rebuke with an ad hominem attack, apparently directed at me. He writes, “I do not condone nor will I engage in any (formal debate) discussion where I believe people are posting for the purpose of engaging in a medical fetish. This blog is not for that purpose, fetish discussions only degrade the true topic of this blogs goal and I will not have any part of it.”
My sentiments regarding expressions of medical fetishism parallel PT’s; such expressions disagree with me whether addressed on this blog or elsewhere. During the other periods of time that I participated on this blog, Maurice deserved accolades for the credible job he did, and I believe still does, as gate keeper. I think he should extend his efforts to blog contributions that include ad hominem attacks, as they undercut efforts at reasoned discourse thereby breaking down communication rather than fostering it. I can tell the reader this much; I do not find the violation of human rights of any sort, whether described in this blog or elsewhere and whether it be fiction or fact, titillating. Quite the contrary, as a matter of fact, my most common sentiments in response to anecdotes about abuses in healthcare are anger and frustration. These emotions are pricked because of, among other things, how little effort is made by authorities to prevent these violations from occurring. The latest story with which I am privy is about pediatrician John Barto who allegedly abused three generations of children before he was apprehended and, finally, sentenced to prison. – Ray B.
I am doing research on gender discrimination directed at male patients during healthcare encounters. To be frank, there is not a lot except what I have from the great people who participate in this blog. I have found plenty about discrimination against male nurses which does fit into why there is a shortage of same gender care for men. But I want some hard facts. I want stories besides what happened to us. I want to write a series of articles and see if any of my newspaper friends from days of old will help me in getting it published. I have written articles for the local newspaper but I am almost certain they will not publish this as their biggest advertisers are the 2 hospitals we had dealings with even though I will not be mentioning them. I am also wondering if anyone knows how many people in this country are employed by healthcare related jobs? Meaning auxiliary businesses such as manufacturers of medical devices, insurance, paramedics, nurses, doctors, techs, etc.? Any input into where I can find some good research is appreciated.
Ray B.,
I know that I suffer from anger because as old as I am I simply never realized what male patients have to endure. I am also frustrated because as a whole the medical community appears to be going backwards instead of forward in being transparent, ethical, compassionate, nondiscriminatory, etc. I still have a hard time believing what happened to us is nothing personal but just a reflection of substandard care in all aspects. It certainly felt personal. I also have a lot of anger as many medical people who commit such crimes like John Barto are able to exist for years without being discovered. I should not find that incredible as when I witnessed sexual abuse, I didn't realize that was what it was until weeks afterwards. For me personally, that is what upset me the most is that I failed to protect someone I love. I cannot imagine what it feels like to be a parent of one of those children who Bartos or someone like him molested. Changes cannot be made too fast. JR
As I have written repeatedly on this blog thread that ad hominem (placing blame or criticizing the writer instead of the topic under discussion) and also on other subject presentations (including, incidentally, the thread where I offered the suggestion with possible supportive arguments for discussion that pathologists should not be given an MD degree but a PhD, getting repeated ad hominem remarks centered on me, the one who offered the topic for discussion. p.s. you might be interested in looking at that thread topic.
I appreciate the comments presented on this long running thread by both PT and Ray B. and every one of the others who are currently posting. It is difficult and emotionally ridden topics presented here but, unlike often what is seen in political discussion elsewhere, discussion here should be always oriented on the issue and NOT the presenter of the issue. ..Maurice.
Ray B.
Please, enlighten us on what healthcare experience you have.
PT
Three generations of sexually abused kids? That isn't good! And it gives reason to believe that medical fetishism is a root cause of many of the intimate exams being given. This is JF. I'm having a hard time entering comments. My phone is trying to make me print out my real name. Printing my real initials is bad enough but I can't even do that and comment on this blog most of the time.
Maurice: You present an interesting empirical question in your middle paragraph. The question is: Would an on-the-job airline pilot (or people in other vocational occupations) be more amenable to considering the technical input of a passenger-airline pilot than an on-the-job physician would be amenable to considering the technical input of a patient-physician? The null hypothesis would be that there is no significant difference between the two. I wouldn’t want to be required to test this hypothesis.
Except when I wrote about The Doctor, my focus was on the patient who is not capable (or, less capable than the physician) on the medical/technical dimension of care delivery but equally or more capable on the social/ethical dimension of care delivery.
