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Patient Dignity (Formerly:Patient Modesty):Volume 102
The last Volume of this thread stressed the patient carries with him or her the ethical power of autonomy, self -final decision-making. And I have a concern that a number of patients don't display that power in decision-making because they are not familiar with issues related to their suspected condition or disease in terms of medical principles, diagnosis or treatment and often the healthcare provider may make assumptions overestimating their patient's medical knowledge or just be too busy to teach. Yet without that knowledge, the power of autonomy cannot be fully expressed in the best interest of the holder of that power. The solution may be self-education in medical matters before the need to express the patient's ethical power.
We call for patients to feel free to "speak up" to their attending medical professionals regarding matters that concern them. But understanding general medical principles beforehand which may apply to the patient's symptoms or diagnosis or treatment is worthy and may be obtained from books and now the more easily obtainable reliable medical internet resources. Sometimes even talking over the fence with a next door neighbor might be of help in the patient's education but be cautious since their experiences and views and philosophy may be different from what you need for your own decisions.
In conclusion, pre-educate yourself in general medical principles for the time you wield the power to express to your healthcare providers your power of autonomy. ..Maurice.
Graphic: From Google Images
NOTICE: AS OF TODAY JULY 29, NO FURTHER COMMENTS WILL BE PUBLISHED ON THIS BLOG VOLUME. COMMENTS CAN NOW BE WRITTEN TO
VOLUME 103.
171 Comments:
I want to add to my introductory message to this new Volume a further important Comment.
I fully understand that for those who write or have written here including Rick and the majority of others, there is underlying PTSD which may affect one's interest and behavior and that someone urging "education, education" with regard to one's illness and anticipated treatment may be difficult to personally rationalize and carry out. The blame and the power to prevent in the future should be put on the physicians, nurses and the medical system itself. It should be these sources of the PTSD who are responsible to educate the patient in advance of an exam or procedure and attend to the concept of patient autonomy. Does that regularly happen? It appears not. ..Maurice.
JR said:
As one of those affected w/ PTSD, my husband and I, do not disagree w/ patients becoming educated about their illness(es). We, in fact, have become very educated about prostate cancer and heart disease. However, in my husband's situation, we were not educated about heart disease when it happened & they did not want to educate us. They merely lied to us about what would actually happen, did it & then lied to cover up. This along w/ sexually abusing my husband lead to the PTSD. It is hard to understand why most in this country cannot believe the medical community who are actually made up of from ordinary human beings can practice lies & deception(s). It is almost impossible to become educated in an emergency situation especially when their main focus is to drug the patient to keep them from participating in their own healthcare decision & keep the patient isolated from the family in order that the family cannot participate in the decision. Since that time we have educated ourselves so that we knew my husband did not have to "strip from the waist up" for an EKG stress test w/ ultrasound. We know from research the stents that put may cause the very thing they said they would cure--a heart attack. Stents may only open the current blockage but a blockage is more likely to occur from the damage forevermore at the stent end. That risk never goes away. Also, you are more likely to die if you have a stent related heart attack. There were other alternatives to the stents but were they discussed in detail w/ the drugged man? We know the medicines are have many bad side effects & do not prevent another heart attack from happening. The drugs may cause permanent liver, kidney, memory damage, internal bleeding, bleeding to death if in a car accident, etc. Of course fixes for the cure just add more money in their bank accts. We know that he did not have to lay naked for hours & this was actually sexual abuse. We know now his nakedness did not have to be entertainment for the hospital staff. But they did not want him nor me to be involved in his care decisions. Supposedly they told all of the risks to a man who was drugged out of his mind on fentanyl & that man made a well thought out decision. So again, while the above advice is good advice it only works when they are willing to let it work. Otherwise, it just looks good on paper and people like us will still get PTSD from how healthcare is delivered. JR
You know, if the patient has the emotional reserve, self-education before being attended by physician or nurse will provide the basis for the patient to be asking specific questions to the healthcare provider and understand when and how the response of the provider fits with the patient's prior education and whether a little physician "paternalism" is being inserted into the discussion. Some physicians and nurses take stands that "My job is to take care of you and therefore what I say and what I do is really in your best interest." Of course, the paternalism, approach of the medical provider with the limited options intentionally presented also makes fair and full communication with the patient difficult, if not impossible. A "take it or leave it" attitude by the provider communicating with the patient is also unacceptable. An excuse by the professional may be inadequate time for communication rather than a professional view that, despite the patient's autonomy in decision-making, the doctor "knows best".
However, it is hard to argue with a professional when the patient knows that in many, many ways the professional does hold the patient's health and life in his or her hands. ..Maurice.
Dr. Bernstein ,absolutely patients should take advantage of the wealth of info on conditions and treatments on the internet if for nothing else to be better able to ask questions. For me personally I find physicians and others are doing a pretty good job of explaining options and conditions to me these days. In my case this currently includes urology, cardiology, gastroenterology, dermatology and primary care. The PA who serves as my primary care sometimes goes too far in this regard and I have to stop her and say "what is it you want me to do". She's one of those smartest person in the room with too much nervous energy types.
I contrast those recent year experiences with 14 years ago when I had a 2nd bladder surgery for biopsy purposes and the doctor didn't even tell me beforehand he was also going to do prostate biopsies, and for my 1st follow-up cystoscopy appt. I was just told it was a follow-up appt. and had no idea I was having a cystoscopy let alone how it was prepped for and done. Until then I had no idea I was going to be having cystoscopies on a regular basis. In response to my inquiring about getting test results that doctor told me that he'll tell me if there's something he thinks I need to know. Thus I know paternalism when I see it and for me personally I no longer see it.
The problem as noted previously is that there is a dearth of info on the internet on how certain procedures are done or prepped for, and patients are taken by surprise as a result. This is especially so for novice patients new to healthcare or new to that aspect of healthcare.
I thought you all would be interested in watching this video about a lady who underwent shoulder surgery and how she was awake at https://www.youtube.com/watch?v=OfI0m4Sq_j4. It is best for patients to be awake for surgeries so it would be more likely that medical professionals would honor their wishes for modesty.
Misty
Try out this link to a Medscape video with ethicist Art Caplan and professional guests and let us know what you think. ..Maurice.
JR, there is a term to describe what the makemsick sociopaths/institutions did to your husband (as well as yourself) - this term is, quite simply, terrorism. I believe I have noted this before. Thus, the title of the book you intend to write, Medical and Sexual Assault: The Gold Standard of Medical Care, is a very apt one. As regards the hospital from hell I, unfortunately, had much experience with Roman Catholicism in my youth; upon educating oneself, one discovers that the Vatican is one of the most corrupt institutions in the world. (I had a friend, a monk, who tutored John XXIII and oh my the parties in Rome! The fine foods, liquors, and of course, both male and female prostitutes – the expensive ones!) Thus, it follows that a Catholic hospital would conduct a night of terrorism upon a helpless, older man in the throes of a heart attack, especially as they believed he was gay. Priests can be gay (same friend was raped by the head priest who interviewed him as an adolescent for pre seminary studies), but apparently no one else is allowed to follow their individual nature as concerns sexual identity. And yes, said friend was gay. Yet I care not what an individual’s sexual orientation is – none of my business. Having been in the entertainment field, I had and still have many gay friends. We are all humans, are we not? But not according to some…
JR, your paragraph here says it all: “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 supersedes 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? “ (emphasis mine).
yep, EO, to be cont.
Interesting Misty. How does one make non-standard arrangements like that when we typically don't even know who the anesthesiologist will be until someone shows up in pre-op?
JR, it is the sound ideas in your above paragraph which might make a great intro to your book, especially the italicized passage. Educated, aware parents of children are in a war to maintain control of their children’s bodies, but we see what the fascists are doing , especially in New York state : isolation, jail/prison, large monetary punishment, id est, fines, for not submitting to the government thugs who use the makemsick industry (both amply rewarded with monies whether in the form of pHarma funds to congresscritters, and of course the HUGE bonuses paid to pedillers [pediatricians] for destroying the immune systems of yet another generation). I WILL REPEAT MYSELF AS MUCH AS NECESSARY – READER, IF YOU DON’T UNDERSTAND THAT MANDATORY VACCINATION IS THE SPEARHEAD OF TOTAL CONTROL OF ALL HUMANS’ BODIES BY THE FOR PROFIT, SUELESS, VACCINES MAKERS (read not just Big pHarma but the monsters behind such entities) THEN YOU ARE TOTALLY CLUELESS AND ARE PERMITTING SUCH AS THE ABOVE ABUSE SUFFERED BY JR AND HER HUSBAND; YOUR GRANDCHILDREN WHO MAY HAVE SOME HEALTH ISSUES OR DISABILTIES THAT PREVENT THEM FROM WORKING, WILL BE THE FIRST TO “VOLUNTEER” THEIR CORNEAS OR KIDNEYS OR WHATEVER THE MAKEMSICK ‘EXPERTS’ DEEM IS ‘NEEDED.’ Come on, we now have medical kidnappings; forcibly subjecting (mainly children) to bogus treatments such as chemotherapy, which latest literature reveals to CAUSE CANCER IN HEALTHY CELLS! But, if the makemsick industry can make $300-$500,000 per victim, this is where the power and control aspect plays out. Hell, when I was a naïve twenty something a million years ago even then I instinctively knew that poisoning an already immune compromised individual was TOTAL NONSENSE! This when I had zero interest in politics/medicine and of course was the time when I was put on display for (can’t recall exactly how many) 6 – 8 male physicians who examined me in the stirrups. I believe I have already recounted how I felt the sick, sexual overtones of the last physician when he lingered oh so long and I hit his arm with great force and he scurried out the room like the rat he was! I was alone, not even a nursing hag there!
JR, I’d also like to note that yes, your husband was raped: “[M]y 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. “ (emphasis mine).
EO, to be cont.
I’d like to include Mr. Kirschner in this discussion. I am sorry, Sir, that you felt the need to leave this blog. I too was taken aback by Maurice’s admonition that you should have been proactive and covered yourself the moment the rapists in the clinic exposed you for their fun, their prank! As you stated: “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.” I hope it was the incorrect way that Maurice at first mention worded it; it seems his later advice is to educate oneself as much as possible as to be ready for an abusive scenario and head it off at the pass! Yep, this is what the makemsick industry has come to. At the nano second the covering was ripped off Mr. Kirschner it was already too late to avoid the abuse! ALREADY TOO LATE! As PT noted: “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.” But, as many here and JR has stated, it’s perfectly acceptable to abuse and yes, sexually abuse/rape a customer if said customer is male! As those who labor in the industry such as PT note that the terrorism inflicted upon JR’s husband and herself is business as usual - de rigueur for the makemsick industry!
I’d like to address another issue which is of paramount importance, not just for our medical freedom but for our rapidly fading democratic processes as a nation. This issue is INFORMATION. Please be aware that our masters, the financial elite who own Big pHarma, corrupt healthcare organizations such as Tenet {they charged me over 1200% more for being underinsured and I fought and won – they have not messed with me since!) and the industries of war OWN THE WORLD WIDE NET AND HAVE CHANGED ALGORITHMS SO AS TO MAKE IT VERY DIFFICULT TO ACCESS NOT JUST TRUTH ABOUT THE DEATHS AND INJURIES PRODUCED BY THE VACCINE CULT, BUT WEBSITES THAT CARRY INFORMATION ON OTHER METHODS OF HEALTH MAINTAINANCE, ESPECIALLY AS RELATE S TO NATURAL SUBSTANCES AND LIFE STYLE CHANGES THAT PROMOTE HEALTH WITHOUT PHARMA POISONS. Let’s just take statins and stents, for instance, HUGE profit machines, that destroy the body in precisely the way they are supposed to help it – all LIES, LIES, LIES TO SELL YET MORE POISONS AND DANGEROUS PROCEDURES.
EO, to be cont.
Thus, I can no longer call these fascist states of amerika the last stronghold of the ugly imperialism known as the British Empire, we are now New China. Forced medical procedures, rampant sexual abuse which is always found in tyrannical regimes, restriction of information, public shaming and imprisonment of those who believe they have a fundamental right to direct their bodies and the bodies of their children, medical kidnapping, widespread lies via a corrupt media, and on and on… Take off that normalcy bias and LOOK AT WHAT IS REALLY HAPPENING! Nursing hags that kill with drugs, that cover up murders they or others committed, that rape males in hospitals – none of these criminals are ever brought before the law – unless they are male nurses or physicians – female physicians, nursing hags, and female tech hags are above the laws of the land! Physicians calling CPS on parents who refuse to destroy their childrens’ health via the vaccine cult are the worst of above criminal lot! I won’t bore anyone with the more recent deaths of infants by vaccines, but be aware that most of these deaths are hidden from statistics. MEs (medical examiners) are complicit in this widespread corruption by covering up the deaths by assigning these deaths as “indeterminate” or “SIDS.” Gee, no coding for death by vaccine, no coding for death by pharma poisons, gee, how are the makemsick perverts gonna make their outrageous monies? I know, FORCE EVERYONE TO USE THE PRODUCTS THEY ARE PAID TO PROMOTE! I have read many accounts of parents desperate to know what really killed their formerly healthy infant and some MEs REFUSE TO PERFORM TESTS THAT PROVE VACCINES ARE THE CAUSE OF DEATH. Some parents are desperately trying to raise money for independent autopsies and some are finding that sites such as GoFundMe are banning them! Parents who formerly trusted “medical experts” and now have to bury a child or determine how that damaged child is going to be managed for the rest of his/her life are now the most vocal in trying to tell the world what vaccines really do, and I believe it is because so many of these parents are now speaking out that our country is now New China with the elite controlling the web. Of course, Boobus Americanus does not have the intellectual capacity to get beyond the first few pages of true “misinformation” put forth by our masters. Most sheeple operate on a rather low emotional level and have little to no analytical reasoning abilities. Common core is doing a great job furthering these deltas and epsilons in their ignorance and stupidity.
READER, WHEN THE FOURTH ESTATE IS COMPROMISED, THERE IS NO FREEDOM OF THE PRESS LEFT. This is exactly what happens in all tyrannical regimes – restriction of information so as to lead los sheeple down the path of no return. JR, the dreadful drugging of your husband is, as we have seen, a common ploy to not only abuse sexually /emotionally BUT TO COVER UP EGREGIOUS MEDICAL ERRORS. I agree with Banterings that there is no way to save the current makemsick industry. Burn, baby, burn, is what I say!
I have been amiss in wishing you, Maurice, a good recovery. I must concur with others however, that of course you were treated as a VIP in hospital. Now, I will be truthful and say that out of all my makemsick encounters, most were abusive in some degree and medically damaging, but I did receive VIP service when I used physicians in Beverly Hills. Though not a VIP, I suspect most like myself were treated as such because many of the customers using these practices were VIPs. So of course, makemsick workers were carefully trained here so as to not offend a powerful player.
As Banterings I believe stated: “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.”
EO, to be cont.
And yes, the ONLY way to begin to stop sexual/medical abuse is with group lawsuits. THE ONLY THING MAKEMSICK B&AS*AR$S understand IS MONEY – AND THIS CAN ONLY BE ACCOMPLISHED WITH A GROUP LAWSUIT. Students of history know that tyrannical regimes always use money and power over others to lure sociopaths into committing crimes, and I’d posit that at least 3/4s of all makemsick providers are sociopaths, some well on their way to the honor of being a true psychopath. That has been my experience with the industry.
So, at Volume 102, what have we learned about the makemsick industry? Male customers have no rights to dignity or respect. EBM (Evidence Based Medicine) is a sham, most studies being conducted by industries that stand to profit from drugs/procedure, and editors of what were considered professional medical journals have stated that most articles are biased and incorrect. Google, which has 90% of internet traffic, is severely restricting information that does not promote allopathic makemsick care. Holistic information is buried. Wikipedia is nought but a rent a boy, similar to Web MD, chock full of lies and bull&s*t. (As an educator, I never permitted Wikipedia as a hard source for info.)
Recall that freedom is lost in small steps, so as not to awaken los sheeple.
JF asks: “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?
No, here in New China we are not free - it is just an illusion. I am installing Opera on my machine and deleting Google. Will have to change all my gmail accounts as well. And, like Banterings, “I have made healthcare as irrelevant as possible in my life.” No physicals, no old sucker poisons, no cancer screenings. Fluoroquinolones thoughtlessly prescribed to me have caused rapid cataract genesis, something they are “famous” for. I am using a natural substance to try and dissolve the cataracts, and seem to be making progress after 6 months. Having fired the ba%^stard that was my optometrist, I now have to find a new one and will report if eyesight is better, which will indicate some dissolving of the cataracts. No makemsick greedster is taking out the lens of my eyes – cataract surgery is often just another scam - but a HUGE profit generator, like colonoscopies.
