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Patient Dignity (Formerly:Patient Modesty):Volume 101
Is the image above, the way patients, especially male patients, as extensively discussed here, are expected to look at and accept nurses and their behavior? Or should we disregard the published
exceptions and look at a nurse this way:
It is the nurse who manages the day to day and hour to hour care of patients after being diagnosed and treated by physicians. The discussions concluding
Volume 100 of this thread specifically deal with nursing behavior which enter into the sexual misbehavior or worse realm. Should this smear on the nursing profession be considered as characteristic of the profession, perhaps more apparent in our current era and more active means be carried out to rid the profession of those who continue "sexual misbehavior or worse"? ..Maurice.
Graphic: From Google Images.
NOTICE: NO FURTHER COMMENTS WILL BE PUBLISHED ON THIS VOLUME.
FURTHER COMMENTS CAN BE WRITTEN TO
VOLUME 102.
191 Comments:
JR said:
There is an interesting article on Pro Publica called Patient Harm: When An Attorney Won't Take Your Case. It says they won't take 9 out of 10 cases. It mentioned for most of us, it is the only way we can learn what truly happened and/or to have things corrected. It is acceptable that Medical Records can be used a more or less articles of protection for the medical providers thus not telling a true story of events. With the advent of EHRs, click and paste is being widely used & is highly misleading in addition to the purposeful insertion of just flat out lies. We have found that telling the dr. about real issues w/ medicine more often than not does not make the MRs. We have bought a device to record all future medical encounters. The patient must be proactive in self-protection as the medical provider(s) are only interested in control, power, greed, and self-preservation. Medical providers know that even though there are such articles as Dr. B. has provided for protection of patients, due to the government and legal they still are very free to lie, steal, abuse, and do whatever harm they choose to any and all patients. The patient never knows if they are the chosen one until it is done. Most of the time, patients are caught like a deer in the headlights because they are there for very real concerns. Many patients don't realize that medical providers can be potential abusers. It has been acceptable to put the otherwise average humans that make up the medical industry on a pedestal and thus putting our heads in the sand denying that these people can act in inhumane ways because we don't want to admit that while we put our defenseless bodies in their care, they may choose to really harm us. It is a worry that no person should have. Once you have that harm, it will be carried with you for the rest of your life. Publicity is the only way to persuade the public that action needs to be taken as there really is a problem. JR
JR
Back to your earlier post on Volume 100. A doctor being convicted of child porn? It must have been pretty blantonly obvious for that doctor to be convicted, being they're given the benefit of the doubt so often.
In my opinion, doctors and judges and people with the ability to harm/help many people need some kind of accountability.
I remember when I first discovered this blog , I was also looking at a similar blog and the MD said that providers never use chaperones for the purpose of embarrassing patients.
I don't know how he arrived at that conclusion but it was a wrong conclusion. Young girls would not be required to shave men on the down below by anyone with any morals.
It's not just females attending to males either. But embarrassing patients is a source of amusement for some medical personnel. Some just don't care if patient humiliation is occurring because they are too godlike to concern themselves about such insignificant people as patients. If this one never returns it's fine because there's plenty more to replace them.
Attorneys won't take difficult cases ? That's probably true also.
It seems to me that recording devices need to be all around. But the medical staff to be UNAWARE! Recording devices should have been in staff break rooms always. Somebody unfamiliar should listen up to give a certain amount of privacy. The hidden recordings only to be used in extreme cases. ( sexual harassment cases fall into that category ) JF
I must do this in 2 parts due to length:
Maurice,
Recently I have realized that I have gained a great disdain for all of humanity. It is not due to a singular event or group of people, it is that when I put the pieces together and connect the dots, I see that every aspect of society has become apathetic and accepted mediocrity.
Feminism has emasculated the male of the species. Unless a man is castrated, he suffers from toxic masculinity. There is a difference between men and women. Testosterone and estrogen create different traits and behaviors. I have seen the effects first hand in friends who are transgendered/transexual. The hormones change behaviors.
There is a reason that men fought the rival clans and hunted the cave bears: they had broader shoulders, thicker skeletal structures, and more muscle mass. Estrogen made women more language oriented, able to express and deal with emotions, and more nurturing.
Granted we no longer have to fight off cave bears, but we seem to ignore common sense, logic, and science in the name of political correctness. My one friend (who co-authored her first psychology book at 16), now in her 50's is dating again. She has noticed that most men are less aggressive and less masculine than when growing up. But at least we are politically correct.
Very few people want to work to succeed. They either want to take the easy route (fame, stardom, crime, etc.) or let society take care of them with entitlement programs. The oligarchs, the kingpins, and then celebrities do not want change, they live comfortable living in Elysium. The proletariat are happy if they can have a cash side hustle where they pay no taxes and are given some crumbs in entitlement programs.
It is amazing the number of people that I know that either supplement their disability or public assistance with all cash ventures (scrap metal, flea market sales, cash labor, etc.) work under the table (cash) jobs, or make money through criminal activity. One common practice among recipients of social security is common practice to get a Rx for some maintenance medication via exaggerated symptoms and sell the Rx. Some of the most common meds are Zanex, Valium, and Ambien.
End Part 1
-- Banterings
Part 2
School teachers form labor unions (because local governments provide such unsafe working conditions) and continually espouse how underfunded education is while dumbing down society to the lowest common denominator.
Then there is healthcare...
The fact that pelvic exams on anesthetized women without their consent still occurs today is a testament as to how dysfunctional and broken the profession is. Yet, when those (like us who post here) bring this up, we are dismissed by so many physicians who condemn the practice but have never admitted or apologized for them having learned in this manner.
The oligarchs ignore the abuses by those sexual deviants who have entered the profession to abuse for their own gratification or by the narcissists with inferiority complexes that need to exert their power over helpless patients, as long as they take their cut of $4 trillion.
Those that have started out by exposing the ills of the profession by becoming America's leading voice for ideal medical care OR social media's leading physician voice quickly find that there is more money to be made prolonging the problem (instead of solving it) through lucrative speaking engagements.
There is a small number of people in this world, that like those who post here fight to make man kind better, fight for human rights, fight for what is right and just. In the same manner that the economy and stock market goes through corrections, society is due for a correction, and healthcare (which accounts for 1/5 of GDP) is long overdue for a correction and is going to get hit the hardest.
Personally, I hope medicine is leveled to the ground. Then we can build something that is truly compassionate, honest, transparent, and respects human dignity.
That is my rant for Monday morning...
-- Banterings
Maurice
The American nurses association says that one in 10 nurses have a drug and/or alcohol problem and this can cause harm to their patients and the industry as a whole. A reflection of disciplinary nursing boards across the nation show an inordinate number of nurses have criminal backgrounds that were not disclosed upon application for their nursing license. Boundary violations as well are an increasing problem as reported by the American nursing association, particularly in correctional nursing. The most bizarre recent case well all know was a female nurse who was having a sexual relationship with one of her incarcerated patients. She murdered her husband, burned down their home in an attempt to cover up the crime and attempted to free the inmate from prison. These are not isolated cases, neither are the articles which we have been seeing in the news. To answer your question Maurice, these are a sign of the times.
PT
But Maurice.....
That picture of the muscular female nurse, she looks soo Strong dosen’t she? If they are soo strong why is it that the only reason they want men in nursing is so they can help turn and lift patients. These female nurses are supposed to be able to handle more than 2 patients if they are such good nurses, why then are they able in some states to legislate laws that say they are only allowed in some units to limit their patients no more than 2.
There is a known bully problem in nursing so much so that the Joint Commission has acted as well as the American nurses association to step in and stop it. That nurse looks like she can bully anyone, are you sure she is a female and speaking of that, you just don’t know anymore these days do you. Instead of having sexy nurse all over her nurse uniform like they used to she will have, “ you better run like hell.
I don’t know where in the world you got the impression for that muscular nurse but, a close look at bmi ( body mass index) for most nurses are off the charts. Not hardly an example of someone who wants to project a healthy image in healthcare, and speaking of a proper image, I think you forgot to put pants on her, that would more portray the gender neutral bullshit that they have tried so hard to push.
PT
Bantering
I think the reason pelvic exams on anesthetized woman vs Twana Sparks sexually abusing anesthetized men being glossed over is from the mindset that because these patients weren't aware, then they weren't harmed.
Even some patients feel that same way. I gave permission for med students to observe my surgery but I wouldn't have allowed them to witness an exam if I were to be awake.
Afterwards I started to worry that I might have had an accident on myself.
There's not a lot I can tell you why Im ok being undressed for the asleep part and not the awake part but it's different to me. I don't get to decide that for anyone else though. JF
PT, it was "bully"..the exact word I was trying to express in the animated file of a nurse. "Bullying" is both a physical appearance and can also represent forms of unprofessional behavior. Our thoughts of nurses in the past was that of the lower graphic (from Wikipedia) who shows off her tools and an attentive stance but not an aggressive, "me" behavior as shown in the animated picture. Isn't that the kind of nurse we all would desire? The patient should be the center of attention and not the nurse or her self-interest misbehavior. ..Maurice.
By the way and in addition, medical students are taught and should be taught that the relationship they develop with patients is not a "me" but an "us". It is very unusual circumstances (an unconscious or severely demented patient) where "us" is missing. Even then, there often is family of the patient where "us" can be sustained. This should also apply to the nursing and others in their relationship to patients. Rather than nurses "flexing their muscles", in their actions and attitudes with their patients for their own personal interest, it is their expressions of beneficence to the patient, not themselves, which will be the needed therapeutic and relational approach. ..Maurice.
JR said:
JF,
It is interesting the doctor didn't lose his license & can still practice. It is wrong on so many levels. What if he moves his obsession to prey upon adults too? I guess that would be okay w/ the powers to be since they weren't worried about his taste for children. Maybe to them that would be totally acceptable. As for being okay w/ them seeing you naked while you are asleep could bring you being exploited even more than when awake. In fact, it gives them greater freedom. At least if you are awake and not drugged, you can tell them to stop and no photos. Because we know from cases here on this blog, that even totally alert patients are mistreated then it makes sense that a defenseless stands to be abused even more. I hope , for your sake that you reconsider letting them do this in the future or else have an advocate present to protect you.
Banterings,
An excellent post that deserves to be seen by many more than just us. In my youth, among other things, I supported feminism but changed my mind after years of real life living. There are certain differences between men and women that cannot change. Women have the right to end of the life of a baby created by two people and men do not have the right to that baby until it is born. Men do not have the right to say I do not want this child & walk away if the woman is not willing to forego child support which actually ends up being spousal support. Women can simply kill a child in her womb or so it would seem once they are born if the abortion was botched. How far will this killing go is anyone's guess for maybe someday in this culture of bending to allow rights maybe women can say although this child is a year old, it shouldn't live. To me, this is where this is heading. For sure women do have the right to control their own bodies but so do men but patients in healthcare don't? It is as if you cease to exist as a human once you entered the gates of healthcare. You lose total control of anything that identifies you as human. Apparently, the nurturing part of a woman's makeup has been lost on those women who now work in nursing.
Nurses are bullies and that pic demonstrates that very well. There should be a pic of a group of nurses standing around with clubs or cell phones while an exposed man lies drugged in the bed. That is an accurate pic of healthcare today. Not only do they bully patient but from what I have read they bully other nurses especially male nurses. The cases of the patients being sexually abuse are mostly female patient/male nurse but we know from this blog the reverse does happen and it probably happens more frequently than even we realize. No man should ever be alone with a female nurse/tech. In the culture of today's America, older men especially are the root of all evil. I think this attitude has encouraged some of these female nurses who feel they do all the work while the male doctors get all the pay and glory to retaliate at the male patients they can control. As in the case of the nurses who bullied and abused my husband, they were not built like men except one of them looked like an overweight streetwalker w/ too much makeup. Some were tall and thin, the real abusive one was short and thin, but the overwhelming majority of them had bleached blonde hair. I noticed other day while shopping in Greenwood that an overwhelming majority of the nurses I saw had bleached blonde hair. Maybe that is the identifying mark of the sociopathic nurse. What I am saying is that a nurse does not have to be muscular to control a male. She can by the use of the drugs injected into her victim or the very art of intimidation which I used to do w/ my schoolteacher tone of voice. I rarely raised my voice but controlled by the tone. And I had the toughest of the toughest in high school. That is where having male patients naked comes into play--a naked man is less likely to be resistant especially in dealing w/ clothed person bc the nakedness puts most people at a disadvantage. JR
Call me Pollyanna if you will but I accept the reality that in an industry with millions of workers, there are going to be many bad ones amongst their ranks. It is impossible to prevent their gaining entry because bad people usually have a way of hiding their faults in order to secure employment. Totally revamp healthcare and there will still be bad apples.
The larger problem is that the self-governing healthcare industry generally looks the other way when they see bad behavior. When sexual misconduct is specifically brought to their attention, they still tend to err on the side of not removing the bad ones. Twana Sparks & her OR team, the Denver 5, and now the Olympia Pranksters to name a few egregious sexual misconduct violations that essentially went unpunished. Surely women who work in healthcare know that if they are inclined towards sexual misconduct that odds are it will be tolerated, and if it goes public they likely won't get more than a slap on the wrist. Male staff know they are at risk in that regard, though at the physician level if they generate enough revenue there is a good chance the powers in charge will look the other way.
Perhaps the good ones look the other way because they know they are at risk of being labeled the troublemaker for surfacing that which the practice manager or hospital administration didn't want surfaced. I wouldn't be surprised if the Providence Healthcare System in Washington put as much effort if not more into finding out who called the Kirschners than they did addressing the perpetrators. They wouldn't have gotten this bad publicity if that anonymous person hadn't called the victim. The whistle blowers in most industries often suffer greater consequences than the perpetrators.
Then there is the age old "the patient was unconscious and wouldn't know" excuse used to justify bad behavior. Add to that the "the consent form had the word student" used to justify not getting specific consent for vaginal exams in the OR or for having high school kids shadowing physicians in the OR. Throw in a few white lies such as "Mary is assisting me today" rather than say she is a shadow or a chaperone or introducing a medical student as "Dr" and before long patient rights and dignity are effectively totally subservient to the interests of the healthcare staff.
It is very odd that an industry dedicated to saving lives and curing disease so easily forgets the basic humanity of the patients. I know that there are more good people in healthcare than bad, but yet the bad are tolerated rather than excised from the group.
Asleep. Uncovered in an R-rated kind of way vs awake in an X-rated kind of way. I'll take the asleep kind of way. They're much less likely to abuse because they can't humiliate their patient. Minus the humiliation their joy is greatly reduced. If not eliminated.
I also don't think the Twana Sparks nursing staff was sexually gratified. Just a bunch of cowards.
JF
This Comment is for all the silent visitors who come to this blog thread (based on my observations on StatCounter) and though you are not identified other than your city or country, I find that some of you come repeatedly. I just want you all to know that I always hope to read your personal views on the topic here even if they may be seen in contrast to most of what is already written by others.
This request is in no way intended to diminish the importance and value to discussion of what has been already written here by the "regulars".
I miss further input by our visitor from France, F68.10. I hope all is going OK with you.
Again, to our silent visitors, don't shy away from writing if you have opposing or opinions phased differently than what is being written by others. This blog is all about Discussion and discussion is more enlightening if contrasting personal views are being expressed. And as everyone can see, as I do, that even with those writing now, visible are some differences in views and expressions. ..Maurice.
The Indianapolis area news has been full of stories of the archdiocese of Indianapolis & their conviction that if you are gay, you cannot have a spouse. What I have read, simply stated the Catholic church stance on being gay is you can realize you are gay but cannot act on it & especially cannot be "married." Of course, they also do not support transgender issues either such as transitioning. One local school, Brebeuf, & the archdiocese parted ways as Brebeuf refused to fire a gay, married teacher while another school, Cathedral, chose to fire a gay, married teacher to stay w/ the archdiocese. Another school, Roncalli, recently fire a gay, married counsellor & her father. Apparently, for the archdiocese, they do not view married gay people as people worthy of being on this planet although priests molesting children seems to okay as the Catholic church gives them shelter & protection forever.
Why I mention this is bc the 1st ER hospital my husband went to put in MRs that were transferred electronically to the Catholic hospital where he was sent that he was a gay man w/ a husband, me his actual female wife. So for hours this Catholic hospital thought he was gay. He didn't know what they thought as he was too drugged. All of his info was given to them by the 1st hospital. The 1st may have done this intentionally bc he said he did not want to go to a large teaching hospital for potential treatment. They also knew he had not decided what treatment he would choose as they had not talked w/ us about treatment options. So I think in retaliation for not going to their large teaching hospital, they arranged w/ the Catholic hospital for him to have a procedure of their choice. The 1st hospital made sure once he was completely isolated from me on the helicopter that he was drugged as they knew from what we had said it greatly affects him. Drugged he offered no resistance. Secondly, they got some payback by telling the Catholic hospital he was a gay, married old man. They knew the core values of the Catholic hospital opposed this lifestyle. They knew that since his treatment did not involve transgender issues he would receive treatment but may not be treated as they would treat a "normal" man with a female spouse. All of the Catholic hospital's paperwork refers to a patient's spouse rather than naming husband or wife such as has spouse/significant other been notified? They are very careful not to at least on the surface let it become obvious of their discriminatory practices. Maybe the female nurses especially the ccu one who in her social medical posts says she is the most beautiful, movie star like female around thought by leaving him naked they could see if he would have a reaction to them. Maybe they could sway his sexuality. Or maybe they just wanted to torment a gay man or see how a gay man's genitals would respond w/ the cold & entertainment committee. I do think he was being punished for them thinking he was committing a mortal sin by being gay & acting on it by being married. That is reinforced in my mind when I finally saw him after hours & hours of isolation & the ccu nurse did not believe I was his wife as she was looking for his husband. I know by the behavior exhibited by this hospital that personal & religious convictions come into play when they are dealing w/ patients although we have always been told that medical staff put away personal feelings & only do their jobs. It simply is not true in all cases or maybe even in most cases but we just never hear what they are really thinking. It is absolute stupidity to think medical people do not let their personal convictions cloud their judgment of how they deliver medical treatment. That is why things to Mr. Kirschner & my husband happen. It is because of the human factor& we have no system in place that addresses these issues to prevent them from happening nor is there one in place that correctly deals w/ issues after they happen. JR
We have a system in place! Have you ever heard of horse whippings?
JF
Of course, there is current uncertainty whether "horse whippings" will solve problems. For example "The Stronach Group thinks that horse whipping might be causing horses to break down. As a result, whipping will be banned/severely limited at their two California tracks — Santa Anita and Golden Gate Fields." But, like so many other approaches to resolve a problem, there is controversy whether the approach has merit in accomplishing the goal (such as too many horses dying at our Santa Anita race track). The same uncertainty may apply to the medical system's behavior. ..Maurice.
To All
I have mailed a letter to Mr Kirschner explaining this blog and what our goals are and I’ve asked him to join us. I am very interested with what he has to say regarding what his attorney has to say if in fact he did retain one. It may be that the case is in litigation and as you know both parties are not to discuss the case. We all know the solution to this problem and that is through litigation. Hopefully, we will hear from him soon.
PT
PT, I agree litigation can be a big part of the solution though even then the hospital systems short circuit it in part by settling out of court. Non-disclosure settlement agreements avoid their being publicly found guilty in court with the ensuing publicity. The best we can hope for is that the financial hit encourages them to clean up their act.
What I think would go a long way would be public disclosure of who the offending parties were. When these stories hit the media unless it is a physician or there are criminal charges filed we never get their names. Who yanked the cover off Mr. Kirschner? Who were the Denver 5? Who were the OR staff working with Dr. Sparks? Why are they not publicly held to account for their actions? Knowing that they would might serve as a deterrent to bad behavior for some.
The bottom line is that just as the priesthood was a safe haven for pedophiles for generations because the church hierarchy chose to look the other way, the kinds of problems such as Mr. Kirschner experienced will continue so long as the healthcare industry chooses to tolerate it. Telling the staff to not do it again is not addressing the problem. Firing the person(s) behind the "prank" at Olympia Urology would prove far more effective in ensuring it doesn't happen again than a hollow threat from corporate to take action if it happens again.
I will note that this story hasn't made it to allnurses. No surprise there.
JR said:
Lawyers in Washington must be a different breed than here in Indiana. In Indiana, they do not want cases that take actual work or someone didn't die. There simply is not enough money in it for them. Most will not even respond or you can't get past the gatekeeper. That is why we are filing the suits ourselves even though we know we will not win but at least we have to make the statement. One attorney did go through the materials completely and said we had a case on several issues but he did not want a case that would take up so much of time,would last for years, and had so many complex issues. The hospital from hell is so arrogant they haven't didn't even respond to the Medicare investigation as per Medicare yesterday. So it seems because of this type of behavior by the legal profession it signals medical providers they will have a extremely high percentage rate of being able to abuse w/o patients having any recourse, at least in this ass backwards state. I don't know if other states are so backwards as Indiana. The hospital won't divulge which doctor actually signed the consent form so we must sue both who talked about consent in the MRs along w/ the ER doctor from the other hospital who they alluded to having gotten the non-existent consent. No one has actually taken credit for the consent except 2 of the cath nurses. The one dr. who actually did the procedure said consent was gotten before he arrived in the cath lab but he was place directly on the cath table by the helicopter crew after wondering the building for 10 minutes because they could not find anyone to help them. But for some reason the helicopter crew knew to take him to the cath lab although we had no idea that was where he would be going but rather we thought to ER. So someone had made secret plans. There also was no date or time attached with the signature of the dr on the form. The mysterious dr who said consent was gotten and my husband said he never saw this man as he would remember this man as he remembers that time before the procedure said consent was gotten but doesn't claim the credit either. It would seem no one wants to claim credit for a procedure the patient did not want to have. The 2 heifer hags were the only ones whose signatures were readable and they had the same exact time attached which was mere seconds before the versed and more fentanyl was given. One who signed it also gave the drugs so the versed/fentanyl was most likely given before the consent was signed by them. My husband did not sign the consent although they said he was alert x3 (although he had already been given fentanyl just 10 minutes to arrival of which there is no mention of by the hospital) which indicates somewhere they lied because why didn't he sign it if he was able and informed? JR
Good Afternoon:
I agree with Biker in that the healthcare system is ill-equipped to stop the inflow of unscrupulous people into healthcare.
What they are equipped to do but in the eyes of many aren't doing is showing the industry they are a part of and the public they serve that they only want people of the highest character interacting with patients.
Unless a healthcare workers indiscretion gets out into the public's eye, the industry just moves the person to another area & maybe sends them for some training. Other than that, they can just pick up where they left off just in a new area with new victims.
Now, if the industry really wants just people of the highest character, then whenever there is an indiscretion that person would be let go as they don't meet the industry's high standards.
The way healthcare is currently running their system tells me and anyone else who's watching them that they don't care about the caliber of the people they hire. Because if they did, there wouldn't be so many voyeurs, and pervs running unchecked in the system as it stands today.
Regards,
NTT
JR said:
From the lawyers we have talked with most of them have said that the hospital from hell is very aggressive in lawsuits and it would drag on for years. One we talked to in depth was currently representing someone w/ a claim against hospital from hell. He said he would not take another as he had "won" after more than 3 years but hell hospital was filing an appeal to drag it out more. The hospital drags it out bc they know most all of these cases are done on contingency so they drag it to make it cost & time prohibitive for law firms. Most of have the amount of research & finding expert witnesses to testify against one of their own is different at best. They saw in our case the winnings would not be worth their time & effort as they did not physically kill him but merely performed a procedure he did not consent to and suffers from PTSD from the trauma of that along with being molested sexually & medically, isolated, MRs falsified, lied to, drugged, privacy invaded both bodily and physically bc we think they though he was gay w/ a spouse which is totally against Catholic belief. I also suffer from PTSD from what they did to him & to me. Some attorneys said they take a limited number of cases & ours did not meet the criteria meaning he wasn't dead. Why we are filing ourselves is to get it into public record at which time we can talk about them publicly like an attorney does. The hospital from hell is self-insured and has a huge legal staff so they have no problem in doing as they please. It is no wonder patients are victims as they really don't have to care nor is there anything that can be done to make them care. For whoever goes to their hospital, they should hope that it is not their number being called for even more abuse like what was done to my husband than just the usual we don't care about you bc we don't view you as a person while inside our doors. Whenever I have encountered someone who calls my husband or I a patient, I now make a point to correct them by telling them no we go to see Dr. So & so for medical advice. We are not patients but people who pay someone for a service that we cannot perform ourselves like when we go to the hair stylist. There is no difference. I get some looks but usually everyone after they have digest the info agrees. One by one I hope to break this deity hold the medical community has over people. I also educate those willing to listen what may take place & many have never thought about what could happen. Maybe for some it will save them from having what happened to us happen to them. JR
JR, according to the etymology of the word "patient" in the sense that you are using it:
Etymology. The word patient originally meant 'one who suffers'. This English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning 'I am suffering,' and akin to the Greek verb πάσχειν (= paskhein, to suffer) and its cognate noun πάθος (= pathos).
It, thus, based on your writings, it would appear that both you and your husband could be defined as "patients" and meet the etymological criteria of "suffering". With regard to your husband, though "suffering" is unlikely during proper general anesthesia or heavy sedation, "suffering" can be an understandable reaction to events afterwards.
By the way, physicians often have to consider interacting with two patients, one also being family members. Family members are what we call in the hospital ethics committee consideration terminology "stakeholders". JR, I look at you also as a "stakeholder" and as such your concerns should be considered and attended to. ..Maurice.
Biker
You are correct, the article will not make it to allnurses. The site is too busy making posts about some physician somewhere allegedly groping some female nurse and how many nurses do not think anyone should be charged with negligent homicide when a nurse bypasses the 10 rights of safe medication administration. There are no ethics, honesty, abiding by oaths, professional conduct in healthcare. The only thing any of there people understand are lawsuits.