Re. your last sentence, “my [meaning “your”] attempt to link the property of a physician’s mentor to one who is the physician’s patient is unrealistic.” That would seem to be what one would infer from what I wrote. Yet, I live close enough to Pollyanna Land to be hopeful. Yes, I think, generally speaking, it is unrealistic. But I also believe that as the circumstances change – all other things being equal including provider and patient characteristics – the chance of a successful mentorship also changes. For example, I think it is a common practice today for new patients and patients before a surgery or procedure to meet with the physician. I would hypothesize that, for any number of reasons, the physician would be more amenable to patient input on the social/ethical dimension of healthcare delivery than, for instance, during the beginning or end of an examination, the latter which I am doing in my breeching experiment.
I’d like to add, Maurice, that I totally missed your Friday, February 8th post where you write, “I fully DISAGREE that ‘the right of the public to know via visual and auricular access to patients’ confidential information and persons in their times of great crisis and vulnerability trumps their rights to privacy and dignity’” I hope you didn’t think that this was a position I took. It was, in effect, the defense used by Johns Hopkins’ CEO and president of its board for the nonconsensual filming of some ER patients in the making of “Hopkins 24/7” that was first aired in 2000. T his occurred after they, from one fork of their tongues, admitted that ABC film crews were “granted . . . unhindered access [to Johns Hopkins] virtually around the clock, over a three month period” and from the other side of their tongues claimed to have been “exquisitely sensitive to issues related to patient privacy and confidentiality.” I meant my reference to “horses’ mouths” to be taken as a flippant gesture regarding the level of authority they enjoyed by virtue of their credentials as heads of one of the most prestigious hospitals in the world.—Ray B.
JF, your pseudonym at the end of a post need not be related in any way to your real name.
The only issue I can imagine by having your pseudonym typed at the conclusion of a posting is that someone inputted as Anonymous else could easily use the same pseudonym as yours--- which should be a "no no". That is why hopefully keep your pseudonym at the top of the text after the date as you have been doing up until now. ..Maurice. p.s. Any suggestions by others for JF's concern?
This is PJF, new to this blog. I am a 60-yr old modest male and have always had a male doctor. I came upon this blog years ago and have read the stories of embarrassing exposure to female medical staff. I vowed to never let it happen to me.
Well it did - this past week I was "ambushed" at a doctor's appointment. My story below.
I recently had a minor ache in my genital area and my regular doctor referred me for a bladder ultrasound and a consult with a male urologist. His office made the appointments so I did not get a chance to ask for male support staff.
For the ultrasound, I was in the waiting room (all female staff so far) when the door to the exam room opens and a male tech calls my name. I was so relieved. I thought how great that they assigned me a male tech. The ultrasound was normal.
For the urologist, I was especially nervous and had practiced in my head how I would tell the urologist that I did not want a female nurse in the room for the intimate part of the exam . I was in the waiting room (again all female staff as expected) when the door opens and a male nurse calls my name. Immediate relief and I questioned all my prior fears and planning. He led me to the exam room, we briefly discussed my issue and he said the urologist would be in shortly. I did not have to undress.
Then the ambush. Minutes later there is knock on the door and the male urologist enters - closely followed by a young female, both in white doctor coats. He introduces himself and then the female as "studying surgery" and was there as a "scribe" and to learn. He did not ask me if this as OK. I just froze! I had not expected this at this point. I lost all courage and could only muster a weak hello. I sat on the exam table, he in front of me and she off to the side. She was oddly not taking any notes like a scribe, just watching. After some discussion, he explained that my ache was likely a pelvic muscle spasm that would subside and not to worry. I was only partly listening since I was rehearsing in my head how I would ask for the female scribe to leave during the pending intimate part of the exam. Then he said "OK let's have a look so drop your pants." I again froze and just did as told. To make things worse, she stands up and moves behind him, I assume in order to see better was he does. He then examines my genitals and then says turn around and bend over for the DRE. I felt so humiliated with her viewing all my front and rear. Thankfully, he did not have her also do a DRE. He said everything was OK, no need to worry and we say goodbye.
So here I am a few days alter. I am thankful to be healthy, but all I can think about was my embarrassing exposure. It is like I have a PTSD. Why was she there? Why did he not ask if this was OK? Why did I freeze and not speak up? How many other men were ambushed that day? We were all nervously there for one of a man's worst fears - urology issues - and this happens to us?
In hindsight it is easy to make plans to prevent such a situation, but it is much, much harder to execute. I recall thinking at the time if I ask her to leave that the doctor had the power in the room and perhaps would treat me negatively. Other than annual physicals all by male doctors, I have had little contact with the medical community. This was a first for me and I could not muster the courage to speak up and protect myself.
It was great that a male ultrasound tech and nurse were assigned to me without me asking. This suggests things are getting better. But my story shows that more change is needed - right up to the doctor level. Many men, me included, still need to find the method and courage to say no and that is not so easy. Blogs like this help and thanks to all who have contributed their stories and advice. I hope to be able to say "no" next time.