As citizens in New China, we would do well to understand Einstein’s words: “Unthinking respect for authority is the greatest enemy of truth.”
And, please, Maurice, I have spent a at least a half hour clicking images to prove I'm not a robot. My Sunday off, I could do something much more useful with the time. Please fix or take off this feature! Such a waste of time and VERY IRRITATING! Many of the images are so blurry one cannot make them out!!!
Per usual, EO will end with her words of warning: The makemsick industry is the thinking man's enemy.
It is not just medical records, but "healthcare" itself that is being weaponized. Remember, freedom is lost in small steps, so as not to alarm los sheeple!
Interesting Medscape discussion. For most behavioral kinds of things if something was within societal norms when it happened I am mostly willing to look past it today. Times and societal norms change. For things that were wrong decades ago, I say it depends on what it is we're talking about. Redemption is possible for many things but not everything.
I've recounted the manner in which school physicals were done for boys when I was a kid. No provision for privacy at all. It would be very wrong now but it was within societal norms back then. I thus would not consider any of those school nurses or other staff to have been bad people for what they did. I don't like that it happened but I understand it was just the way it was.
58flyer's example of the nurse flicking him is a very different situation. Harming a teenage boy in that manner was wrong then just as it would be wrong today. The only difference between then and now is that today she would lose her license, possibly see some time in prison, and be the centerpiece of a lawsuit. Sexual assault against minors is not anything I can see ever gaining redemption from.
What the Medical Boards see as unforgivable is interesting. Dr. Sparks who sexually assaulted her patients for years got a slap on the wrist. A former physician that I know in the way you know everyone in small towns lost her license for insurance fraud and was denied when she tried getting it reinstated 10 years later. I agree her license should have been pulled for insurance fraud, but I'd also pull the license for anyone sexually assaulting unconscious patients.
EO et al: I have no power to control over that image identification annoyance, it is all a Blogspot.com "protective" mechanism which fortunately as "owner" of this blog I don't have to respond to get published.
By the way, you all don't know how much SPAM, I have to deal with and I do appreciate some mechanism to prevent automatic input of advertisements from some automatic computer robot somewhere in the world. ..Maurice.
P.S.- EO, don't get too frustrated, your lengthy Comments are appreciated in content. I'm sure others would also agree. ..Maurice.
With regard to the Medscape discussion video topic, how much detail would you want, as a patient or potential patient, to know about your doctor or prospective doctor's "shady" behavioral background? When, where and how would you want their story told? When and what can be considered "a thing of the past"?
Physician-patient history taking could or should be taken in either direction?
Should nurses also be questioned by the patient as the nurse introduces herself? Or will such patient questioning impair the patient's therapeutic goal? ..Maurice.
Dr. Bernstein, I don't want to interview physicians or nurses on their histories. I want the Medical and Nursing Boards to do their jobs and weed out the bad ones. Therein lies the problem. I see sexual violations as a problem but these Boards don't seem to. Dr. Sparks is Exhibit A. Then there's the Denver 5. Apparently they are still considered to have the moral character expected of nurses. And the Univ. of PA Medical Center that turned the OR into a photoshoot of some guy's genitals around the same time as the Denver 5. What are the odds any action will be taken in Mr. Kirschner's case?
Biker,
In response to your comments:
Interesting Misty. How does one make non-standard arrangements like that when we typically don't even know who the anesthesiologist will be until someone shows up in pre-op?
It varies at each hospital / outpatient surgery center. The best thing to do is to ask the surgeon to talk to the anesthesiologist or the anesthesiology practice that will be administering the anesthesia. The patient also could ask to meet the anesthesiology practice to discuss what kind of anesthesia he/she wants.
Some women have asked in advance for the hospital or anesthesiology practice to assign a female anesthesiologist for gynecological surgeries that require exposure of private parts so it is possible to plan your anesthesia team in advance.
For some surgeries that only require local anesthesia, an anesthesiologist may not even be necessary. For example, vasectomy is often performed in doctor’s office under local anesthesia so there is no need for an anesthesiologist.
Misty
Dr. Bernstein, I'll answer the question directly. I would want to know if my doctors or nurses have engaged in sexual abuse/improprieties/whatever you want to call it whether for entertainment or otherwise. For example if I were told the nurse assigned to me was one of the Denver 5 I would politely ask that I be assigned someone else. I'm there for medical care, not staff entertainment.
I suspect Medical and Nursing Boards don't really view the kinds of offenses we talk about as a problem if the offense occurred under the guise of staff entertainment, and that is what almost all of the cases we've discussed are, staff entertainment. The extent to which it is viewed as a problem is simply that the patient found out, and even then these Boards are quick to accept some lame statement from the hospital that they've addressed the problem.
Medical & Nursing Boards seem solely focused on the technical aspects of delivering medical care. Behavioral issues such as staff drug abuse or alcoholism are acted upon because that can jeopardize patient care. The Dr. Sparks, Denver 5, Mr. Kirschner kinds of issues don't directly impact patient physical care (note that I leave out emotional impact) in the same manner and thus aren't viewed as a problem. The staff just carried their entertainment a bit far is all; don't get caught doing it again.
Good Morning:
To add to Biker's list we also have Radonda Vaught the nurse at Vanderbilt University Hospital who gave her patient the wrong medicine which in turn killed her. The authorities saw fit to charge her with reckless homicide while the TN board of nursing decided that she did NOTHING wrong. There letter to here is here.
https://www.tennessean.com/story/news/health/2019/02/25/radonda-vaught-after-vanderbilt-nurse-error-health-officials-said-discipline-not-needed/2961464002/
All medical boards MUST have a civilian majority or this protect all healthcare employees first & foremost mentality over the public safety will NEVER stop.
Regards,
NTT
Maurice,
You have avoided my question as to the cause of your UTI and blood infection.You have simply parroted what healthcare says: there is a risk of these infections from the use of catheters. I was looking for your insight as a person, as a patient, and possibly as a neutral physician.
If you told me that you had been swimming in the LA River (with harmful levels of fecal bacteria and E. coli in the 20% range), then you would say with some certainty that it was not a hospital acquired infection.
I believe that you know (or strongly suspect) the cause of the infection, but the physician in you won't let the patient be honest. Too many of us here know what really goes on in healthcare, we are not buying that your infection just happened. Furthermore, as a physician (with experience using caths), having you straight cath yourself twice a day would be far less risky than a 3 week indwelling.
Most people do not the whole story of Twana Sparks: Her medical license was reinstated WITHOUT restrictions. A PR firm was hired to obscure the story of the alleged abuse in search engines. She is currently working with the local Democrat party, looking at elected office.
As to education of patients. First there is an obligation by the provider to properly educate, and that is the LEGAL requirement of informed consent.
Although the provider may want what is medically best for the patient, the means which they achieve it does NOT take the patient's values into account, it may simply be about the provider's convenience.
For example, Maurice needed a catheter, but he was not offered a male to perform the task. For many of us that participate here, that would be a traumatic.
-- Banterings
Now what I am about to write here to this blog thread may bring out a lot of anger either to me or the hospital staff and disagreement with my response but I think there is merit to the discussion to make this disclosure.
I was awaiting initial lab work and the obtaining of a ward bed while in the emergency room from late evening to around 2am when I was finally wheeled to my assigned ward room. Moments after the bed being rolled into the room where two or three nurses were present (I am not sure..I had been in lying in a lateral position and didn't see the staff.. about to get me clinically settled with IV and other essentials..when a female voice behind me asked me if I would permit a photograph to be taken of my exposed back and buttocks though I don't remember the staff's explanation, I immediately sensed the practical value of a photograph and promptly agreed without further conversation. Snap. Snap and that was over and the settling in bed followed.
Later, I thought again of the photos and the rationale and felt the permission I gave was appropriate for situation.
As you know, starting out as a bed patient, at the time of unknown predicted duration, there is reason to be concerned about the development of bed sores within the skin of the back and buttocks especially if the supine position was required for the IVs and monitor attachments and no obstruction to Foley urine flow. It would be for the hospital's legal protection to document whether there were already skin lesions on entry but also for my legal value to have documentation that there were none present on admission if sores did develop during my hospital stay (at that time hospital bed stay of unknown duration). It made medico-legal sense to me. Now it is true, no images were in my possession but I have to have trust in the system since I had to enter the system because I sensed I could not have proper workup and treatment in my bed at home.
So..that's it. I am anticipating sinister responses from some here but I think that my decision to allow the pictures taken was ethically and definitely legally of value for me personally. I did not request a photo copy at my 2 and a half day hospital stay.
What do you think? Anything "sinister" in what happened? ..Maurice.
Banterings, I am not sure what to say in response to your argument regarding the etiology of my e-coli urinary and blood infection. I never had it previously..so it was no recurrence. This infection can occur in males who have enlarged prostate impeding normal urine flow. It can happen in patients using twice a day catheter insertion. It can happen in patients who require a Foley catheter which is not removed (except replaced every 3 weeks)--all this was confirmed by a infectious disease specialist who attended my recent hospitalization. I am certain that this was NOT a hospital-acquired infection since I haven't been a hospital patient for 15 years. My infection then was West Nile Virus! ..Maurice.
Dr. Bernstein, I don't see anything sinister in it at all being they asked your permission and gave you an explanation. The only missing item is the staff in the room not having introduced themselves, my assumption being they didn't based on what you wrote.
I have heard than many hospitals do full skin checks on all new inpatients, or at least the sicker or more injured ones that might be bedridden for a bit. This is for the reasons you noted and also checking for any cuts or bruises that might have been missed prior to being assigned a room. It makes sense to me, though if it is a full skin check I want a male staff member doing it.
Maurice,
I was just looking for your insights as to the cause. These things don't just happen for no reason. You attribute it to complications of an enlarged prostate. Fair enough.
As to the photograph, you were asked and granted permission.
Nothing sinister.
Would I have allowed it? NO F'ing way...
Under HIPAA, the photos must become part of your medical record, so if you request a copy, the photos SHOULD be included.
Not remembering the exact reason for the photos, especially by the one who moderates this blog, says to me that you were either in severe pain, afraid, drugged up, tired, or a combination. If this was the case, it is easy to see how JR's husband was taken advantage of.
You also stated:
"...if I would permit a photograph to be taken of my exposed back and buttocks though I don't remember the staff's explanation..."
My question is was your back already exposed OR did they mean that your back WOULD be exposed for the photo?
The 3rd shift is not exactly the "A team" when it comes to providers at a hospital. It is usually the rookies...
I think that a number of us fear that you are a passive patient, that you will not speak up to protect your dignity. Perhaps that is your clinical training telling the patient in you that you are silly because they are all "PROFESSIONALS" there. Equally harmful to patients not knowing what is necessary is drinking the kool aid that medical education passes around to providers.
I say this with nothing but love.
Those of us here who have been hurt, LEAST OF ALL, want to see another hurt or disrespected in a healthcare setting.
I trust that you ae feeling better returning to the blog.
-- Banterings
Maurice
Well, I’m not impressed with their precautionary measure, besides it’s stupid!
Hipaa says that 1) If a photograph is to be taken of a patient it must serve and benefit a medical reason.
2) The camera that takes the picture must be a designated hospital camera, not a personal device, cell phone etc.
3) The patient must give permission for the photograph to be taken.
The photograph serves no useful means even in court. I’ve seen a number of patients die from bedsores. Who came up with
that redundant idea. Many stupid nurses think that a photograph is not a Hipaa violation if it does not have identifying patient
information in it. WRONG. If it were me I’d say no.
PT
Maurice
Another reason I think that taking a photograph just of your backside is somehow justified in documenting any kind of pre-admission screening is not only irrelevant, stupid and redundant. Here’s why. Patients get bedsores anywhere on their body. On the knees and heels or where their is bony protuberance. I’ve even seen bedsores on patients face and in the occipital region, all because nursesand staff were not diligent in turning patients, placing pillows under extremities etc.
In conclusion I can’t help but wonder who in risk, administration or some nursing director thought up this one. I’ve never heard of this behavior. You can’t help but wonder who reviews the pictures that not involved in the direct care of the patient. I sure hope that in your mind this dosen’t justify nurses in the Denver 5 who went back to review the dead patient in the body bag. Are we to believe that they were looking for bedsores POST-MORTEM.
PT
I was ill and tired at the time my bed was wheeled into the room and I really didn't feel motivated at that moment to try to turn around to view the nurses and engage in a conversation regarding the law and ethics. I just assumed the picture would be of general benefit based on my knowledge of hospital bed patients. I must admit though, as I recollect, that, as a flash thought, what just was happening was pertinent to what I have read on this blog thread. By the way, my wife who was with me in the emergency room and followed me to the ward was, I think, out in the hall and not involved in this decision-making. Believe me that is true!! And so now, back home, recovering, I thought the episode was worthy of presenting here. But as you recall from my initial posting today, I anticipated some critical feedback. ..Maurice.
EO
It's good to hear from you again. I was having problems with those pictures blocking me from posting to. Finally I complained to Google by using the search bar and asking them to tone it down. I don't know if that was the reason or not but it's much better now.
I wonder if medical/ health insurance and that package in general in the number one key the people in power use against us to put us in our place and keep us there. I have experienced a wonderful outcome once. My mom was pulled back from the brink of death once. She lived for ELEVEN MORE YEARS when it was questionable that she would live through the night. For it seems like she was that way for WEEKS!
What impresses me in a bad way about laws and medical is their power to MANDATE vaccinations and then they can't be sued if the patient given the vaccine is harmed or dies!!!
Biker. Boys being made to drop their undershorts in front of open doors and multiple females??? Even some students?? You don't think that wrong was being done? SOMEBODY made that happen! Believe me. I have sympathy for cowards. They are a large part of the problems but I still think they are less guilty than the main players.
What about Hitler's employees? They also were just doing their jobs. Possibly if they had refused to do Hitler's bidding, they might have endangered themselves and their families. That wouldn't have been the case for the secretary or teachers at the school though. They just would have endangered their jobs. JF
I totally understand being too sick or tired to focus on that which we discuss here. I recently noted that I was in so much pain after breaking a rib in my back slipping on ice last winter that I wouldn't have cared what they did to me in the ambulance or in the ER. Nothing more than my shirt needed to come off and every one was totally professional but I doubt I'd of cared if they weren't. Maybe afterwards I would of but not then and there.
JF, my point was that school physicals being done that way would be very wrong today but it was not considered wrong back then, hence I don't fault them and accept it was just the way it was even if I didn't like it. They were not operating outside of the then societal norms for what was acceptable for 6th grade boys physicals. My parents wouldn't have objected if it was brought to their attention. Boys weren't supposed to have any modesty and school authorities were just that, authorities to be obeyed. It was a very different world in the 60's.
JR said
It is worth wondering if the camera was hospital property or someone's personal phone. Check your mrs to see. Could be they took it to be on their wall of Drs butts. Had you received pain killers prior to this decision as they affect older individuals more. Why wasn't your wife in the room? Was she not allowed to witness this secret ritual of transfer and why does it need to be so secretive?
I'm not understanding some of the reaction to the skin check photo of Dr. Bernstein's butt. Skin checks of patient deemed to be bedsore risks are fairly routine. Taking photos might not but they asked permission first. Had Dr. Bernstein said no, they'd of still sought to do a visual check.
No offense to Dr.Bernstein who may have an exceptionable butt for a man his age, but automatically assuming in the absence of anything else being amiss that the staff is getting a thrill seeing the butts of sick old men is a stretch. I'm pretty modest but I'm not seeing anything improper here. Had Dr. Bernstein asked for a male nurse to do it, then the interpretation of events would depend upon how they reacted. He was OK with female staff and so there was nothing wrong with what they did.
JR said
Biker
Given what happened in the case of husbands old man parts I don't put anything past them doing. Dr. B said be educated and since this type of behavior is our experience I view all as being capable of the same behavior. Be proactive and know why especially knowing who owned the camera. If it was a private camera then crying after the fact does mot help. He should have asked if he didn't. Everyone should ask about any photos so they know. Do you think nurses do not takes pics just bc they can like has been documented on this blog like in the case of the deaf man's penis. Nurses may like for whatever reason to have compromising pics is Drs especially since many feel Drs don't appreciate them. We learned our lesson the hard way and will NEVER assume they will act in good faith ethically or morally again.