PT
JR said:
The way "patient" is used today makes it seem to me like a 4 letter word. It seems to me to be demeaning. FYI, conscious sedation does not eliminate pain. It is used to reduce pain and erase the memory of pain and events. However, as he is overly sensitive to painkillers and has had bad reactions to versed in the past, it acted strangely this time when given with so much fentanyl. He does remember the pain of the procedure saying it felt like a semi truck was sitting on him during the catheters' insertions, the burning of the dye, the pressure of whatever they were doing, lying there w/ a bad back, and sewing in the devices in 3 separate place w/o any numbing gel. They also did not numb the left groin so he felt that too so under your definition that would make him a patient because he did suffer greatly during the procedure. Also, he was confused as he had no idea what they were doing, wondering why I wasn't there to talk w/ them and him to decide what needed to be done, heard them say they were sending a chaplain so he thought he was dying, and not to mention being totally exposed for the prolonged period of time and wondering why they were doing that to him also. He also was suffering because he did not know he had been drugged and thought because he was dying (the chaplain) that his functioning ability was shutting down because he could not voice his concerns, questions, or move his arms to cover himself up. So yes, according to the definition they made him a patient and I guess according to the definition they also made me a patient by the torture they inflicted upon him and me and have made me suffer too. As for their physician they did not interact with me except the one of them briefly but very rudely so I guess he skipped that class during his class at a foreign school to become a doctor that practices here. The hospital from hell did not care about its "patients" and certainly did not care about the stakeholders. This hospital has changed over the recent years from after it moved totally into its current location and has acquired many more hospitals to add to its empire. They make so much money and with this money comes the absolute power and control that they no longer care about people or even if there are consequences as they have the resources to outlast the people who dare complain.
For me, this blog is therapy. My blog is therapy as well as well as my journey to better healthcare. I know that it seems I am always negative about your profession but even I realize there are good doctors and nurses. I interacted with a derm. dr. and his nurse a couple weeks ago. That doctor is a good guy as well as his nurse. (My husband wouldn't go alone even though there was no genital region involved. He stresses out over the thought of me not being present and I literally have to hold his hand. This is how the dr. knew about our story.) He doesn't belong to any hospital but prefers to be independent. He understood our concerns and even shared his own story as well as his nurse. It was nice to see medical staff as people too. JR
How can we have better healthcare when we can't even vote about laws? We vote for who we think will vote our way but they forget about us once they get their jobs!
The laws that ARE in place get ignored.
Letters are written only to be ignored! There's a solution somewhere but it won't be quick and it won't be easy. It wouldn't be quick and easy even if it happens today! Too many people have died or suffered over a long period of time. JF
JR said:
JF,
You're right about our elected officials. They don't care about us once in office. We are just means to an end. It makes me "ill" when either side talk about healthcare as they do not have any idea what is really going on w/ healthcare. Their healthcare is so elite and so far removed from what we have to suffer through. They talk about us having when control when in our healthcare system, patients have no control because of insurance & the medical providers themselves. We are just chess pieces to moved about at someone else's will. You're right--letter don't matter as mostly some low person in the office may or may not read them but in any case, they are just dismissed.
Dr. B.,
What is it called when by your definition the medical industry makes a stakeholder a patient (one who suffers) by their delivery of medical care? Is it called bad medicine? I could handle my husband having a heart attack but I could not handle the subsequent abuse of especially him and the torture they inflicted upon me weakened me to a state of not being able to defend him properly. There is no cure for this patient as I will never forgive nor forget the horrors they inflicted. Why do medical staffs have such an opinion that what patients may not know because of being drugged doesn't cause harm? Do they not have enough education to know some patients are aware & will retain some memories of the harm? Why is the medical community so arrogant they perceive their decision is the only treatment when supposedly patients have the right to decide at least that is on paper? I am not an expert on car repairs but I demand that if I take it in for an alignment that they don't replace the whole steering system without first explaining to me my options and consequences so I can make the decision based on their expert advice. Would medical personnel be okay if a mechanic would fix whatever they want on their care as they are the expert? The analogy is not the best as a car is nowhere near as important as the right to make decisions about our bodies. I always tell them to park my car away so it is not dented in the parking lot and lock the doors. Why don't they understand they need to care for our bodies in a more responsible manner such as no unnecessary exposure and no using patients for entertainment? Where is the humanity at in those people?
For all, I have decided to write a book about our experience because it is important to let the public know what can happen. I also will include more than just our story but other things not working within the medical system. Insurance has way too much control over treatment. If any has anything they would like to add in their chapter in their own words, I will give space because what we have to say is important. Once done, I will send it out to media outlets and other interested parties in hopes that some may help us get the word out. It is a long shot but I think it could be worth the time and effort. You never until you try. JR
JF, elected officials only react to two things, money and voting blocks. The healthcare industry is powerful via their donations to all candidates so that they are on the winning side no matter who wins. Far more money can flow to politicians from them than any of us here can contemplate. On the voters side of things, the healthcare industry represents millions of voters and on top of that are the women's groups that will protest any effort to give men equality in healthcare. Women organize and work cooperatively towards common goals. Men don't. There aren't any national men's groups in the manner that exist for women.
What remains however is the even larger issue of societal norms. The mantra that men have no modesty remains deeply entrenched as does the perception that most non-physician careers are women's jobs. Boys in high school that express interest in maybe becoming nurses are still likely to be subjected to some degree of mocking over that. One of my anecdotal observations is that many of today's male RN's did not pursue nursing as a career straight out of high school but rather they served in a healthcare capacity in the military and pursued nursing after discharge. What's needed are high school guidance counselors promoting nursing and other non-physician health careers to boys.
RN's generally earn more than most guys can anticipate going into blue collar jobs and what most of the liberal arts majors in college can expect to earn. Granted a 4 year RN course is far more rigorous academically than is most liberal arts programs but if money is a motivator the RN's at the local hospital are in the 90th percentile for wages in this rural county. It would seem that would attract more boys into nursing programs, but it doesn't. My guess is they aren't being encouraged by their guidance counselors and teachers in high school.
As an aside I just took a look at the website for the nursing program at the state university in my county. It only includes a few photos but two of them include a guy. The local technical high school's LNA program now features two male students speaking in the video they have about the program. I had approached both schools a couple years ago about not seeing any males on their websites. Whether that triggered the change I don't know but I'm glad to see guys represented now.
JR, my use of the term "stakeholder" is the term used in medical ethics and by hospital ethics committees. It is used when clinical decisions need to be made and all those individuals who may have some "stake" in the final decisions are so named. This, obviously, includes the patient, his or her legal medical surrogate, family members, physicians and nursing staff assigned to the case and occasionally the hospital administration. In what may be a "final" or "temporary" decision, all stakeholder views are and should be taken into consideration. Of course, a competent patient's final decisions take priority generally over those of the other stakeholders. Usually, unlike stakeholders in business, the decisions are focused on actions to the patient's benefit, what is legal and what is ethical. In ethics consultations, all aspects of the patient's clinical dilemma is taken into consideration by the consultant or the ethics committee. But unlike other business consultations, the final decision is made, not by the consultant or committee, but by final agreement by the stakeholders themselves. And, my experience, as chairman and members of two hospital ethics committees is that there is usually final agreement amongst all stakeholders with final shaking of hands in acknowledgment. ..Maurice.
Maurice,
You have chided us about moaning & groaning & doing nothing.
I have been bringing attention to the Providence Twitter page when they espouse how they treat patients with dignity.
I have also reported the incident to the Thurston County District Attorney's Office for investigation. No guarantees, but a chance for justice.
So, I am doing something.
-- Banterings
I should add to what I have written above is that I have never participated in an ethics committee dealing with purely hospital administrative issues which could involve employees or physician and should be resolved by the administration, administrative ethics committees and the legal department of the hospital. By the way, in a hospital which has a specific religious base, the religious leaders in the community of the hospital may be directly involved in both clinical and administrative ethics issues and set certain standards for what is religious behavior and what is misbehavior. ..Maurice.
Banterings, what you are recalling had been regularly posting by me years ago when we were purely receiving personal symptoms and observation of medical system misbehavior. In recent times, I see that you and others are writing here that the participants on this thread are, in fact, doing something beyond "moaning and groaning". I am pleased. ..Maurice.
JR
Best of luck on the book. I think you will achieve much more than you think. For reference material please google Doug Capra and his website on patient modesty. Another reference is a book by Art Stump, My Angels are Come, about his journey with prostate cancer. This book is currently available.
58flyer
Maybe we're getting started in a wrong place. Patient dignity is not our only problem with lawmakers. There's police brutality. There's Children's Services... Different problems when people in.power don't feel like doing there job in a responsible way. How often are judges removed vs how often SHOULD judges be removed? How long does it take vs how long should it take?
If our elected officials don't vote our way how soon do we get to say This isn't working! We need to be allowed to vote on laws ourselves! ?
JF
JR said:
58flyer,
I went to the website ClumsyDucks (I believe) & their website is down for the book. Is there another website you know of where I can access the book? Thanks for the reminder about Doug Capra, I had forgotten about him as a source. Also, thanks for the words of encouragement. I have always wanted to write a book but never was quite sure about the topic & unfortunately it is going to be about this horrible experience, what it meant but the positive spin is letting people know so they hopefully will be better informed & won't be such easy victims or victims at all.
JF,
I hear you. Police have always been brutal but now we get to see it. Lawmakers & judges have always been corrupt but again now we know it because everyone has a phone with video on it. In the last 12 or so years, this country has changed & it hasn't been for the best. People are downright rude & don't care about others. You see a lack of decency just going to the grocery store. Other day at a large craft store, a cashier was so very rude so I just politely but very firmly with a smile told her if she wasn't so busy being impolite & short tempered than maybe her job would go better & she wouldn't have made the mistake she did after she first snapped at me for no reason. Given what I & my husband went through, I no longer hold back. I am polite but I am not a doormat. As for child abuse, I don't understand it but this country encourages it by the idea of having children earns money. So people have children to get money but they have no intention of assuming the responsibility of a child. Our laws need to be changed to discourage the production of children to bring in money to otherwise worthless people. There are many people who would love to have a child & can't. So many of those children would have better homes. They say it is infringing upon rights of individuals to limit the children they have while on permanent aid but it also infringes upon my rights as I must support them while they use and abuse the children and in turn, my children do with less. CPS also needs to be changed to effectively take care of children and not be such a useless agency. My opinion of social workers is just about as high as my opinion of nurses. I personally feel the quality of medical care has worsened in the past years as medical people feel emboldened and empowered as they too are part of the growing lack of compassion, basic politeness, etc. They too are aware they don't have to follow established rules but rather can write their own. I think one solution to getting the word out there is for every patient to have a recording device on them. I read in a couple of doctor's office rules they require patients to sign is a no recording device to be used. Evidently they have something to hide. Audio recordings should be made of every procedure encounter and be available live for your advocate to listen to if they are not allowed to be present. At least the verbal abuse would be slowed down. Also, there would be a more true accounting of an encounter than the MRs that are produced solely to protect medical providers by them giving the narrative that best suits their self-preservation. JR
JR, it is my opinion that audio recordings should be allowed and carried out by both the patient and by the medical profession since it is so easily performed by either party. The primary value of any recordings by either is to preserve the information provided for later review. There is nothing written in medical ethics that full communication details not be available to either physician or patient. Knowing that the details of communication is available to both physicians and their patients is part of a solid doctor-patient relationship. Memories fail completeness or become partial, ambiguous and even erroneous for both parties. Recordings should solve this issue for both parties. This recording by both patient and physician may resolve some issues involved with the use of scribes in the room. I disagree with those who find that recordings by patients be not allowed in a medical relationship. If ambiguity is the issue of concern, then that concern should be prevented by additional information but not by ordering patient recording abolished. So JR, I agree with you on the topic of recordings. ..Maurice.
JR
I just checked and found several of the books on Ebay. I searched for "book, My Angels Are Come." Also, they are sold by Amazon.
58flyer
JR said:
58Flyer,
Thanks, I found the book & read some of the reviews. It sounds like Mr. Stump had an entirely different journey than what my husband experienced. Have you read the book and if so, what is your impression? My husband's prostate journey was not like this journey but we both wish we had been better educated so he could have asked for same gender care. Also, we would not be more fine tuned into some of the jargon they use such as nerve sparing and what it really means. We would also be more alert to heart conditions that most likely be a result of having a prostate removed too as no one educated us about that as he was relatedly young at the time. Too many times physicians are intentionally vague when discussing matters. They will not give concrete answers but rather are vague & dismissive & that is what leads to mistrust & non-compliance w/ treatment. If we ask a question then they can be certain we really want the answer. The doctor my husband say for the lap surgery only put his positive stories on his website which we were aware of what he did but at that time the Internet didn't have the info like it does now. If we would have known that he was going to have a heart attack, then the outcome of what happened to him would have been different as we could have directed what was done to him rather than them dictating what they were going to do. We would not have been at a Catholic hospital on a Sat. night w/ them believing he was a gay, married man who them believe to be a deep sinner.
Dr. B.,
I would see you would be in the minority of drs. that would encourage the patient the right to use a recording device. Most would feel it violates some sort of their rights but if you are a medical professional doing your job in an ethic manner, you have nothing to fear from a patient w/ a recording device. In fact, it should be welcomed. Both parties should be able to have an audio only recording device. You are correct in saying it would protect both involved parties and that is fair. What is not fair is currently patient medical records are manipulated by medical "professionals" to serve their purpose & not to serve the welfare of the patient. There also is no recourse for the patient once a medical record is discovered by the patient to be inaccurate. If only we had had a recorder on the fateful night when my husband was violated & abused. There are many recorders out there that will record through pockets and last for many, many hours. Through a cellphone recording is how one man found out how he was treated when under the influence of their "drugs" and his cellphone was not left on intentionally. I imagine this type of mistreatment is more frequent than anyone is aware of or will admit to. I imagine it is tied to certain doctors & hospitals too. JR
A little constructive teamwork: Before a book is written, let's here create a list of actions which a physician or nurse can take which can lead to the patient's trust in the professional. Don't start with the negative "I will never trust any doctor or nurse". Virtually every human is going to be involved personally with a doctor or nurse. So let's first make a list of specific behaviors which will lead to enhancing the possibility of the patient developing trust in the professional. Every patient should have such a list in mind and I am sure that virtually everyone writing here is checking off their healthcare providers with such a list. So let's start a list and discuss that list. ..Maurice.
JR said:
I am excited about making the decision to write a book. In addition to possibly helping others, the book will be therapy for me. I have a title in mind: Medical and Sexual Assault: The Gold Standard of Medical Care. In talking to CMS about what happened to my husband, I keep getting that he had the gold standard of care for heart attacks. It doesn't matter how many times I tell them that one size does not fit all especially if someone had decided not to have the gold standard done. Livanta, which is the branch that reviews, has said that patients have no choice in treatment options. Having the oversight agency say that whatever is done to a patient by medical providers is okay is really scary. It does confirm that once a patient enters a hospital door, you have forfeited your individual rights & signed over control to the hospital. For those of us who do not think that having a service provider perform service supercedes your constitutional rights, this is a scary proposition. Will this go further? Will medical professionals will be able to control your life once you have been paroled from the hospital? Is that coming next? What type of punishment will be inflicted if you are not totally compliant. It was noted in my husband's initial file that he was not compliant w/ prostate treatment. Was what they done to him part of his punishment for denying the orders of a medical professional? There are so many questions we have and so many answers we need. However, we probably never will have the answers only the questions as no one really cares a man was victimized and abused. However, we care and we can't do nothing as we know abuse happens and it probably happens a lot but not talked about because most men are ashamed of being victimized. My husband was very ashamed and still is. Most victims of sexual abuse feel ashamed from what I have read. Some may have physical trauma but it is the unseen trauma of being victimized that makes the lasting impression. Anyone with anything to contribute can send it to info@Issues4Thought.com whether you have a paragraph or a chapter, let your voice be heard too. JR
JR said:
Dr. B.,
Beat you to that one as I am doing research on creating a power point to be used for training nurses/techs and maybe doctors in the delivery of compassionate, dignified, respectful, etc. care. In this pp, I will not do my usual criticisms or negativity I have for the medical community but rather hope to help change to the positive how they deliver care. They need to realize what harm can come from how care is delivered. They may physically "fix" the patient but the mental harm inflicted on the patient by them may be stronger and actually lead to the patient's death in the long run. They need to realize there are consequences for actions even if the demeaning, devaluing, demoralizing, dehumanizing is not intentional. However, any and all suggestions are welcome. With your permission and with appropriate credit, I would like to use material from this blog as well as other research I will be using. This type of research is what I did in my pre-education days when I was in college and involved in a labor union. I had a column printed in the ISEA and later nationally in the AFT/FSE national newspaper. Of course it was an opinion column as anyone who knows me knows I am opinionated but I am always eager to listen and learn. JR
Maurice
I think we’ve reiterated that list many times over during these 101 volumes. I have mailed a letter to Mr. Kirschner, the gentleman who had the extremely unprofessional experience at the urology clinic in Olympia Washington. I’m anxious to hear his side and hear him present what if anything his attorney has said. If he dosen’t reach out on this blog in say, another week then I will call him. I have his phone number.
I’m going to suggest to him to contact the Washington state medical board and complain about his physician since medical assistants are licensed UNDER the physicians license and are responsible for their behavior. It is beyond fuc&king pathetic that people who are paying these people’s salaries to have to be submitted to this kind of pathetic crap.
The only way to get the attention of these hospitals and clinics are to make these kinds of behaviors public, get some greedy attorney involved, sue, complain to the medical board and the state health department. I didn’t know that we have to make a list on how we are to be treated professionally when we visit these facilities. Are we to do that first, then ask for the VIP card or what is the proper sequence.
It’s apparent that I’ve no interest in getting some stupid newspaper to write some story, it’s just redundant and a waste of time. A more productive method is to send every lawyer in this country a heads up on how to make a shitload of money in a bunch of class action lawsuits or something to that effect.
PT
PT "reiteration" of parts of some comments is not a list. There should be a current actual list which is accepted by most of the contributors here as the minimal for acceptable behavior of physicians and nurses in relation to the subject of their work..their patient. Such a list of values, actions and final behaviors should be established here. This then becomes the backbone of any books or articles or other public pronouncements to be written or spoken.
PT, I am in full agreement of your attempt to communicate with the Kirschner family and hopefully the outcome will be their participation in this very discussion blog thread.
I also would be interested in having administrative input here from the Washington hospital and clinics on this thread regarding how training techniques for employees there could have prevented what had happened there.
So.. may I start with the first of the list? Assuming the list will be the content of the patient actually "speaking
TO and not felt by the patient as "speaking UP": 1. The physician and nurse should be able without distraction LISTEN TO (HEAR) the upcoming words of the patient.
OK, with that, what are the essential parts of such a list to follow? ..Maurice.
In preparing our list, you all should know what healthcare providers are instructed to get to know and understand the needs and uncertainties of their patients. Here, reproduced, from MedlinePlus, Review date 11/20/2017. ..Maurice.
Patient education allows patients to play a bigger role in their own care. It also aligns with the growing movement toward patient- and family-centered care.
To be effective, patient education needs to be more than instructions and information. Teachers and health care providers need to be able to assess patient needs and communicate clearly.
The success of patient education depends largely on how well you assess your patient's:
Needs
Concerns
Readiness to learn
Preferences
Support
Barriers and limitations (such as physical and mental capacity, and low health literacy)
Often, the first step is to find out what the patient already knows. Use these guidelines to do a thorough assessment before starting patient education:
Gather clues. Talk to the health care team members and observe the patient. Be careful not to make assumptions. Patient teaching based on incorrect assumptions may not be very effective and may take more time.
Get to know your patient. Introduce yourself and explain your role in your patient's care. Review their medical record and ask basic get-to-know-you questions.
Establish a rapport. Make eye contact when appropriate and help your patient feel comfortable with you. Pay attention to the person's concerns.
Gain trust. Show respect and treat each person with compassion and without judgment.
Determine your patient's readiness to learn. Ask your patients about their outlooks, attitudes, and motivations.
Learn the patient's perspective. Talk to the patient about worries, fears, and possible misconceptions. The information you receive can help guide your patient teaching.
Ask the right questions. Ask if the patient has concerns, not just questions. Use open-ended questions that require the patient to reveal more details. Listen carefully. The patient's answers will help you learn the person's core beliefs. This will help you understand the patient's motivation and let you plan the best ways to teach.
Learn about the patient's skills. Find out what your patient already knows. You may want to use the teach-back method (also called the show-me method or closing the loop) to figure out what the patient may have learned from other providers. The teach-back method is a way to confirm that you have explained the information in a way that the patient they understand. Also, find out what skills the patient may still need to develop.
Involve others. Ask if the patient wants other people involved with the care process. It is possible that the person who volunteers to be involved in your patient's care may not be the person your patient prefers to be involved. Learn about the support available to your patient.
Identify barriers and limitations. You may perceive barriers to education, and the patient may confirm them. Some factors, such as low health literacy may be more subtle and harder to recognize.
Take time to establish rapport. Do a comprehensive assessment. It is worth it, because your patient education efforts will be more effective.
References
Duffy FD. Counseling for behavior change. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 14.
Falvo DR. Communicating effectively in patient teaching: enhancing patient adherence. In: Falvo DR, ed. Effective Patient Education: A Guide to Increased Adherence. 4th ed. Sudbury, MA: Jones and Bartlett; 2010:chap 8.
Ghorob A. Health coaching: teaching patients how to fish. Fam Pract Manag. 2013;20(3):40-42. PMID: 23939739 www.ncbi.nlm.nih.gov/pubmed/23939739.
Dr. Bernstein, I will start by saying that I go into healthcare interactions with the premise that whoever I am dealing with has the technical expertise to do what they are doing. Losing my trust at a technical level is thus something they have to earn.
At a non-technical level I go into it in the opposite mode. They need to earn my trust. The difference between the two is simply life experience. A big part of the issue there is that earning my trust at a non-technical level is more than how the physician interacts with me. It also includes the staff supporting him. The physician sets the tone for their practice. If upon check-in or when being roomed by a Medical Assistant or LPN the staff is unprofessional as concerns my privacy, dignity, or otherwise, I will go into defensive rather than trusting mode with the doctor. This is because if he allows the staff to behave that way then he too is likely unconcerned with my privacy and dignity or me as a real person.
Using the Olympia Urology example, what the staff did to Mr. Kirschner would never have occurred if the doctors there set clear standards on staff professionalism and patient dignity. What are the odds the physicians at that practice care whether staff barge in during a patient exam or how the staff respond to modesty concerns patients may express? Little to none is my guess.
A few other things include:
Making eye contact & not otherwise being distracted are essential to signalling me that the doctor is focused on me and why I'm there.
Telling me what is going to be done before doing it is also essential, as is asking for OK's beforehand as may be appropriate. Again, its recognition that I'm a real person rather than an object.
If you want me to trust you, then no ambushes please. Ask me before they come into the room. My appt. was with you and I shouldn't be learning there would be other staff or observers only after they're in the room. Your staff could address this for you when I am being roomed.
If you are sending me off for a test or procedure of some sort, explain what it consists of so that I am giving informed consent.
If there are alternative courses of treatment, tell me what they are and why you recommend the one you are.
JR,
Here is a power point about trauma informed care.
I strongly disagree with slide 28: providers should say "I want to."
The words NOT to use are "I NEED to." The only thing that any of us "NEED to do" in our lives is die at least once.
Their recommendation of saying "I am going to" reminds me of a bully about to beat a weaker person senseless (or in the same token a person about to be sexually assaulted)...
"I am going to give it to you now..."
Their suggestion SHOULD be preceded with the phrase "with your permission." In fact "I want to" should be used with the procedure and "with your permission I am going to" be used with each step.
I also do not like using "examine" instead of "touch" or "feel."
Merriam-webster.com (dictionary) defines "EXAMINE" as:
: to inspect closely
: to inquire into carefully : INVESTIGATE
Merriam-webster.com (dictionary) defines "INSPECT" as:
: to view closely in critical appraisal
: look over
: to examine officially
Merriam-webster.com (dictionary) defines "INVESTIGATE" as:
: to observe or study by close examination and systematic inquiry
: to make a systematic examination
: to conduct an official inquiry
NOWHERE in the definition does it say "touch." If I agree to let you examine something and you touch me, then there is a problem.
Another problem that I have with the concept of trauma informed care,is that providers put the onus on the patient to "INFORM" the provider of their past trauma.
The reality is that Trauma-Informed Care understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize.
"Trauma-Informed Care (TIC) is an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma. Trauma-Informed Care recognizes the presence of trauma symptoms and acknowledges the role trauma may play in an individual’s life..."
Trauma Informed care (born in the human services field) assumes that the person in front of you is the victim of past trauma. You treat all clients (patients) as victims of trauma whether they deny, disclose, or not, any past trauma. That is because most victims of trauma do NOT disclose their trauma even to family and especially NOT to healthcare providers.
Men are even more unlikely to disclose past trauma, especially sexual abuse.
-- Banterings
JR said:
I don't know where my last post went but I said that I had beat you to that idea of making a list as I have been doing research for a PowerPoint to use in training sessions for medical personnel. The hypnotist my husband saw does training sessions at smaller hospitals to help them with better customer service so that is what gave me the idea. Not only a book for the public but also if we can get into the secret sanctum to bring ideas of change to those involved in delivery of treatment. My PowerPoint won't be my usual rantings as the tone needs to be different as it shouldn't be offensive to the audience it targets.
Dr. B.,
The article you cited is a start but also the medical provider needs to give details about them too. The patient needs to know their core values and how they will go about making a strong and trusting relationship. The patient needs to gauge the medical provider too. The medical provider needs to be receptive to the fact that the patient is in charge of their healthcare and the provider is the one with the information and the ability to carryout the patient's wishes. Yes, a majority of times if the patient trusts the provider, they will heed the advice but even if they trust the provider they may choose options that the provider may not agree with but should be willing to listen and carryout. The provider needs to be careful not to be dismissive of the patient's stake in plotting the healthcare choices of their life's journey. Medical terminology should be delivered at an 8th grade level so most can comprehend. This is where the encouragement of recording devices would be great as the patient could listen again when they are not so stressed with the actual encounter. Patients should be encouraged to review their medical records and if a recording device has been used, corrections to information could be made if necessary like a doctor didn't record all the medications or allergies the patient listed. This all should be done while the patient is fully dressed and on equal footing with the medical provider. This may be a little detail to the medical provider but can mean how open a patient will be especially when they perceive they are at a disadvantage by being physically exposed they will be less likely to expose any mental thoughts. Having a patient sitting on the exam table is also a little detail that puts the patient at a disadvantage as this should be perceived as a chat rather than an uncomfortable interrogation. This is the time the medical provider should be willing to share a little personal information themselves as it shows interest and openness. This makes an encounter more like 2 equals working together rather than one authoritarian figure to a subordinate.