PJF
JR said:
Maurice,
I agree that disagreements should not be personal. None of us should expect that everyone has to agree with all or even anything we say. That is why there is discussion and that is how change happens. I spent some time reading your discussions in the other blog. Your arguments were solid and thought provoking but clearly were not the majority viewpoint. The same thing happened here in the teaching field when the state decided to encourage more to become teachers, they offered life experience in business or another degree to shorten the time needed for a degree in education. Most teachers took that as a personal insult. If a school administrator does not have an education degree or teaching experience, teachers often do not respect that person. Degree sensitivity is widespread in other fields too. Since you have stated it above, I will try to remember to put my JR in the beginning.
Going back to research, there are all kinds of articles on why women do not want male nurses/techs. I have even read articles where male nursing students report female nurses and/or educators harass them as they are going through the nursing program. I have found other blog sites where men voice their concern but some of these sites get pretty gritty. Some posters are just downright vicious.
When I was younger and had just decided that being an attorney was not for me (it now appears I should have stuck with that). I thought about becoming a surgery tech or something along that line. I had just started college at IUPUI and wasn't sure about what I wanted to be when I grew up. I went to the local voc. school. They, in turn, arranged with their training hospital for me to spend a couple of days in the patient prep area and OR as an observer. I did not return after my first day as I was mortified to be allowed in during such a time to watch. It was when I really became aware of what indignities patients have to suffer. I wanted to cover them up but was told not to interfere. It was the blood and guts that bothered me but how patients are treated--the actions being in form of verbal and how care is delivered. However, I had no idea how far this abusive behavior could lend itself. I have always felt guilty that I had intruded on those patient's personal dignity as during that time they were allowed to have no dignity. When I visited with my husband in Florida in 2006, the above is the reason I kept my eyes averted as best as I could when I was with him in the pre-op area and in PACU.
Later on while I was still attending school (took a number of years as I had to work my way through school), I worked for disability in claim review. Having read thousands of medical records, it was clear to me that many doctors were very subjective in their reviews of patients. Yes, there was the usual medical review but also there were a lot of their personal opinions which at times were downright vicious. Our lead doctor, a former surgeon with a hand injury which prevented him from doing surgery, would always note how unprofessional those "jerks" were. I wonder if in today's age of EHR if there are additional records that doctors keep that are not for patient review? It is clear that in today's records there are automatic phrases they select but the real question is whether they have actually done what they have selected. Procedure logs of past yielded much more information than those of the present as they now use electronic systems that have standard phrases for the corresponding procedure. I wonder about the truthfulness and how complete these records are nowadays? It is truly an assembly line mentality which have made people into objects. JR
Welcome PJF. The more voices the better. Don't be too hard on yourself. Pretty much all of us here have had our stories to tell too, and I readily admit it took me far longer to find my voice than it should have. It was really hard at first and initially a bit embarrassing to speak. This was because men are socialized to make believe it doesn't bother us, but speaking up does get easier each time.
I do want to point out one thing that the doctor did to you which says he knew it was wrong but he did it anyway. This was introducing her as "studying surgery". Were she a medical student he'd of introduced her as such. Odds are she was a college student thinking about going to medical school, or perhaps even a high school kid thinking the same. Yes, high school kids shadow doctors and doctors obscure the introductions so as to make the patient think they are medical students. Giving them white coats to wear is one of the tactics they use to trick patients into thinking the kids are something they are not. My local hospital allows kids as young as 9th graders in the OR to observe surgeries if they are shadowing doctors. At that hospital there are no policy restrictions as to what a high school kid can see. It is up to the doctor. Patients can refuse the presence of these kids, but there is no policy requiring the doctors to accurately introduce them. Simply calling them "student" is all that is required, knowing most patients will assume they are medical students. Not every kid can get such access though. Often it is professional courtesy for the kids of their doctor or other friends.
Having had the experience, just make the resolve to speak up next time. Doing so when you make your appt and/or check in works better than a confrontation when she comes into the room. For example, for a recent dermatologist visit, at check-in I told the female working the desk that I had requested only male staff when making my appt. She tells me they only have female staff, which is what I expected to hear. I then tell her I don't want to make more work for the doctor but I want to speak with someone about how my privacy will be respected during the exam. A nurse promptly comes for me for a private conversation and assures me she'll speak with the doctor and will take care of it, and she did. Their norm is an LPN and scribe in the room. The LPN stayed out altogether, the scribe turned around to not see me during the exam, and the doctor positioned me so that the scribe couldn't have seen anything even if she did try to look. No extra work for the doctor and my needs were met without a confrontation.
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