JR, at the moment I was asked permission for the photograph, I was sleepy, tired and felt sick. The nurse, who was behind me, while I was lying on my side, made this as the first instruction prior to helping me lie on my back to proceed with the other nursing chores on entering the ward room. I had no thought of consultation with my wife whom I did not see as I was facing away from the door. My response of "OK" was quick and based on a knowledgeable rationale from what I instantly felt was a rational request. I was in no condition to go into a philosophic or legal-like discussion, even if I intellectually disagreed with the request.
How does my experience differ from another "modesty" issue such as that rationally described by Rick? I was intellectually understanding of the rationale for my physical exposure, Rick was not and did not know how to respond to what was happening and so truly emotionally, psychologically suffered. Of course, there was other differences in that Rick apparently had a emotionally upsetting prior history and I had not.
I still think that some advance understanding of medical system protocol contributes to making the experience more under the patient's control. ..Maurice.
Biker,
The whole point PT is making is that there was no medical reason for the photo. It doesn't matter if they asked or not. It is the fact that this was ritual and not evidence based medicine.
I wonder if Maurice has enough curiosity to get a copy of his medical records and see if the photos are even in there let alone with an explanation.
As to the myth of "...as long as no individual identifiable information is present in the photo..."; as PT alluded to, that is not the case with the law. Beyond that, a mole on a person can identify a specific individual. Hw many moles cover our skin? Scars are individual identifiable.
This is the same way that fingerprints and iris scans (eyes) are individual identifiable. I would argue that with the quality of today's digital cameras, a picture of the hands can allow one to zoom in on the fingerprints.
Informed consent is not only asking permission (which is status quo in healthcare today), not explaining the reason why.
My friend up up north had his PCP order PSA testing. The only discussion came when he refused (twice).
-- Banterings
JR said:
The point is not at this date is not whether you said yes or no to the photo but on whose camera was that picture taken? There is a pic but you have no idea on whose camera it is on & that should be very troubling regardless of having an old man butt or not. That pic should have been taken on a hospital owned camera period. As for your wife, it is always important for you the patient to have your advocate with you whether you anticipate abuse/violations or not. Everyone should have that safety measure. As we learned the hard way, you cannot count on each & every staff member to do the right thing. It only takes one & that one may control the others to go along w/ whatever harm or prank they have in store. You don't know is the point. You assume, like we did, that the care givers are good people only trying to do the right thing. We were wrong. However, I feel you do not think what they did to my husband was wrong. It is my feeling you think that exposing him medically unnecessarily was okay even in his drugged state which rendered him defenseless. He had no choice but to suffer through whatever they did to him. He was restrained and drugged. His exposure was not 5 minutes, 10 minutes but literally hours. Do you have any idea what this does to a person's mental well-being? He never had issues before w/ medical care but bc of this, he does now. This was not we need to check your foley as he had none. This was not just checking his groin wounds as his penis did not need to be uncovered and especially for hours in front of scores of non medical personnel. Sure, everyone has essentially the same body parts but we wear clothes so no everyone can see those body parts. They were covered so it does make a difference. As Banterings has explained, this is how torture is conducted. A naked, victim in a room full of clothed people automatically makes the naked person more vulnerable & defenseless. Is it not an oath to guard each & every patient's personal dignity in most hospital patient bill of rights? So how can healthcare be called compassionate, caring, & patient centered when they treat patients, any patient, so callous & uncompassionate? Is it bc they were counting on the versed to erase his memory of how terribly they treated him?
EO,
Your remarks are very insightful. As for the vaccines, I often wonder if my son developed Type I diabetes which is an auto immune disorder bc IU mandated that student teachers get vaccines before student teaching. His slide into type 1 came a few months after that. My son was rarely even ill during his life before diabetes. Of course, if big pharma would spend as money on research as they do the insane tv ads, etc. there would be a "cure". However, cures don't make as much money as all the drugs and treatments so most disease will forever remain uncurable but "treatable". Vaccines for kids are much like rabie shots for animals. They too are a sickening hoax. One shot will last most animals a lifetime. If they are to get something like cancer, it will most likely develop during the time shortly after the vaccine. It is said a natural cure for the rabies vaccine is to give dogs green potato peelings. I do. They have their tags but they also get the peelings. Your comments about new China are also spot on especially when you become a part of the healthcare systems where there exists no rights for anyone who enters as a patient. Sometimes they let you think you have rights but really it is just a game until you don't. I am w/ you & Banterings--Burn Baby Burn to the bitter end! Maybe that would cure our PTSD. JR
I think most patients would be highly upset with being treated like Rick was. Prior abuse or not. Rick's treatment was blantonly abusive. If he had retaliated by pulling her pants down , even if only he and two other people saw her he'd be in big trouble.
Biker, about the school physicals, sometimes treating other people right takes a little effort. Somebody should have shut the door and seen to it that it stayed shut. Every single non medical female should have removed herself from the room. The principal should have had a male doctor or nurse do the physical and a male chaperone.
Actually the whole thing should have never happened at all. Did they have a plan for the boys who weren't up to par? Were they looking for signs of child abuse? They would have been looking at their backside if that was the case. It seems like they could do whatever they wanted to a kid in that time period.
Also if you have noticed people can justify any wrong behavior they want to do. I heard on TV once the rationale of the reason certain fathers felt that they were doing a good thing by having sex with their daughters. They wanted their daughters to know the difference between a man who cherished her. They wanted her to be treated gently the first time. JF
Good Afternoon Ladies & Gentlemen:
Could they have wanted the pictures of Doctor Bernstein's backside to use a a baseline to have for verification no new bedsores were developing? If each shift checked for sores they'd use the pic as a reference to know if anything new developed while he was laying there in bed.
Just a thought.
Regards,
NTT
Banterings, going to your last statement regarding your friend's PCP ordering PSA testing. "The only discussion came when he refused (twice}." Current advice to the medical profession is that patients should be made aware of the uncertainties of significance in the values and changes of values of the PSA test. It should be a final decision by a patient who has been educated by his physician how the PSA value has been, in recent times found. by studies, not always meaningful of diagnosis or even prognosis, since many prostate cancers are static and the PSA's value for determining the need for invasive workup or prognosis of an identified prostate cancer is not absolute. The physician not educating the patient first about this current view before ordering or "interpreting" a PSA value already obtained is currently a professional wrong. ..Maurice.
Postscript to the current Comments here. I am pleased that there may be consensus in the opening theme (with the pile of books) of this Volume about the need for patient education prior to "having something done". ..Maurice.
Maurice,
That is agreed by all. Unfortunately that is the status quo. I really disagree with the new recommendation for PSA that it be a shared decision. EVERY MEDICAL DECISION SHOULD BE A SHARED DECISION!!!
If PSA testing was recommended for all men, would there be no conversation about the risks and benefits?
What if a patient refused?
Then what happens when the science is review and screenings that physicians forced upon patients (because the screening was recommended at the time and shared decision making is not part of routine recommendations)???
The answer is that the physician looks like an idiot, the patient knew that he was right (in not wanting screening), and EVERYONE loses trust in the profession of medicine.
EVERY GUIDELINE should start out"
It is recommended to (not to) screen for condition or disease by the following method xxx in the population of xxx, ONLY AFTER a discussion of the RISKS, BENEFITS, and ALTERNATIVE SCREENING METHODS are discussed between the patient and physician (shared decision making), and a mutual decision is reached with the patient preferences and goals not only being respected but being paramount in the decision.
-- Banterings
SURPRISE!! So based on Banterings and JR advice, I went now on my computer to the summary of my hospital stay (a part of my overall medical summary available by personal password and where I had reviewed my labs) and clicking "Clinical Image"...there it was---the photograph that was taken I, out of my personal modesty, will not reproduce the image here but I will describe the giant image that I just saw.
Lying on my left side, at the top left was two purple gloved fingers on the right bare hip. Immediately below is a 15cm ruler with the date written on it and attached to the ruler a patient identification sticker for with my name and identification. Below that is a clear picture of my bare lumbo-sacral back and buttocks, mostly the right and a bit of intervening scrotum and a bit of the underlying sheet.
I found no skin lesions in the area photographed.
So that's the result of the photo taken moments after entry into my assigned room. I'm satisfied. It is a worthy document both for the hospital and myself. ..Maurice.
Maurice
Surprise!! That photogragh is worthless. It’s a worthless document because it dosen’t entail all anatomy that is subject to pressures that lead up to a bedsore resulting in infection and osteomyelitis. But then in your mind you and I both know that. Even more stupid is the fact that the ruler is only accurate for measurement of tissue in proximity. My guess is that facility was sued and this is some stupid requirement that some brilliant person in risk management proposed.
Hospitals do really dumb things that are knee jerk reactions in many cases that subject all patients to worthless scrutiny giving opportunists reason to be wierd. A camera for instance in icu units, yes let’s get all the eyeballs possible looking at that patient every moment of the day despite the electronic monitoring for heart rate, blood pressure, o2 sats and respiratory rate and a nurse, respiratory and hospitalist in the unit. It’s just stupid!
PT
JF, yes they could do as they chose with the boys back then, and parent's wouldn't have objected for things as routine as a physical. I only remember that physical because I was a shy kid. I didn't like it but we boys knew if we objected we'd of gotten in trouble with our male gym teacher who was the authority watching over us. 6th grade was also the start of mandatory gang showers with the gym teacher watching to make sure we all did it. As one of only two early bloomers in my class I was very self conscious because I was aware that made me stand out, and shy kids don't like to stand out.
I can remember a group physical when I was in 1st grade where 4 boys at a time had to strip down to their underwear in the outer office of the principal's office where her secretary worked. Then when it was our turn we all went into the principal's office where the female school nurse did her physicals, with the principal watching.
This was all normal back then and any boy that objected would have been thought to be the one with a problem. It was a different world that no longer exists in school settings because at some point along the way society decided it wasn't acceptable.
The difference between then and now is I can speak up and object to the modern day accepted current practices that I don't like. Society today says it is a normal and acceptable practice for a female scribe and female LPN to watch a male patient get a full skin exam. I disagree and I have the power to object. In the 60's objecting was inconceivable for a kid.
A lot of things were deemed acceptable that actually weren't. For instance certain intensity of whippings. Not just everybody can tolerate the pain and humiliation.
I saw on a true murder story last week about a young girl suddenly come up missing. After the story unraveled, it turned out her good friend ( a boy ) had done it. I think they were pre teen. They'd been playing some version of baseball, just him and her. She ended up accidentally hit by the bat and was crying loudly.
He panicked because he was afraid his dad was going to beat him so he hit her a few more times to quiet her down. He quieted her down alright, and she died.
Another story, not quite as tragic was me when I was 7. I carved a word into a bedroom dresser. I didn't know I was doing anything bad. My 6 year old brother got blamed for it. First my stepmother whipped him for it and after she finished up my dad whipped him again. He kept telling them he didn't do it. I felt so horrible but couldn't bring myself to owning up to anything. JF
JF, in 5th grade my best friend shouted something out in class and got the crap beat out of him by the (male) teacher. He beat him with one of those long sticks with a hook on the end used to pull the overhead screen down for films. His mother complained to the principal and 3 days later she came to our classroom to talk to my friend. She saw the welts still on his back but nothing happened. The teacher wasn't arrested nor was he removed from the classroom. The 60's was a very different time, and boys were just supposed to take whatever was dished out to them. The "manning up" socialization in healthcare and elsewhere was a societal norm. This is why most men are loath to speak up in healthcare. The socialization to see it as a sign of weakness is deeply ingrained. We who speak up are the brave ones.
JR said:
Part of patient education is to know who took the photo on what device. It is good it is in his file but still unknown on what device. Like in the case of my husband-- was drugged & not ill, that is the time if you are going to be taken advantage, it will most likely happen as they know you cannot defend yourself & you are alone w/o an advocate. Not questioning is what they count on. Knowing about the whys of this pic is part of the education process Dr. B. says a patient should know about.
PSAs are tricky. They can vary from lab to lab too. Many PSAs have false positives & cause many needless biopsies to take place. My husband's had risen only slightly & the drop your pants & bend over in front of the everyone exam did not show any prostate enlargement. He was in his mid 50's. The cure itself is not w/o its own set of gifts from the medical community. If he had gotten all the subsequent treatments they had said he would have to have, he would have had an even worse quality of life. They suggest all these treatments w/o any regard of the decrease quality of life. He has been cancer free for about 14 yrs now. Hospital from hell put in his file he had been non compliant about prostate treatment bc of this. He did not have his prostate surgery done there. This is another reason why he would have refused the PCI as it uses massive amounts of radiation during the procedure & he would have refused it due to his fear of radiation & previous cancer & it fueling new cancer. The next most likely place would be bladder cancer. Just another on the list of knowing he was not given informed consent or even coherent enough to understand what was going on. The radiation would have panicked him out of his mind. Having had the prostate surgery is one reason for being at higher risk for heart disease as we now know. What a wonderful thing modern medicine is in that one cure causes the need for other cures and so on and so forth. The medical community knows it but we only find out long afterwards when it is too late. Drs. are the masters of misinformation. Just look at their gold standards of treatments that currently bring in the big bucks that everyone will get. Pretty soon these preferred treatments will give way to another gold standard that will too wreck havoc w/ the patient's quality of life. This is done all in the name of accepted standards of care. But whose accepted standards--the patient or the doctor? Who has to live w/ the results forever? JR
Is it society that thinks it OK ,or maybe the lawmakers who think for us? JF
Dr B, You're not embarrassed being seen exposed in medical situations. Not everybody is. Some patients actually get a sexual thrill from it.
It's the patients who are embarrassed/ humiliated that need protected, not pushed through the cracks because everyone should feel the same way as the non embarrassed!
JR thinks that you don't see anything wrong with how her husband was treated ( for now I'm speaking of the exposer part. Not the damage done by the unconcented to work done. Medicine given , huge bill.... )
Is she right? JF
JF, I really have no final conclusion regarding the good or bad which was going on with her husband though I see JR, understandably, with her knowledge of her husband's experience, is the person on this blog thread who is the best personally to come to a conclusion. And as moderator, I accept that.
We teach medical students that when they take a history from a patient, it is the patient's history and it is important to dissect the history with direct questions to the patient about some clinically important points. But it is the "patient's history", important information, but still the patient's history as told and explained by the patient and has to be taken as such.
That additional history is not to be ignored but cannot be instantly verified and a final conclusion made but can be the basis for further direct questions and attempt at direct emotional support if that is needed, though it still is the patient's story. Physical examination is different since it is what the student observes, palpates, percusses, auscultates and being aware of the patient's behavior or reactions during the exam that can lead to a proposed conclusion. But history is history and critical aspects should be followed up by the physician with attempts to get details from others including previous physicians or institutions.
Sometimes, as in Rick's case, the history is detailed sufficiently to make a conclusion as a generalized statement about the event itself, however obviously that was not acceptable to the patient since there was much more emotional past history that affected the value of my generalized advice. And since, this environment is not a one to one patient-physician clinical interview, I provided generalized advice to all my readers on the immediate history provided.
This is a blog discussion thread and not a clinical interview--pertinent difference. However, I am not against emotional ventilation here since I do think it has therapeutic potential in one way or the other. ..Maurice.
JR said.
JF
You can see from all the run around in the post that no Dr. B does believe my husband suffered any injury from the constant unnecessary exposure. He clearly thinks from Ricks story there was harm. I don't understand how such exposure can be devalued while another isn't. It should not make abuse violations acceptable since my husband did not have documented prior abuse history. I am not sure what the h & p had to do with your question. I too am offended like Rick and will be carefully reconsidering if I want to continue on this board even though I respect most of the contributors. JR
JR
To me it seemed like he didn't understand Rick's harm either. He seemed like whatever harm he experienced was because of prior abuse and if the prior abuse would have not happened Rick would have been fine with what was done to him.
I sometimes wonder if Dr B has EVER experienced any kind of embarrassment over nakedness in his entire life!
I still think he's a good person. He's just stumped that people exist that are embarrassed over exposure and questions whether or not it's for real. JF
JR, there was a difference in presentation between your husband and Rick. The difference is that Rick "spoke" for himself here and apparently your husband has not. Of course, we are all engaged in the description of your observations and conclusions but there is a potential difference in the way distress is expressed as written by the patient and the wife of a patient. Clinically, of course, as medical students or physicians we are interested in the history and reactions as described by a family member of the patient. However, if the patient is available and able to communicate, we aim to hear the history directly from the patient, him-herself.