As for medical providers in general, the language used should be re-evaluated to rid their vocab. of such words/terms as "strip", "must", "comply" or any words that indicate commands over an inferior in ranking. "Strip" to me is completely unacceptable as that reminds me of what a prison guard would say to someone who has been stripped of all rights & freedoms. Patients should be asked. Patients should always be asked in what manner would they like to be address and it noted in their file so it is done. There is nothing wrong with issuing number to call patients into the process but once inside the area they should be addressed in their preferred manner. Even though medical providers see intimate parts of a patient does not automatically give them the right to discard common manners and address patients by their first names. Medical providers including all the office workers know every bit of your information without you knowing theirs so this little hat-tip to respect of the patient. JR
JR said:
Ask me about my preferences for gender care. In our daily lives, we go about our business in a clothed manner. As a medical provider you are clothed but oftentimes, I am not. Be aware of the disadvantage being unclothed, exposed puts me in. Treat me as you would want a loved one of yours treated meaning you would not want them to feel violated or abused. Just because a private part of my body may need to be exposed for examination does not mean I am comfortable with or that I want an audience. Just because everyone may work in the medical office does not mean that everyone has the right to see my naked body. Only those who are medically necessary should be involved. I should be covered so I am exposed only to the one needing to do the exam and I should remained covered until that time. During a procedure exposure should be limited and if my genitals are not involved in the procedure such as in the cath lab. then they should remain covered with a garment such as Covr which I can put on myself. When I am undressing, no one should be in the room watching me undress as that is very unsettling and very much like for entertainment purposes. No should try to undress me without first seeking my permission or asking if I need help. Do not assume that giving me drugs such as versed or ketamine makes it okay to expose me unnecessarily, make irresponsible comments, or any other type of behavior that is not acceptable. In fact, during the times when I am completely vulnerable are even more the times when how treatment is delivered should be completely above board and professional. When I am vulnerable, it is your responsibility to see no harm, mental or physical comes to me. Make sure that I am covered when those who are not needing to be involved in my intimate care are in attendance. The phlebotomist, registrant, chaplain, other nurses not connected with my care do not need to see me exposed. The curtain should always be drawn for privacy and if a door is shut, knock and wait for permission to enter. No personal cell phones should be used in a patient area as it is very unsettling knowing that video/pics could be made of me without my knowledge or consent. JR
Banterings, the "laying on of hands" upon a patient is defined for the medical students and the patients as follows:
Palpation: Touching the body tissues either superficially (lightly) followed by deeply (with more pressure). Tissue resistance, superficial or deeper, and patient discomfort from these actions is noted.
Percussion: digital- the examiner with one finger on the body, striking that finger with a finger of the other hand and perceiving the response with regard to discomfort by the patient along with the returning sound. But also the quality of the returned sensation to the finger touching the skin is also observed. Fluid in the abdominal cavity may be detected by a slapping percussion on one side of the abdomen and detecting a moment later a fluid wave striking the other hand laying lightly on the other side.
Inspection of the superficial bodily tissues begin the physical examination and followed by auscultation (listening through a stethoscope) applied to the body part being examined for expected normal or for abnormal sounds. If the abdomen is being examined, auscultation is performed prior to palpation and percussion since these actions may abnormally affect the auscultation examination.
DURING ALL OF THESE EXAMINATIONS-THE EYES OF THE PHYSICIAN SHOULD BE ON THE FACE OF THE PATIENT TO DETECT PAIN SINCE MANY PATIENTS MAY EXPERIENCE PAIN WITHOUT SAYING A WORD AND THE LOCATION OF THE PAIN, AN IMPORTANT PHYSICAL FINDING, MAY BE MISSED.
I think I have gone through all this at least once in the past volumes but it's time to repeat it. ..Maurice.
Banterings,
Thanks for the info. At first, I was the one who informed potential medical providers about my husband's trauma he suffered but now he tells them. Some of them are dismissive and then we dismiss them by saying we are done here but sadly there is a co-pay. The local hospital who is the closest competitor to the hospital from hell listened intently though. I agree how things are said absolutely need to be reconfigured. The medical community operates as if it is totally in charge and in command of the patient. There are commands, rules, and punishment. They act as if they are the adult and we are the wayward toddler. Having to pay them and being told does not go well as far as I am concerned. As I have said before, I think of medical providers as supposed to be experts w/ information I may need. I have the power to pick and choose what information I use. They do not have control of me nor do they boss me around. I decide what they may do or not do. As I have said before, their tone sets my tone as well as their actions set my actions for my healthcare. I think most medical providers think it is a joke when a male patient says he has been sexually violated. It is because they believe men must accept whatever and however they choose to deliver treatment. Forever, male patients have had to endure care being given by female nurses/techs while women have always been somewhat protected and shielded. For a lot of women, they would refuse intimate care given by a male nurse/tech/orderly. Why it is acceptable that males have no choice is just discrimination. As for recognizing you as a person & not an object would force them to admit that you have say in your healthcare. From what I have encountered in this horrible journey, very few in connected to healthcare whether it is insurance, government or the healthcare industry itself truly believe patients have any right of decision in their healthcare. It is merely lip service, another vague uttering or in reality, a lie. I also totally agree that the attitudes we encountered were the attitudes of bullies preying on the weakened patient & and then upon the stressed family of which they orchestrated most the stress. As I have said before, my husband's encounter was much like he was a victim of rape although not in the sense of penetration but rather their motives, how it was done, etc. as rape is a crime of control and power rather than for sexual gratification. Certainly, Ms. Sociopathic Nurse fits the profile of a rapist. The abuse he suffered has had the same effect on him and us as a typical rape victim. While some may not think a male can be raped by a female, put yourself in his position & I am sure you will agree the violation was every bit as intense & real as a penetration rape. What I have read happened to Mr. Kirschner also in my eyes fits the definition of rape. They commanded him to be exposed even yanking away his covering and stood there staring at his exposed genitals. There was no medical necessity in what was done but was done rather as them making Mr. Kirschner their sexual victim by being able to expend their control and power over him. That is what rape is. One makes the another one a victim hoping to belittle, control, demean, etc. JR
JR said:
The eye contact is what I have now taught my husband to control as well as any telltale signs of pain so he will be in less danger of being drugged. He will not again tell them painkillers make him a zombie so he will be intentionally drugged with that info conveniently omitted. Since he makes sounds in his normal activities that could be construed as moans, he is now learning to control those normal sounds as the unexperienced, uninformed observer may think his normal sounds are indicators of pain. I have also told him the eyes are mirrors so guard his eye expressions by following a few simple steps or close them and go to your place. From our experience, there is very little truth in treatment. He now divulges only what he wants to divulge as this is the consequence of this encounter. Posture and how he holds himself are other things he can control. It kind of goes back to never let them see you cry mentality as they will make it even worse. Blood pressure is already extremely high in encounters so it is doubtful it would go much higher--normally his blood pressure is well within the normal range as he has never had high blood pressure but now has white coat/scrub hypertension. Kava kava helps with that when it is needed like for an EKG. Kava kava has also been my friend as it keeps me from having really PTSD episodes. When our new motorhome was vandalized at the RV lot as the idiots parked it at the rear fence so the thugs could climb the fence to the roof and them smashed in a window, I took a kava kava before confronting the service manager who said they weren't paying for damages. I remember thinking I wanted to wipe the smug expression off his face as he stood across the counter arrogantly saying too bad for us but per the kava kava I didn't but also they did pay for the damages their stupidness caused. The thieves were stupid too as the RV place also was even more stupid as they did not lock it. This is kind of the same mentality that Livanta has about medical records having no untruths in them. Is that why the hospital from hell mentions in a 67 yr old male's record "This report shows a record of the newborn patient's delivery, drawing information from both the mother's and child's charts, as well as data from the pregnancy episode associated with both patients." We are RICH if they can find this child my 67 yr old male husband delivered. It is beyond news worthy but since it is in the medical records and the medical records only speak truth, then where is our baby at? Complete idiots. The other blaring truth is they said he was a transfer from their other campus when in fact he was a transfer from an entirely different hospital system so we should have never been billed by the other hospital bc medical records never lie or have falsifications. Also, no acknowledgment from the insurance company for saving them money on the fraudulent room charges nor any apology from the hospital from hell for trying to steal either. JR
Hello,
The excerpts referenced from Duffy, “Counseling for Behavior Change” seem to adequately formulate the steps for educating the patient, presumable re his/ her particular infirmity. What is missing is the education OF the physician re the patient’s concerns.
The ancillary questions that the physician should ask are “What concerns you about my proposed treatment of your condition? How can I better address those concerns? What are your (the patient’s) recommendations for addressing your concerns?” These questions will then direct the conversation towards a truly patient-centered treatment.
Additionally, subsequent to these questions are the MODIFIED procedures for ACTUALLY resolving the patient’s concerns. Will the ultimate resolution to patient concerns be, “No. That’s not our protocol. Well, you’ll just have to endure x, y or z. No. What if everyone asked for that?” How much effort will be expended to actually accommodate the patient? (Here, I’m presuming that all parties are acting in good faith and that medical staff would not say X but, do Y. Also, the presumption is that patient requests for accommodation would not violate medical standards.)
To make my point more concrete, I ask you view the following video. (https://www.bing.com/videos/search?q=knee+surgery+prep&&view=detail&mid=42B6FBFC7B4D2950485542B6FBFC7B4D29504855&&FORM=VRDGAR)
As you watch the video, you’ll notice that the man’s genitals are exposed before a nurse covers them with a blue cloth. Why was this exposure necessary? It wasn’t! He could have been wearing a Covr garment with no compromise to him or the procedure. Do you suppose that he was informed that he’d be exposed or that remedies to this were available? In fact, even with the patient questioning re concerns (outlined above), would the patient have been aware that this situation would occur? Again, probably not.
I have proposed to hospital personnel that videos be made of surgical (or other) procedures done at that hospital by doctors at the hospital. (Obviously, permission would be obtained from the patient on which the procedure was performed and filmed.) These videos could be made available for prospective patients to view. After viewing the video, the patient would then be truly informed re his/ her proposed procedure. Patient concerns could then be formulated and addressed based upon patient knowledge of what would actually happen. The mystique and fear would be eliminated, and truly informed consent could be given. NO patient could then ever say (or sue) that he/ she was not adequately informed of the procedure. A win-win for everyone. This would truly be PATIENT EDUCATION.
I can think of only one reason why the patient protocol that I’ve outlined above is not instituted – medical convenience. If patients see the procedure, they may ask for changes or accommodations. Medical personnel would then have to consider making individual changes. How horrible! The patient would have to be treated as an individual! We can’t have that. What would happen to medical efficiency? NO! Let’s educate the patient only within the parameters set by Duffy, et al. Any further education would only upset the status quo. Dignity must not impede efficiency.
Reginald
As a physician and moderator of this blog, it is appropriate, in view of JR's description of her use of Kava kava to provide clinical information regarding the use and clinical risks of this agent: WebMD: KAVA
..Maurice.
Concerning the SAMSHA presentation Banterings posted I find it interesting that the presenter is a female physician at a VA hospital where the patients are predominantly male yet only a female patient was used in the photos to demonstrate points being made. The comments themselves were mostly female-centric as well. Are her words and concerns equally applicable to male patients?
I also noticed that there was not a single word in the presentation about staff gender vs patient gender. How could they miss gender entirely when training on Trauma Informed Care? Have they really convinced themselves that all of those other things matter to patients but not staff & observer gender? Is the "medicine is gender neutral" mantra that deeply ingrained?
Biker,
The presentation is a good starting point, as I have pointed out, it has some flaws.
-- Banterngs
In the matter of fairness, I have also mentioned versed & fentanyl. So therefore, should it not also be mentioned about the possible negative side effects? Herbs/supplements are often attacked as being bad but in reality most of today's drugs are modeled after them. Statins are modeled after Red Yeast Rice but the thing about statins is every thing healthy has been stripped from them while the red yeast rice is not nearly as harmful as a statin. Medicines for anxiety & stress have modeled after kava kava, St. John's Wort. There again the rxs may actually do more damage & are addictive. Kava is can take it now but don't crave it or become dependent on it. For ADHD, lecithin is actually the preferred choice as our bodies need lecithin but most food sources today are lacking in lecithin bc of the processing. My son took lecithin for years until he was able to learn to focus on his own. They wanted him on rx medicine w/ really nasty side effects & I said no. My son was not ADHD but rather they bored him & he didn't focus. The natural remedy helped him focus until he learned to control it himself. Many mds look down upon natural supplements because the money is in big pharm & big pharm opposes natural supplements. Natural supplement take more time to work & of course, you have to be conscious of the quality. There is a book called Prescription to Nutritional Healing which is co-authored by Phyllis and James Balch. My husband did not have any additional treatment for prostate cancer except his regimen of herbs which sadly, he did not take for the past few years which is probably why he had the heart attack. He is now back on a full regimen for prostate & heart health along w/ some very serious lipid testing which we have done independently of any md so we are able to control the plaque & platelet buildup in his arteries that will be caused by the stents. It was mentioned in his medical records that at age 67 old he was on no rx medications & they noted this w/ a lot of malice dripping from their statement. It was as if all "elderly" persons must be on the big pharm train or they will be punished. However, again, his cholesterol levels were will within the normal range w/ no indication of any issues. This is what the specialized test will tell us as most cholesterol tests do not give info on the protein that is part of the plaque/platelet issue. Statins are used mainly to combat the buildup of a certain protein by making cholesterol none existent. However, in doing so, the lack of cholesterol to the levels they want cause memory issues, muscle deterioration, kidney damage due to the muscle matter being filtered through the kidneys, along w/ other issues. FYI, contrary to what we are told, since the heart is a muscle statins do not know the difference between a heart muscle and a muscle in a leg that it attacks & weakens. To find drs who will admit to this is like pulling teeth w/ a pair of pliers. It can be done but only w/ major interventions. My mother is a victim of statins attacking & weakening her heart. Statins are big business and will remain so until they find another miracle drug to take their place so they will keep their dirty little secret until then. This episode of medical assault has cemented our belief in natural supplements w/ as little md intervention as possible as the lies, untruths, or however they want to call it has completely & permanently eroded our trust. For months after the PCI was done, he felt worse than before the heart attack. Now he is on a natural regimen he feels really good. In fact, no one believes he is a man who has had prostate cancer and a recent almost widow-maker heart attack. The cardiologist he sees thinks he is a miracle man & is not thanks to the DAPT but rather his regimen of supplements. Again, his cure was not due to big pharm or even the PCI as it did just the opposite but with a lot of research, we have found what works for him. JR
JR said:
Banterings,
I looked at the PP but the one I want to do I want it to be more human feeling. That PP felt cold & clinical but did have some good ideas so I will use some will credits due but I want to humanize them. You're right on their usage being offensive as it makes it seem they think they are in command of a subordinate or assuming they have more rights then they should.
PT,
I wanted to mention that we have talked to many attorneys. Our case has the potential of a class action suit as they have violated the Patient Bill of Rights which guarantees certain things such as personal privacy, right to decide care w/o coercion, not being isolated, etc. These are rights not only guaranteed federally but many hospitals also provide their own set of Rights. There are no exclusions listed like in from the hospital from hell. Banterings has been a big help in this area. The problem is most attorneys will not take this type of case as they are not willing to fight against the money and power of the medical community. Unless you are a female, it seems to be very acceptable that males can be exposed, molested, isolated, have anything medically done to them, etc. and everyone but the victim is okay w/ whatever happens. Unless there is a death, malpractice is out of the question. All attorneys agree (except one) that we have many issues in our case but all of said it would take too much of their time, resources, and be cost prohibitive for them to pursue our case. So I am going to get creative about how it is done. Being a former union rep, I do know how to get creative like a horsefly on the back of a horse. The except attorney said we should be grateful as he didn't die & I told him exactly what I thought of him w/o much of any filter. Piece of slime or a slug as I think of lowlife. As I have said, one attorney was involved in a case w/ them, had won but they were in the appeal process now. He said he would not take another case involving them as they were extremely aggressive & just did things to run the clock time & costs up. If you have any ideas on how to attract an attorney, I am open to try to it. Most attorney would even agree if this had been a female victim, it also would be a different story when I asked if this had happened to their wife or mother it did make a difference. But to a man? It seems our male lawmakers have succeeded in making discrimination work effectively upon the male population excluding certain males like politicians, drs., etc. I have talked to a local attorney who doesn't take this type of case but he was very clear that medical people are the most vilest on earth. He said they are legalized criminals & that they do indeed hold all the cards & even having a case doesn't mean anything as they have the resources & the law on their side. He said that is why they do what they do & rarely answer for it. He is the one who fixed our new directives to specify what can or can't be done like if there is an emergency just leave us to die w/o intervention from EMS or anyone else. We have the paperwork on us at all times. He also said this country is so anti-male that harming your average male seems justifiable in the eyes of most which if you watch the news it will confirm. JR
Maurice,
I understand inspection, auscultation, palpation, and percussion in clinical training, but the average person does NOT know what auscultation consists of. My point was how do you tell a person who (potentially) was the victim of abuse and/or trauma what you are going to do medically?
I argue that the .ppt that I referenced was wrong in using words like "inspect" or "examine" because as a traumatized patient I might allow you to look but I did NOT consent to being touched.
Are medical students taught not to use technical terms and jargon?
It comes down to physicians are not taught how to speak to patients who (may) have been traumatized.
-- Banterings
First and second year medical students are aware of the medical expressions of the techniques of the physical examination but for some terminology which is not expected to be fully understood by all patients and certainly not the specific parts of the body to be examined, the procedure is explained in more common words.
For examples: auscultation-"I am going to listen over your lungs and heart with my stethoscope." Palpation- "I am going to lay my hands over that lump you feel in your neck to feel if it is hard, soft or can be moved back and forth." Percussion: "I am going to tap lightly and perhaps a bit more firmly over your abdomen. You must tell me at once if the tapping is painful to you."
Inspection: "I need to lift the garment to look at your painful thigh." So you see, the students know to tell their patients in advance and momentarily await signs of understanding but also acceptance.
All above is common "everyday" communication between student and their patient..who at the outset accepted that specific student for a history and physical examination to be performed--permission that can be cancelled at any time by the patient and which is not a rare patient order.
Medical students use technical terms and appropriate "jargon" as they relate their experience with their patient to the other students and the instructor.
The concept of educating the patient throughout history taking "I am asking about your sex life because.." and the physical examination "I need to press very lightly on your injured arm to detect any "crackling" sensation on my fingers which may represent "gas" mixed in the tissues and which could represent a complication".
There is no reason why this type of narration to patients as physicians can't be carried out. A few words, appropriately spoken, is therapeutic. ..Maurice.
Marice,
This is not expressed in terms of trauma informed care.
"I need to lift the garment to look at your painful thigh."
This has the potential to retraumatize a patient who is the victim of abuse. This is the problem, physicians are not being taught sensitivity for victims of abuse.
The first tenant of trauma informed care is to assume that all patients are victims of abuse whether disclosed or not.
-- Banterings
Banterings, our students are taught early (first year) that when there is a hint of trauma the possibility "abuse" is a consideration and this is why a history is taken first so that the patient can explain how the injury occurred. Many patients, especially the elderly and, of course, the very young will not provide such an explanation but it is the professional duty of the student or physician to consider abuse as they proceed with further history and physical examination. And, of course, in view of what has been written here and in the newspapers, "abuse" in its various forms should unfortunately be considered as a possibility for every patient who have been "managed" within the medical system.
By the way, that USC gynecologist: here is a KTLA current followup:
The attorney for the former University of Southern California campus gynecologist charged with sexual assault argued Monday his client is suffering from heart problems and diabetes and should be allowed to post bail.
Dr. George Tyndall, 72, appeared in Los Angeles Superior Court on 29 felony charges that could send him to prison for 53 years. Prosecutors say 16 patients ranging from 17 to 29 were abused during visits to the student health center for annual exams or other treatment.
Tyndall is being held on $2,075,000 bail in the Twin Towers Correctional Facility's medical unit after spending several days in the hospital following his Wednesday arrest. Tyndall's lawyer, Andrew Flier, entered a not-guilty plea for his client during the arraignment.
Flier said his client is neither a flight risk nor a danger to himself or anyone else. A bail review hearing is scheduled for Wednesday.
Allegations against the doctor first surfaced in May 2018; authorities say they may file additional charges as they continue to talk to former patients.
In the past year, more than 380 women have reported misconduct by Tyndall, authorities said. Some of the cases fell outside the 10-year statute of limitations, while others did not rise to the level of criminal charges or lacked sufficient evidence to prosecute.
More than 700 women have filed lawsuits in state court against the doctor and USC. A separate $215 million federal class-action settlement that could potentially include thousands of payouts is in the works.
Flier said his client never conducted exams without a chaperone and never touched anyone inappropriately.
"None of this ever happened," he said in a news conference after the arraignment. "We hear 100, 200, 400 complaining witnesses. Well, without minimizing the number, we're down to 16."
Flier said his client has been threatened and was carrying a loaded revolver at the time of his arrest for protection. ..Maurice.
By the way, if that gynecologist who "never conducted exams without a chaperone" is found guilty and guilty and guilty.. what penalty is presented to that or those chaperones? Anyone know the legal issues involved for the physician's chaperone when one is present and fails to report a crime? ..Maurice.
Dr. Bernstein three possibilities concerning those chaperones.
1) They were afraid to speak up because they feared retribution, the doctor being more valuable to the organization than they were.
2) They did speak up and were ignored, the doctor being more valuable to the organization than they were.
3) They were untrained/unqualified to serve as chaperones and didn't understand improper conduct when they saw it.
That's one problem with chaperones. They will testify to the doctors innocence even if he/she are GUILTY! Unless they want to find themselves suddenly fired, it's what they have to do! JF
Chaperones: Their presence in a doctor-patient session is for the protection from misbehavior by either party, doctor and patient. Their presence and duties for such protection, I would think holds legal responsibility for which failure to report or even attempt to prevent merits legal scrutiny. ..Maurice.
Dr. Bernstein, in theory chaperones may have fiduciary duty to protect patients given medical practices and hospitals represent that chaperones are there to protect the patient. The reality is chaperones are typically going to be very low level employees; most often medical assistants. How skilled can they possibly be to know whether something improper is occurring during a pelvic exam? How apt are they to understand whether a patient was exposed more than was necessary? Given the organizational power differential how many would dare to ever speak up or report sexual misconduct? Chaperones are there as a legal prop to keep the lawyers happy. Their presence raises the bar patients have to overcome to claim sexual misconduct.
JR said:
Chaperones are not there for the protection of the patient but rather for the doctor's protection. Most of them will not protect a patient. Like in a case of hospital abuse where a doctor is not even present, if one of the group is abusing a patient, the others let it happen & say nothing. It seems to be an unwritten rule that protection of the group is more important than the protection of the defenseless patient they are being paid to provide service to & that would include when they use drugs to make them completely defenseless and isolated from their protectors. In today's world, it is so much the fear of losing a job as switching jobs is common place but rather it is a club membership they are unwilling to lose. The chaperone would have no issue in reporting if a patient done something inappropriate bc they are not in the membership.
As for the poor, sick doctor--too bad. Most criminals are still imprisoned despite having illnesses. Perhaps he should have thought about the consequences before he chose to commit the crimes. What about the illness he has brought on to those women they must live with for the rest of their lives. The prison he put them in has no such chance for bail. Maybe some hardened prisoner can give him an exam because that is exactly what he deserves just as the women who abused my husband deserves the same in turn. The Old Testament was not wrong in an eye for an eye.
Reginald,
The video would be a good idea but I would suggest a couple of changes. Instead of using a patient, they should use staff to simulate what happens. If exposure is not a big deal then prove it by having all participate as a patient in the videos so they could be rotated. That way they have their fair amount of exposure to their colleagues and patients and thus proving it may not be a big deal as everyone has seen naked bodies including the patient seeing theirs. However, I do not think the videos will make a difference bc they are trained (at least the textbooks are written to be) to limit exposure by uncovering only as needed, to be respectful, etc. but they simply choose not to do it. The videos might reassure the patient but in reality they are still doing what they choose by disrespecting & betraying the trust of the patient therefore inflicting intentional harm upon the patient. So much for "doing no harm". Most patients do not realize once they are in the OR they are stripped and are left totally naked no matter what type of surgery. That is why they give the cocktail of versed and/or whatever to make you cooperative, uninhibited, and erase the memories. Versed is an anti-anxiety med but that is not the main purpose as it is given in higher doses than needed to relieve just mere anxiety. The use of fentanyl gives makes a sexual high so it can be entertaining for staff. Versed is also like a truth serum so patients will tell things they would never tell but will not remember it. There are some nurses who have recorded what patients say with their handy dandy personal cellphone along with the video. So much for patient privacy as it really doesn't matter to them. Patients are just something they put up and will sometimes be of entertainment value. They are only there for the money, control, and power. JR
Maurice,
You stated "...our students are taught early (first year) that when there is a hint of trauma the possibility "abuse"...
Trauma informed care treats ALL patients as if they are victims of trauma. That is because many victims of abuse either do not disclose abuse or only do it many years later. See: Psychology Today, Why Adult Victims of Childhood Sexual Abuse Don't Disclose
You ask, "what penalty is presented to that or those chaperones?" Here are some possible civil and criminal legal actions they can face:
Conspiracy
Perjury
False Statements
Obstruction (of Justice)
Lying to Government Agents
Fraud and related activity in connection with computers (due to electronic medical records)
Wire Fraud (due to electronic medical records)
Boogie Jack (due to insurance and patient billing)
Failure to report (Cali)
accessory before the fact
accessory after the fact
These are just the ones that come to mind off the top of my head.
-- Banterings
Dr B, In THEORY
JF
A uptodate detailing, a worthy read, of the role of the chaperone in medicine and the "limits" of these examinations from Michigan Medicine (Univ. of Michigan) but also applicable to Michigan laws.
However, what is apparently not fully described or even described (unless you can find something I missed) is the occupational or legal penalties for missing or ignoring medical misbehavior. ..Maurice.
Maurice,
Until healthcare starts being honest, the working conditions for providers is not going to improve.
Let us start by acknowledging that these additional voyeurs in the exam room are there strictly for the protection of the physician.
-- Banterings
I'm sorry Dr B but I agree with what Banterings said. Not in every single case but often enough to cause some very real problems. JF
Hi.
My name is Rick Kirschner and I am the person who was victimized by Providence Urology in Olympia Wa. I received a letter that invited me to contact the members of this site to further discuss what occurred at my Urology appointment on Feb. 13, 2019. I noticed there was a comment that included a link to the investigative story that was done here in Washington state regarding the initiation that happened. I have never participated on a blog or really know how to attach a link so I will leave that to others. The story was done on KING 5 television, they are the Seattle affiliate for NBC. I was told a search of my name and KING 5 will bring up the interview. If anyone has any questions, please ask. I assume they are answered here and I will do my best to figure out how to find any questions and respond here. If there is a different way to respond please advise me. I read many posts and am impressed with what people say and their thoughts regarding patient rights and the dignity that we all deserve and must demand. Thank you for the invite to join your fight to stop abusive and unprofessional behavior. I am currently waiting to start intensive PTSD therapy (July 18) but will do my best in answering your questions.
Rick, as Moderator of this blog thread, I am pleased that you are willing to contribute your experience and understandings and feelings to the visitors here despite your emotional injury. With continuing contributions here, please identify yourself with Rick at the end of each posting. Again, thanks and hopefully you will get some supportive feedback. ..Maurice.
JR said:
Another point I would like to add about chaperones is that even when there is more than one involved, they still don't protect the patient. There were multiple as Biker would call them professionals who were present when my husband was being sexually abused and they did nothing to protect him, stop it, or report it. They know how patients are supposed to treated but allowed him to be exposed and ridiculed for hours in their presence. It wasn't they were lacking education just morals, ethics, compassion and a disrespect for any decent treatment of a male patient. They stood looking and making comments as they knew he was drugged and unable to defend himself. It was a great deal of fun for them. Did they not speak up for fear of losing their job? I highly doubt it. To them, it was entertainment pure and simple. They figured who is going to do anything about it as it is not believable when it happens to a man or it can be justified if needed but they will stick together. There was no doctor present in his ccu room. There was a doctor present in the cath lab but he was not the one who did the procedure but rather the one who graduated from a 3rd world country of dentistry. He probably enjoyed the tormenting of my husband as much as the women did. His reasons for allowing it were probably different from the women's reasons. I would guess all thought they would be rewarded in the hierarchy of the church because they had punished a mortal sinner (the gay married man) who dared to enter their doors not knowing they thought he was what his medical records listed. I think it would be rare for someone to actually protect a patient. I think medical workers are so jaded by their issues of having control and power = greed they don't even think of us as being worthy of any compassion or ethical treatment. The newer ones might be afraid of unsure like the one who just stood and stared at Mr. Kirschner because their training hadn't prepared them for the reality of such callousness and abusive behavior towards a patient. But as they get experience, so will their lack of compassion disappear until there is none. The woman who pulled off Mr. Kirschner's cover and left him exposed to try to "merely" embarrass the newcomer should be sentenced to suffer public humiliation too. That day, she and whoever else was involved in this despicable scheme created two victims--not only Mr. Kirschner but also Mrs. Kirschner was present too. Even if she wasn't, like me, she has lives through the carnage it has created. Deep violations never heal completely and never go away especially when it is done by the medical field. Avoiding walking in dark, unlighted areas is easier than avoiding medical care and not knowing which one of them has rapist-like tendencies. Being molested affects not only your physical body but cuts deep into your soul. It is difficult for some to believe but being exposed as a male like my husband and Mr. Kirschner is very much like being a female who has been raped by a male. The trust we put in medical people is a blind trust and they deal with us in a deeply personal way. When they shatter this trust, it effectively shatters us because we no longer can trust them to do the right thing in helping us with issues that require blind trust such as an operation would require. Can you imagine how traumatizing it would be for someone like my husband to agree to an operation knowing what happened the last time and that the medical world would refuse to accommodate his needs knowing he has been a victim of medical abuse? Can you imagine Mr. Kirschner ever trusting another female medical worker again after this episode? JR
Rick
I am the one who reached out to you by mail. I’m happy that you have joined us and certainly do appreciate you sharing your story as you know we have a number of questions.
PT
Hi Rick .
Welcome to the blog . I want to thank you for standing up to this injustice . Most people would sit back and suffer in silence . This kind of crap has been going on for far to long and needs to stop . I wish you luck .
AL
Rick
What I am interested in is have you contacted an attorney? If so I would like to know what your attorney’s thoughts are regarding this matter, you see I am of the belief that the only way to get their attention is through a lawsuit. My second question is, I know Dr. Cheng is a female urologist. Did she speak with you or in some way acknowledge that the behavior you experienced was unprofessional? Additionally, I’d like to know what communication after this incident did that Urology clinic have or did they in some way attempt to reach out to you.
I suspect that as usual it’s swept under the rug. Pathetic that it took a month for someone in the Providence hierarchy to communicate back to you regarding this and everyone you had to document up the chain but you see healthcare is a greedy conglomerate that sucks in $4 Trillion dollars a year. This is the shitty way patients are treated. You see, you as a victim are not alone. Everyone on this blog are victims and some of us many times over.
PT
Thank you PT for finding my address and contacting me. I decided to go public because remaining silent was no longer going to work for me personally. I was abused as a child during school physicals from the age of 7 until I was 11. I did not tell anyone for decades, and then only a select few. I am now 61 and this incident has convinced me my silence was a mistake and I needed to change my approach in order to survive. I appreciate the comments from AL as he stated most people would suffer in silence. That fit me to a tee a short time ago. I would have hurt like hell and found a way to stifle the feelings. Except this time was different. The flashbacks are horrible and the nightmares constant. The feeling that I could not handle it anymore was and is paramount. I had to try something different.
PT, the urology clinic never contacted me. I wrote the doctor a couple days after the incident to tell her of my experience and suggest they leave sterile drapes on patients. My original message was written before I was informed by an anonymous caller from Providence that the appointment was an initiation for "the new girl". I was later told my ecare message was removed from the doctors inbox and "sent away" by a person at the clinic. The original message was eventually returned to the doctor but she never contacted me. I have been unable to find out who removed the ecare message and who it was sent to. My very personal information was included in that message. No one from the clinic, besides the caller advising of the initation, has contacted me. The investigator from Providence explained to us that she offered the doctor an opportunity to meet with us but was told the doctor declined.
The only contact from Providence was from an HR administrator who also did the investigation. No one else has ever responded.
I will answer more in a few minutes.
I have obtained the services of an attorney and am currently exploring options. I have several medical issues including M.S., diabetes and am in the process of being worked up in order to find out if another neuro muscular disease is present. There is so much going on, and PTSD therapy starts soon. Until then, I have been meeting with a psychologist to assist with issues until my other therapy starts.
The attorney has presented options and the only way I will find out what occurred is through discovery, which will take a lawsuit. In order for me to find out what really happened, to find out where my ecare message went, and who was involved, a lawsuit will be necessary. I want to know what Providence found out from their investigation. The investigator stated and wrote that changes company wide were going to be implimented because of this incident. I was sent a draft of new policy that was being worked on. In it they talked slot about patient dignity, which is already in their mission statement and their core values. They even use Bible verses to back up their core values. It truly sickens me of their hypocrisy.
Rick
Though I am aware of Rick's home address, everyone please be aware, I don't intend to have it published on this blog. As with the legal involvement suggested by JR involving herself and her husband, I wanted her to also remain free from full identification on this blog.
On the other hand, since Providence hospital system in Washington state was identified in the news, they, as well as other hospitals described here from the news media in the past are certainly welcome to write their views and explanations on this blog thread. We deserve to read directly here responses, explanations and views of the medical systems involved.
Finally, my thanks to PT who initiated the current contact. Reading the story out from a newspaper article is one approach but reading words written directly to us by the patient is what has been going on for years here and has always been appreciated. Next, we have to decide how to change the medical system and make that known to our readers. ..Maurice.
Mr. Kirschner, thank you for sharing with us. Do you know if anyone in that clinic was punished or was this simply handled as another "don't do it again" kind of thing? That Dr. Cheng declined to meet with you speaks volumes as to their not thinking anything was wrong with what they did. Perhaps Dr. Cheng was in on the prank. I'm shocked corporate didn't force her to meet with you.
Did Dr. Cheng do or say anything when she entered the room and saw you exposed? If not, then again it speaks volumes as to their utter lack of concern for the dignity of male patients?
JR said:
Rick,
I have a lot of questions. My husband was sexually molested after he had a heart attack. They left him exposed before for prolonged periods of time both before and after the cardiac cath in a room full of at least 4 women and others coming and going. They had drugged him in order to make him defenseless as he did not consent to having a cath but rather wanted to use blood clot busting meds first. They, of course, had called in the cath lab & was going to make sure they made their $200K+ at that hospital for the cath. plus what the other hospital charged. He was exposed for no reason for 20+ minutes before the procedure as they stripped him entirely naked except his footies although they did could have covered his genital region as access was not needed for prep. They did not give him informed consent (which now I have learned something very interesting from Livanta). Once in the CCU, he was kept isolated for hours from us as they did not allow us to see him. While there, a nurse, techs (IT), the phlebotomist, and other nurses were in his room while the nurse had his genital area completely uncovered for hours. He was aware but was so drugged he was unable to do anything about it as drugs really wipe him out. The nurse made him urinate in front of the crowd several times and also performed perineal care in front of the crowd. When I was finally able to someone to tell me where he was, I was so very stressed that when I walked into the room I saw him exposed but didn't react as I should have. The nurse laughed and thought it was funny and used the excused after 10 yrs of being a nurse, she didn't know how not to expose a patient. The other nurse in there who was a social worker laughed the entire time too when she told us where we could find him. By the way, this social services nurse was asking him if he was spousal abused sexually all the while she was part of the medical sexually abusing of him. The nurse would not let us stay for more than 10 minutes even though now we know I could have stayed all night with him. The abuse by her continued until her shift was over.
We have many issues with what happened. The sexual abuse, the lack of consent, a catholic hospital thinking he was a gay, married man and reacting as such, falsifying his medical records, giving him drugs he had refused to name a few. However, in Indiana, we have tried to get an attorney but most say it is not worth their time and the money they would spend. All agree we have a case on many different aspects. My husband has not went to the police as he just couldn't stand having this made public and the whispers of this type of thing doesn't happen to men. Both he and I suffer from PTSD but neither one of us has sought treatment as we have absolutely no trust in medical providers. He went to a hypnotist who helped bring about some of the buried memories. Not all returned as he was drugged but enough returned to tell the story of what he did already remember and of what I saw. We haven't given up. He is beginning to tell some people especially those who tell him they are seeking medical treatment as he feels he has to tell them what could happen. This affects every aspect of our lives. He has decided no more emergency or hospital care. I too have decided that. How did you get an attorney interested? Did you file charges? How is your wife doing? For us spouses, it is hard too because we suffer along with you. From what I read, she like me, witnessed what happened. JR
Rick,
Welcome to the blog. Most (if not all) of us have been abused in a healthcare setting before. My abuse occurred when I was 5 or 6. My mind has blocked what happened some 40 years later.
After that, I avoided healthcare altogether. All my vaccinations and medical forms were done by a relative. My family thought it perfectly normal that a child NEVER went to a doctor. To me, that speaks of the severity of what happened. I did not seek out a primary until my mid to late 30's and that is only because my relative retired his license and I have ADHD.
Along with what is legally required for my ADHD meds, my PCP (who is an old school physician) throws in cholesterol and some other screens. I allow this because it makes him feel good. I also go to him for the occasional sore throat and tetanus shot.
I have NEVER had a complete physical exam in my life. I have NEVER done any cancer screening in my life (and never will). Most of the meds I get come from outside the proper channels. I have made healthcare as irrelevant as possible in my life.
Welcome. You are safe here. I wish you healing.
-- Banterings
Rick
You were Pranked! Not in some high school activity, not in some college fraternity, not at some birthday party by well meaning friends but rather as a patient. A patient who needs medical help that was pranked by those who are supposed to be your advocates. By those that you were paying good money too. How does it feel getting hit upside the head with that double standard brick?
Double standard. Yes, let’s reverse the roles for a moment. If the patient had been female. There would be riots on the streets and neighbor hoods would be set on fire. When Biker first posted your story from King5 we saw how meticulous you were in documenting a paper trail. I’m glad you have done that for it clearly demonstrates the ineptness of that organization.
First, I’ll say that those 2 females who pranked you were most likely medical assistants and there is no governing body for licensed medical assistants in most states. In Washington state all medical assistants, their actions and their behavior falls under the responsibility of the physician, Dr Cheng. This is why Dr Cheng is being mum on this issue. Rick, I would like you to make a formal complaint to the Washington State medical board against the license of Dr Cheng.
Write to: Provider review and education, Department of labor and industries, P.O. Box 44322, Olympia Washington98504-4322
You can also do it on line at at the Washington state medical commission at 360-236-2750.
Secondly: One of the Hipaa laws states that it is illegal to block, intercept or void any communication that a patient uses to contact his/her medical provider. In your case you sent an e-mail to your provider. Please make that complaint here. The federal government can investigate with their own IT investigator regarding the e-mail, 1-877-696-6775
PT
Again, thank you all for your support. It means so much and is truly a blessing.
Biker, I was waiting for the doctor to enter the room so that I could see her reaction. I anticipated that she would be upset knowing a first day employee was being trained by her staff and had been left I the room with me completely exposed. When the doctor did finally enter the room her reaction was totally unresponsive, very nonchalant. The first day employee was standing at the foot of the table I was laying on, and had been there silently standing for over 10 minutes. It was painfully obvious the doctor could have cared less what was going on. I was shocked as I was anticipating at least a shocked look. She was expressionless. The investigator from Providence refused to inform us of any personnel action that was taken. The incident was labeled as "desensitized employees."
Banterings, I am so sorry. I have tried to do the same over the years but the medical issues caused me to abandon that system. I had prostate cancer and felt as if that mental experience alone would kill me as the thoughts were horrific. Every doctor appointment is a nightmare, so I understand your thoughts and reasoning. Since I went to doctors, I avoided feeling. I tried to bury the thoughts and experiences as deep as I could. I was able to somewhat cope for years on the outside but inside it was devastating for me mentally. I dont know if therapy for the PTSD will work but I need to try something as I now feel as if not being here at all is an option. I love life. The pain that has occurred over the years is terrible. The simplest word or thought can trigger deep pain, and that has gone on secretly all my life. I hurt for you too. I hope you are able to continue to control your world. This experience at the clinic forced me to again change tactics and try something else. I hope you can have a plan beforehand if you need help medically. I have a ton of doctors. There are good people out there. Again, I'm sorry for your pain.
JR, thank you for sharing and caring for how we are. Your anger must be similar to what we are feeling as we did not know where to turn or how to get help. We tried daily to find someone at Providence who cared. We thought of an attorney but only found one after the story aired on TV. I read statutes that did not clearly state what happened to me as I imagine lawmakers did not consider initiation by medical professionals a strong possibility. Someone suggested I contact my represenative and I will be doing that in the near future as new laws to protect people from this sick type of behavior needs to be enacted. The anger we felt became dibillatating as time went on without any acknowledgement. We can only imagine what you and your husband are suffering through. We are so sorry for that pain and the pain from the ordeal. My wife is hurting, thank you for asking. She was there and was aware of my past experiences. She goes to all my medical appointments as I would not be able to handle them alone. My M.S. has caused cognitive issues and she helps me with questions and instructions. She knows my hatred of appointments and the unbelievable stress they cause. I put her in an impossible situation as I have asked her to allow me to get through an appointment my way. That way was to endure and go home. I did not foresee this initiation as a possibility and had I had tied her hands regarding taking action. I had been instructed repeatedly not to touch the groin area as it was a "sterile field". One thing medical providers have over me is complete power. I obey, as I did as a kid. My brain was screaming for me to run from this appointment, again as my childhood brain did, but I couldn't. I was more concerned with what the doctor would think or write in my records concerning me. That fear kept me frozen on that table, naked and humiliated. I hate myself for inaction, but after all these years understand it is the way I am because of sexual abuse.
Rick
PT, thank you too for the thoughts. My first contact with the doctor mentioned that males are expected to have no modesty nor complain when they are naked in front of others. I told her that was not the case for me and others and I was aware that doctors as a whole were becoming more educated about it. I told her a sterile drape was appropriate. The investigator from Providence mentioned to my wife and I to imagine if this had happened to a female patient, being left uncovered while in stirrups. She mentioned the outrage that would occur and that it would not be tolerated! So yes, a double standard does definitely exist and is tolerated by the medical community. The only way they will learn is to become outraged and demand a change. I read where someone made contact with Providence concerning this issue and it is appreciated as they do not care until enough people, in numbers, care. Change can come.i am in the process of sending all my interactions with Providence to the medical board and will call the number regarding HIPPA on Friday as my intercepted ecare message was removed from a doctors inbox. The information I disclosed in that message was extremely personal and it sickens me to not know who has it or who has seen it. Thank you so much for your thoughts and ideas on who to contact. It us greatly appreciated.
I hope I answered all that was asked. If I missed something please reask and I will get back to you. Thank you all for the care and support. Our hearts also hurt for those on this blog and the unimaginable pain that is occurring. Change for the future patient is possible. Support of current victims is needed. Thank you for providing much needed support.
Rick
Rick
You are saying those were the first words out of her mouth before the incident or after the incident? Do the male physicians in her group say that to their female patients? Those comments that she made to you sound like someone who is so self absorbed in herself, much like a used and discarded tampon.
You see, entitled people like her feel very comfortable saying that to her male patients. A first class hypocrite as she is would never seek out a male provider of any sort. There are no male mammographers in this country and if there were one at her appointment I’m sure she would run like hell, she would have to eat those words she made to you. But then, I’ve seen her picture. I’d run like hell too if I had to perform her mammogram.
As you can see Rick I like to use sarcasm when referring to our healthcare industry. I’ve seen first hand for decades how people are treated as I’ve worked in the industry for many years. I’m anxious to hear what options the attorney provides to you. The only option that would work for me of course is to be able to push a wheelbarrow stacked full of money by that urology clinic three times a day with a sign hanging on my back saying. I sued this Urology clinic, ask me how.
PT
Hi PT
I'm sorry PT, I was not clear. I sent an ecare message to the doctor where I told her that males in our society are treated like they should not be modest in any way. I told her in my message that I expected to be treated with dignity. The doctor has not said a word to me regarding the incident. Because of her demeanor when she walked in the room I fear she was aware of what was going on. The employee left in the room was there on her first day at the clinic. I fear this is business as usual for them. I'm sorry I was not clear in responding, I stretched my abilities a bit too much in replying to questions!
I understand the sarcasm. I think I have gone to hatred.
The only person from Providence to speak to us was an HR Administrator who also did the investigation for Providence. Again, sorry for the confusion.
Rick
Rick, unless I missed it, I haven't seen from our contributors here any question to you about, beyond our PT's invitation, what kind of feedback have you been getting from the "public" who have read or heard about your experience as the patient. Without naming specific names, what kind of public feedback have you already received either supportive or whatever is "otherwise".
You are an example of what has been and is being described here on this blog thread for years (since 2005) and here you are now a "subject" of a news story and can tell us whether the public considers your story "a statistical outlier" or something that they have also in some ways experienced when facing the medical system. You already know the past histories of some of our contributors but you are special since you have had potential contact with the "general public" and how that resource behaved in response to the story presented about you I think is very important for our understanding. Your comments on this subject I think will be greatly appreciated by all here. Again, I apologize if I somehow missed your words already written above. ..Maurice.
I think somebody needs to make clear to that doctor and her staff that many men avoid healthcare because of dignity violations. The doctor should be asked how much preventable death is ok because many men won't seek care because of it. JF
Rick
There is no confusion and no need to apologize. You are among friends on this blog, it’s a safe place for you to speak. Yes, I agree and I fully understand your hatred and appreciate this is not our first rodeo. I want you to feel comfortable here but please, do put those big boy pants on and complain like hell to those two agencies I asked you to and document it. In the end, someone is going to have to pay for all the therapy sessions you need to recieve.
PT
Maurice,
I get alot of my feedback from the reporter who did the story and posts on the stations website. At first I read only a few and was satisfied that they seemed very positive. Then my wife told me she read over a hundred responses and they were all positive. I then felt comfortable in reading the comments in depth and was overwhelmed by the care and support. The reporter gets personal messages that are relayed to me (just content, no names) where the people are extremely supportive and caring. I have numerous doctors who became aware of the story and watched it when it aired. These doctors all ecared messages to me or called personally to express their sorrow and concern. None of these doctors (except for my Primary Care doctor, who I confided in just prior to me going to the Urology clinic) knew of my past history of sexual abuse. I had to explain to friends and neighbors why a television station van was going to be parked in our driveway. The reaction of neighbors was amazing as were friends. I explained everything, from childhood on and the reaction was anger from some towards the clinic, to tears from many who felt our pain.
The most difficult notification I had to make was to my mom, who is 86 years old. I never told her, or my brother or sister. (Or any other relative) Telling my mom was heartbreaking and difficult. She of course was shocked and devastated. She feels pain from the guilt she is experiencing as she wishes she "could have been there for me." I have explained numerous times that the decision to remain silent was mine, and I desired it that way. I am not sure I can help her as she too feels terrible. I had to tell her, as the news station it was on is her favorite.
My brother has also been very supportive and helpful. He recalled the other day an incident from our childhood where I was about 10 and he was 6. I was going to a doctors appointment that day and had on three shirts. He remembered me telling him that he should wear three shirts too when going to the doctor. I of course did this to expand the time in disrobing. The adults just thought I was a jokester and it was embarrassing to my mom, I'm sure! My dad never knew of the abuse either but he passed away 3 years ago.
About the only "negative" thing I have read is a couple people wondered how I just didnt cover myself up? I haven't responded but I was instructed not to touch or have my hands anywhere near the groin area as it was a sterile field. Besides that, I am (was) unable to stick up for myself. I was literally frozen in reacting on my behalf. I had asked my wife to just help me get through appointments, not to interfere in any way as that to me would have been extremely difficult for me to handle. I went to doctors because my health demanded it and I endured the appointment and would leave. I would handle any appointment later, in private. I did not think something like this was possible and we did not realize the extent of what occurred (initiation) until a few days after the appointment. I dont know if people who suggest I could have covered myself up understand my inability but that is why I could not, or did not just cover myself. Just like my brain was screaming to me to run out of the clinic, I was more concerned what would be said of me and what would be written in my medical records. I was frozen as I was when I was a child
In short the response has been amazing. Informing the general public has been a blessing. The TV reporter has assured me that she has personally heard from many people who have been helped. I hope this answers your question. I am glad I did go public. Many people, I have found, if not most, do care. It's been a blessing.
Rick
Rick, as a physician, I can assure you that "sterile fields" can be readily "re-sterilized" if no longer sterile. 30 seconds or less to re-sterilize is no clinical hardship for those performing the procedures.
And obviously, with the final wandering in of the physician, there was no emergency status to consider.
Think of it this way: in a non-clinical emergency with an awake patient, the patient should consider him-herself as an active participant in the procedure not a bystander or victim. You are the "subject" of the procedure and not some "object" simply to be manipulated by the medical profession. It is unfortunate, that this concept which we teach our first and second year medical students was ignored for some apparently unethical process of nursing "education". ..Maurice.
JR said:
Rick,
My husband and I understand the hate. If we saw any of the people involved in what happened to him and me on the side of the road needing help, we would not help them. It is a deep hate for what they have done and no one is sorry. The hospital told us to get use to such treatment as the older you get the more medical treatment you will have and therefore be exposed more often. They said if we don't like how we were treated don't come back because they are a religious hospital and they will do things their way. My husband cannot go anywhere without me as he wants me to be with him so he won't ever have emergency care again. He would rather die is what they have done. He was not like that before. I don't want that to happen but it has changed him and me forever. I too will not seek medical treatment. The night it happened I told my son to drag me out of there if I passed out from stress of waiting, not knowing what they were doing to him for hours. The stress or torture they inflicted upon me is what prevented me from recognizing immediately what the nurse was doing to him when I walked in.
Did you go to the media with your story. We have been unsure how to handle ours. Here in Indiana, no attorney will take our case but we haven't given up and will be representing ourselves. My husband knows he should go public but he feels so ashamed of "letting" it happen although he had no choice as they rendered him incapable of defending himself bc of the drugs. My hope for those female nurses and anyone who witnessed what happened to him and did and said nothing is for someone they love to be a victim of a sexual crime. Perhaps then understanding of what it feels to be a victim will penetrate their empty head and cold heart. I know wishing for such a thing seems cold but to us it doesn't as they didn't care about sexually molesting my husband. My husband is on Medicare and since the sexual abuse was not documented by the "rapists" in his medical records, Medicare doesn't acknowledge anything could have happened because medical people do not commit such vile crimes. They also only believe what is in the MR which is so very convenient for the criminal to know and use. Hopefully, you have some proof. We did have in a letter from the cath lab dr. saying he was sorry if they offended my husband in any way which is a really weak and insincere apology for what they did and what happened to him in ccu bc of what they did. Most medical workers do not even consider us to be humans and deserving of respect and dignity. That is why my husband freaks out over seeing anyone medical which now includes even eye care as I had to go into the exam room w/ him as the dr. was female in a darkened room. JR
JR said:
Even in an emergency, the patient should think of themselves & act as participant in what happens. However, the medical team doesn't think of them as a participant but rather an object. Of course, drugging the participant out of their mind so they are both physically & mentally unable to participant seals the deal in making sure they are only a spectator and at that, one who is on a time delay in seeing what happens or too many technical difficulties that wipe out for the spectator what happens. You forget you can be awake but not really functioning as with "NOT Conscious Sedation." It is given on purpose to make the patient act more like a deer in the headlights type of behavior. The older one gets the worse the effect. Also, what you may teach in 1st & 2nd year med school is ignored more often than in the case of "nursing education." It is ignored because they can control and exert their authority which must give them a feeling of power, they do it for entertainment, they are sociopathic, but mostly it is not ignored as they make a very conscious decision to torture and abuse which may be standard operating procedure in places like the cath lab, OR, and ccu where they are dealing with heavily sedated individuals.