The way the patient's symptoms and emotional concerns may be different than how interpreted and then expressed by a family member, such as a wife, like you, who has been a witness and validly expressing your own feelings and your evaluation of your husband's feelings.
I look at all that is written by my visitors here both as a physician and medical instructor but mainly as a bioethics blog moderator where the goal is to try to provide fair and full access to all views and set limits to the quantity of my own opinions, though I do try to respond to issues when challenged (for example, my uncertain issue of "statistical outliers as those who are presenting their bad medical system experiences here". Note, i AM NOT denying their experiences and presentation but I have expressed concern about the ratio of such experiences relative to the general population.
JR, you should continue to write here what you experienced and know and your husband is strongly invited to write and ventilate his understandings and emotions here. But don't expect me as Moderator (not Commenter) to make specific conclusion based on validating the history presented. Stay around since you are read and responded to by the others here and that is what a discussion blog is all about. ..Maurice.
JF, I didn't publish here the picture taken of my butt on hospital admission for general viewing, so I am not of "nudist" orientation.
However, I look to those who take care of my medical state to behave professionally and not engage in comparing one naked body with another when they are supposed to be attending to my clinical condition. So far, throughout the years I have seen no unprofessional behavior--even well before I obtained an MD degree. Am I the "statistical outlier"? ..Maurice.
Maurice
If you ever do experience it then how will you interpret it? Just an anomoly of human behavior in the healthcare industry. An unlikely probability of events that are of no real consequences because they managed to get you well didn’t they? What is the point of having all these warantless guarantees of core values, trust, oaths, most trusted profession, wearing white coats, titles, licenses etc.
What is the point of having doors, curtains, privacy dividers, gendered restrooms, exclusively females as mammo techs,L&D female nurses and for the first time more female residents than male residents in OB/GYN. It all sounds like a fake front to another business as usual. Whatever has been structured in healthcare, well that’s just the way it is but yet any minute changes will have to be fought tooth and claw from here on.
PT
PT, if that is the prognosis from the past and now into the future-- then what are all those millions and millions of potential patients or actual or former patients going to do about it? Moan and groan.. or DO SOMETHING to CHANGE so that everyone, everyone male, female or other finds comfort and benefit at all times and under all conditions in the future..hopefully the near future. Something, then, must be started, must have universal support. I don't think just writing a book is the answer. If people are talking about "Medicare for All" beyond just the issue of financing, the population of the United States should force CHANGE of the medical system's various behaviors--make them ethical and make them for the "Safety and Comfort and Decent and Ethical Behavior and hopefully a Better Life for all."
Regardless of my "benign" personal medical care history--I would want everyone, when ill, to be fighting the illness and not have to fight the medical system with its various misbehaviors or worse. That has been my goal and I have always encouraged all to SPEAK UP AND DO SOMETHING to create that change. Grumbling here on this blog is not enough. Go ahead and begin the fight "tooth and claw"! ..Maurice.
Maurice,
I have a question about your treatment; if you had been asked to allow a student nurse assist with your catheterization or a student doctor or resident perform a DRE (knowing in addition to the attending), would you have allowed either or both?
In the same manner you would have been presented with an explanation that makes the situation appropriate.
-- Banterings
Banterings, you actually asked a very pertinent question which I had not previously disclosed about my hospitalization and which I had not previously mentioned here.
On the morning of my scheduled day of discharge from the hospital, the new day shift came on with the nurse asking me whether I wouldn't mind having a nursing student attend to me too. I agreed. It turns out that the female "student", I found out later had completed all her academic work at a local nursing school but was now being exposed to "practical" work and observation within a hospital itself. As part of this "practical experience with patients", the hospital itself was said to be evaluating her for actual employment by the hospital.
Later, she (alone without the nurse) came in the room with a stethoscope telling (I can't remember if she asked permission) me that she was to perform a brief physical. After taking my temperature and blood pressure she then listened to my heart and lungs through my gown for heart and breath sounds and lightly palpated my abdomen through the gown. And finally very briefly partially exposed my catheterized penis for 2 seconds. She then left and I can't recall what she said on leaving. The chore, whatever she was assigned to do, had been completed and I didn't see her again through the remainder of my hospital stay. That's about it. I wasn't in a mental state at the time to have her explain to me her findings, as I would to a medical student when I am teaching physical exam on a hospitalized patient. I know and I was surprised that the registered nurse was not in the room supervising. So that's that. I expect criticism here about my behavior if not that of the student-- then ME!
However, this is what happened. You know, maybe as an instructor of medical students I am a bit more understanding of the value of a patient as means for student education.
My only concern and question is where was the supervision or patient feedback if this exercise was also an activity by the graduate-to-be, which was part of an evaluation for employment.
In your responses, please be kind to me--I was very sick and just recovering enough to be allowed discharge and home. ..Maurice.
Dr. Bernstein, only you get to decide what you are comfortable with and so I see nothing wrong with whatever you agreed to and were satisfied with as concerns professionalism etc. That others here might make different choices and/or interpret the actions differently doesn't matter. We each make our choices and interpret things as we will.
I do think a far more valuable lesson for a female student nurse, tech, or physician than doing the intended task at hand would be patient push back on the gender/modesty issue. The sooner they learn that it is an issue for some patients the more sensitive they will be to the issue.
I will say again, that when we are sick and tired, many of us will let things slide that we might not otherwise.
Biker, I totally agree that the beginner healthcare provider be aware of the concerns and feelings of many of those writing here. In the case of a hospital where there are no male nurses on this one shift on this day and the male patient, as an example, "speaks up" to the female assigned nurse and demands a male nurse should now take over his management, what should be the appropriate and considerate first reaction of that assigned nurse? ..Maurice.
Maurice
Your example is one of the reasons why I don’t allow student nurses or residents in my care. I’m not responsible for their training nor am I responsible for their education. I’m paying for my healthcare, not to train someone using my body as a practice template.
PT
Maurice
You said “ the student nurse said she was to perform a brief physical and lightly palpated my abdomen through the gown and finally very briefly partially exposed my catherized penis for two seconds.”
Not sure how many fodder points and jollies some people will get reading that. There should on this blog be a jolly scale that some posts generate a jolly scale from 1-10. Too many sick people out there and I’m not talking about physical illness.
Now, as a medical person I just can’t even begin to imagine what information this student nurse would glean from palpating your abdomen or for that matter through the gown. She looking for positive Murphy signs, checking for rebound
Maurice, can you see me laughing right now? Oh, I’m sure she ran back and checked on the student nurse’s worksheet, yes he has a urinary catheter but would never state that she almost tripped over the tubing cause she didn’t notice the foley bag on the floor.
She’s on the fast track career after working as a cna for 5 years and finally, finally got accepted into the grand onion nursing program despite having to repeat basic algebra for the second time. Her nurse preceptor didn’t care about supervising this wanna-be. She’s too busy out smoking and checking her Instagram.
Maurice, can you see me laughing 😂 right now. I know you will write some comment that justifies the reasoning cause you were too sick and tired and don’t remember. We will go easy on you right now and do appreciate I’m doing all I humanly can to holdback a truckload of sarcasm.
PT
JR said:
JR said:
But even if he doesn't express himself it doesn't make it any less what happened to him vs. what happened to someone who is able to talk about it. I have described what I saw & I have described what he actually experienced. It does not matter who told it as the fact it happened doesn't change or lessen what happened. And I am not even talking about the other issues such as the medical assault, falsifying of medical records, billing fraud, isolation, lack of care instructions, inappropriate release information, etc. I am just talking about the constant, medically unnecessary exposure. No human being should have to be treated in such a violative manner. For people who are supposed to have been trained in compassionate, professional, and respectful/dignified care, it is totally unacceptable and should be thought of as being criminal. I don't care why they did bc there is no justification to abuse someone who is defenseless & in your care. As I have stated, he has never had any issue w/ female staff providing care before this & would have accepted having to be foley cathed by a female if needed but that was not the case. His exposure was totally malicious & heinous in delivery. He was literally put on display. He was left exposed & trapped--his mind worked but his body didn't respond. It is akin to being fully restrained knowing your captor(s) have total control over what torture they want to perform on you. From the medical point of view, I know this concept may be alien as maybe you have never had any sinister thoughts/plans to carry out on a patient but medical providers are human & there is no way of truly being able to gage which ones may have their own mental health issues until something like this happens. Even then, it is still impossible to get this type of behavior derailed as no one is willing to see why this happened so we both know it has happened before & will happen again. This encounter changed everything. As w/ Rick, apparently he wasn't as ready as he thought to talk about it. And no my husband has not typed on this blog but that long account I recently typed is his thoughts recorded when he was in hypnosis. My husband, as many men, doesn't like talking about things. I do as you have well witnessed. During medical appointments especially after the abuse, he has charged me in talking w/ them. He wants as little to do w/ them as possible & tells them as little as possible which has probably labeled me in their files as being a difficult wife who doesn't let her husband talk but that is his wish. JR
JR said:
He doesn't want to share w/ them how much he now loathes each & every one of them as he's not sure who will be the next abuser. I want him to talk & tell the world but that is something I cannot force on him or that would be me in same league as them being someone he trusted to not do him harm but actually did massive amounts of harm. Clinically, he knows they already have not listened to him which is what lead to his medical & sexual abuse. He has also witnessed medical providers since that time devalue & dismiss what happened to him which makes him mistrust them even more & shut down. I don't know if most are not trained to deal w/ what happened to him or if they dismiss it as not being important but it doesn't matter to him as they makes him automatically freeze. Bc of this abusive encounter, how he perceives & deals w/ medical people & health issues have changed entirely. Medical encounters never bothered him before but now he has more than white coat hypertension which of course, he does have. I don't believe someone who has not experienced what happened can fully grasp the damage that has been done. I also don't think most medical people can accept that something so heinous happened for any number of reasons. However it is the denying, dismissing, deceptiveness that allows this type of thing to happen. Although I do not believe what the severity of what happened to my husband happens to everyone, I do believe on a whole that most medical people think their judgment & decisions are supreme and that patients do not have the right to personal privacy being respected while they are a patient. I think many of the stories on this blog verify that concept. Again, not all medical providers may think or act that way but enough do that real harm is caused by people mostly males avoiding medical care. He wants me to talk as he wants change but he is not ready to become part of the spotlight. I too want change bc I absolutely hate what was done to him & everyone who has had a part in what happened. I don't want what happened to him to happen again to him nor to anyone else except to those who have inflicted this pain on him & anyone who they love I also hope they have a chance at receiving such abuse too. Right--wrong I don't care bc if they are victimized or especially if someone they love is medically victimized they well get to feel how their actions have hurt & harmed any number of patients through the years. JR
JR said:
And yes, Dr. B. I agree that if you don't have a problem w/ your care there is none for you. I only raised the camera issue to see if you knew whose camera it was. If you don't have a problem knowing the ownership of that camera then for you, it is no problem. For me, it would have been a problem if it was someone's personal cellphone. You were also at a teaching hospital where it is expected you will be taught upon.
However, what I don't like in what I have been reading is that since my husband was very ill & hospitalized, he should have been too sick, ill, etc. to have any care or thought that he was being sexually abused. To me, it is that type of attitude that allows any sexual abuse to flourish. Having stipulations like it is okay to expose or sexually abuse a patient when they are ill but not when they are in a dr's office is really beyond my scope of understanding. To me, it is when you are ill & totally defenseless that your dignity/modesty should be more carefully guarded by them as you are too ill to defend yourself. So if what I am reading is true than my husband should have no complaint or ill effects such as PTSD from his sexual abuse/excessive, unnecessary, prolonged exposure as he was very ill and drugged. What a crap of a rationale. It is no wonder they don't care bc the rules of what is acceptable exposure would depend on how ill you are. Maybe their first question after who is paying for this care should be are you too sick to care if we expose you bc we are too lazy to cover you, we don't care who sees you, we like to be entertained by making you feel dehumanized, etc.? By the way, nursing textbooks & classes do cover patient modesty so it is not an unheard concept for them. It is a choice they make in how they choose to deliver patient care. At least for Dr. B., that nurse had a "reason" to briefly expose his penis & that would be to check the foley cath entry for issues & hopefully she would recognize an issue if they were one as she was unsupervised. I am w/ PT, I don't allow to practiced upon as I pay money to them & they don't pay money to me for my services. I don't care about their education just as they didn't or wouldn't care about mine. JR
Dr. Bernstein, if the patient asks for a male nurse or tech and there isn't one that the female staff member can switch off with, perhaps the single most important thing she can do is acknowledge the concern the patient just expressed. I think that is often the missing piece. If instead of acknowledging the concern she immediately moves into dismissing it she'll have eliminated any chance of gaining the patient's trust. She needs to start with something like "Yes I know some men are more comfortable with a male staff member doing this" rather than the standard mocking/bullying phrases "We're all professionals here, you don't have anything I haven't seen etc.".
After acknowledging the concern the patient has expressed, then she can move into the fact that there aren't any males and explain why the procedure is necessary, how his exposure will be minimized etc in hopes she can gain his trust. A little understanding and empathy will go a whole lot further than mocking & bullying. As a patient I want to know she is concerned with my comfort rather than just her own.
JR said:
As far as a book not being the answer, it is better than nothing. It may help getting people educated if it can reach people and they can relate to it. Letter writing does nothing. You can't be sure anything ever gets read which I am pretty it doesn't. Unless someone has a really big social media presence, social media doesn't do much either. There are a couple of organizations I have found that I am going to contact. They like these kinds of stories that grab headlines. It is time for all to know what really can happen when you have an emergency illness. Everyone needs to know about the power, control, and greed that is our healthcare system. While not every healthcare worker is bad, even one is too many especially in life/death situations they deal in. Just being lucky they didn't outright kill him is not acceptable as they are, in fact, killing him a little at a time by what they did. The lesson we learned is when you are sick/tired is when they know they have more opportunity to abuse/violate.
I am fine w/ those who don't care how they are treated while ill bc they is their choice. However, there are those of us who do care and think perhaps when we are ill is when they should be even more respectful & compassionate but that is also not saying they can be less so during ordinary times. To me, healthcare workers are one of those groups whose actions should be beyond reproach. They deal w/ such sensitive matters & info this is the way it should be. However, it would seem too many may have issues that directly affect patient care. JR
JR, I have no problem with you ventilating you and your husband's experience with the medical system. As you see, I have also been ventilating here. I really didn't have to present my recent personal medical issues such as insertion of a Foley or my hospital experience as a potentially very ill patient with a couple of incidents for my personal ventilation. I could have kept it for my wife and family. But I thought it would be of value to the worth of this blog thread to make a few of these experiences for discussion since this is what this blog is all about. I encourage ventilation and writing a book is certainly of value to you in this regard. My only advice is that something more needs to be done to make the changes necessary in the medical system and we should discuss what to do next to make those changes. ..Maurice.
Biker says
“ Yes I know some men are more comfortable with a male staff member doing this”
I think a more appropriate response would be as well to ask “ why don’t you hire male staff in these areas? And who is your director?
I’m sure you don’t have this issue when it’s time for your mammo, delivering your baby or your visit for your OB/GYN and especially
a visit to your female urologist.”
When is the word discriminatory going to start being used and used appropriately.
In other news Brittany Zamora, a married school teacher in Arizona was sentenced to 20 years in prison today for having sex with her
13 year old student. I think we are now beginning to see laws applied evenly in the courts.
PT
JR
Said “ that nurse had a reason to briefly expose his penis and check the foley cath entry for issues”
Whaa?
Where have you ever read that?
Where did you come up with that?
The end of a urinary catheter has an inflatable balloon at the tip whereby once inserted the balloon is inflated
which serves as an anchor. This is the prime reason you never ever use a foley tray meant for a female on a
male. Imagine, the balloon being inflated in the urethra. Don’t think it dosen’t happen.
What’s more important is what’s in the foley bag, volume, color and does it needs emptying.
PT
PT, I fully agree. It is the Foley output which is important and to keep the flow moving and old urine not just sitting around in the bag over prolonged periods. In retrospect, I should have asked the nurse-to-be why was that momentary inspection of the tip of the penis necessary. I can understand auscultating the heart and lungs and palpate the abdomen though I don't recall her percussing over the kidneys..but to be honest, I was in no mood to start a teaching exercise.
..Maurice.