What is interesting about what Livanta is they agreed that my husband was not given consent prior to the beginning of the procedure as it is documented in the file. However, they made the excuse they beforehand, everyone was too busy and that included the mysterious dr. who supposedly did the consent but left before the procedure started. They said they noted and signed it once the procedure started as they had more time is what they thought. So they had spare time during the procedure? How odd? It took 4 heifer hags to intimidate him while he laid naked on the cath lab as they prepped him for a procedure that had not been consented for along w/ a mysterious dr who & assorted others but had no time except during the emergency PCI? Who knew there was spare time during a major procedure that takes so many women to be present? Livanta certainly showed their bias by making snap judgments to protect their medical peers. Certainly they are not there to protect their Medicare clients. No one is there to protect the patient as they are drugged & isolated from their advocate. It is no wonder the health system is so corrupt & abusive. It thrives on causing selected patients as much pain & suffering as they can for sport. JR
JR, you write " It is no wonder the health system is so corrupt & abusive. It thrives on causing selected patients as much pain & suffering as they can for sport." I can't believe that the "healthcare system" is "thriving" on any selected patient for providing "as much pain and suffering as they can for sport". Is the much discussed "physician burn-out" based on such "thriving"? Sure there are documented exceptions supporting your argument but these are isolated unprofessionals as there are in a host of relationships with the public including religion. What you and your husband experienced is sad but as a longtime physician and longtime teacher of medical students and a longtime active participant in hospital ethics, the conclusion you have reached, though personal and important for you and some others, is not what I have practiced or even observed in others. We all should alert and remind the medical profession about "wrong" behaviors towards some situations and patients but hardly generalize to every physician, every nurse and every tech. I, like Biker, see some "good" within the system and that is why the medical profession is not completely abandoned by us patients. ..Maurice.
I know there is truth in what you say but we never expected the abuse. We do not ever want to experience that type of purely evil & despicable behavior again so we now have to operate on the assumption that all may be bad until proven otherwise. My husband had faith & trust in the medical profession before this happened. What they did completely shattered him & his belief on many different levels. When he left the 1st hospital that night we felt he was in good hands having no idea how devious & manipulative they were being in not making note of information that would affect what type of care (drugs) & that they had actually planned for him to have the procedure of their choice without telling us anything about the procedure or it was planned in concrete. The helicopter carried out the drugging. The 2nd hospital manipulated his MRs to cover up the lack of consent although they were as smart as thought they were a Livant even had to agree the consent was actually done after the procedure had begin. They made comments in his file as he was noncompliant, etc. Understand it is just not our bitterness & anger over having a procedure done w/o consent but it was also the exposure for their perverted pleasure along w/ the torture of forced isolation, being held captive. Exposing his body wasn't enough they also exposed his personal info to the whole public hallway. My husband & I have talked about Mr. Kirschner going to therapy for his PTSD but neither of us have any faith in pouring out our thoughts for another provider to rape our souls & whatever again. These were professional medical providers who committed these heinous acts & not techs for the most part although they were part of the audiences. We met a nice derm dr. & his nurse who asked why I had to literally hold my husband's hand as he needed to have some places examined due to the high levels of radiation he received against his will. He is not real far from the hospital from hell but he does not practice there. W/o the k word, he would not be able to face any medical appt especially when there are any females involved. He thought the female tech was okay for his stress w/ ultrasound EKG until she tried to take his shirt off. He told her to remove her hands from him as she didn't have permission to touch & he could unbutton his own shirt w/o her treating him so impatiently. No, it is not necessary to remove your shirt for a stress test. The full exposure just is easier for them but not necessary. There seems to be an attitude with the majority of medical people that their wants & needs are more important than the people they serve.
Maybe someone like you may have trained students to be ethical providers but would mostly likely adapt to the toxic atmosphere like at the hospital from hell. It would be how they too survive in a place like that. They may not sexually molest the patients like the heifer hags did but they would probably not be as respectful & give the patient the dignity they deserve. Certainly they would not stop or report abuse. This would make them as guilty as the actual pervert. For the most part, male patients are treated in a cold, unfeeling, callous manner when it comes to preserving their medical modesty. Men are expected to man up & be okay with it. Men are expected to have women providers see them naked & perform intimate care without any issue. On the other hand, female patients are treated differently although some still suffer from abuse from the male dr. or nurse involved in their care. However, these cases are treated differently than when a man complains. Most do not take it seriously when a man has been abused because they have the mindset that females do not act in a sexual manner. My husband had prostate cancer & we made it through all that intimate exposure without having any issue &/but I was allowed to be with him except during the actual surgery. They were much more open & honest in what they did & he was accepting of that & there were females involved but the urologist was also present. But then again most of the operative team for a male procedure was female & for like L&D there may not be any males except if you choose a male dr. There is an undeniable bias/discrimination in gender care against male patients of any age. There is an acceptable double standard that desperately needs changed as women providers have finally become equal in all things male providers can do like molesting. Equal opportunity molesting but even a greater chance of a male patient being molested as healthcare nursing/tech jobs are over 90%+ staffed by females. I think we will start to hear more & more stories. I continue to work on my husband to go public but just the thought totally stresses him out and he has enough stress just having to deal w/ what they did
There is another area I disagree with you and most of the medical community is that even an emergency patient should have full informed consent unless they are unconscious and no family can be contacted. Also, if they have been given any type of medicine that could alter their mental status such as fentanyl, versed, ketamine, Demerol , etc. family should also be present for consent. In any case, all consent needs to have an audio recording that cannot be altered. It is way too easy to manipulate MRs to cover up the crime of no consent. There also should be a standard test to see if a patient really understands what they are consenting to and that they agree with the areas. I am all for audio being used as it would serve better to protect all involved. All medical personnel should wear audio recorders that could be used in court cases if needed. Knowing there is an audio recording would help make some more compassionate and less likely to abuse/manipulate a patient. These recording should be available live as the situation plays out. Also, not all emergencies are as emergent as others. Most have time that could be spared for true informed consent. My husband was stable and there was no reason it could not have been delayed for his benefit as his treatment had already been delayed due to both hospitals. Also, patient wishes and instructions should always trump what the medical provider wants as the patient has autonomy over their life. JR
Hello,
Posters may wish to subscribe to the OIG newsletter.(https://public.govdelivery.com/accounts/USDOL/subscriber/new?topic_id=USDOL_225) It is sent via e-mail every two weeks. One will be amazed at the disciplinary actions taken against medical personnel. Many of these never make the national headlines. I'd like to suggest that these actions DO NOT indicate corruption of the entire medical world. Is it possible that SOME in the medical field have joined others in society who have found unethical activity enticing, lucrative or, otherwise, appealing?
Reginald
JR, you write "patient wishes and instructions should always trump what the medical provider wants as the patient has autonomy over their life." And as a former chairman and currently member of a hospital ethics committee, it is our responsibility as a Committee to see that such patient autonomous decisions regarding treatment or no treatment be followed..unless, of course, established medical/surgical principles are being challenged by the patient. In that case, the physician and medical system have the professional responsibility to vigorously attempt to transfer the patient to a facility, if one can be found, where the patient's decision will be followed. Sometimes, in conflicting issues, an ethics committee can suggest behavior and actions of both parties, patients and physician/nurse/medical system (we call that "mediation") to help resolve the conflict. But never, never is the patient or family ignored and medical/surgical actions taken without true informed consent nor not taken without fully informed understanding of stakeholder (patient,family, medical professional, administration) views by all parties. involved.
I have a "big question" (unless JR already has answered it and I missed it): Does your hospital(s) have hospital ethics committees and, if so, were they consulted and fully attempted to investigate and provide direction for resolution by the parties involved by medical, legal and ethical education through the process of ethics committee education and mediation?
This question should apply to the personal issues brought up by all who write to this thread. Was a hospital ethics committee involved? If not, the initial phase of resolution was missed. ..Maurice.
In my case, no, a hospital (or corporation) ethics committee was never involved. My letters were ignored and calls misdirected to wrong numbers, or numbers not answered. What should happen and does happen have two different outcomes. Providence writes beautiful ethic statements and core values, backed up by Biblical verses, only to in reality work their hardest to ignore and diffuse. Their caring words are worthless and their numerous committees worthless. As a teacher, one can try to instill morals and compassion to others but the reality is the person being taught has their own thoughts and agenda. This is true for all professions. Trying to teach an immoral person ethics is a lost cause.
There are bad people in all professions. When a doctor or medical personnel, who are given an incredible level of trust, break that trust with abuse, a person's faith can be shattered. The level of trust given by a person to another will dictate their response, as will the profession the person is dealing with. I agree an ethics committee is a great resource, IF it is set up to be a resource. If it is just for appearances, it is a worthless entity.
I have taught people in my former profession, and some hopefully benefited by what I showed and taught. Others thought they already knew the best way and went about their way with their preconceived notions. I understand what we hope to instill but realize you cant instill morals or professionalism when the student does not or won't accept it.
Rick
JR said:
We did not contact the University hospital bc after dealing w/ the other one, we just didn't see the point. After the fact, we did contact the hospital. The night it happened, I didn't know there was an issue as I was in shock especially after being guarded by the nasty man and not knowing for hours what was going on. It was too much and Ididn't react as I should have. I didn't know he had had a procedure until the nasty man said it was done. It was very shocking to find that out. However, once he was home and his mind cleared up & we started talking, we got the MRs. It took forever for them to come as I think they tried to delay them. By that time he was starting to have memories & nightmares which made what I saw click together. I contacted the hospital & 1st they put in touch w/ the cath lab manager. She didn't give me what I was looking for so I again contacted the hospital & they have a Service Excellence Department that is supposed to help patients & the hospital resolve issues. If there is an Ethic Dept., they have not divulged that info. The Service Excellence Dept. are the ones who basically said deal w/ what happened, he's older & needs to get used to it, it is a religious hospital and they have their own set of rules and refused to investigate as my husband and I both agreed we could not ever set foot in that place again so they refused to meet anywhere else and said the matter was closed as far as they were concerned. They said we could talk to the legal dept. if we wanted money but we aren't after money just for the sake of trying to get money out of them. We want explanations, apologies, people fired at least, change. Money won't make what happened go away but I guess it is a language they understand better than compassion and respect for the patient. Before the fact, it was known that he did not want intervention without both of us being consulted and he would want the least invasive but then he was only given very vague ideas of 3 things that could be done and was told we would consult w/ the other hospital for treatment options and then be able to decide. At that time he and I discussed finding out from the transfer hospital what the blood clot busting drugs would do in addition to info on the other 2 options as we were not at all educated in heart care as no one in our families had heart issues like this. So there was not any conflict as far as we knew to even request an ethics committee intervention. That hospital was also very dead at 11:30p on a Sat. night. It was difficult to find any live staff members. They simply choose and remain steadfast on a road of dishonesty and secrecy. As for all being bad, like I said we have to assume this until proven otherwise because we have to be extra careful not to have this lack of judgment in trusting the wrong people happen again. JR
I think what our cause needs is for a certain number of patients to volunteer to have their care video'd. WITHOUT the medical staff being aware of it! Some patients would never go for something like that but SOME WOULD! Care being intimate exams also.
THEN staff covering up for staff would actually backfire on them and they'd lose credibility.
Also, there needs to be an hour long TV show ( every week? 5 days a week? ) discussing the making of laws. A tracking system so that it's known if many letters are being ignored. People that don't write letters or make phone calls or won't, don't get to participate.
We the people should have MUCH to say in the formation of laws. If and when lawmakers turn inactive on us, it's time for that lawmaker to find other employment. There jobs are too important for them to suddenly not care. JF
OOPS! I accidentally deleted Biker's comment from this afternoon. Sorry. Here is what Biker wrote. ..Maurice.
JF, change will continue at a snail's pace until such point as a critical mass of men begin to speak up. The healthcare industry and the politicians they donate to can legitimately say that it is a rarity that men complain about the modesty/privacy/dignity double standard. The few of us who do speak up are outliers as far as they are concerned. Many may feel as we do, but if they silently "man up" and say nothing or if they avoid healthcare, they are invisible to the healthcare system.
Until such point as large numbers of men speak up, the rest of us can continue to chip away at it one practice at a time. For sure the bad publicity Olympia Urology garnered from their treatment of Mr. Kirschner will cause them to be far more respectful in their treatment of male patients going forward. It perhaps will have had an effect on other urology practices in that area who don't want their moment in the spotlight. I recently noted that the 4 year RN program at the local university and the tech school LNA program both now include males on their website following my contacting them about there not being any males 2 years ago. Elevating my dermatology complaint resulted in a whole new protocol. Others here have effected local changes too. Seizing opportunities on internet forums and responding to pertinent internet articles serves to give the issue some publicity as well. Hopefully it encourages other men to speak up.
The bottom line is more men need to speak up if the issue is to be taken seriously by those in a position to make fundamental changes.
Rick,
Because of your health issues and your age, you have 2 specially protected classes that make you VULNERABLE individual protected under state lay: your medical issues qualify you as disabled (I bet you have a handicap parking placard) and your age makes you a senior.
You should file a report with your local district attorney of sexual abuse of a vulnerable patient. It will be easy to determine the new MA's start date coinciding with the date of your procedure.
I will tell you from personal experience that nothing softens up a defendant in a civil suit like a criminal investigation (and prosecution).
You can also contact your state attorney general's office. They will have a spacial office for crimes against vulnerable individuals (such as seniors).
Furthermore, as a person with so many medical conditions both you and your wife FEARED for the quality of your life (if not your life) that you would do anything that they said, thus making you an easy target for abuse.
I have already alerted the Thurston County DA's office of the news story on KING5.
I do not know about, but fighting against the profession of medicine brings healing. IMHO, criminal convictions against the perpetrators is JUSTICE.
-- Banterings
Banterings, though I understand Rick's emotional reaction to a "very wrong" educational technique that someone "cooked up", I hardly think that what happened to Rick represents a true criminal offense. There are certainly publicized and legally involved worse behaviors that demand jail punishment as part of the punishment. It is hard for me to picture Rick's experience identical with those cases. It is my opinion that the urology clinic's punishment was and should continue as unhealthy and possibly destructive publicity of Rick's experience and, perhaps, investigation and publicity of other "misbehaviors".
Rick, with regard to what public feedback you obtained with your publicized experience, have others "spoken up" to you about their own behavioral issues or worse with that urology clinic?
I am not trying to deny the psychological trauma Rick experienced from unprofessional and unethical staff behaviors but with regard to potential PUNISHMENT, there has to be legal proportionality. I look forward to legal corrections to my opinion. ..Maurice.
Maurice
I have found a number of cases presented on the student doctor forum as well as allnurses whereby pranking was considered the offending behavior to the patient and both cases are working their way through the Texas criminal court system. You can call it anything you want but in the end it’s unprofessional misconduct. Rick has rights and they were violated. My only desire is that he follows through with my suggestions as well as Banterings.
PT
Rick
From the beginning I’ve felt from what’s been presented from the organization and just a horse and poney show. An HR administrator should not be the one reaching out to you. Now Banterings gave you several outstanding ideas as to who to complain too. I’ve given you several which will get you quite a bit of momentum and attention.
There has been a lot of diversion I believe in minimizing the trauma that you have been subjected too, that’s their game. I do have your phone number, I could call you in a few days and over the phone give you the home address of the CEO of providence. I assure you he most likely knows nothing of this.
PT
Whether anybody wants to admit it or not, a crime was commited.
Do I think it will be treated as a crime? No. Medical staff did it. JF
Dr. Bernstein, even if nothing came of it, just having someone from the DA's office show up at Olympia Urology asking questions will get their attention at a whole different level than simply corporate telling them to not do it again. An alternative would be a visit from whatever constitutes "Senior Protective Services" or "Council on Aging" in that area. The staff legally sweating a bit in this regard might result in a little soul searching on their part about what they did to Mr. Kirschner.
JR said:
Not having been abused by the medical yourself that I know of, I believe it is very difficult for you to understand how deeply this has affected some on this blog and others who are totally silent in their sufferings. I am not as eloquent as Banterings but try to place yourself on that bed (2-cath lab & patient) where my husband was. This is some of what he remembers from his time with the hypnotist along with some of the memories he already remembered. We have a recording we made of his hypnosis session because without it, we were so upset and traumatized by what he revealed we probably would not have remembered all the details. You can hear the pain in his voice as he is telling his story. The hypnotist was very careful in not leading him by asking certain questions or asking them in a certain way. We had given him details of what had happened so he could formulate how to question without leading him on. We didn’t have a whole lot of faith that hypnosis would work but it did and was absolutely amazing. I just wanted you experience secondhand what someone who has been abused was thinking and feeling.
I was scared and confused by the time the helicopter landed. During the flight, I began to feel very strange, different. It was as if my body and brain didn’t respond to one another. I felt as if I was floating above just observing the man on the gurney. All I knew for sure was that I had had a heart attack that had taken me totally by surprise. We landed and I could for the first time hear conversation of the crew. They were upset as they was no one there to greet them. They searched and finally saw someone going to their car. One of them ran over and flagged that woman down. She let them into a door. They wandered with me through hallways trying to take me somewhere. They knew where that was but I didn’t know. Finally, they came upon a couple of people who led them to a room.
JR said: Cont.The helicopter transferred me to a table in a room that was very cold. Later I would learn they had laid me directly on a cath lab procedure table. A couple of the nurses just stripped me without asking and didn't cover me with anything. I kept waiting to be covered but wasn’t. I didn’t understand why and I was upset. The room was full of people. Why didn’t they cover me? I was cold. I could hear others talking in the room. The women were doing things to me but what I didn't know as so many things were being done. No one seem to care about me or letting me know. It felt surreal. I just wanted to disappear—I was naked and cold. Why did I need to be naked? I heard them from behind my head say they were sending a chaplain to my family and I knew that would not go over well but I also wondered if I was dying because why else would they send a chaplain? Maybe they were getting me ready for the morgue and that was why no cared if I was naked and cold. You get cold before you die? This was during the prep period I later read but I know having me naked was not needed so now I question why they treated me like that. No one cared and no one was talking to me but they were laughing among themselves. I wondered what they were doing and why was it taking so long so have my wife come to discuss what was going to happen? How long had it been anyhow? Cold, I was so cold but no one cared. I was scared, alone, and upset but no one cared. Where was my wife and had they told her I was dying? She said she would come and they said my family was there. I laid there trapped in my body with my thoughts. I knew I was dying because I couldn't seem to get anything words out of my mouth. Something was wrong with me but what? Over and over I wanted to see my wife to know everything was going to be okay or to say goodbye. I was still naked and then I heard buzzing around my genital area? What were they doing? Women were lifting my arms and legs. They used some straps. Why were they inserting more IVs when I already had 2 from the other place? Who was that man who made it feel as if a semi was sitting on my groin and then all the way up to my chest? It hurt as bad as the heart attack but they didn’t seem to care. What was that machine over me and why was I seeing maybe my heartbeat? What did it mean? Why was I shaking so intensely and why was I so cold? Why wouldn't anyone talk to me and tell me what was going on so I could talk w/ my wife and get my treatment options? Then the man left. I was alone again with 4 women and they again yanked off the coverings to make me totally naked again. One said they were going to suture and it would really hurt. Suture what? Had I passed out and fallen? No it was in my thighs and it really hurt--3 areas. They were talking & laughing. One poked a pill down me & told me to swallow it. Finally they lifted me from the table the helicopter put me on to a gurney. One woman threw a gown over me & another put the sheet on me. They were taking me somewhere. Where was my wife? Why hadn't she come? They were pushing me down a hallway where they passed my wife & son but didn't stop long. I could hear my wife say something to me but I didn’t know what. I wanted to reach for her and have her to take me but I couldn’t get my body to work.
JR said: cont.They took me to a room & another nurse was there. They pulled back the blanket & the new nurse was upset that my gown was not the right one for her area. She wanted in changed pronto but as they were getting me off the gurney it fell off & they left it off. The new nurse left & they left me uncovered, naked no curtains drawn. Why are they doing this? I don't want to be naked & cold. Why don't they know that? The new nurse comes back and puts my arms through the new gown. She leaves it bunched around my abdomen. The blanket stays at the bottom of the bed. Clearly they can see I am agitated and say it will be a little while & I can see my family but first they must do some things. The other women leave & I am alone w/ the new nurse. She is getting upset & making calls. Why is she leaving me exposed? People start coming in both males & females. They gather around the bed & are working on the machines at both shoulders & the area around my groin. My penis is exposed to their eyes. I am told I must urinate or I will be cathed. The nurse grabs my penis and puts an urinal there. I just want to die so I close my eyes so I don’t have to see everyone seeing me pee in front of them. The nurse takes the urinal away and starts wiping my private area. I am totally humiliated and really wished I was dead. Why is this happening? This happened a couple of more times, I can’t remember for sure how many exactly because I was so humiliated and upset. There is another nurse who is with there too. Everyone in the room is talking & laughing but I don’t remember because I just wanted to disappear or die. The one nurse is asking me questions as I lay there exposed: “Are you sexually active? Are you married? Does your spouse sexually or verbally abuse you?” Everyone is laughing—I am still exposed while these questions are asked. Some go and more come and go. Some woman is there to draw blood. She sees my penis. The 2 nurses evidently are the only ones left. They are constantly laughing. I am still exposed. Finally the one leaves. Sometime my wife comes in & the nurse seems to be angry & confronting my wife about something. The nurse finally pulled the covers over me. My son comes in. At least he didn’t get to see me naked like everyone else in that place did. I feel so not like a person. My wife talks to me but I don’t remember about what except we called our daughter so I she could hear my voice. I later learned that my family had been left for hours without any information about me. The nurse doesn’t leave but too soon my wife and son do. The nurse again pulls the cover back down and the other one comes and goes. The nurses talk & laugh & I hear noises I could not identify because I tried not to look at my nakedness. I remain exposed as I did not know what to do as my body didn’t seem to respond to my thoughts. I am upset and still naked and cold. I threw up my undigested dinner & was able to get it out after choking as I am flat on my back. The nurse comes from somewhere. She takes off my gown & starts to clean me. She rolls me from side to side to take off & put on sheets. I am completely naked. Finally she puts a gown back on me. Sometime later she pulls the cover up & a new nurse introduces himself. After that, I am no longer naked as the male nurse makes sure to keep my genital area covered even when the man I saw before comes in he says to he has to remove something from my groin. He says he was the doctor who did a procedure on me. What procedure? But he is in a hurry as he said he got very little sleep.
JR said:
This is where the hypnotist stopped as my husband had become extremely upset so he ended it. It was his advice that maybe he would be better not knowing everything that happened as he was extremely upset so that meant there was probably more. My husband at this point has enough to deal with having been medically assaulted and sexually assaulted in the parts that he remembers and doesn’t feel he could handle more details. Heart attack survivors are lectured by medical providers to avoid but what happens when they are actually the cause of the stress by their actions? My husband lied to them about how he was feeling to get out of there because although he didn’t remember everything they had done to him, he remembered enough to know how they had abused him. He also knew how he still was not mentally functioning so he tried not to interact with them a lot so they wouldn’t be able to figure that out and try to keep him longer. We had to protect him by getting him out of there.
I hope, Dr. B., this will help you gain insight into what a patient suffers when they are abused. Being trapped inside his body with only his thoughts and knowing things weren’t right was very, very horrible. I can’t imagine how tortured he was. The drugs they used on him had a very bad reaction to him. If they had acknowledged what he had originally told the first hospital, if they had been upfront about what their plan was, this may have been avoidable. He is super sensitive to these drugs. Instead of erasing all memory ability, it allowed to keep most of the bad ones while eliminating the “little” ones. The drugs also made him feel trapped, unable to communicate, how scared, upset, uninformed he was. I know how they purposely tortured us by not giving us information and not allowing us the basic right of being able to see him like normally in this situation. For over 2 hours, we had no word about him. We did not know beforehand what they were doing to him either. Clearly the evil chaplain did not having training or was so arrogant when we told him 3 things to leave that he did not comply and try to find a solution. This is where your ethics committee would have come in handy. We were told he wasn’t leaving and besides it was a Sat. night and they don’t have the staff available. Clearly their 24/7 advertising is a lie. They do have a patient bill of rights that guarantee these things are not supposed to happen but they did. He may not have been raped by penetration but what was done to him was a form of torture by the constant exposure thus demeaning him and harming him. When there is exposure like what happened to him, it is sexual assault. It is done by someone who has power and control over the victim that allows them to control them by sexual intimidation. It is done all the time in war. It is a criminal act because sexual harassment, assault, intimidation or whatever you want to call it has a victim and a perpetrator. Part of a nurse’s duty is to protect their patient especially when the patient is unable to self-protect. There was no reason for him to be exposed except she chose to bring harm to him for whatever reasons in her sick, twisted mind. The others are just as guilty as they allowed it and did not report it. It seems to be accepted behavior when it happens. No, it does not happen to everyone but it should happen to no one. Again, we understand that if nudity is necessary it is one thing but this was not necessary for his care. In fact, because of what happened, his whole healthcare future has been damaged beyond repair. In my opinion, what Mr. and Mrs. Kirschner experienced is also sexual assault. There was no medical reason at that time for Mr. Kirschner to be fully exposed. It was done by someone who had power & control to use his sexual organs for their entertainment purposes. That is the definition of sexual assault. All of these instances should be considered criminal. JR
To say I felt victimized is a severe understatement. The investigator for Providence told us they also had a potential issue with the first day employee, as she was possibly being sexually harassed. If that was the case, she (the first day employee) has a case against Providence that is criminal. I, as the unwitting subject of her harassment, should also have a criminal complaint against those responsible. I agree with Maurice that there are worse behaviors that occur, but that is hardly the standard needed to commit a crime. I am not here to debate whether or not a crime occurred, Also, not all crimes are punished with "jail time". I never compared my situation with any other, I simply explained what happened. Of course worse things can and do occur, but this was enough for me to contemplate ending the pain forever for me personally, so I see the fallout from their actions as extremely serious and criminal. If the standard is "worse things can happen", we could eliminate most statutes.
PT, the CEO of Providence, Dr. Hochman, is aware of this situation. I wrote him a letter and then an email and he is the one who contacted the HR person to look into it, according to that person. The HR person was surprised I hadn't received any communication from him as she was under the impression he reached out to me. He didnt. The only contact from Providence is from the HR person and the person who called and notified me that this was part of an initiation.
Maurice, yes I have heard of at least two other people with experiences. One has talked to the TV investigator who had an issue with the same doctor. (This patient was female and was traumatized to tears according to what I was told) She stated she had no idea who to report it to. Whether she was willing to come forward is unknown to me. There is also a former employee who is being interviewed that left the clinic because of employee behavior. Again, I am not sure if she would come forward, but a civil or criminal case could bring about depositions from people like this.
I have seen many posts here where people say they are being encouraged to go public, come forward or "do something" regarding their own situations. That is, to say the least, difficult. There are so many hurdles that one has to endure and overcome. Fighting a corporation or hospital is extremely taxing. I am finding just taking on a Catholic organization as challenging as they are well respected and people count on them for care in this area. I feel the people here on this blog are "doing something" huge. It's more than many do. One problem is finding this blog. Many would want to participate, many dont know it's available. Being here with support and thoughts is doing something. Being here is huge, and the participants are making a difference because of their extremely unfortunate experiences. Going forward with complaints or public notification is just another option.
Thank you all for your ideas. They help. I am looking into them as I can. I also am contacting a state senator for assistance and a federal legislator in regards to the HIPPA violations. (that too is a crime..no jail time but jail time is not the penalty for all crimes) Please know support is doing something that helps tremendously.
Thanks Rick ( Of course, I assumed it was you though not signed--but everyone: please sign on either via Blogger or at the end of your presentation.)
Rick, I fully understand your present argument. I do hope that, with your reactions, that you can leave an constructive, ethical, legal imprint as well as what I also think is important, religious attention within the Providence system. ..Maurice.
Oops. Yes the above unsigned submission was me. Sorry.
Rick
JR, I think what is missing in the understanding of most patients is that autonomy of the patient (the right to "speak up" and make final decisions regarding their clinical management and treatment.) Paternalism power for physicians, staff and system is now ethically gone. Ethically gone..hopefully soon legally and medical business-wise abolished.
Rick, as I previously noted, you should have made an effort to cover yourself or order the "new nurse" to help you do so. I know it is hard to realize but at that moment you should make full use of your clinical autonomy and "given orders" if you couldn't obtain cover yourself. You must think about your ethical autonomy even if others around you say "what's that?".
Yes, paternalism still remains in the medical clinical profession but it is mainly related to selection of appropriate workup and treatment possibilities. The patients are usually not asked how to interpret diagnostic tests or established treatments for the final diagnoses. However, it is essential to understand that these are simply "professional suggestions" and the final, final decider is the ethically autonomous patient him/herself.
It is only when the patient is unconscious and there is no legal surrogate to make decisions that the medical system, usually with the assistance of the ethics committee, can do that. The last resort and the "worst" is the court system to make decisions for the patient.
Rick, so you should have had the confidence in your ethical power of autonomy to call out and ORDER that you be covered until the physician arrives. That ORDER will be readily supported by any ethics committee.
And we have talked here about patients who are considered by the profession or themselves as VIP ("very important persons"). As a patient and with your power of ethical autonomy, you have become a VIP and your orders must be taken seriously by the "professionals" around you.
Rick, I am not blaming you for ignorance of your potential powers at the time of the incident you have described since I think there are majorities of patients or potential patients who are unaware of their autonomy within the medical system. As a physician and a medical school teacher and a longtime clinical ethicist, I am aware and I do want to spread the word.. and that has been the basis for the many different subjects written within this blog and, of course, this thread of Patient Dignity (Formerly Patient Modesty). ..Maurice.
OK, we male victims need to "speak up". Last week I received a call from an MD's office manager after I canceled my appointment since I didn't want to wait four months again. I told her the previous appointment had been canceled enough times that it was four months after the initial schedule. She replied that the MD had been sick. I said that had I known that it would have made a difference. Then I used the opportunity to saw that I could see why the receptionist didn't bother to tell me since patients are just objects to be processed so boxes can be checked and revenue received. She didn't like this and couldn't get off the phone fast enough. Since she had enough curiosity to call me, just maybe I might have put a hint in her mind.
BJTNT
I just want to make it clear that "patient autonomy" is not limited to male patients but also to all patients: of "other genders" including female. ..Maurice.
Maurice
No one expects to be pranked while a patient, I’m sure Rick never thought something like that would happen. Appreciate that Rick has lived his whole life under the auspices of Paternalism, he has never known anything else. Yes, he could have asked to be covered back up. It’s easy to sit back and quarterback the circumstances after the fact. Take note though, the damage has already been done. Maybe the healthcare industry should just come out and make a disclaimer to all the bad negative things that could happen to you. I’ve presented that list but we have a new one to add.
Disclaimer: A defensive measure used generally with the purpose of protection from unwarranted claims or liability.
Dear patient
We are advising you that while you are a patient in our facility you could be pranked, robbed, raped, molested, groped, assaulted,disfigured, victim of identity theft, bullied, screamed at,yelled at, made fun of, gossiped about by any member of
our team. Since we have informed you of the possibility of the above mentioned unprofessional acts you may not hold us
responsible. Your complaints will fall on deaf ears by all in our organization.
Good luck and please pay your bill promptly. Signed your healthcare team.
P.S. we reserve the right to do these things wether you are alive or dead.
PT
JR said:
PT,
Loved your last post as it is true what we have seen.
Dr.B.,
My husband thought he had autonomy at the first hospital. What he did not know as probably no other would not have known either, they were working in the background to take away his freedom of choice. He should not have been drugged but that is the way of the EMS. Once drugged, he was able to use his autonomy as they had effectively ended that and made him submissive & compliant. They have their methods which is akin to how they do it in wartime. Once he explained to them what he wanted to happen & that he did not want anything done w/o 1st having a discussion w/ them at the 2nd hospital, all those involved knew they needed to isolate him and drug him to render him incapable of resisting their plan. Very sinister for such a place of compassion-not. This too happened in a religious hospital. Medicare-Livanta also says patients do not have right to choose their treatment or even consent in an unplanned situation. Remember, he was not unconscious or without family. He was severely incapacitated due to the drugs. They had him how they wanted him. I think most of what they done was punishment for him trying to have autonomy. Catholic hospitals seem to march to their own drum and don't have to answer to anyone. It is clear this Catholic hospital does not think extremely unnecessary patient exposure, lack of consent, isolation, torture, etc. are issues.
If it is sexual harassment that may have happened to the new employee then what is it called for the person they exploited? Shouldn't it be called sexual abuse?
I am making myself some t-shirts for some embroidery designs that I can modify so I can wear what I think about nurses, air ambulance, cath lab procedures, etc. I hope that people will ask so I can tell them what can happen to them if they are not careful and are trusting that the hospital will do the right thing. I have one w/ a mean nurse holding a needle that I am going to change the wording to say something like: We drug you w/ Versed & Fentanyl so we can molest you. I have another one w/ a air ambul. helicopter which I will change the colors of and use something again is our first priority is to drug so you can be involved in making decisions about your care. Really, I can make them say anything I want. It will be satisfying to me to do this. JR
The damage has already been done! Even if he would have immediately demanded to be covered or covered himself.
My regret is that more victims don't violently assault their abusers. Strangulation and depantsing comes to my mind.
JF
Let's be realistic as to the patient vs medical professional ethical relationship. The voice of the patient trumps that of the medical professional at all points in the relationship except if the patient is unconscious. If the patient is unconscious, it is the ethical but also legal burden to demonstrate proof that the patient would have accepted the behavior and acts of the professional if the patient was aware of those acts. This latter state is one where our hospital ethics committee deal with most of the time. Usually these are therapeutic behavior and acts under consideration. If the patient is unaware (demented or unconscious) this presents the most challenge for us when there is no patient selected surrogate. But we look to what we think the patient would have approved. In Rick's case, in my opinion, his professionally unattended exposure was of no patient-needed therapeutic value and such behavior would not be an acceptable act concluded by any ethics committee.
If patients such as JR's husband was given drugs to promote, unawareness or frank unconsciousness without prior approval and permission to perform other acts during the period of unconsciousness would be not only unethical but also illegal.
Our medical students are taught from the very first day of their hospital ward experience regarding the need for informed patient approval for whatever is going to be carried out during their relationship.
It is sad to hear from Rick that such basic teachings have failed to be followed whether or not the medical staff is aware of the ethical concept of patient autonomy. And if the urology clinic wanted a "teaching tool" event for a new nurse, do what we do in medical school genitalia teaching: pay for a "standardized patient" but don't use Rick. ..Maurice.
JF is right. The damage was done as soon as they yanked the covering off him. The violation is not a reflection of how long he was exposed but simply that he was needlessly exposed.
Mr. Kirschner did nothing wrong and had no obligation to seize control of the situation, though again that is irrelevant. The violation occurred the second the cover was yanked off him.
Maurice
We don’t know if the woman was a nurse, medical assistant etc, this just violates human decency 101. I don’t even see how a standardized patient would be utilized, beneficial or even a worthy teaching tool in this regard. What is the point, indoctrination? At whose expense? And would you do this to a standardized patient?
I have learned that some medical assistants in physician’s offices are simply trained on the job. That they never attended any kind of medical assistant training. It’s sad and I’ll mention this again as I have over and over that, Rick is not an outlier. He may be regarded as an outlier in the eyes of those reading this blog in that it made it to the news. Only after Biker found the article and posted it to this site.
Think about how often instances like this occur every day in medical offices and hospitals across the nation, but that they don’t make it to the newsroom. Rick has suffered for years since childhood and now this incident. He never would have found this site, probably never thought to look for any online help, I myself stumbled across it by accident years ago. I’ve seen many people treated exactly as JR’s family has. It’s nothing new.
PT
Perhaps Rick might want to contact the newspaper reporter and give the newspaper a link to this website for those readers of the newspaper who would be interested in participating here in matters of patient dignity. Rick, do you think that the reporter has been "following" you here? This is all part of the necessary publicity of the issues of this blog thread which may, by widening the scope of participants and viewers, increase the possibility of getting the necessary changes in the behavior of the medical system. ..Maurice.
Rick,
Here is the link for the Washington State web site for report concerns involving vulnerable adults.
You qualify as a vulnerable adult due to your age and multiple medical conditions.
You can report by phone or online.
The fact that there are other victims (that the news reporter found) shows a "PATTERN OF ABUSE."
Let the state investigate and determine if this rises to the level of criminal.
You may want to call the phone number: 1-877-734-6277 (for Thurston county.
Note that it is for reporting:
Contact APS for reports on allegations of abuse, abandonment, neglect, self-neglect and financial exploitation of vulnerable adults living in the community and in facilities.
Allegations of abuse of vulnerable adults living in the community... THIS IS YOU.
Because of your age (alone), you are considered a protected class of person by the Washington State Aging and Long-Term Support Administration (ALTSA). Your medical conditions only add to your vulnerabilities.
There are also applicable Federal statutes that ALSO APPLY to your age AND medical conditions. Here are those Federal statutes with links to the Federal departments where where you can ALSO file complaints:
Americans with Disabilities Act (ADA)
The ADA prohibits discrimination on the basis of disability in employment, programs and services provided by state and local governments, goods and services provided by private companies, and in commercial facilities.
Older Americans Act
The Congress hereby finds and declares that, in keeping with the traditional American concept of the inherent dignity of the individual in our democratic society, the older people of our Nation are entitled to, and it is the joint and several duty and responsibility of the governments of the United States, of the several States and their political subdivisions, and of Indian tribes to assist our older people to secure equal opportunity to the full and free enjoyment of the following objectives:....
Telling your a lawyer that a criminal investigation will persuade a jury in civil cases that you were abused, even if NOT under the legal definition of abuse, at least by moral standards of conscience, this will result in a higher monetary judgement of punitive damages is a definite proper template for such a scenario that you that you endured.
The carrot for your your attorney is that other victims may allow your attorney file a CLASS ACTION LAW SUIT (big bucks for your attorney's firm.
If you have NOT directed your attorney to this thread, PLEASE ask them to REVIEW this thread. There are experts in legal strategies that specialize in that most liability attorneys are unaware of.
You were DEHUMANIZED, there NO that you should show mercy.
You wil gain some of your dignity back.
If convicted, they get to allocate and they will apologize .Tell the court that this is only "sorry I got caught, If they they are truly sorry, a letter after they have served their sentence shows true remorse.
-- Banterings
How about a posting at the Urology Clinic door in large clear letters:
BE AWARE: AS A PATIENT ENTERING THIS CLINIC FOR EXAMINATION, BECAUSE OF UROLOGY PRACTICE NECESSITY, YOUR GENITALIA MAY BE EXPOSED TO
EYES OF OTHER CLINICAL WORKERS BEYOND THAT OF THE ASSIGNED PHYSICIAN
That should take care of the issue at hand--OR DOES IT??? ..Maurice.
Dr Bernstein,
First it is suggested by you that a crime wasn't committed because other incidences are far worse, completely ignoring the fact that the basis of a crime is not contingent on severity. Now I am told that I was suppose to cover myself, because of my patient power, completely ignoring the fact the medical profession realizes past psychological trauma has an effect on individuals. Past psychological trauma can hinder how a person is capable of responding. I have no desire to quote medical papers supporting the position, you and I both know that to be true. I could cite numerous books written by medical doctors who are experts in their field discussing what childhood abuse does to an individual psychologically. You have zero information about what trauma I experienced as a child but are able to state uniquivablly that I was suppose to stop the abuse before it even happened. Your arrogance and ignorance is nearly unbelieveable, but coming from a medical doctor, I find it unfortunately common.
I feel as if I have been scammed by this site and am deeply saddened by your writings and thoughts. I have seen where you tell people to report, but you will find fault afterwards when they do. Using your logic, my abuse at the urology clinic would have never occurred if I simply covered myself, an act that under my circumstances was impossible. Go argue with your colleagues concerning medicine. Dont put douple standards on victims of your profession. The medical field is who is responsible, regardless of ethics committees. Why would anyone here dare come forward when you will explain to them how it is our responsibility to stop abusive behavior instead of the medical professions responsibility. I am in not in a good place where I will discuss with you your opinions regarding issues you have limited knowledge and experience. You think crime is based on severity and stopping abuse is the responsibility of the victim. I know you are proud of your role teaching students, you might want to include another angle to your thoughts and use a victim of medical abuse to further teach others. I am backing away from this site with a heavy heart as the people that are here are amazing. I do not have the strength currently to continue when the moderator seems to have double standards (i.e, report abuse, but then hold on...and I (Dr. Bernstein) will tell you how you're wrong.)
I wish all here good luck, stay strong.
Rick
Rick
I know how you feel and I’m sorry, I’d appreciate it if you didn’t leave. I spent a considerable amount of time and energy looking for a valid address to write you. My hopes were that we could learn mutually along this path and above all know that you are not alone. Some thoughts to ponder are this: When I write on this blog I’m not addressing Maurice, I’m writing to a bigger audience. My only thoughts about him are that he is the blog administrator and when he writes I write to give the reader another perspective. That’s all.
Many years ago I spent 6 months researching on the web about the employment of mammography. I called upon every state radiology licensure in this country, for every state. Some states don’t have a radiology licensure and when I found that out I called the companies that repair the mammography equipment. After speaking with hundreds and hundreds of people I learned this: That there are no male mammographers in this country.
When I presented those facts on this blog they were not well recieved, some simply did not believe me. Rick, this is a subject you cannot be nice about. People will ruffle your feathers, you are here for change and don’t ever forget that. Do you understand? We need your voice. With your help you can effect a small chain reaction that sets off a bigger chain. You’ve spent countless hours we saw writing complaint letters and making calls. This blog is not about Maurice, it’s about you, me, everyone on this blog and those that come after you.
NOW GET BACK ON YOUR FEET SOLDIER AND COMPLAIN LIKE BANTERINGS AND I TOLD YOU TO, THEN REPORT BACK TO US.
PT
Sorry, Rick. My input to this blog thread is consistent with the concept set by the title of this blog which includes the word "Discussion". Discussion is a process where many various views on a subject and are defined and similar or alternative views are presented. I periodically enter my views as set by my experience. This blog thread is not the place to dissect in detail or, in fact, validate, the fortunate or unfortunate past history of the contributors to the topics but simply to set the basis for further discussion.
My contributions are based on my own personal experience and as the same with those presented by others here can't be validated or invalidated by what others write about their own experiences. It's all about discussion. To evoke further discussion, I occasionally may enter a controversial statement, such as the suggestion of a Urology Clinic sign written above. But look at my final statement "That should take care of the issue at hand==OR DOES IT?" which should indicate my consideration of controversy and the initiation of discussion.
I occasionally make controversial posting comments to stimulate further discussion and that is the part of the role of a Moderator--to open other avenues for discussion. One of my classic early comments was to suggest, over the years, that what was written here about personal abuse by medical professionals represented patients who, though suffering from experiences, may from a statistical perspective might be considered "statistical outliers". Now, I am not so sure.
Rick, whether what behavior imposed on you was criminal is for others to define and decide. What I do know is that it was clinically unethical and if you had the knowledge and understanding of your "power" as a patient in a non-emergency situation, you could have immediately complained and made an effort to cover yourself. It's not your fault for the inaction but it is understandable by the history you have presented. This is my conclusion.
I hope Rick that you change your mind about participating here and contribute to the goal of this blog thread discussion--change and improve the behavior of the medical system. ..Ma;urice.
Rick
Oh, one more thing. I don’t give a shit rats Ass what anyone else on this blog thinks or writes in regards to this subject matter. There are many here who are Read only for whatever fetish, smirk or jollies they get, that’s besides the point. There is a greater good, calling to promote equality, non-discrimination and fairness amongst both genders. Yes, we are amazing, I don’t think you realize the time and energy we have put in this. Don’t think for a minute this is the only rodeo in town that we blog on. Many of us are secretly working on pulling strings to effect change. You can sit in that chair we see that your wife help put you in and sulk all day or you can get back in the fight and join us and you too can be amazing.
PT
Thanks PT for your own comments to Rick. It would be a shame to
lose a participant here who has a true experience that was
considered publicly newsworthy and would have the potential to
add to the value of this discussion blog. ..Maurice.
Jr said Rick, dr. Bernstein has always made little of what my husband experience. The others on here have been very supportive and banterings has been very helpful. My husband has a decided to go public because he just feels like he couldn't face everyone knowing what happened to him. You are very brave for going public. Medical providers including dr. Bernstein things that patients in emergency situations don't have any right. You can see that from his last post. It seems like emergency patients can be abused anyway medical providers seafood and that is what happened to my husband. Even today we went to a doctor's appointment, and the doctor was not at all sympathetic toward my husband having been sexually abused by a hospital. It is attitude like that that make this type of behavior acceptable in the medical community and it will continue. It is up to people like us to stop it. Hopefully, my husband will be able to deal with the trauma and go public someday. What happened to you this horrible. We know it is. Even though outside of what happened, we may think that we know what we would have done differently but when it is happening to you you don't have the same reflex. I know now that night I should have done things differently but I was in shock and I was like a deer in the headlights. My husband was drugged so he couldn't defend himself. If only we could go back and we had 20/20 hindsight like we do now things would have turned out differently. Uneducated people blame the victim. It is easier for the medical community to blame us because they don't want to admit that they do indeed have a problem. That we were trying to explain to the doctor today why we have a lack of trust and basically his attitude was get over it. I wonder if that's what they tell with female victim of rape just to get over it. It seems there is a double standard for men. Even if a woman is raped in a medical setting babe just believe it at first. It has to be scores of scores of women who have been abused in the medical setting before they even start to investigate. That is why other day I went back and listen to the transcripts of my husband's hypnosis session so I could maybe educate doctor be on what it was like for my husband when he was going through this. I hope that it would give him some insight on what it felt like to be victimized. I guess it didn't. Unless you have been in this position like many of us on this blog have been I guess it is hard to understand. However don't leave this blog. I have a Blog too. It is called issues4Thought.Com I would love to have you share on my blog anything that you want to share. The more stories that get out there everywhere just not in your state of Washington will be helpful to all of us. I hope that someday my husband too will share his story that I cannot push him to do so. He knows that I'm on this blog, he knows about my website, and he will even discuss some of the things that we talked about on this website. However for him, it stresses him out to think about what they did to him. I don't know what the solution is for him. I don't know what the solution for any of us would be. Jr
The solution is speaking up when and as we can. It can be before, during or after. It can be directly to the medical practice or hospital or it can be in response to media postings. I've been the proverbial deer caught in the headlights too shocked to respond and I've done the "manning up" silently suffering routine society expects of men. Now I go into any medical encounter that involves exposure speaking up before it starts or standing ready to speak up as may become necessary. This gets easier to do the more I do it. It doesn't mean I won't be taken by surprise again someday and if that happens, I'll speak up in arrears.
I find Mr. Kirschner incredibly brave going public as he did. You are my hero Rick! That your case was part of a prank that the practice hasn't denied, with you and your wife there as fully alert witnesses is a tough scenario for the practice to explain away. They cannot establish a medical necessity case for what was done to you. Even their non-apology apology didn't try to do that. That the media response has been positive affirms that many people are on your side. The more publicity your case gets the better because none of the healthcare apologists can justify what was done to you. It is one of those classic cases that affirms not everyone who dons a pair of scrubs is a "professional" acting in the interests of the patient. Usually bad behavior is somewhat more subtle than what you experienced.
JR said:
Sorry about the grammar earlier but was using dictation from phone & it never goes well.
I do feel that Dr. B. doesn't understand but most med. providers don't. Dr. B. keeps saying the exception is emergency care but emergency care is also a time where a patient needs providers to respect, give dignity, & show regard for modesty as they certainly are not able to defend themselves. I understand the need to inspect for injuries but I do not understand their need to totally degrade a patient by leaving them naked for prolonged periods of time for no medically justified reason. They say, "Well this is a hospital. We don't care, we have seen it before." Well, if that's true why are you leaving a patient exposed if you don't care or have seen it before? Obviously, it is doing something for you that is in the perverted sense. Just because a patient had an emergency need does not mean they can be treated as less human by superceding patient wishes & making sure they are exposed-viewed by anyone & everyone. What are we fighting for if we let them treat us like garbage during emergency care? I don't understand why a patient must lose their dignity, modesty, & etc. just because they had a heart attack. In my husband's case, he was stable & should have been allowed his right to choose his course of treatment & not be purposely exposed for their entertainment value. It is pretty simple. But Dr. B., you don't seem to understand as neither does the majority of medical providers. The exposure that is unnecessary is a sexual crime as it is done by someone in power & control over someone who is defenseless. Being naked does put patients at a disadvantage as is the purpose of stripping them of their identity so they become objects that are compliant & submissive. I don't imagine Mr. Kirschner was aware of what the procedure entailed. He did what he was told which is the objective of a medical procedure. That is one reason patients are drugged are so they are cooperative & do not interfere w/ the procedure. By exposing him, they automatically put him in the deer in the headlights mode. My husband felt the same way. He too could not help himself. This practice probably choose him because the medical industry do not view older patients especially males as having human qualities. A younger man would have seemed more like sexual molesting in their eyes as he would have been closer to the age of their workplace victim. My opinion is they used Mr. Kirschner as they did not feel him as being worthy of having sexual respect. They also did not have any thought torturing him in front of his wife. They in fact made both of them victims. If this had not been brought to the attention of the practice, the new worker would most likely become desensitized to especially nudity in older male patients & probably participated in this "prank" for the next new worker bee. By the Dr. B., my husband was not in the ER when he was exposed. Do you think that nurses have the right to expose any patient for hours in a patient room without a medical reason? Do you think it is okay to make patients urinate in front of multiple people--people who are not directly involved in care like the IT dept. or the person who draws blood? Do you think it is okay to leave patients exposed for hours in front of those people? It is written somewhere that when in a hospital you are no longer entitled to have personal privacy or modesty even when there is no reason for it to be denied? Do you not think that type of degrading, demeaning care adversely affects patient outcomes? Does not how a patient mentally fare have a lot of influence on their physical well-being? There are many studies citing how important respect & maintaining patient dignity is to a better outcome? Why it is so hard for too many providers to do something so small as to make sure someone is not exposed? JR
JR said:
Rick,
While I sometimes feel that what happened to my husband has been marginalized by Dr. B., there are others of us on this blog who are here for one another for support. To me, in reading what Dr. B. says is that an emergency has no right to have the expectation of respect & personal dignity. That is a bunch of bull! Emergency patients are human too. I understand what you went through. It is not the fault of the victim. I too did not take action when they did what they did bc I was too caught up in the moment to think clearly. Of course, someone who has never had anything so vile happen to them can say from the safety of the sidelines that you should have known or you should have done this. I always thought I would react differently but I didn't. My husband never thought he would be a victim of sexual abuse as he is now 68yrs. old. He never dreamed they would drug him, medically assault him twice, and then sexually abuse him. It never occurred to him they have no problem lying on the medical records. He didn't go to the hospital intending on having to be able to defend himself from their violations & abuses. You didn't either. You give these people the ability to be part of your private space where you allow access to very few. These people are supposed to be respectful, trustworthy, compassionate, etc. They completely blindsided you. You do not need to defend why you didn't act a certain way. My husband in his drugged mind knew what they were doing & just wanted to disappear, die, or for it to stop. They tell you not to disturb the area bc it is sterile. We are medical people so we assume they know what they are doing because we have to have blind trust in them because we really don't know these people who can completely alter our lives w/ one little mistake. My husband always had the attitude he didn't want to make them as they could be even worse. My husband feels a lot of guilt bc he thinks he let himself be victimized but he had no choice. They were in control of him. It can & could happen again in any hospital at any time. They really don't understand they need to be very respectful & protect every person's modesty & dignity as it is how we identify ourselves. I have thought to leave this blog many times but there are a lot of good people on it & for us, therapy is not an option as we have no trust in the medical system if we get labelled w/ PTSD. I may yet decide to leave. I don't think Dr. B. meant harm but he simply hasn't been a victim so it is way too complicated for him to understand. He has seen many naked bodies over the years so he too has become desensitized in my opinion. But naked bodies have a human soul & feelings. That is what their medical training is not teaching well enough. If you leave, as a wife, please see your wife gets through this okay. It is tremendous to be a witness of your husband's sexual molestation. I will never forget or forgive what I saw that night & all that I know my husband endured. JR
Rick,
Then prove Maurice wrong.