JR said:
My husband had a foley after his prostate surgery so I did not dream or make up anything. The tip of penis needed to be inspected for discharge, extreme pain, etc. Also, when in bed, they need to check to see if any urine is leaking from the cath. & I wouldn't think a visualize inspection of the tubing would be out of line either. Of course, the urine in the bag is important. Those instructions were from 13 years ago so maybe today it is not a thought about the tip of penis becoming inflamed or a big deal if there is leakage from the penis area onto the bed or even if the tubing gets bunched. Actually, I have read from several sites still confirming the need for visual inspection. When my father was dying, hospice from hell told us to inspect & clean around the catheter for signs of infection but that was left to my stepmother as I didn't feel it was appropriate to totally destroy my father's dignity. I am not medically stupid either & knew the difference between a female & male urinary catheter.
Since children are a number one priority it is not surprising about another conviction of a female teacher acting criminally. However, the protection of hospital patients especially when the are "elderly" males are far from being important or even on the radar of anyone caring. There is no real organization that stands up for patient rights or even the rights of older people. Most of the so-called senior advocate groups fold & buckle under pressure. They, too, like lawmakers fail to represent the people that are supposed to represent.
JR
PT, a student nurse has absolutely no control or responsibility for the staffing mix of the facility she is doing her clinicals in or for the student mix at her school. That there aren't any males for her to swap off with is not her fault. I only hold people accountable for what they do or what they can control. She is accountable to acknowledge your request in an appropriate way and to help you elevate your request to the charge nurse if that is what you want. If you allow her to proceed with whatever she was going to do, she is accountable for the manner in which she does it.
I have not been an inpatient since I was 11 years old. Everything since has been office visits, ER visits, outpatient procedures, and day surgeries. I thus have no experience as a modern day inpatient with round the clock care from a periodic changing of staff such as Dr. Bernstein just experienced. That poses a question for anyone here who may know the answer.
If for example a male inpatient does not want a female CNA(LNA in VT & NH) helping him shower and upon request for male staff is told that area does not have any male CNA's, can he ask the charge nurse to pursue finding a male CNA elsewhere in the hospital? Of course he can refuse a shower altogether but assuming the hospital does employ male CNA's elsewhere how realistic is it to be accommodated in this manner? Perhaps it is my bed bath experience as an 11 year old that haunts me but I'll let a female staff member catheterize me long before I'd allow her to bathe or shower me.
Maurice,
I see a couple issues with what happened:
The most glaring is her NOT asking SPECIFIC PERMISSION to expose you. Next is not explaining why she WANTED to do that (there is NEVER a NEED to). As you pointed out, she did not examine the kidneys.
Did she check the tube for kinks (free flow) or the bag for hematuria?
Another problem is that you were sick, in pain, and not mentally focussed. IMHO, they violated the concept of informed consent by NOT explaining what they WANTED to do, AND the purpose for it. If this had been doe, you would have a better recollection of the clinical reasoning other than "it seemed appropriate at the time."
I suspect that the staff realized this, and that is why those events occurred to you, especially the student ALONE.
I wonder if she was even supposed to do that or just took it upon herself to gain a little experience...
Further, I would be deeply concerned with a student palpating the bladder of a patient with urinary tract and related infection. The potential for harm should have required supervision.
I also believe that EVERY licensed provider (and student) has a moral and ethical obligation (I also believe this it should be codified into law, AND should be part of licensing renewal requirements), to allow student participation in their healthcare.
-- Banterings
Maurice,
I am saying this with love, and as a warning so that you may protect yourself. You are extremely fortunate having never having your dignity disregarded in a healthcare setting, never having experienced abuse (including sexual) that causes you to shield yourself, AND that you are comfortable with being exposed to anyone in a healthcare setting.
This has made you naive. Many of us have already seen red flags with your care that you are overlooking. Due to your naivety, age, and the nature of your current illness, you are EXTREMELY VULNERABLE to abuse.
Once you are abused and recognize the abuse, your ENTIRE view of healthcare WILL change.
You will look back at this hospitalization and see the problems that we see. The photos will not seem like the reason was clinically acceptable. The student nurse situation WILL ALL BE WRONG!
I forgot this in my last post: Were you OFFERED a CHAPERONE?
As a professor of medical students, tell me the reasoning that a YOUNG FEMALE NURSE would examine the genitalia of an OLDER MALE without at least the offer of a chaperone.
That would make me question if she had actually completed ALL her classroom training.
I hope that you heed this warning. None of us here would wish what we have suffered on another human being.
DO NOT THINK THAT BECAUSE YOU HAVE NEVER EXPERIENCED IT THAT IT DOES NOT EXIST!
-- Banterings
Oh, Banterings.. I DO believe that what has been described here and worse exists as part of the patient's experience within the medical system--certainly documented in the newspapers and TV to the public and part of legal documents of courts and licensing boards. What I am saying is that what is happening is mostly routine ethical behavior within the limits set by necessity and even tradition. What we have here on this blog thread are all the experienced exceptions which has injured the Commenters
as patients and their families.
I can't answer your concerns about the behavior of the "graduating nursing student". Her "peek" at my penis tip was virtually momentary but the "why" and "what" of her action is unknown since I did not ask and she was quickly gone.
By the way, my wife was absent at the time, later to take me home, and had she been present perhaps my story here of my recollections would be more valid or more detailed or, in fact, more explainable. As a previous active physician, one thing I know about hospitalized patients who are sick and being treated with this or that, mental status and reactions are going to be different than being well at home. My personal goal now is not have to return. ..Maurice.
JR said
Although I disagree, I have read in many sites that because you are in the hospital that is implied consent to let them do whatever they want to do to you. I believe that many hospitals take that as gospel. Another interesting note of my husband's hospitalization, is that he was never offered a shower or was he ever offered a bath. Taking a shower was the first thing he did when he returned home. That course was for two reasons one and the most important was he wanted to shower way any lingering traces of sexual abuse from his body + 2 because of that he also just felt dirty.
JR said,
"Taking a shower was the first thing he did when he returned home. That course was for two reasons one and the most important was he wanted to shower way any lingering traces of sexual abuse from his body + 2 because of that he also just felt dirty."
In my experience as an adolescent, with the abuse I encountered, this was exactly what I wanted to do once I got home, just to try to wash away the sexual abuse from my body. Only I couldn't wash away the physical injury and it's impact on me. That lingers to this day.
58flyer
JR said:
58flyer,
You're right. You can't wash away the lingering effects either physical or mental. That is why today I must go almost everywhere w/ him as he does not want to be alone in case something happens as he does not want anymore emergency care. That is why he is frightened of being in a situation where they physically make him helpless to override his wishes & then pretend he never stated his wishes. That is why he no longer wants female care that involves any intimate care or exposure. He was not like this previously. Their assault of him has deeply affected me too. We are extremely close if you couldn't have already guessed that. I vent here so I do not burden him w/ all my thoughts bc he has enough to deal with actually being the physical victim of their assault. He, like most men, will suffer through w/ any help as for one there doesn't seem to be any help that deals w/ what males suffer as most help is geared towards females or children, 2. most people do not think adult males can be victims of sexual abuse. For me, I feel that I failed him & that guilt is overwhelming. Had no idea that PTSD could result from hospitalization. Even my mother who has in the past had a love affair for going to the doctor & hospital now has put the brakes on dr's visits & no longer wants to go to the hospital for attention. She is now afraid of them once she saw what happened to a man who was assaulted & overwhelmed by them. She now is aware of the power & control they have & has knowledge they can use & abuse whenever, however, whomever they want. JR
What do my visitors think might be the most common patho-physiology (psychic pathway) of the current attention, concerns and psychic distress which are being described on this blog thread? What I am getting at is what has been the common, universal start (the inoculation) which begins this process of subsequent psychic distress and intolerance to matters of current professional behavior? Could the common denominator in answer to this question is sexual trauma as a child which then leaves a ongoing emotional stain?
For example, I can't recall any upset or distress as to how I was treated as a child by parents, brother or medical professionals. No lingering or smoldering memories along with emotional distress.
So could it be that this absence the clue to why I am generally tolerant of how I am being treated by the elements of the medical profession irrespective that I have been a member of the medical profession since 1958?
I am sure that if I dissected and further detailed my recent hospitalization, the visitors here might find a host of professional and individual doctor or nursing personal misbehaviors that might provoke further discussion beyond the two episodes (photo and student examination) I did describe. Could it be that, because of my benign earlier years, I wasn't "looking out for or "checking a list" of those personal misbehaviors? Or maybe with my e-coli septicemia I might have been too sick to be further attentive to these missbehaviors.
I have a strong suspicion, that is boils down to the patient's early age exposure to personal embarrassment or worse which sets the path to more personal scrutiny of medical care behavior as an adult.
I look forward to read your evaluation of my theory. I wish someone would join this conversation who, like me, had a benign childhood and now is tolerant of current profession behavior. ..Maurice.
Maurice,
The problem is that the providers think that they can do no wrong. That is what trauma-informed care hopes to correct.
It is NOT being abused as a child, it is being abused in a healthcare setting that makes you question all previous an subsequent treatments for abuse.
If you ever experience abuse in a healthcare setting where your wishes are not honored, you will see all past encounters (including this one) in a different light.
-- BANTERINGS
JR said:
I think you are wrong. I have asked my husband if he has had bad experiences in the past w/ either healthcare or during his school years. He said no he had suffered no sexual abuse until this hospital experience. There also is a difference between feeling uncomfortable w/ opposite sexes examining you & sexual abuse. While you may not feel comfortable, it does not mean you have been sexually assaulted. Big difference! I had a male dr. examine me before my female baby dr. arrived. They asked if it was okay & I gave permission. I didn't like it but he was professional. I have been naked in front of male drs & it is not a thing I like but have tolerated as they have acted respectfully & professionally. There is the difference. Men like my husband & Mr. Kirshner did not go looking to be abused. One had had prior abuse & one didn't. Both were taken by surprise & were rendered helpless to defend themselves. In Mr. Kirschner's case, it was going to happen to some man that day bc it was a planned assault. As for my husband, we think it was also planned as it was a Catholic hospital giving out punishment for his supposed sin of being a gay, married man. Also, he had other strikes such as being "non compliant" & not wanting their gold standard of treatment. Other encounters of misconduct like not drapping or giving respectful care is done bc patients are drugged, don't feel good & will let things slide, caregivers cut corners to get the job done faster, flatout no respect for male patients, etc. Most schools & class material teach the proper methods but something happens to change this in the real world of healthcare. They do think they are superior & you don't matter which is a big issue. As Banterings said they think they can do no wrong. A lot of people out here also think that but as Banterings pointed out that would change once what has happened to some of us here happened to them. At that point, it is too late bc you cannot erase it. Even their versed failed to erase all his memories of abuse. In the drugging dept., they use love to use fentanyl bc it paralytic properties like it made my husband unable to lift his hands/arms to help cover himself. They know that too. The know it causes mental confusion & the inability to make decisions you would normally make. That is why many instructions say do not make important decisions for 24 hrs after conscious sedation but it is okay to make it during conscious sedation? What a double standard! They have made the argument for not trusting! JR
Dr B,
You seem to have it locked in your head that WE the patients who have been abused are who are different. I don't think you keep any of our accounts we have given in your mind more than a few minutes after we've given them. JF
Again I suggest:" I DO believe that what has been described here and worse exists as part of the patient's experience within the medical system--certainly documented in the newspapers and TV to the public and part of legal documents of courts and licensing boards. What I am saying is that what is happening is mostly routine ethical behavior within the limits set by necessity and even tradition. What we have here on this blog thread are all the experienced exceptions which has injured the Commenters
as patients and their families."
It is NOT that I think those writing here are "making up" stories to prove any points. My feeling is that what has been written here, has occurred has happened. What I was theorizing was the possibility that those patients who find comfort and goodness in their experience with the medical system and how they were treated may have a different experience in their childhood and youth with regard to sexual abuse than those writing here. Just a theory. For those like JR's husband whose abuse started in his current experience with the medical system, this theory would not hold.
In no way am I trying to defend a defective medical system as reported on this blog thread and factually detailed in the news media. In fact, I repeat what I have repeatedly advised--don't simply ventilate your experiences here expecting a change. We should do something more to make the medical system attend to the issue of patient dignity in all that is done and make all medical care as a gift to one's physical and mental and emotional health and not a hazard experience to be avoided.
Please let's start for a cure for the sickness within the medical system. What are we going to do about that? ..Maurice.
Dr. Bernstein, the childhood school physicals that I have described are to me symbolic of the "manning up" socialization forced upon boys back then. Being shy as I was I didn't like it, but that's as far as it goes.
This is hard for me to write but here goes. My childhood trauma was the manner in which the doctors & nurses and my parents treated me when I lost a testicle at age 11. As I was being rushed to the hospital from the doctor's office for emergency surgery, my parents didn't tell me what was going to happen. All I overheard was a whispered I'll die if they don't operate quickly. Nobody at the hospital told me what was going to happen as they prepped me for surgery. No doctor or nurse spoke to me after the surgery explaining what had been done. All I knew was I was all bandaged up down there, and I had to figure out myself what the surgery was. My parents never said a word about the surgery to me and a few days later when I went home my siblings didn't know why I was in the hospital nor apparently anyone else in the family or otherwise. I desperately needed some adult to tell me I was OK but nobody did. My 11 year old mind interpreted this wall of silence to mean that this was something so deeply shameful that it could not be talked about, and so I was ashamed.
This made for awkward teenage years. Girls started throwing themselves at me at age 15 but I found a reason to break up with them just as we were reaching the having sex point. This was out of fear my secret would get out and I'd be the laughing stock of the school. By college I started to gain confidence and life proceeded normally. Fast forward some years and my wife and I were done having kids and I go for a vasectomy. This was the very first time since age 11 that I was in a medical setting that included being exposed to a female nurse. While I was nervous about the procedure, I figured these were medical professionals and the exposure was just a routine matter. I was OK with myself. It thus came as a shock to me when she momentarily forgot to maintain her gameface and her body language fairly shouted her judgement. I was suddenly that scared 11 year old again. To make my humiliation worse she didn't do any draping at all so there I was spread eagle wearing only a polo shirt and socks knowing that she had judged me harshly. No towel, sheet or anything else to at least let me feel a bit covered.
Ever since then I go into medical exposures to female staff assuming that they are judging. With a couple notable exceptions, most subsequent encounters have been totally professional on the surface but because of that urology nurse I did not automatically extend my trust to them. I have been in shower/locker room situations thousands of times and never was there an issue with another guy making me uncomfortable or being judgemental, assuming they noticed at all, thus I'm totally comfortable being exposed to male healthcare staff.
Had the doctors & nurses and my parents talked to me when I was 11 perhaps I'd of seen that urology nurse's judgment as simply her lack of professionalism rather than losing my trust in female healthcare staff, but they didn't. The couple unprofessional incidents I've subsequently had only served to confirm that some female staff sexualize some of their male patients. Most haven't but I have no way of knowing beforehand, and so I try to avoid them when I can.
So yes Dr. Bernstein, some of our perspective can have its roots in childhood trauma.
Biker, thank you so much for telling us your story. I can see how the "roots" of the present interactions with the medical system were planted. And, as I said previously, I am not diagnosing every troubled interaction with the medical profession is childhood experience related... but I thought this might be an important factor in how the patient appraises the behaviors of those in the medical profession. Again, Biker thanks.
Now I would like an opinion regarding continuing on with this blog thread (currently of 14 years duration and partway through Volume 102. We have here a small number of steady contributors but I have evidence of a number of visitors from various parts of the U.S. and a few from other countries and their posting comments here as you have seen has been very limited, France and Canada is in my recollection.
But the issue is whether what has been posted here over the years has contributed anything, except ventilation by the writer and, of course, many worthy links to pertinent literature. Have we reached the limit of value to my regular writers and the others who just read so that continuing this topic of Patient Dignity (Formally: Patient Modesty) has reached its maximum value and it would be unnecessary to continue on, when it is time, to the next Volume? What more can be accomplished here? So far, there has been no vigorous movement of working together to change the medical system. What is necessary is showing that someone or some group is actually doing something to promote the change and encouraging readers of this blog thread to join the movement. As I have repeatedly said just "moaning and groaning" here might be therapeutic for the writer but does nothing to accomplish the goal of medical system change and the prevention of the acts described here and in the news.
So, what should be the decision about whether to continue this blog thread further or wrap it up? Please present your opinions--also from the visitors I know come here but don't write to our thread.
..Maurice.