Contact the Washington State web site for report concerns involving vulnerable adults AND the Thurston County DA's office.
File a report.
Let justice be served.
ALL PROVIDERS THINK THE SAME WAY. THEY THINK THEIR MAGIC WHITE COATS AND MAGICAL STETHOSCOPES KEEP THEM FROM DOING ANY WRONG.
SEND A MESSAGE TO ALL PROVIDERS THAT THEY CAN DO WRONG, AND IT IS CRIMINAL.
I have already emailed the Thurston County DA's office with a link to the King 5 story as a concerned citizen.
If you make a report as a victim to either organization, you are IMMEDIATELY granted rights as a victim. First and foremost being an inquiry into the events.
-- Banterings
JR, you have misinterpreted what I know. A medical-surgical emergency, often with the patient in a hospital emergency room but also within the ambulance speeding to a hospital or even at home as attended by the fire department does NOT in anyway diminish the ethical principle of patient autonomy: the potential for any patient to set DIRECTION and LIMITS to the medical or surgical care and treatment they are about to receive.
You may have forgotten that in virtually all states, there is the equivalent of a POLST document, perhaps readily accessible..like on the refrigerator door which represents a formal medical order but prepared by an informed patient which sets the limits of the care, emergency or otherwise. "I refuse to be sedated before I can further describe my desires and rejections" might be such a written order. Of course, if there is no POLST prepared and the patient is conscious in the ER and can understand the immediate options, the patient has every right to express their requests to be followed by the staff. If the patient is unconscious and there is no POLST recovered by the first responders then the decisions are made by an accompanying legal surrogate or family member who will speak for the patient known desires and philosophy for personal care. Without a POLST or surrogate, the ER team must direct their actions based on the best techniques and common propriety to accomplish their goal of stabilizing the patient for possible further hospital treatment and return of patient consciousness and ability maintain their autonomy verbally.
Even if the patient has had a sad prior medical experiences, as many here have also have described, patient autonomy with regard to the current event is maintained. Hopefully, in a truly non-emergent situation such as described by Rick, the patient has every ethical right to demand immediate explanations of the behavior of a professional and, if not available, take the "matter in the patient's own hands". It is sad that Rick was not aware that sterilization of tissues before his procedure can readily be repeated if the procedure is to be delayed. This would not have made the professional misbehavior ethical but would have put the decision-making to the person that ethics and law sets as the definer for proceeding with a medical or surgical process..the patient.
I apologize if I was remiss in presenting this ethics and legal understanding to Rick and perhaps to others. ..Maurice.
Again, I appreciate the people of this blog and their care and understanding. I felt I was invited here to share my experience. I wrote and shared, and never once asked a question. I hoped I was helping someone, even though I am in an incredibly difficult process and condition right now. It was my mistake to see the word "discussion" and not realize it meant be prepared for "controversial" thoughts. Anyone who saw my interview knows I admitted to being suicidal. Just that alone is something that is more than I can handle. I admitted on this site my emotional state and feelings of wanting the pain to stop. Still, using my story for "controversial" thoughts was what I was really here for. I put everything aside to try and answer any and all questions, I was not here to debate or be used to stimulate conversation by a doctor who obviously understands one side of this issue. His professional field is littered with garbage, that being abusers, and he finds it necessary to defend the medical community above what he knows is a broken and sick system.
I came here because I was asked. I had no idea what it entailed, which is ultimately my fault. However, asking me to share because I went public and people needed and wanted more information does not mean I need to be used to stimulate controversy. I am in a much worse place right now by trying to help, after the crime debate (which I never brought up) or the pathetic ramblings of a doctor who suggests it was me who could have stopped sexual abuse. In a perfect world doctor, your thoughts may work. That's not reality and deep down you know it. Your true purpose is to stir controversy. That too is sick, especially on me when you know my mental status and background.
I start my PTSD therapy in a couple weeks and I am holding on for that. I hope I helped in some way and appreciate the people here. Since I am worse off today than I was a week ago it is time I think of me. I'm not bailing or quitting my fight, I will take it elsewhere. Take care all.
Rick
By the way, probably the most common case we cover in a hospital ethics committee consultation is that of the unconscious or chronically demented patient with regard to further diagnostic procedures and therapy where there are no surrogates present and we need to know WHAT WOULD THE PATIENT ACTUALLY WANT? Sometimes, the patient's name is unknown, the location of any family is unknown and a social service routine may be to publish a picture of the patient's face on internet sites requesting identification or family recognition. Again, with no results, we have to create a
"surrogate committee", a few ethics members including a community member and a physician to try to establish from any of the known facts, what management the patient may have desired or approved if able to personally decide. This is an example of how decision-making in a hospital is carried out ethically and legally. ..Maurice.
Maurice
You are under no obligation to apologize to anyone after all, this is your blog. You are not getting paid to do this! You could be watching old reruns of the three stooges or watching movies of Rita Hayworth in her hayday. Instead, you manage this blog, a platform so we can present our views and you presenting counter views because, it’s your job. That’s what blogs are for.
Let us see what would happen if Rick tried to present his story on Allnurses or some medical assisting site. His thread would get shut down so fast it might make it maybe 2 pages and that would be it. He would be told to seek counseling by some stupid psych nurse who got her MD, PhD online.
PT
JR said:
But that was not the case, he was not alone and he had told them what he wanted. However, they chose to disregard what he had said and manipulate the situation in the background to do what they wanted. We saw them making notes thinking they were noting what he said and at that time, we had no reason to think otherwise as we had no reason to distrust them. He was not unconscious but they purposely knowing what he had said, drugged him to be able to do treatment he had not consented to have without having me involved. He had family present as both me & our son was there. We too thought they would abide by what a patient desired but we learned the hard way they do not. By the time he had reached the 2nd hospital, he had been drugged out of his mind & was no longer functioning meaning he did not have the ability to talk to them. As for me, they refused to let me see him or even give me info. The warden they assigned would not help & the hospital section I was at was empty. I also was afraid to leave the area as I kept hoping to hear something or be able to see him. I know it was stupid for me to think they were good compassionate providers who only wanted to do the correct thing. There is not a day that I don't regret my stupidity. So none of this you mentioned worked and there is nothing today we can do about it as no lawyer cares enough to take this case. For us, it is not about the money but rather what they did. THEY HAD NO RIGHT TO BE SO INHUMANE. Livanta has said patients in emergencies have no right as patients should get what the medical community considers their gold standard of the moment. No one will address his sexual molestation. Because he was an emergency patient everyone gives the impression he got what he deserved because he had a heart attack. Again, it came w/o warning as he had been to see a dr. and was misdiagnosed. His cholesterol levels were fine and his blood pressure has always been well within acceptable ranges. Even the hospital was pissed and said so that night because he interrupted their Sat. night. To top off being medically assaulted twice, he was also sexually abused. And we, his family, were treated like prisoners & so was he. No, you have not be plainly spoken about this situation and oftentimes, I feel you too think what happened to both him and me was perfectly acceptable. If they had not drugged him then he would not have allowed this to happen. He would have demanded me present but they made sure this did not happen as he had told them in good faith what giving him drugs would do. So they did it & because what he said is not in his MRs, we are liars & it is not true. So from our point of view, how can we be sure this will not happen again. We thought we did what needed to be done. We have even been told by EMS that they can disregard patient wishes if they decide too. It is really scary that people patients have no rights. I see what you said above but around here and w/ CMS, it just doesn't happen that way. This was a huge Catholic hospital & they are not sorry about what they did but rather the opposite & told us basically to deal w/ it. I have to get off bc this is making me cry again & it will be another bad night for me & I don't want to upset my husband by him seeing what it does to me as he struggles to deal with what it has done to him and me too. JR
"Maurice
You are under no obligation to apologize to anyone after all, this is your blog. You are not getting paid to do this!
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PT"
PT --
There are exceptions, but most older faculty in higher ed don't contribute much research. They are usually assigned to teach introductory courses and encouraged to do service (sometimes referred to as outreach); otherwise, most wouldn't have much to show on their annual faculty report. It certainly doesn't bother me, but I'd be surprised if the moderator here didn't document "blog" efforts each year. I point this out just in case that possibility had not occurred to you.
REL
Rick,
I will keep you in my prayers and pray for serenity and healing for you.
Please know, your presence here has brought so much to those of us who have suffered as you did.
We all know that pain having suffered through it.
Also know that your life has purpose. Now it may be to help others come forward and heal.
Is there anything that I can do to help you cope or heal?
For many of us, fighting has helped us heal. I can also tell you that those who post here have made changes in the industry. I have seen ideas expressed here making their way into healthcare policy statements.
Going back to Volume 90, I started putting forth the idea that this thread's name change from "Patient Modesty: Volume XX" to (its current) "Patient Dignity (Formerly: Patient Modesty): Volume XX."
Keep healing and keep fighting.
My prayers with you and your family.
-- Banterings
What Dr B said could be taken two different ways. I don't think he was criticizing Rick for not covering up immediately. I thought he was informing whoever else was listening for future reference. He has admitted all along that he's never had our problem. JF
JR said:
Dr. B.,
I appreciate you giving a more clear explanation. In our case, my husband was conscious though severely drugged. As he mentioned to the previous hospital before they administered what was supposed to be a "little" morphine" drugs like that affect him severely. He did agree to morphine along w/ nitro as they said that would control his chest discomfort. It did. He said that was all he was agreeing to and mentioned by name no versed or benzo type drugs to be used either. As I said, we thought that had made note of it. What else could or should we have done? It was during the air ambulance transport that he was given fentanyl w/o knowledge, consent, & against his already expressed wishes. The fentanyl was noted by the air ambulance hand-off sheet but not by the 2nd hospital as a drug given prior to arrival. They only noted the heparin & aspirin. They did not note morphine & fentanyl. The morphine had started making him act strangely which I could tell but not to the point of not being able to function yet. However, the additional dose of fentanyl for someone like how he responds to these type of drugs which fentanyl is 100x more powerfull than morphine (it was like they gave him 10mg of morphine) made him conscious but not mentally functioning normally. He probably responded to simple yes/no questions thus they said he was alert to cover the fact about not getting the consent. Should they not have listed his prior injections of morphine & fentanyl? It is said you are not to sign legal papers when on such meds so why it is acceptable that a vital decision that affects the rest of your life can be made? Again, I was there & he was stable but was not ALLOWED to see him as he had already expressed that to the other hospital. I have read that informed consent is not valid if a patient has already received sedation. Livanta confirmed from their review of the MRs that he had also been given the versed and more fentanyl by the time the consent was signed. Livanta confirmed the consent was not signed until after the procedure started. This is why we know for a fact that he did not give consent. He also was naked and being prepped. This also goes against how informed consent is to be given. The scenario reeks of coercion and a coverup. Also, for him, if he had not been given so much drugs after he told them he couldn't handle them, he might not have been molested & would have been able to speak for himself. But they made sure that could not happen. So although your information on how to defend oneself is good advice sometimes it is not possible as they make sure you have no possibility to control your treatment. JR
REL
I’m well aware of that, but I’m always looking at the big picture. We don’t need someone who pouts, needs affirmation and just wants everyone to say they’re sorry to him ( Rick). We want soldiers.
PT
PT, If Rick thinks he can be helped by this blog, then he'll come back. If he thinks he can be helpful, then he MAY come back. But sometimes focusing on pain causes it to grow and fester.
I felt like what that employee did was worthy of death. Instead it is him who is being tempted to die. We don't know what is going to help vs further harm somebody else. JF
JR said:
PT,
Usually I agree w/ you but on this one I will have to disagree. Rick is suffering. He has PTSD which I know makes you have a wide range of emotions. He is suffering greatly. Dealing w/ us victims of sexual abuse is difficult as you yourself know. Small things can set you off--I know I have been offended by what has been said like you should have covered up. Yes, but it is easier said than done when it is happening at the moment. I was guilty of letting things happen when I definitely knew better but was in shock & tried not to be in your face w/ them. Maybe the outcome would have been different. Maybe they would have removed me the hospital. I don't know. I just know that everyday brings to us pain and frustration. I am helping my husband take baby steps as now our daughter knows her dad was medically and sexually molested. I am trying to help him cope while helping me cope w/ what was done. For Rick to have suffered abuse 2 different times of his life is something I cannot imagine dealing with. Rick too has to deal with the fact his wife saw it and has to deal with it. It was probably too raw for him. Somedays for me is more raw than others. At least Rick has a chance of getting something done. I may disagree but I always want to hear what you have to say as I learn a lot.
Dr. B.,
I didn't mean to act like shooting the messenger but I was dealing yesterday w/ other medical providers who acted like what happened was no big deal. It isn't because it did not happen to them or their loved one. This has rocked our lives. Their big line is you should just be glad he did not die. So for them, the ends does justify the means and so we have abuse, violations, assaults, falsifying info, or whatever else horrible they can do to us as patients to look forward to. All of the ethics are of no use if they do not use or have them. Your university hospital must be one of the few ones that has such a procedure in place. JR
The more I think about what happened to Mr. Kirschner the more I shake my head as to how anyone who works in healthcare could possibly have thought it was acceptable behavior. Obviously the perpetrators thought it was OK, but with the exception of the person who anonymously called Mr. Kirschner, apparently everyone else who worked at Olympia Urology thought it was OK too. As did the people who worked in the corporate offices. People would have been fired otherwise for something this egregious.
When we look at other cases such as the Denver 5 or Dr. Sparks that also essentially went unpunished, it begs the question as to just how bad does the sexual misconduct against male patients have to be for it to be deemed not OK? I know that the Administration honchos always say it is not OK, won't happen again etc, but it is never deemed bad enough to get someone fired.
Dr. Bernstein, have you any insights as to why bad behavior to these degrees essentially goes unpunished? Is it possibly as simple as there being a general consensus that sexual misconduct doesn't matter if the victim is male? As an outsider looking it, it is what it appears to be.
"REL
I’m well aware of that, but I’m always looking at the big picture. We don’t need someone who pouts, needs affirmation and just wants everyone to say they’re sorry to him ( Rick). We want soldiers.
PT"
PT -- Well, you won't get them by denigrating the severity of past experiences of newcomers and suggesting that they didn't do enough to protect themselves. Would anyone aside from the moderator here have contributed these ideas? Seems strange to me. But I guess the perfect recipe for making sure a discussion like this remains in check for 15 years is to have it led by someone in big med that is being rewarded, at least in part, by big med for doing it. Perhaps that's the big picture. REL
JR said:
It was said to me yesterday by a supervisor at Livant-KEPRO-Medicare that we should just be grateful he didn't die. That seems to sum up for me the state of our healthcare system. It does not matter what they did to you if they medically assaulted you and/or sexually assaulted you if especially you are an older male. It also does not matter if your medical records are falsified, untrue, or whatever you choose to call them. My husband's medical records state he had a TAVR procedure in addition to the PCI. The TAVR is a separate procedure involving putting a mitra clip in a valve. It is a 3 to 4 hour procedure. When asked if they reviewed it in the procedure file, they said no. I asked them why. Their reply was did he have one. I replied that is what I am asking you. We don't review for that. Well, he doesn't have one but that is not the point. The file has him having another procedure & we had to find out on our own if he had had one done. His file also states while in the hospital he had a baby. He was a 67 yr old male. Again, Livant doesn't care. However, as far as the patient is concerned, they only review what is in the medical records because the medical records are always accurate so they said until it was apparent they were not just as we had been telling them. However, it doesn't matter because their review is a double standard and they only review to protect the medical community. Yes, Livanta agreed that the consent was not done until after the procedure actually begun but we should be grateful he is still alive. That is what they had to say. So anyone if you are involved in any type of crime, the criminal should not be caught & punished as you should be grateful they didn't kill you. How pathetic is our medical care and the ones who oversee it? My husband told them he would not seek any hospital or ER care in the future. They, in turn, said you can't do that. Chances are at another hospital it won't happen. He asked how he could be sure it wouldn't happen again? It doesn't happen at all hospitals so don't go back to that one. I said do you think we chose that one in the first place because we thought it would be fun to be medically & sexually assaulted? What tests can be give a new hospital to make sure they do not do the same? They replied just think positive thoughts. Well, that worked so well last time. Yes, we are lucky that they did not manage to kill him outright. But there is the stress he has to live w/ knowing he was sexually abused while he laid helpless much like a person who is bond & gagged by a sexual predator. Those thoughts do not go away. He also had to live w/ the reality that ignored his wishes & did a procedure on him against his will that has forever changed how he can live his life. He has nightmares about being injected w/ drugs against his will. They treated him worse than a prisoner because prisoners do have rights--sadly, patients do not. However, in talking w/ Livanta has pushed him into saying he thinks he is ready to go public because it is clear that both medical and sexual abuse/violations are acceptable parts of our American healthcare.
And to answer a question by one blogger, it cannot be fixed until they are willing to admit they have issues. In this, they will not do because they fear they will lose their power and control and in turn, money. So enjoy according to our government we should enjoy our Be Grateful You Didn't Die healthcare system because the healthcare system is waiting on its next victim OOPS patient but OOPS again, I really did mean victim. And you will never know if you are it or maybe the next man will be the lucky victim. JR
REL
My violin is broken so I can’t play anyone a lullaby and I’m fresh out of wine too. I made the effort to find him, sent him a letter and invited him to this blog. Banterings and I gave him the best advice on how and who to complain to. If he can’t handle a little feedback from Maurice then yeah, he’s in the wrong place. He has recieved much sympathy regarding the incident, perhaps more publicity than any of us ever have.
I’m not here to feel sorry for you, him nor anyone else. I’m not with the complaint department for 60 some year old men who need to pout and have everyone say POOR BABY. I’m here to find solutions and change a discriminatory and unethical process. If you can’t handle the heat get out of the kitchen.
PT
JR
I checked out your blog. It seems like medical workers just allow their coworkers to do their jobs however they feel like. The chaperoning concept is a joke. ( but not very funny ) It's part of the problem, at least for the patient.
The reason the doctor treated you like he did, in all likelihood is because his behavior is the same as what you complained about ( would be my bet )
A court case is needed accusing medical staff of using MR's as evidence. There needs to be testimonies that MR's are often inaccurate.
Really,I think a major cause of the problems is we the people have too small a part is creating laws. Are we really a free country if we have so little to say about laws? Or are we just free compared to some other countries?
I've talked about how I think medical care should be paid for. Monthly payments vs health insurance.
That way a patient or their family members on their plan could be helped financially by money payed years earlier in many cases. Health insurance is just more people being paid and they might help you and they might not.
This here is just an opinion and I will admit right off the bat that I'm not educated. The same way I think medical care should be paid, is my opinion about how lawyers should be paid also. Them refusing to take difficult time consuming cases needs to come to a screeching halt. Lawyers/doctors who do substandard work need lesser wages.
As a tracking system about lawmakers, whether or not they are ignoring the wishes of many people (the way we suspect they are ) would be a TV show There Aught to be a Law. Maybe just once a week. Maybe oftener. Veiwers would write in what laws they want and why. Also tell whether or not they wrote to lawmakers about it before or if they wrote other concerned agencies. It might be found that MASSIVE amounts of ignoring people's concerns have been going on. JF.
JR said:
JF,
You have something that a college degree cannot buy & that is common sense, ethics/morals. For insurance companies are on the side of the medical provider as well as the government. It is just big bed but no patients are allowed. I agree--what happens to the people we think we have elected as the laws they pass aren't to help us. There should be an easier way to recall politician who don't keep their campaign promises. If only someone would take my husband's case it would be a case that would make national news. So many things were wrongly done and it would seem it was no accident. We are not going to stop trying but changing tactics. Trying to file the complaints would be laughable if not so utterly disgusting. This attitude that medical people can do no wrong even though there is proof is beyond ridiculous. That is why crimes like we have described on this blog have happened & will keep on happening. There is very little to stop them. I don't believe these crimes are few & far between but rather widespread. However, some people may not know they have been victimized. Some may be scared to talk. Some may be too ashamed to talk. But I am betting there are a lot more silent victims than we can imagine. Yes, you're right that they input information into MRs as if they would be used in a court case. Companies that sell the MR systems also say this is one of the wonders of their systems is to help medical providers in lawsuits. It would seem they are more interested in saving their asses than actually doing right by the patient. So in that case, maybe anyone who leaves the hospital alive should be grateful because leaving alive might have been an accident & not the desired outcome for the medical community because you never know when they want to do harm rather than compassionate healing. It really stings that the government knows the hospitals did wrong but actually defends them. This is not the country I thought it was for sure. There are good people but certainly not many of those good people are in government, healthcare, insurance, etc. JR
"REL
My violin is broken so I can’t play anyone a lullaby and I’m fresh out of wine too. I made the effort to find him, sent him a letter and invited him to this blog. Banterings and I gave him the best advice on how and who to complain to. If he can’t handle a little feedback from Maurice then yeah, he’s in the wrong place. He has recieved much sympathy regarding the incident, perhaps more publicity than any of us ever have.
I’m not here to feel sorry for you, him nor anyone else. I’m not with the complaint department for 60 some year old men who need to pout and have everyone say POOR BABY. I’m here to find solutions and change a discriminatory and unethical process. If you can’t handle the heat get out of the kitchen.
PT"
PT -- I suspect that we may be on different wavelengths in this discussion. I''m glad you are a contributor here and feel you've done more that most (certainly far more than I). I believe you are correct that Mr. Kirshner is probably the highest profile individual to show up here. Given that and given that he may be considered to be especially fragile due to both age and past abuse as Banterings has asserted,, why was he selected for two absolutely preposterous attacks, not by lay contributors here but rather by the moderator. I simply don't get it. Insulted, he leaves and, on his way out, describes this blog as a scam. The question this episode raises in my mind is, is he right? REL
REL
Mr Kirschner chose a female urologist within that group which in my mind is a red flag. Now, you know some people love to be the object of everyone’s pity and he has recieved plenty. On the other hand Maurice is not hosting the Jerry Springer show here, nor is he Dr Phill, his speciality in internal medicine. A little thought experiment might help.
Let’s reverse the roles and assume it’s Mrs Kirschner, the patient. Assume the urologist is now male as are the assistants. Would the female patient follow the same suit if our blog administrator was female? I’ll also ask you to examine the video from king5 a number of times and carefully note the expression.
I’m thinking I wasted a letter and a few postage stamps!
PT
REL, this forum is anything but a scam. Dr. Bernstein has done a tremendous job hosting these discussions for many years. This forum is quoted or referred to in discussions on other sites. It has helped people, me included, find their voice and encouraged us to take action. Dr. Bernstein's insights into medical education and practice have been very helpful. His asking questions that might challenge our thinking is a good thing. The forum would have fizzled away long ago if it were simply an echo chamber.
I feel bad for Mr. Kirschner. He is suffering and perhaps it was too early for him to join in here. I very much hope he gets himself to a better place and can find his way back to us as he would have a lot to add.
Dr. Bernstein, please continue to ask questions, offer your thoughts & insights, and challenge our thinking as you think appropriate. This forum has done more good than perhaps even you realize.
Hospitalized past 2 days.. expect to go home today. More later from home. Pertinent to discussion. .. Maurice.
Maurice
My hopes for you a speedy recovery.
PT
JR said
Hope you are okay.
"REL, this forum is anything but a scam. Dr. Bernstein has done a tremendous job hosting these discussions for many years. This forum . . . "
Sorry Biker but I'm not convinced. In fact, I've not mentioned it before but have noticed more than one occasion when it appeared that the group was beginning to move strategically only to see the moderator introduce some tangential issue (race, etc.) that sidetracked progress. PT suggested that I leave if I couldn't stand the heat in the kitchen. It's not the heat that concerns me but rather the realization that there isn't going to be any food prepared, very possibly in no small part by design. Perhaps it's time for me move on as well. REL
Maurice,
Hope all is well with you and whether VIP status or not, you were treated with the dignity and respect that every patient deserves.
-- Banterings
REL
I say and mean this for everybody “IF YOU CANT STAND THE HEAT, GET OUT OF THE KITCHEN “
Everyone has a free will. No one stopped Rick from using the newfound tools that were suggested to him. He can still complain in the manner that was suggested. In fact, Maurice told him to be his own advocate, cover himself back up. I didn’t really see any issue that were presented to Rick. You would think that some people need to grow some thicker skin or go stand in the corner.
PT
JR said:
Sometimes it is not as simple as being able to cover yourself back up. Being drugged so your physical reactions don't work w/ the thoughts of your brain come to mind. I think that being a prior victim made Mr. Kirschner have that deer in the headlights reaction. It can happen & I think most of us have had moment that we have thought why didn't we react differently. As I remember what Mr. Kirschner said was that the whatever was yanked off as the head molester exited the door. Maybe there was nothing to cover himself up with. Perhaps he felt getting down & walking around would have made it worse. Why didn't the med. asst turn around & get busy doing something else other than staring? That would have been more logical. She is supposed to be prepared for male nudity working in a urol. office or didn't anyone tell her she'd be seeing nude males? Could of--should of only work in hindsight. In the moment when caught off guard it is kind of like on the I Love Lucy show when they rehearsed what would happen when Lucy went into labor. It was a real mess that they forgot to get Lucy. The kitchen I am in is very heated as we chose the hell hospital rather than the university hospital so like we were told, it is our fault that we chose a hospital where he would be both medically & sexually assaulted. In fact, it's past heated, it is burning down around us but we are still trying to cook. Sometimes victims vent at the wrong people out of frustration. Dr. B. thinks we are going overboard by not trusting any medical providers by acting as if they are all bad. He is entitle to his opinion and truly we know all are not bad but for our future self-preservation we must now act as if they are all bad. We obviously failed in judgment the last time so what's to say we won't fail again. I understand Mr. Kirschner's anger bc we have plenty of it too but at least he has a chance where ours is very slim but still a possibility. Banterings has given us plenty of advice but so far none has worked but we will keep trying. Probably going public & suffering more humiliation at admitting the story of being a victim is the only way so be it. Just remember that all of us react in different ways & maybe this blog was just not for Mr. Kirschner. You found him whereas most of us found this blog by searching for some common ground with others who have suffered. Maybe he was ready yet. It took me months to talk about my feelings of what happened to my husband even though I do so in the safety of my sewing room. It was a big step to be so open to Banterings but we have been looking for help & really appreciate all of Banterings help & knowledge. It is a very smart & good man. JR
I just got home after spending 2 1/2 days in the hospital. In a way it is a clinical followup to what I first presented here on June 5 2019 (reference direct link to to my posting then:https://bioethicsdiscussion.blogspot.com/2019/05/patient-dignity-formerlypatient_31.html#c176968018486123897 }
But in another sense, the clinical aspects of my reason for admission was an acute urinary tract infection and septicemia (infection in the blood), potentially fatal, related to the clinical use of a Foley catheter..is not the basis for the current posting. I wanted to tell you all why, though clinically sickly, I found no issues for time after time inspection of my penis by female nursing staff (none males except one male nurse on the night to morning shift) A female nurse was the one who inserted a clean Foley shortly on admission to the hospital. Why?