JR
Your posts continually condemn the manner in which your husband was treated. Not only are your posts voluminous but they go on and on in a raging rant and therefore I quite reading them. You call us wrong about how some procedures are done because of what you read somewhere etc etc. I don’t often step in the Dr. Phil role and don’t get me wrong I despise the discriminatory process as to how men are treated in healthcare. Yet, I get the strong feeling that much of your anger and rage comes from jealousy. Are you jealous perhaps because female nurses saw him nude? If that’s the case this blog may not be for you, furthermore, this blog isn’t really about incompetence by nurses in regards to procedural tasks. I’ve seen many nursing directors pick up very quickly when a family member attempts to throw their nurses under the bus. Yes, they listen to complaints by family but, if your verbal complaints are anything like your posts I as a nursing director and yes they have the right to ban you from the hospital. While your family member is still in the hospital!
PT
Dr B,
I think this blog is doing some good, even though change is not happening fast enough. I don't think I would want to do your job though and can see why you want out.
If you do stop this blog would you still leave it up so it can still be seen?
Some of it I need to copy and share with other people but it's gonna take time.
JF
JR said:
Biker,
What a heavy burden for an 11 yr old boy to have. Things were so different back then & things were hushed up & kept from kids even though they needed to know.
Dr. B.,
Yes, I think we should do something. As far as the blog, continuing, I found it when I was looking for information on what happened. It has helped & given me many resources. There isn't much out there about this subject. There is little information that deals directly w/ negative issues arising from medical care. I know a book is not the complete answer but I have no idea what the right answer is or what will work. I have talked to lawmakers about the need for true informed consent, patient protections such audio recordings, true & accurate medical records, patient dignity & respect, etc. but it is always the same answer--the medical lobby is too powerful to let change happen. As for as most media, their advertising dollars come from medical interests & most are not interested in offending the big money. I don't know how to get change but I will keep trying. I think the blog serves an important place as it helps me gather information & I am educated by what I read on the blog. JR
JR said:
PT,
What can I say that won't make you even more aggressive? Obviously you read my posts bc my disagreement w/ your gospel has set you off. That was part of the instructions given by my husband's urologist after prostate surgery when he had to wear a foley for 10 days. Once you said I was wrong in your nice way, I did some checking finding many sites that said what we had been told wasn't wrong.
You also forget my husband is a prostate cancer survivor so he has been examined by many females over the years. As I have said, opposite sex exams are not an issue when done professionally & w/ consent. However, from what you said I am jealous bc w/o medical necessity my husband was exposed for hours by female staff. Jealous is not quite the word try angry, livid, enraged they sexually assaulted my husband. Maybe in your medical world such behavior is justified but not in my world. Hopefully patients under your care did not suffer in you became aggressive if they disagreed w/ you but you do get very upset when someone has a different point of view from you casing point Mr. Kirschner and me. I have also seen you attack others on this board when they haven't met your expectations. I meant you no harm but rather there may be 2 schools of thought on how care is given which apparently there is. Yes, I am wordy but my posts are clearly labeled so just avoid them. And yes, you are probably correct the nursing staff probably would have thought they have the right to unnecessarily expose a patient for hours w/o any justification & that in complaining, both my husband & I were either jealous, immature, crazy, etc. That would seem to be their prevailing attitude & why this type of behavior continues. Yes, we would like all those who abused him thrown under the bus. Yes, they have the right to ban anyone so that is one reason I tolerated some of their behavior but he also had the right to leave against medical advice too if that had been done. Hospitals are like prisons in that they have rights to act as such if you cross them while someone is a patient. Thanks for helping make my point that dissent could end badly w/ a hospital while someone is a patient. That answers for some as to why some do not complain while they are a patient. We were well aware of their power even before this hospitalization. So I continue to rant & work more calmly on situations as I know when to control my venom. If it were just jealousy that some female nurses saw him nude then wouldn't I also need to check to see if the male staff were gay? Think about that one. As for Dr. Phil, he is just another Jerry Springer whom I don't take seriously either. Sorry to all about this & for venting as much as I do. PT, I hope we can get past this but I do punch back when punched. JR
JR said:
Dr. B.,
I had been thinking about your question. I did share about my traumatic visit w/ the male dr. when I was eleven. He wasn't inappropriate but he should have never had me undress from the waist up to listen to my lungs, etc. especially w/ my father present. Thinking about Biker's experience, I developed early & was targeted by boys bc of that I was very sensitive. I think those things shaped my dealing w/ the medical community. As an 11 yr., it really floored me that I had no control over what happened to my body. There has only been one male dr. who made me feel uncomfortable but that wasn't w/ an intimate exam. He was the partner to my female dr whom I saw for some minor illness. I made a point to avoid him from that point on. Later I found out my thoughts were correct that he was indeed a cheater & pervert. Otherwise, I have had no issues bc I have addressed those issues before they became an issue. I went to a female ob/gyn practice who only had one male dr. He was there for one delivery before my dr. arrived. They asked permission for him to examine me which I gave. He did--no issue. My husband always goes w/ me as I w/ him. This was at an all female hospital. They wanted to train a new employee on me but I said no. They didn't like it but she didn't train on me. My dr. was aware of
My husband has had care before & had no traumatic experience like I did. Most things don't bother him. My husband has had rectal exams done by a female ER dr. as well as exams done female ultra sound techs, nurses who have done biopsy prep, prostate prep, etc. w/ no issue. Definitely, what happened this time has changed his view. Neither of us can fully understand why something like this could have happened. It is a fluke or is it a standard of care. Rationally, we know it is probably a fluke but how likely will it be it can happen again? Is this the age of where there is no consequence for acting out & the consequences of bad behavior goes unpunished? It seems to be.
I know you must be tired. This board has helped me and I do appreciate the opportunity to share & learn with/from others. I hope what we have had to say may help the medical community in learning that before anyone becomes a patient, they are also a person with their own unique identity and life experiences. If I have your permission, I would like to use some information from this board in my book. Of course, I will give proper credit. JR
JR
Why isn’t your husband on this blog telling (his?) side of the story? I’m questioning your credibility as anyone would. I know you’ve been asked this before. I often wonder about people on this blog and we’ve seen a number of them come and go. Is this a case of a new form of Munchausen modesty by proxy?
I thought we had struck gold a short while ago only to find out it’s just pyrite. A grown man constantly telling everyone he’s sorry over and over, looks like Mommie made him stand in the corner a few too many times.
Then we have those who just love to post their most embarrassing story just so they can come back and read it, over and over and over again. Anyone know are the VOY forums locked up or is this the new fetish game in town?
PT
Of course, the text in this blog thread or any of the other blog threads can be copied and used despite my stated Copyright which should have been updated in the right side posting to 2019. Use the text as written here and refer to the origin of the copy so your readers can refer back to the original and the context in which it was written.
With regard to completing the goal of this blog thread which should be creating active changes in the medical system with more intention to the issue of patient dignity and which I think is possible and much more constructive than simply telling "bad news" about oneself, ones family member or a news story about another patient's hurt or worse.
But I think this blog thread has sufficiently covered the personal or published "bad news" about the medical system and now there should be plans presented on how to realistically make the necessary changes.
Let's here from you with regard to changing the repeated "moaning and groaning" over the 14 years to plans for constructive actions. It should be this change in purpose and significance of this blog thread toward changing the medical system which should pre-occupy the further content of this blog thread.
For example, does anyone have an active and popular site on Facebook, Twitter or YouTube or elsewhere where ideas for system change can be disseminated to a greater public? Obviously, Trump has such a site for "system change", unfortunately not espousing the needs being discussed on this blog thread.
You know the defects in medical system behavior..it has been amply dissected here. Now is the time to plan to do something about it.
The medical system has slowly evolved with still many outmoded aspects and behaviors still persisting. Now is the time to talk about doing something to change..and beyond that show beginning action. What do you think? ..Maurice.
Here is a very interesting current article in MEDSCAPE Internal Medicine which deals with the issue "Should Docs Rethink Saying 'I'm Sorry' after a medical error?"
Read the full article. Although it deals with physician apology for medical or surgical errors, it might be interesting how my visitors feel about that but also errors in behavior of nurses or techs when they are confronted with the matter. Or are they fully confronted with what the patient experienced? Would you feel comfortable if the nurse or tech did apologize or would you feel that this would not be a complete eradication of what bad feelings you were having about what happened?
By the way, have any of my visitors here experienced an apology from a healthcare provider? Read the article and expand your response. ..Maurice.
Good Afternoon Ladies & Gentlemen:
Here's the problem as I see it with healthcare.
Healthcare has two sides. A technology side & a human side.
On the technology side, over the past century, healthcare technology has grown by leaps & bound to the point that today from a technological perspective, the American healthcare system is the most advanced system in the world today.
So, while the technology side evolved & grew over the past century, the human side hasn't done so well.
Over the past century, society as a whole has evolved and grown. At the same time the human element of the healthcare system has stayed back in the 20th century. They still think their original "Medicine's contract with society" is still valid. When the public knows they violated their end of the bargain so many times so badly the that contract went null & void YEARS AGO. Their policies towards patients haven't really changed since the model-T, corsair, & 8-track player. They still use stereotypes from the 1940's & 50's for their staffing needs.
They're also, under the impression that GENDER-NEUTRAL exists. They still think it's real. Sad.
In order to bring the human element up today's standards, Congress will need to step up & mandate changes to the system. First change is there is NO MORE hiding in the shadows. The paying public deserves and DEMANDS that the veil of secrecy that they were allowed to run behind is removed. Today's system MUST be run with COMPLETE TRANSPARENCY. No less will be accepted. Next, NO MORE autonomy. Civilian oversight will be put into place. Any legal violations will be reported to the authorities for prosecution if necessary.
Finally, hiring quotas & mandatory cross-training in gender specific intimate related areas will be implemented until staffing needs for all genders are met.
TOGETHER the congress & the public they serve can bring the human element of the healthcare system into the 21st century where together with the 21st century technology, the system can grow & prosper.
In order for us to get our message out of cyberspace we need a "champion of the PEOPLE". This could be someone from congress or the news media. We supply data that can be proved & they deliver it.
I have friends that are daily brow-beating congress & healthcare on twitter about their failure to step up. I myself email legislators both local & federal on a daily basis.
If we keep up the pressure with "factual" information, somebody WILL notice & approach us.
Regards,
NTT
NTT, Great! Just what I wanted to hear. Are there any readers here who haven't written to this thread but are in the news business and can help get our message out? You are needed now to get the medical system behavioral changes started! ..Maurice.
JR said:
My husband and I received an apology of sorts from the cath lab dr. It started out "if we did something" so it really wasn't an apology at all. For my husband to write a letter, it wasn't an if something happened so apology was not accepted. I think for some things apologies go a long way if they are felt to be sincere and if there is action taken to correct what happened. That is the key. Saying you're sorry is easy but meaning it & carrying out necessary action is a different story. Today I was going through my husband's meds. that he was supposed to have sorted into his pill box. He had not but had been taking it. I opened it the bottle to find it was the wrong pill. I went to the pharmacy w/ thinking it would be a battle but the pharm. was very apologetic & took info. & said he would report it to corporate & they would call us. He said they would also report it to the dr's office so the dr would be aware he had been taking the wrong med. by their mistake. He appeared to be sincere so we'll see if corporate calls. He said they need to rethink how they check for meds & will have a "talk" w/ whoever dispensed it.
As far as why things are so bad in medical world & issues like described on this blog happens, I have wondered if it is bc we are not the payors but just the recipients of the services. Money talks & has power. We are not in charge of the money/payment. Insurance companies/government are the bosses. The other thing is healthcare is like a corporation that doesn't care bc they are so big & powerful like Microsoft, Google, Amazon, etc. If you have a complaint, so what. There is always someone else to take your place. They have come up w/ patient centered care as their slogan but why do they need a slogan to tell me what already should be a given? Obviously, healthcare is not patient centered but payment centered care as right after who you are, they want to know how you're paying. It used to be you paid your co-pay upon leaving but the other week they wanted it before he was called back. That demonstrates payment centered healthcare. JR
Continuing with the topic of apology in medical practice, I found my blog thread on this very topic, with some visitor comments from December 2 2008 "Apology in Medical Practice: A Changing View".
Again, anyone here think that an apology from a medical professional will make a difference in the "post-traumatic" period of those who have suffered misbehavior or worse but who immediately spoke up about that misbehavior to the professional who "did it"? Is there any role for apology in medicine? ..Maurice.
An apology without change afterwards is worse than nothing!
JF
Dr. Bernstein, in our litigious society it is understandable that apologizing for medical errors is a rarity given it is more or less an admission of guilt. I suspect a genuine apology sometimes might preclude there being a subsequent lawsuit, but that's a risk the medical world doesn't often take.
Most of what we talk about here are not medical errors but rather staff behavior which is much less risky to offer apologies for. Even there the risk managers or administrators come between the staff who made the offense and the patient who was offended. A direct apology from the offending party would mean far more than one coming on behalf of the organization. More important than that would be offering a real apology rather than the standard non-apology apology which can only make things worse given it can be more offensive than not saying anything at all.
Better to directly say "we apologize for leaving you exposed to everyone in the hallway and have addressed protocols with staff to ensure it doesn't happen again" than to say "we regret not having met your expectations". The former acknowledges they did something wrong. The latter doesn't admit any wrong doing at all but instead casts it as merely having been your perception that something was done wrong. You the patient are the one with a problem, the hospital didn't do anything wrong.
JR said:
Biker,
Some good insight. Alluding to it is the patient's perception of it was wrong makes it worse. Also, a half-hearted apology of "if" makes it even worse. You are correct in saying what we are talking about here are not medical errors but errors in how they humanly deliver the method of care in personal dignity/modesty.
JF,
You are also correct in saying w/o change an apology is not any good. Those post hospital surveys do not address how you were really treated. Who really cares about the food? Why wouldn't they want to know if a patient was treated respectfully? It is bc they already know the answer on that. I think the more ill and more drugged you are, the less they make any effort to respect your personal dignity/modesty. They count on the fact you are to sick or drugged to take notice or even care. JR
Maurice,
I understand the threat of litigation, but a lack of display of human emotion or a lack of common decency will be more angering of the patient and family. Some providers are haunted by being restrained from acting human and suffer guilt.
Some states like Michigan allow for apologies without an admission of guilt.
As for discontinuing of this thread, look at what you have learned during its span. As a scientist, is this not a treasure trove of data?
Have you ever considered having a research institution taking over the blog for longitudinal study?
As I have addressed your vulnerability as a patient, if it happens to you (which I hope it doesn't), you will find some healing here.
NTT,
Healthcare will never go back to the days of paternalism. Just as physicians have tasted the power and refuse to give it up, so have the patients as consumers. Healthcare is no match for society. Society will subdue physicians and providers as it is doing now. The ONLY hope is to voluntarily hand over power to patients. At least there will be an appearance of concern for the patients.
Look what society has done to the financial industry, the once prestigious job of bank manager has been replaced with customer service reps (those who are not tellers).
I am happy with the direction healthcare is going in.
-- Banterings
Continuing with the discussion about receiving or giving an apology, here is a brief dissection of the dynamics of an apology from the
United Nations Ombudsman and Mediation Services
The power of apologies
Apology – A Sign of Weakness?
In our personal relationships, apologies seem to be easier than in working relationships. We may fear that apologizing to a colleague in a competitive environment might be perceived as a sign of weakness, undermine our authority or even negatively affect office dynamics.
However, an honest and sincere apology has the potential to restore dignity and diminish fear of retaliation or even desire for vengeance on the receiving end. On the giving end it can be a powerful tool to reconcile a working relationship and to initiate the restoration of trust. Accordingly, an apology can show strength of character, demonstrate emotional competence and reaffirm that both parties share values in their relationship they want to commit to.
Depending on the situation, there are certain factors that can contribute to the success of an apology:
When you OFFER an apology
Consider to include following elements:
1. Specify and explain the perceived offence
Example: “Yesterday during the meeting, I said…”
2. Acknowledge that the other person’s feelings are legitimate
Example: “I understand that this must have felt hurtful.”
3. Take responsibility
Example: “I should have addressed it differently”, “When addressing it, I should have taken into consideration…”
4. Include a judgment about the offence
Example: “How I addressed it was wrong.”
5. Voice your regret
Example: “I am sorry I used those words.”
6. Indicate your future intention
Example: “From now on, I will try to speak in a more friendly tone / use different words”, “I hope that we can have a relationship of mutual respect.”
When you RECEIVE an apology
The response to an apology is critical for the future relationship with the apologizing party. First consider whether or not you are genuinely ready to accept the apology.
If you are ready to accept the apology
Demonstrate acceptance and extend forgiveness by shaking hands or another method you feel comfortable with.
If you are not ready to accept the apology
Acknowledge the value of the apology and ask for more time to heal. Indicate when you are ready to speak about the issue again.
The healing effect of an apology through restoration of trust, caring and respect can best be achieved when one has a chance to clearly define the harmful behaviour, apologize and indicate how future misunderstandings can be avoided.
Can you classify situations in professional-patient interaction where a proper apology could remove the patient's emotional/psychic upset, could relieve some of the upset or finally make no change in the upset or even the acceptance of the apology?
Where in the list of remediation of a emotional upset by the patient with regard to the behavior of the professional or even the institution is an apology? ..Maurice.
Dr. B.,
Please keep this blog thread active. I started reading it 11 years ago and went back to read the first three years. It's one of two must-read blog threads every day for me. I guess you need a "like" response - not really.
I think of writing a response almost every day. I draft many, but discard approximately 4/5 of them because other posters do a better job of making my points.
BJTNT
Apologies are dangerous coming from medical staff. It's the same reason that wrongful convictions are extremely unlikely to be overturned. Danger of being sued or admitting to having caused irreparable harm to other people.
Modesty violations are sometimes done unintentionally through carelessness or rushing to get things done. Other times it's because of staff arrogance. They look so dignified by being with the naked patient while other staff meanders in and out. There's plenty more where that patient comes from so SO WHAT if the patient never returns and suffers permanent harm because of it.
Also, it's not realistic to believe medical staff are never affected in a sexual way by naked patients, including doctors.
A number of doctors and nurses are amused by humiliating kids in front of their parents to. JF
BJTNT, I appreciate your comments and current support. What I want to emphasize is that, you as an example, should feel free to express your view in the way you feel is appropriate to express and not simply compare how the other contributors do it. Subtle differences on viewpoints are of value to the interested reader.
I think you all noticed that I am inputting more of my comments on this blog thread Volume than in Volumes of the past. It is because I have more time. Because of my current health issues, I decided not to participate in the first or second year medical student teaching program which has been my interest for 30 years and which would resume in a few weeks. I will continue to contribute my ideas to the school program from home. So with no preparations for the upcoming class and while recovering from my Foley catheter precipitated e.coli septicemia , I can and will attend to my blog more frequently throughout the day. I still intend to continue my participation as a physician in a twice a month "free" medical clinic and my role as a member of a hospital ethics committee. ..Maurice.
Maurice
In my opinion, you should end this blog. It has gone on long enough, don’t you think?
PT
Dr B,
I would prefer that you keep it going but I want you to do what works best for you. Even if nothing further is written, there's a lot here. A lot that needs shared with other people. Especially uninformed people who don't know what we know yet. JF
"In my opinion, you should end this blog. It has gone on long enough, don’t you think?
PT"
PT,
I will have to differ with you on this point. As a person who has experienced some really bad stuff from the medical community, I find this blog to be a comforting place to be. I have learned that I am not alone. Many feel as I do. It has allowed me to vent, and that alone is priceless, but it has also allowed me the opportunity to find my voice in dealing with the encounters I will face in the upcoming years. As I age, I will be confronted with many challenges relating to my health concerns. My reading of the concerns, experiences, and challenges of those who post here will give me the ammunition to confront my caregivers in the future. While I earnestly hope that those caregivers want the best for me, I know from past experience that there are many who are not inclined to do their best. I find this site to be a learning exercise, where I can use the information to prepare myself to obtain the best outcome going forward.
58flyer
58Flyer
From a self help perspective this blog has served its purpose, the industry is not going to change overnight. We all can make the change ourselves by simply speaking up. Patients have more power than they realize, this blog has ran for over a decade so it’s time to close the doors. For those that have Munchausen modesty by proxy I say let their “ significant other” read through all the volumes. The rambling long hate posts are just really ridiculous and serve no real purpose.
PT
PT, I think you were referring to this "blog thread", Patient Dignity..but not the entire blog in which I have over 900 threads of all sorts relating to bioethics particularly in medicine but even occasional plant and animal --many of which you, PT have contributed worthily--remember?? I find that visitors still come to read many of these other threads daily but only a few contribute their thoughts..perhaps because they find the Comments there by others many years old and this may think the topic thread is comment-wise inactive. That isn't true, since if they post, I publish them and may myself follow up with a comment pertinent to what they write.
With regard to this bioethics topic thread "Patient Dignity", whether to continue the sequence of Volumes depends on it's worth. Now, as I have said, "a million times", ventilation of experience and feelings here is a self-worthy contribution and may be of real value to those other visitors who have similar experiences and feelings knowing they are part of a "community".
However, should this simply be the goal of this thread topic or should it include constructive plans with presentation of signs of initiation to CHANGE THE MEDICAL SYSTEM so that the need to self-ventilation of terrible experiences become less frequent? I think it is important for all to consider the primary goal and value of this 14 years of this thread topic.
Again, PT, I want to thank you again for your contributions here and hopefully to new topic threads which I really should be adding to this bioethics blog.
There are much more bioethical matters in our society than the one isolated in the first to 102nd Volume here. ..Maurice.
Maurice,
I have seen the change this blog has made. Terminology and wording used exclusively here is making its way in to healthcare institution policies.
I wish that some policy maker would contact you off-blog and tell you how this thread has influenced policy at their institution.
Here is an interesting article: For LGBTQ patients, discrimination can become barrier to medical care
Here is an example of medical sexual abuse mentioned:
Lunn has heard of a transgender person with a respiratory complaint being subjected to an unnecessary genital exam while trainees observed.
In true style of the profession of medicine, patient sexual abuse is minimized to an inappropriate encounter...
The article made me think of you having never experienced or witnessed abuse:
Surveys show how widespread such discrimination can be.
Lunn, an assistant professor of medicine in nephrology at Stanford University in California, cited the 2015 U.S. Transgender Survey, which found a third of transgender people who saw a health care provider in the prior year had at least one negative experience, such as being verbally harassed or refused treatment.
A 2014 report by the advocacy group Lambda Legal found more than half of lesbian, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care.
You have made great strides in your acknowledgement of the scope and depth of the problem. The article sums the situation that you face here:
People who haven't been discriminated against say, "'I can't believe this would happen!'" said Cooper, who is co-chair for the Society for Adolescent Health and Medicine's special interest group on LGBTQ health. "Well, it does. And it's not just in the small towns. It happens in Dallas. It happens in New York City. It happens all over."
This article gives hard numbers:
A 2014 report by the advocacy group Lambda Legal found more than half of lesbian, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care.
HOW ARE THEST NUMBERS ACCEPTABLE?
I have to believe that if you live in the Greater LA are, you have to have LGBT friends. ASK THEM>
I am sure that your school or affiliate undergrad school has a LGBT group.I am sure that they will be happy to share their healthcare experiences with you.
This is only a portion of the population.
-- Banterings
TO THOSE READERS OF THIS BLOG THREAD WHO HAVE NOT PARTICIPATED BY COMMENTING;
I know that you have come here (based on information from StatCounter program) and taking time, hopefully to read but you do not actively participate by writing. I don't know your identities but I know from which city or country your computer is located. And I know that some of you come back and back and back, based on the time recorded but DO NOT write to the blog thread. But we need YOUR opinion too as to the worth of this blog thread topic and discourse to you personally.
Please, don't remain silent. Write. You can write fully anonymously by simply ending your message with a unique pseudonym as others have done without providing further identification to the blogger.com system or in your written text, unless desired. Even I have no insight into you or your e-mail address except what you might write here.
In this discussion regarding the value of this blog thread on Patient Dignity, we need your input too. PLEASE, PLEASE join the conversation and provide your input and suggestions. We are getting opinions from some of our repeat writers but now I WANT TO HEAR FROM YOU, TOO! ..maurice.
Maurice
As I’ve said, you know they read but they never comment. Why should they, after all they’re just here to fulfill their fetish. My suggestion is that you end this modesty ( dignity blog). Let them go elsewhere wherever that might be to get their kicks. Maybe they will buy a trench coat and start flashing people and get arrested, I don’t care! Just end it.
PT
Good Afternoon:
In our search for answers, many of us stumbled upon this website where we found others who were looking for answers also.
Together we all shared our stories and are brainstorming as a group on how we can bring the curtain down the medical community & start an open dialogue to fix the wrong that has been done to many of us. We're here to continue the fight so that our son's & daughter's, grand-son's & grand-daughters, and their children don't ever have to go through what we've been put through today.
We owe it to them to end this with our generation.
Back in volume 99, Misty had made mention she was in contact with someone at CNN about helping here make the public aware of the modesty issue that currently exists. Maybe that's the way we get our foot in the door.
Right now, all we can do is keep plugging away & see if Misty gets the door open.
Has anyone heard from AB in the NW? I for one learned a lot from what he wrote here.
Regards,
NTT
PT, a curiosity question on my part. On what logical basis permits and supports you to define the motivation of those visitors who read but don't write? We really don't know who they are and their personal reasons for not actively participating by writing about their interest, experience and conclusions. Are you not making a enormous conclusion based simply on evidence of visit but no written response? Are you upset because you are thinking of "fetish" and not "contribution"?
I admit I look to you based on your participation within the workings of the full medical system in a far more complex relationship and experience than me. But I don't understand your rationale for how you arrive at the "fulfill their fetish" conclusion. Are they only interested in the details of sexual misbehavior and gender inequality amply described on this blog thread?
One reason for encouraging the silent visitors to write here is also to read their explanation of the "why" of their visit. But also, of course, if it is other than "reading a sexy book" but finding support here of their emotional upset derived from their personal bad medical system behavior experience, it would be worth knowing. ..Maurice.
NTT, I recall recently posting here whether AB in NW was still around. As an official in the hospital medical system administration his (I assumed he was male)... his output to us was quite informative. If AB is still around here..I will remind him of my e-mail address for any communication he would tell me which he didn't want published. By the way, the same goes for everyone else reading or writing here. I will not disclose the e-mail address of the visitor nor will I return an e-mail from me unless specifically requested regarding the latter.
My address as you all should know by now:
doktormo@aol.com
..Maurice.
Maurice
Oh believe me, I don’t let it upset me in the least but let’s look at the possible scenarios as to why they read but don’t write. Apparently, if they are reading then something attracted them to this particular subject matter of your blog. Perhaps they are caregivers and enjoy the misery they cause and get a kick out of reading about it. I’ll suggest that might be a very small percentage and I’d suspect they would tire and move on.
Now,I’ve posted a number of true scenarios that were of unprofessional behavior by nursing a number of years ago. Immediately, several posters chimed in to add to the discussion in a manner suggesting that I had no opportunity to refuse to the behavior which would fuel their fetish desire. I immediately picked up on it and I don’t post little fetish stories and I recommend no one else do the same. Maybe they too will tire and go away.
These lurkers as I call them troll the web looking for stories and this site I believe is ripe for it. I’ve other suggestions but again, I’ve no desire to provide fodder for anyone, this blog is not meant for that. People have experienced serious ptsd which negatively impacts their trust in providers which as you know precludes them from seeking healthcare they need.
Maybe we have posters as well who like to post their fetish fortunes which might be misfortunes to others and in return enjoy reading about it. For them they don’t want solutions, they want this to go on forever despite the cost of potential patients health which goes untreated. It is this fetish you can say that adds to the problem, those people never speak up.
PT
Dr. B.
The reason I want this blog thread [plus the use of other social media] to continue is that it's the start of a grass roots campaign to change the medical community. The current ideas, e.g. a book, are fine, but I think the best way is to elect politicians that campaign on changing the medical community consistent with our requirements which we haven't finalized yet. It's ineffective to try to recruit existing politicians because the AMA has enough money to buy them.
It's will take many years [sorry to be pessimistic] to affect pro-patient changes by lawmakers. Is there any doubt that MDs will be unhappy with the changes, so why don't they advocate for patients today?
Last month I took the opportunity to inform my urologist. He even brought up this blog thread on his monitor while I was talking about it. I tried to inform the office manager of my previous urologist, but she wouldn't listen. I agree with her, why waste her time when she knows her bosses couldn't care less about treating patients with respect and dignity [she was polite].
Dr. B., You seem impatience to accomplish change, but we need time, admittedly too long, but being an MD you need to have patients [pun intended].
BJTNT
We all want there to be a rapid change in the way men are treated, but I am also convinced that at the present rate it will take a long time. Especially going about it the way we are. We may reach a few people here and there, but it will take something radical to effect a major change. The radical I am talking about is legislation. It happens quickly, and it's either comply or go out of business. It's easy to say that the lawmakers are bought out, but has anyone approached their legislators for an in person discussion? You might be surprised to find them willing to help out, especially if they have their own bad experience(s) to draw from. I am guilty of not making the effort to contact my elected representative, but I plan to change that very soon. It doesn't take widespread sweeping legislation to bring about change. For example, a single federal law mandating that anyone who performs intimate care or examination of an opposite sex patient shall have a medically trained person of the same sex as the patient present, with few exceptions, such as emergency care. That alone would eliminate 90% of the issues we males face in healthcare.
I know I am jumping back on my soapbox here, but I am certain that a well written, straight to the point book, would be a powerful asset going forward. It would prompt discussion from a large audience. Who knows, what if it made the New York Times bestseller list? It just might.
Good Morning Ladies & Gentlemen:
Update from Misty;
I am still waiting to hear from them. They laid off some people in their
health unit so they are reorganizing. Hopefully, things will work out soon
so the reporter who was interested can do a story.
I had the privilege of meeting Dr. Bruce Levy in Minnesota last month who
invented the modesty garments at Covr Medical (http://www.covrmedical.com).
He is a wonderful doctor who understands the importance of patient modesty.
I had my friends put cnn & all the rest of the major news outlets on their twitter feeds on anything related to this issue they send out.
Regards,
NTT
BJTNT
No, you missed the point. You might think she was being polite, that’s her excuse. As the office manager who do you think does all the hiring at that office.
PT
You may want to peruse this short article in Very Well Health (September 2018) "Patients and Modesty in a Healthcare or Medical Setting: How Does Modesty Affect Medical Care?"
Does it tell us here at this thread anything we haven't already talked about? I think I found two actions: Encourage Patient Modesty Issues to Be Taught in Medical and Allied Health Curricula, Encourage Patient Modesty to Be Addressed in Continuing Medical Education
Most of the stuff in this presentation sounds OK but then comes the last sentence:
Modesty is not a good enough excuse to avoid care, especially when problematic symptoms arise. which might find some discomfort by most of the contributors here. My response would be "Modesty is a good enough reason to SPEAK UP when care is needed" ..Maurice.
Maurice
The article is worthless, not worth anything it’s written on. Look at the author, she is not trained in healthcare. We have made a number of complaints about her on this blog. This is just one of many reasons why this blog ( modesty, dignity) should be discontinued.
PT
Dr. Bernstein, most of the points in the article are good, but it comes across as her just going through the motions. I say that given her auto mechanic analogy. I do appreciate her specifically including male patients in the article though. Most such articles don't. That she'd equate a patient expressing a modesty concern with an inanimate object (car) tells me she doesn't really take modesty concerns seriously. It begs the question why did she write the article if she sees patients as objects.
On the excuse aspect, I would never forgo needed healthcare due to a modesty concern. I wouldn't be alive today if I did but it isn't my place to judge the choices others make. All I can hope is that they are informed choices.
PT, I understand your argument which you are making and certainly you are free to comment but also free to refer to an article that supports your view. That is the basis of "discussion" (title of this blog).
The question I put to those visiting and or writing here is whether this blog thread should no longer have visitor or my comments published but remain available to access and read.
On the other hand, I have continued to have present on this blog literally hundreds of various topics regarding bioethics which were started years ago and many have the last visitor posts years ago. I can see from the StatCounter that folks are going to these posts to scan or read but are not commenting presumable because they see no recent comments and assume that no further comments are being read and so they don't add a fresh comment. And I have plenty of such transient visitors. If rarely they do write, I promptly write back with a response to their view and demonstrating the thread is still active.
PT, what are you requesting. All 102 Volumes be deleted so no visitor can see the topic or responses or as an alternative to maintain their presence but indicate on 102 that no further comments will be published?