Because these ladies were doing their jobs of what I know as clinical necessity. And many didn't even know I was a physician at the time of their work (no VIP behavior by them on me) except later I did introduce myself as a physician and discussed associated clinical issues but they all did their jobs as they would be doing to non-physicians. It was my impression by communication and by observation that none of the female nurses was acting unprofessionally in any way. My attentiveness in this regard was to explain my experience on this blog thread honestly.
So what am trying to teach my blog thread visitors and writers? What has been described in great detail of behavior or misbehavior of clinical female staff
including Rick's experience may possibly be repeatedly anomalies but carried out in patients who have personal emotional injury sometime in the past even repeatedly which has set their definition of "professional care" now, as they also read stories or others even in the newspapers. But, I can't believe that professional misbehavior is the characteristic of medical care held by the entire or almost entire patient population---driving me back (I know I hurt you with this) with the conclusion of "statistical outliers". I know, I know PT in particular disagrees and admits to extensive observation as a medical system worker...he sees and thus he knows. So even with the publicized "bad apples" in the medical profession--I CAN'T FULLY SWALLOW these "bad apples" are themselves NOT JUST statistical outliers.
I think the majority of patients are like me.. with no history of major single or repeated experiences with "bad doctors or nurses" and continue to find comfort by the professionals who treat us.
So the main impetus of our blog thread narrative is there should be NO patients mistreated physically, emotionally or ethically and therefore NO OUTLIERS . And the ones that were should get help, advice and support.
This hospitalization gave me additional insight into the "professional behaviors" described here. I looked and I found none...as I have repeatedly failed to personally observe in the past. What everyone here needs to be aware is what is clinically ethical, legal so to set background limits and then if you see departures: SPEAK UP. You are doing that here..but now do it to your doctor, nurse, institution and government since in some areas of medical system care there could be found valid need for change and as appropriate system change and punishments. Thanks for the good wishes regarding my illness..so far they are working. ..Maurice.
Thanks for the update. I'm glad to hear you are doing well Dr. Bernstein.
Two things. First, even if those female staff are doing purely clinical functions in a professional manner, it is still objectionable for modest men who want male staff for those functions. Healthcare recognizes and accommodates female modesty while expecting modest male patients to just deal with it. If women are not expected to just get over being modest, why does healthcare expect men to do so?
The other thing is for some men once they have suffered through an incident or two of unprofessional conduct they are going to be wary going forward. Each encounter becomes an "is it going to happen again" moment. I'm not saying these men won't come to trust certain female healthcare staff in this regard, but most encounters are sufficiently brief that there is no time for the staff member to earn the trust of the patient.
For you and many others gender doesn't matter, but for me who has had female staff add a sexual component to my exposure, I now err on the side of avoiding female staff when and as I can, and insist on what I consider to be professional conduct when I can't.
There is as well an issue with what exposure is necessary. The former protocol at my dermatologist was that a female LPN and Scribe observed all full skin exams. To that practice their presence was deemed necessary. To me their presence wasn't necessary which then became the basis for my complaint. I have no doubt that LPN and Scribe would have maintained a professional demeanor but their presence would have been unprofessional nonetheless because it truly wasn't necessary to the exam.
At my former urologist, the all-female staff's protocol was to leave me exposed after doing the cystoscopy prep. The urologist I go to now has a couple male nurses who promptly cover me up as soon as the prep is done. I now look back and realize the professionalism at my former urology practice was not as professional as it should have been being I was left exposed more than I needed to be. My point here is professionalism is more than just being polite and maintaining a proper gameface. Professionalism includes minimizing patient exposure to that which is truly necessary.
Maurice
I’m glad you are ok medically. Now, regarding your narrative as it relates to this blog, I’m not moved one bit. One paragraph is not going to change my opinion ever, especially after the many ways I’ve been treated and the way I’ve seen patients treated for over 4 decades. Oh, but since you’ve found none that’s great, how did you look, beyond your own treatment? I still suspect your vip card was at work wether you admit it or not, it dosen’t matter. Another thing, if you were a victim of what’s been mentioned I seriously doubt you would mention or admit it on this blog.
PT
PT, if I was observed and felt to be a victim of what has been mentioned here, I would readily report that to my blog readers but also to hospital administration. But in this isolated experience, I didn't have that finding. There are standards of action by members of the medical team treating patients and it is those standards, usually based on the patient's underlying pathology or pathologies which must be considered. But first the patient must understand the anatomy, patho-physiology and current treatment to fully understand whether standards of practice observed are the standards set by the medical profession's research and experience. If you don't know that then you might be one of the millions of patients who might think in Rick's situation simply pulling his pants up was a hazard to him. It wasn't since the tissues can be sterilized again when the physician took entered the exam room.
All of these standards of practice actions are always under the patient's own autonomous decision or by his or her surrogate if patient cannot speak up.
My own personal concern now is not the nursing staff but that e.coli that made me sick and hopefully with antibiotic keep it out of my blood. To me it is the sickness and the prognosis but not the nursing staff, male or female. So, right now in this regard, I am definitely prejudiced.
..Maurice.
Dr. Bernstein, yes your health is of primary concern and I accept that sometimes patients are so sick that the things we discuss here aren't going to be anything they care about. When I slipped on ice last winter and broke a rib I was in so much pain that I don't think I'd of cared what they did to me.
I know you don't care about the gender of your caregivers and you considered your treatment to have been professional, but did they follow the kinds of protocols we've discussed? By that I mean did they ask before lifting your gown, only lift your gown enough for the need at hand, pull the curtain, and excuse from your presence any other staff that might have been there?
Dr B,
I'm glad you're OK. I'm glad you weren't treated badly. More often the staff will treat a patient OK so long as it doesn't endanger their relationship with other staff. But in all likelihood if Twana Sparks or a similar person was around??? The staff who attended JR's husband??? Many friendships are only surface deep. They'll like you and treat you decently so long as it doesn't jeopardize anything they have going on.
Otherwise people can tell by talking with you that you are intelligent and educated. That isn't true of everybody though.
I'm like you in that I don't have to have same gender care. In fact when I have had modesty violations it has been female staff doing it. I have read through some of your earlier volumes and when more females were contributing, the number one complaint from female patients were other unnecessary females looking on from the foot end of an examining table.
JF
REL
The food is whenever someone is able to get a better outcome because of something they heard on this blog.
JF
Good Morning All:
Dr. Bernstein, all of us here wish you a quick & full recovery.
Sir, if there is a next time you need a Foley, ask for a male nurse to do the deed.
Let's see if they handle your request with professionalism or turn on you for questioning their ability.
Regards,
NTT
JR said:
My husband's experience was not bc he expected to have a bad experience based on prior abuse or bc he had read about abuse in the newspaper. Exactly what could he have done to have prevented it? He had verbally told them about the effects of the pain killers. Maybe he should have gotten off the exam table & went over the computer to see if indeed they had made note but then how would he had been sure they did not hit the delete button when he went back to the exam table? After he experienced the abuse both in the cardiac cath lab & in the cardiac ccu rm by the 1st female, all nurses male & female after her shift did no sexual abuse. Of course, by that time he was able to defend himself as the drugs did not limit his physical capabilities and although his mental capabilities were foggy, he was much improved. I would argue that when sedation is used, the more likely this type of behavior will surface as they are aware they don't have to follow protocol bc most victims are either or both physically or mentally unable to stop their actions. The drugs may alter a victim's reaction to the crime. Certainly while he was in the regular patient ward, where patients are more independent, there was greater consideration shown to those patients. Your experience is comparing cabbage to onions w/ the only thing in common is that they stink. It is discriminatory that males have to have mostly intimate care given by females when the reverse is not true. However, as I have stated, my husband never complained about this nor did he ever feel like he had been raped. Unpleasant yes but was what he had to do to get care. However, there is a huge difference between a nurse uncovering you w/ permission to insert a foley catheter for medical reasons and a nurse who leaves your penis uncovered, opened to view for techs including IT & the one who draws blood, chaplain, etc. This was not done for seconds, minutes but hours more like 5 hours to be exact. Is this acceptable medical care in your opinion? It is also acceptable in your opinion for a supposed informed consent to be done while a patient is lying naked on the procedure table itself while being prepped for the procedure while omitting on all hospital related logs you had received 100mcg of a very powerful drug they also were going to use w/ the consent not signed by you but signed by them after the procedure actually began? Would it also be acceptable to have a female cath lab patient lay on the procedure table for 45 minutes after the procedure in a room w/ 4 male nurses with her vagina entirely exposed while they did whatever as that time has very little documentation? Even if she weren't w/ 4 males, more than likely her genital area would have had some sort of covering. The only way my husband could have prevented any of this from happening would have been not to have gone to seek treatment as he did not plan or scheme to become a victim of both medical & sexual assault. However, you are correct that going forward, he will now like most victims of crime be forever vigilant by assuming all medical workers are capable of committing the same crimes again. He learned his lesson & doesn't seek a repeat. Just bc it didn't happen to you doesn't mean it doesn't happen nor does it mean it is not more common place. It just means you weren't a victim this time as he had never been a victim up to that point when he did become a victim. JR
Hello Dr. Bernstein,
I hope that you are feeling better and that you have a full recovery. I'm surprised that you acquired sepsis and were discharged after only two days. A friend spent a month in the hospital with sepsis and took a full year for complete recovery. Since you seemed to indicate that a UTI precipitated the sepsis, have you investigated the cause of the UTI? As a patient and, especially, as a physician, I would expect that you'd be keenly inquisitive regarding the origin of the UTI. Since you were carefully monitoring the procedures, can you isolate the probable cause? Additionally, I would think that your interest would be piqued, since a UTI in a male is far more rare that one in a female. I know that you mentioned "the clinical use of a Foley catheter"; however, this, in and of itself, should not be the expected cause. Otherwise, Foley related UTI's would be astronomical. Do you have a probable cause, other than an expected hospital-acquired infection? Again, I wish you Godspeed for a complete recovery.
Reginald
Hello again,
The House Oversight and Reform Committee held a hearing yesterday regarding
Identifying, Preventing, and Treating Childhood Trauma: A Pervasive Public Health Issue that Needs Greater Federal Attention
Date:
Thursday, July 11, 2019 - 10:00am
Location:
2154 Rayburn House Office Building, Washington, DC 20515
Identifying, Preventing, and Treating Childhood Trauma: A Pervasive Public Health Issue that Needs Greater Federal Attention.
Since many of the posters have indicated, directly or obliquely, that they were childhood victims of abuse, this hearing may be extremely important. A government panel is discussing the identification, prevention and TREATMENT of childhood trauma, including domestic and sexual abuse. Maybe this is the forum to contact re same-gender treatment for abuse victims, especially the underserved male victims. This may be the vehicle to open a discussion which may recognize the broader issue of male dignity discrimination (one step at a time).
Those of you who'd like to give your views re childhood trauma, its effects on you and recommendations for treatment may wish to contact the committee at the url below.
This may be a golden opportunity that you may not want to miss.
https://oversight.house.gov/contact
Reginald
Maurice,
I don't know if I missed it or not, but what was the cause of the infection that hospitalized you for 2 days?
Was it your initial procedure that caused the UTI?
Or is it just an "unknown" cause?
Personally, after a cath procedure you develop a UTI seems too coincidental. Was it from that procedure or did you have to keep one in? Either way, there was a failing of professionalism if you developed a UTI after that initial procedure. So how do you reconcile that?
Just as damaging as psychological harm is physical harm. Is this too NOT a failing of professionalism?
Unless you needed to keep an indwelling catheter, there would have been no reason to cath you again (except laziness in needing a sterile sample).
I am sure that you are aware (at least from this blog if not from your professional medical training) the issue of overuse of catheters.
I would further assert that if you needed an indwelling cath, that your failure to recognize the need for a change and cleaning of the area, or the care of your cath was also a failure of professionalism being you as a physician should have more knowledge than the average patient.
If you fall back on the argument that a patient needs to follow the instructions of their providers and as a physician you knew this and complied, then that is another failing of the profession of medicine. Everyone here questions protocols and recommendations. I would argue the medical necessity of needing an indwelling cath.
-- Banterings
First thanks to all my Commenters concerns and support. Even ill physicians can benefit from written or spoken support.
Again, I must say that to understand one's illness fully, the patients needs to know the pathophysiology and common clinical course.
E-coli infection in the blood, confirmed by blood culture is a serious medical condition and, unfortunately not uncommon at all in patients who have to use Foley catheters or those who manage with a regular catheter self-inserted twice a day. The infection, even despite attempts at caution, can migrate up the tube into the bladder and then spread into the blood stream causing systemic symptoms including unexpected fever. So when I had to start using the Foley something like this was in the back of my mind but hopefully wished not to appear. But that wish didn't happen. It happened, I became suddenly sick with at first was "fever of unknown origin but suspected urinary tract infection and sepsis" and then, when hospitalized, finally proven.
I hope this presentation here doen't too long or boring but what happened "suddenly" to me provides suggestions and support important aspects to the discussions going on within this blog topic thread.
First, to start out, the goal is for all patients or "patients to be" to know that they are in ethical and legal control: AUTONOMY. All Adults and youths in some cases carry this "power". But to use your autonomy in the best and full power is to really understand the issue for which you want to wield it. Even at the current year of 1900 with all the spontaneous internet along with the pharmaceutical on TV commercials, not every "patient to be" knows what the active medical professional knows about diseases including patho-physiology, approaches to diagnosis and the full and hopefully effective treatment methods. You have got to be a patient's physician or pharmacist to really "know and understand for decision-making.
So even though all patients have autonomy in final decisions over their physicians or nurses, the patient, to be fully educated and safe has to really understand their disease and I am afraid that even 2019, many patients don't. More on the next posting. ..Maurice.
First, an obvious correction to my above posting "even at the current year 1900" and not correctly numbered "2019". To me this is skipped re-reading or hopefully not sepsis symptomatology though I finally corrected the year at the end of the posting.
It really is the patient's first understanding the disease in all of its components of presentation, diagnosis and treatment that can make the patient's autonomy a benefit for themselves. If the patient is to make the FINAL DECISION on what is being done or what should not be done by their doctors or staff, the patient should know a bit about the medical standards of actions or behaviors currently required for that disease. Gross example: if you know that a rectal exam does not itself meet the exam criteria for rhinitis (runny or stuffy nose), the use of your autonomy to deny the rectal exam is not only to your emotional interest but also your interest in relieving your nasal symptoms. OK.. you are faced with Rick's situation and you know what the nature and reason for outpatient preparation and whether once completed can be spontaneously undone without harm and still allow the preparation to be repeated later, then you utilize your autonomy without hesitation. But that is what I am trying to say, you should be educated as to what was done, what is to be done and how your decision might affect your health--and then, as you feel your decision is valid then "speak up"
or "act up"and demonstrate your self- autonomy as a patient. If you don't really understand what is being done or to be done then SPEAK UP to your healthcare provider or find other ways to get the details to make your decisions. And if you are gender sensitive with regard who examines or takes care of you and you won't change your opinion or feelings and you understand all the risks or complications of your decision then that is your power of autonomy and your freedom to act on it. But only if you know something more than only the "name" of your potential and active disease will you be using your autonomy fully to your interest. More later..I want to see how you digest my concept of your autonomy and personal decision-making in medicine. ..Maurice.
Banterings, sorry for the delay in responding. I wrote my last postings before looking at postings by others awaiting publication.
The insertion of the Foley was 8 weeks ago when I wrote here about my experience. Yes, it was for its general purpose, obstruction of urine flow. The facts are that anyone has a chance for urinary tract infections via the urethra or via blood stream with or without a urethral catheter although at times a foreign body passage may facilitate movement of germs.
Catheter insertion and use opens the patient to infection whether for temporary or ongoing urine passage and whether it is prescribed as a twice a day insertion of a simple catheter with no leg bags or a 3 week before required anti-infection replacement Foley catheter with leg bag use and attention. One hopes this won't happen but infection at some point in time may occur even with best attention to sanity and with either application or as I stated not uncommonly with no foreign device present.
Decision for the long term use of a catheter is one for a physician and patient to decide. At this point in medical treatment alternatives, Banterings, your view is your own view and urethral catheters for more than momentary use is still medically acceptable practice. And again remember physicians see many patients with urinary tract infections who don't use catheters. By the way, a consultant on my case in the hospital is an infectious disease specialist whose comments supports what I am writing here. ..Maurice.
Dr. Bernstein, yes we should all make an effort to better understand what a medical condition and its treatment entails. This is something I started to do after having had a couple uncomfortable surprises.
If one doesn't know what normal is you can't advocate for yourself if something different is occurring. Using a personal example, when I had my 1st bladder ultrasound I had no idea that standard protocol did not include any genital exposure so thinking this is just how its done I let her needlessly expose me.
The problem is despite the vast amount of info on the internet there is surprisingly little about how many procedures actually are done, especially anything involving genital exposure. It is typically just not mentioned. Patients are then caught by surprise when the general nature of the procedure doesn't involve the genitals (cardiac caths for example) but they find it involves exposure anyway. Sometimes the nature of the procedure might be known but the patient is surprised anyway because they just assumed there would be male staff for something like a testicular ultrasound. It doesn't occur to the patient to ask about staff gender and the referring doctor and schedulers never mention it.
One hugely misunderstood aspect of treatment is sedation. The literature almost universally portrays it as something to relax you when it is instead something to erase your memory of the procedure. In this case the medical world is purposely misleading the patient given helping them to relax is not even remotely the same as inducing amnesia.
The internet has made it easier than ever for patients to be knowledgeable about their conditions and treatments, but it remains difficult for patients to know what to expect when it comes to that which we discuss here.
OK, if we're talking about catheters and understanding what is considered normal, there is something I'm not understanding. Fourteen years ago when I had my initial bladder cancer surgery I was sent home with a catheter that I had to keep in for a week. I was not given any instructions about cleaning it or checking myself or for its removal. I was simply told to keep it in for a week. Why then would a hospitalized patient need nurses to be checking it periodically?
Or is the issue I wasn't given the necessary instructions? The nurses is post-op were annoyed with me because I was having a hard time coming to from the anesthesia. They'd be telling me to wake up and I'd be fading out again. Even my wife in the waiting area knew they were annoyed with me for taking so long. When I did come to enough to be functional I did ask about why the catheter hurt so much but they dismissed the question and so I didn't ask any others. So maybe I did miss getting instructions.
On the removal part, why would a nurse be needed to remove it for a hospitalized patient when I was sent home with instructions to remove it myself? What am I missing? As an aside I will say I'd of appreciated it if they warned me what the removal would be like. Fearing I might make a mess of some sort I got in a bathtub before removing it and quickly learned making a mess was the least of it. It was excruciatingly painful, literally making me fall to my knees. Passing blood clots the next couple weeks proved to be far worse though, something else I wasn't warned about.
I will say that in recent years whatever it is I have had done has come with clear instructions and warnings given verbally and in writing. There have not been any surprises for lack of information. From my perspective patient education has improved.
Biker
When a urethral catheter is placed you should have been given instructions called peri-care. That is to pull the catheter out slightly and clean about the catheter prior to reinserting it. The amount you pull out is about an inch. This can reduce infection substantially, but you know it’s all about simply educating the patient. Something that should be done in a healthcare industry that pulls down $4 Trillion annually.
P.S. Peri-care should be performed at least twice a day.
PT
Biker, you may have already responded about this here and I missed it but I hope your cancer problem itself is a thing of the past.
Things have changed in medical practice despite what has been personally described here. The details of the condition are presented to the patient faster directly and personally by the healthcare provider but also through the internet medium directly to the specific patient. Still, the patient should continue to "speak up" since, as PT says "it's all about educating the patient" in addition to providing the appropriate treatment. ..Maurice.
PT, unfortunately that "pulldown" is not keeping Hahnemann University Hospital in Philadelphia is slowly closing down on or before September 6 after more than 170 years in operation. ""This was a difficult but necessary decision due to financial difficulties," Hahnemann officials said. "The hospital cannot continue to lose millions of dollars each month and remain in business."
And, of course, employees but also hundreds of resident physicians will be looking for a hospital to resume their work and training.
I had my internship ("first year residency" ) at Philadelphia General Hospital, now long gone and now its Hahnemann in Philadelphia.
PT and Bantering may want to present here more info regarding the bankruptcy of Hahnemann. Somebody has been getting rich. ..Maurice.
JR said:
Indiana must be really different at least the Catholic hospital from hell as my husband left there not fully knowing what had been done to him. Their instructions were vague as he didn't know how to care for his wounds or what to look for as they were swollen, black, and about 10 inches in diameter as we have pics. They also let him leave with stitches left in by mistakes in the one groin. They wanted him to come back but he didn't. They also forgot to give him nitro like they were suppose to upon leaving. They sent paperwork to the cardiac rehab which he quit after learning their part in the crime after a few visits saying he had more stents put in then his card they had given him so we weren't really sure how many stents until we got his MRs. They never spoke to me about what anything. He was waiting on the sidewalk for me to pick him up. They gave him a booklet detailing heart failure but none much of anything about the stent care, etc. We thought he was in heart failure & didn't find out until October he wasn't. Of course, he knew by the next day after they put the stents in him that anything that had been done had been done against his will/wishes. He also knew how they had treated us, his family. He also remembered enough of how he had been sexually molested/violated and he didn't want them to know how the drugs they had given him to control him were still effecting him as he was afraid they wouldn't let him go. He knew for his sake he had to escape them at any cost as he did know how they had treated everyone of us.
The major university hospital here closed down our town's local hospital to be only a ER that transfers, does some outpatient procedures, & has offices in it. They tore down part of it. This is where we took him when he had his heart attack. If he were to have another one & we would call EMS, this is where they would take him despite the fact he would tell them he did not want to go there or to the hospital from hell. So therefore, I would have to drive him to another hospital which they should have made us aware that they also handle heart patients as I now know of some people who had good reports from there & he also had his EKG there. He has a medic alert type necklace he wears stating no which hospital systems he refuses to go to & what meds he refuses. He also has modified the stent card so it no longer identifies the hospital/doctor along w/ if they check by serial no. to identify that he does not authorize any contact of hospital/doctor. He also carries paperwork & electronic record of his much modified directive saying I must be contacted in any situation before they have permission to do anything to him. He also has a clause saying failure to regard his directive will result in legal action. In there he states he now refuses to have any female staff present when his genital area is exposed due to past sexual abuse/violation by female staff. He also carries a recording device he can activate so he can hopefully have a record of what is discussed to the outright lying on the part of the medical community can be countered. It is beyond a shame this has come about but it is necessary bc of all the abuses that occurred related to his heart attack. He feels he must protect himself from the ones who are supposed to protect & value his life. JR
Maurice
You know, it’s sad! I used to live in Philly and I’m very familiar with that hospital. There is always going to be trouble when Tenet has their hands in the pot but much worse a venture capitalist. Typically, all a hospital that wants to close needs to do is give the city a 90 day notice.
There is always much work in running the day to day operations of a hospital. Essentially, the CEO sets the tone, he/she sets the culture and you must constantly work on that daily. A quick review of yelp will tell you obviously that was not done. You have to constantly oversee patient satisfaction and strive to improve on patient services that will in the long run give solid monetary returns.
I’ll tell you that when a hospital is slated for closure and I’ve worked at a few that closed it just dosen’t happen overnight. It takes years and years to start the downward slide, a lesson in mismanagement that’s years in the making.
PT
JR said:
Our local hospital that the university closed was actually fairly good. Our son in his 20s developed type 1 diabetes. He went to the university clinic & saw an old nurse who took one look at his long, blonde hair & his different mode of dress & all she kept asking was what type of drugs was he taking or how much alcohol had he been drinking? I was there & actually helped him walk in to see her but he didn't want "mommy" w/ him. She did nothing but offered to give him a flu shot on Monday. I took him to the local hosp. that evening as he was much worse. I got a wheelchair to take him in & immediately someone from the back came out as he was slumped over. Five minutes later, after my husband had arrived the NP came out to say she was absolutely sure he was having a diabetic incident as she could smell it on him. She said if he had waited until the morning, he would have been dead. They did right by him so this is why when we told them about his drug side effects, when they told us we would be able to talk to the other hospital before anything was done, we didn't question them. We at that time had no reason to not believe what they were telling us. The hospital was small & was having trouble competing w/ the hospital from hell location in a town north of here which by the way does not have cardiac capability. Have to go to the main one for cardiac. The local hospital told us one thing, told the hospital from hell something else & also put lies in the MRs. We gave my husband's cardiologist redacted MRs w/ a signed statement saying he did not give permission for seeking more MRs as the MRs were falsified. Of course, his cardiologist is not associated w/ the hospital he would get any treatment done at if he were to change his mind about further treatment. He wants to keep everything spread around so there is not a monopoly of power & control through the EHR systems. From talking w/ Livanta, they confirmed there are different sets of MRs that are released to them from what is released to the patient. Not supposed to be but again it is part of the secrecy of the powerful society of the medical community.
JF,
I think you may have a point. I think females as a whole care group have less concern about any patient's modesty needs. Too many of them are in it for the money & do whatever they have to do to get their job done faster & w/ as little effort as they can put forth. Also, females are nosier by nature & love to gossip about others so knowing & seeing everything would be more in character. JR
Can you believe it..we are now at 191 Comments and it is time to move on to Volume 102. ..Maurice.
NOTICE: NO FURTHER COMMENTS WILL BE PUBLISHED ON THIS VOLUME 101. FURTHER COMMENTS CAN BE WRITTEN TO VOLUME 102
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