Do you think that would be a "fair' decision? Or should I continue as I have always done on this blog, keep the postings available to read but also to comment as desired or keep them available and state no new comments will be published or finally just delete all 102 Volumes, thus avoiding any reading or discussion on this topic. Until 'updated' Google search and other topic research resources will be misleading if the latter is decided and their program is not yet revised.
PT, my suggestion is to comment on the nature and value of references provided here by me or others but also input your own references.
Please, all should now indicate whether you want this thread topic of dignity and modesty deleted from the blog or continue with the alternates described above. ..Maurice.
The ultimate choice is yours Dr. Bernstein, but I would like the forum to stay open for comments. It was reading the experiences of others and advice here that helped me find my voice and realize that it was the healthcare industry that had a problem rather than me.
Should you close this now or in the future I do thank you for all that good that you did by hosting this forum.
Actually, Biker, as long as I am around, the current possible choice is that of consensus of the participants. If the value, therapeutic or otherwise is now gone or the potential for discussion and action about changes in the medical system is gone then their absence may drive a decision. I just wish that those repeatedly coming to this blog thread and not participating would at least provide a comment on this matter. It is important for you as well as those who write here. ..Maurice.
Hello Dr. Bernstein,
After discovering your blog a few years ago, I was able to have a successful hip replacement wearing a garment (see Covr) and with an all-male team. I would not have known to speak up about my exposure concerns had I not found your blog. I would still be in pain, walking with a cane. There's no way that I can quantify the value of this blog. I will be forever grateful. Discontinuing the blog would be a great dis-service to other future, hurting individuals.
Additionally, with your new-found time and your medical expertise, you may wish to encourage fellow (retired) physicians to spread the dignity/ modesty message and/ or join the blog.
Reginald
Thanks Reginald for your input in the issue we are now discussing.
You know, one contributor to this blog thread from whom I would like to hear about this threads future status is MISTY. She, I think, I have the feeling, is more educated in the public interactions and values of comments on this very subject of modesty than me. I think she might help educate me on the potential value or the potential needlessness of what is being written here.
I look for more of our writers here to speakup about this thread's overall value both in the past and possibly in the future.
PT, even if this thread continues on, I still respect your extensive medical system background knowledge to add certain perspectives to what is written here by me or by my visitors. Your many comments to so many other ethics topics on this blog was welcomed and I think many welcome it here.
And I can't leave out Banterings who provides us with an "overwhelming" but important literature links and pertinent resources which obviously takes up his time and computer energy.
Finally, all the other writers here over the year or years, your participation is fully accepted and needed to provide personal background and more based on your own personal experiences.
But, now, from a "spreading the word" expertise, I look to Misty to offer her ideas based on her publication experiences.
..Maurice. p.s.-Misty, where are you??
Hello again,
I think that all would agree that a cystoscopy (to check for bladder cancer) stresses one's dignity/modesty sensitivities. The following article describes a non-invasive method of checking for bladder cancer, which is presently 75% effective. FIY: https://www.medicalnewstoday.com/articles/325824.php?utm_source=newsletter&utm_medium=email&utm_country=US&utm_hcp=no&utm_campaign=MNT%20Daily%20Full%20%28non-HCP%20US%29%20-%20OLD%20STYLE%202019-07-23&utm_term=MNT%20Daily%20News%20%28non-HCP%20US%29
Reginald
Maurice
My suggestion is to keep all 102 volumes so visitors can read them but no new comments are to be published.
PT
Thanks for sharing that article Reginald. It confuses me a bit. In my case a routine annual physical urine sample indicated microscopic blood was present. My doctor then sent me for an ultrasound that saw the tumors. Two weeks later I had surgery w/o ever having a cystoscopy. Apparently the ultrasound was definitive enough for the urologic oncologist. Since then I've had a couple dozen as part of ongoing monitoring.
I'm glad to know there is an alternative to cystoscopies but I'm not going to seek it out if it is only 75% effective. I prefer the comfort of the more definitive answer I get from an actual cystoscopy (and urine test that they also do each time). Fortunately I am now with a urology practice that has 1 or 2 male nurses for the prep.
PT, explain again the rationale for allowing reading of the 102 Volumes but no further additional comments. Wouldn't it be more effective even in terms of "ventilation" for the reader to express their views rather than just read the expressions of blog thread reader of the past? Do you think that simply "ventilation" of emotions on a world-wide blog is of no value but reading the "ventilation" of prior writers is beneficial?
And how do you feel about discussions of "moving ahead" with regard to attempt at medical system "cure"? Hopeless?
These areas represent the potential goals of this Patient Dignity series of publications.
Actually, when I first wrote recently about terminating the blog thread, these were the issues I wanted to have discussed with regard to necessity and overall value. ..Maurice.
I still read this blog, but I do not comment as much as I used to. I feel that sometimes there are too many long rants and comments to keep up.
I personally think you all should keep this blog going. I understand the distress of patients who have had bad experiences. At the same time, I’d like to see those patients take steps to try making changes. For example, consider starting a petition at your hospital or urology clinic. Just venting your feelings on the blog will not change things.
I would like to see more people here taking actual actions to change things. Think about how much impact you could have if you got a bunch of men in your community to start a petition at the local urology clinic to ask them if they would hire male nurses and assistants. I think every man here should consider printing out this article, How Urologists Can Be More Sensitive To Men’s Modesty? and take it to local urologists. You won’t see much change in urologists’ offices unless a lot of men voice their wishes.
I really appreciated Reginald’s recent contribution. I love how he has shared about how he stood up for his rights to modesty in medical settings. Those cases encourage me.
A lung cancer surgery who was stripped naked for surgery volunteers with Medical Patient Modesty. I love how she has turned her distress into trying to make some changes. She has done some radio talk interviews including one with Dr. Bruce Levy who invented Covr garments in hope to encourage other doctors to be more sensitive to patient modesty like him. This lobectomy patient has taken many steps to ensure that she does not have another bad experience and it is her goal to educate patients so they do not have to endure what she went through.
I had the privilege of meeting Dr. Bruce Levy and his wife in Minnesota last month and it was so encouraging to talk to him about patient modesty issues. He really understands patient modesty. He has helped other orthopedic doctors to be sensitive to patient modesty. We need more doctors like him. His wife talked about how those garments helped to improve quality of medical care and I agree completely with that. Dr. Levy shared that a lady who was having a heart attack called and asked how she could get those Covr garments because she did not want to be humiliated. Those garments have been used for cardiac catheterizations in the groin.
I personally would like to see all hospitals offering Covr garments to patients who require procedures that involve access to hip and groin.
Misty
Maurice
I have mentioned many times that the solution to this issue, largely discriminatory would come from legal intervention and that I had hoped would begin with Ricks case. I still believe that once a legal precedent is set based on discrimination the culture will change, it’s only a matter of time. Much of the ventilation is not based on modesty, dignity but rather just a flat-out hatred. I get that, but the subject matter deviates far from this subject title and I feel is largely distractional.
First, medication has nothing to do with this subject title. I fear it is a hugh mistake for anyone to attempt to dissuade patients from having an examination without medication, be it twilight or conscious sedation, there is a difference. That the suggestion that healthcare workers want to drug you so they can take advantage of you is just idiotic. Only a physician can order sedation and I’d like to see any of you try to get a biopsy, egd, ercp, colonoscopy without sedation. Do you think the study would be of value while you are squirming, I doubt it.
Personally, I want to invite some really hungry attorneys to this blog, I just don’t know how to do it. In conclusion, this subject material has gone on for 14 years, what has been accomplished? Nothing from what I see. Just some moaning and groaning from some posters I see that at times is just ridiculous. I don’t know all the answers but one thing I do know and that is the culture, the bad culture within the healthcare industry will never ever be expunged from within, that will never ever happen. Only legal and financial forces outside the industry will effect change.
PT
PT said: "Personally, I want to invite some really hungry attorneys to this blog, I just don’t know how to do it. In conclusion, this subject material has gone on for 14 years, what has been accomplished? Nothing from what I see. Just some moaning and groaning from some posters I see that at times is just ridiculous. I don’t know all the answers but one thing I do know and that is the culture, the bad culture within the healthcare industry will never ever be expunged from within, that will never ever happen. Only legal and financial forces outside the industry will effect change."
PT,
I agree with you here. All it takes for major change is for some enterprising attorney to come up with a new style of lawsuit (in the legal industry they call it an innovative lawsuit) which would have far reaching consequences. Take the Miranda decision for example, those of us in law enforcement are VERY aware of that one. The Supreme Court decision that one has the right to legal counsel and the right not to incriminate oneself. Imagine a similar decision today in which men had the right to be treated with dignity and respect, which also codified the way in which men would be treated and specifying the correct nature of a chaperone.
Reginald,
Thanks for your comments. While I did not use the Covr garment for my recent urologic procedures, I did use one from another company. Not only did it provide me with additional comfort, but it educated my treatment team about the availability of such garments, and I am happy to say they now use it in all the male patient procedures. I know this because after my procedures were done I went to a friend of mine in the floristry business and had them deliver flowers and candies to the medical office to thank them for treating me with dignity and respect. He is an aging male and in need of urology services. He thought that if I was showing my thanks in this way then they had to be an excellent medical facility. So my friend went to them and he is now in their care. He told me last Sunday at church that he is appreciative of the way he has been treated thus far.
Misty,
Thanks for your attention to this blog. Please keep us here informed.
58flyer
My apologies for going off track from the main conversation but I wanted to respond to PT's assertion that certain routine procedures can't be done w/o sedation. I have had 3 colonoscopies, an EGD and a TEE w/o sedation. The colonoscopies are not a big deal at all, though my gastroenterologist says my colon is textbook perfect which makes it easy for me. I understand for some people it might be painful or uncomfortable. The trick to the EGD & TEE is to numb the throat beforehand and for the doctor to just insert quickly. For the patient the trick is just relax and stay calm so as to fight the gag reflex. For me this is far preferable to being as sick as I get if I am sedated. It as well brings with it assurance modesty will be preserved. My gastroenterologist says EGD w/o sedation is the norm in Africa where he volunteers in one of those doctors w/o borders things.
I, too, want to thank Misty for her comments and for her support and spreading the word of a "tool" created to provide "privacy" and yet allow necessary operation/examining room procedures.
I also understand the frustration of PT at the slow (if any) progress, toward constructive goal of this blog thread to change the attitude of the medical system from purely disease diagnosis and treatment but importantly to also attend to the individual patient's dignity.
I also agree, clinically, that there is a role for sedation ranging to full central nervous system anesthesia, though it is essential to be absent with an awake patient to communicate when involved in establishing focal diseased areas of the brain with open skull before final surgical procedure. I doubt medical staff uniformly abuses patient dignity when the patient is sedated or absent awareness. If some do, the awake staff observing have ethical and legal responsibilities to bring this to the attention to the institution, patient and family.
Every patient and family member has different concerns and different ways of expressing them when they write about their experiences to this blog thread. I have to accept their expressions which may be exaggerated or in ways accurate since "I was not in attendance" to verify.
I think "spreading the word" about this blog thread and about the basic goal of this thread: to create attention and change. Any way to do so would represent "steps forward". Can we focus now beyond "grumbling" to the methodology of taking those "steps"? What are you doing about it? What is your observation of the reaction or response to what you are doing? Reporting on these observations would be more productive for everyone than just reading other patients "moaning and groaning" ventilatory presentations here.
Maybe what is necessary is to go beyond Banterings "Patient Dignity" title which we accepted. Maybe we should add a first word to the title which would show the direction of this blog thread. The word should be "Establishing" ("Establishing Patient Dignity") Patient dignity is not fully established in patient-medical system interaction--I think we all agree to that including me. So the new title will set a goal and a direction to what is further written here. What do you think? ..Maurice.
Biker
What are you going to do if during your next colonoscopy you have a perforation? That requires a colon resection along with a colostomy bag and a reversal provided everything goes ok. Are you going to refuse sedation for that to ensure your modesty is preserved? Now I’d like to see a patient do that trick.
My thoughts are that those who like reading these stories for fetish reasons as well as those who enjoy receiving those exams for fetish wouldnt it just be ironic if the case didn’t go as planned, happens all the time. At a hospital in Georgia I believe over 10,000 patients were exposed to hiv all because the colonoscopy scopes were not cleaned properly.
Or what if you did get a perforation resulting in a resection and colostomy but then you had leakage at the anastomoses and resulting infection, mersa and c-diff along with many other complications. Your medical bills are through the roof, in the hospital for weeks. You can’t pay your mortgage and your dog runs away cause no one fed him. You can’t seem to get home health out to educate you to change your colostomy because they can’t find the homeless shelter you are staying at!
Several months later you have had enough of the colostomy bag and it’s time for the reversal, but you can’t get it done cause you have no health insurance. Well, you lost your job from being gone from work for soo long, now you have no insurance. They don’t work for free. I’m writing this because I’ve seen this happen to people many times and similar cases. Wouldnt it be ironic if it happens to people who pursue this as a fetish. I’ll bet that would cure them of it.
PT
I read your "anticipated bad news" possibilities to Biker. However, at this point and with regard to halting this 14 year history of thread Volumes, I am most interested in your opinion about continuing on but with the title suggestion I made:
"Establishing Patient Dignity (Formerly: Patient Modesty)". The goal of this blog thread topic is clarified: 1. Patient dignity is missing and/or incomplete. 2. The title implies that the thread deals with attempts to reverse that inadequacy. Would that change in title make you feel more comfortable regarding goals and participation by yourself and others with this as an ongoing blog thread?
Again, as a physician, I believe in treatment of disease and if a certain amount of "ventilation" in response to trauma is therapeutic, I would agree with that. However, as a physician, I also believe in attempts at "disease prevention" and if the change in thread title implies active attempts in this regard, I would feel satisfied. Remember, the final goal is "Establishing" and NOT "Looking Forward Toward..." We should demand the goal be met! ..Maurice.
Hello,
Could the following be useful?
At Wednesday, September 12, 2018 8:01:00 AM, Anonymous said...
Hello,
Suggestions for blog title:
"Promoting Modesty/ Dignity in Health Care"
or
"Advocating (or Advocates) For Modesty/ Dignity in Health Care".
Reginald
Notice: Without evidence of further discussion regarding my changing the title of this thread, tomorrow I plan to create Volume 103 with the new title:
"Establishing Patient Dignity (Formerly:Patient Modesty) Volume 103".
However, I look forward today to receive my visitors' opinion regarding the change, that title or an even more definitive title to express the PURPOSE of this blog thread.
Remember, I brought up the question as to whether or not to continue this blog thread since its value should be in its defined goal. ..Maurice.
Biker
Sword swallowing and gag reflex go hand in hand. So when I looked that up on the web the hits were porn sites, no thanks. Really, that patients have to overcome the gag reflex to preserve their modesty for what, an egd or a tee. This is why no one is ever going to take any of this seriously, ever. Most egd’s are a challenge for a gastroenterologist even when the patient is sedated and a cardiologist performing a tee often requires a pediatric probe in adults due to narrowing, a challenge even with sedation. During a tee you are taking pictures of the heart and chambers while the heart is pumping so getting good pictures is critical.
You see Maurice, you see my point. The commentary is just so ridiculous that even those in healthcare truthfully are laughing. I’ve been in on thousands of egd’s and over a handful of tee’s, what in the world are the issues. This is why you should end this subject matter of your blog. I implore you!
PT
Maurice,
...then by changing the name you admit that the profession is severely lacking in respect of patient dignity, just as George Annas shown in 1974, in his work; "The Hospital: A Human Rights Wasteland."
We are not the outliers, this is business as usual. The profession of medicine is a dismal failure.
-- Banterings
I think the blog has affected some changes. It just hasn't attacked the problem from the root. Certain individuals have found their voice. But it rolls the responsibility back unto the patient and ambushes don't allow for speaking up until after the fact.
What a lot of people won't say for whatever reason is overcharging is actually STEALING! But since it's done legally ( WE don't get to vote about billing, or stating costs.... )
That is the problem. We need a tracking system so that vast numbers of letters and emails can't be ignored anymore. Maybe be given/sold letters with confirmation numbers or tradable finger prints uses... I don't know how to set it up. A TV show called There Ought to be a Law. Can't we take back power from people who use us and milk us? JF
Banterings, so what should all those patients who not only suffered from their underlying physical pathology but was subjected to psychological injury or possible ongoing damage via the medical system do? Keep taking it..hiding it except those writing to blog threads? My aim has been over many recent Volumes to encourage my readers to research how best to carry out their goal for change and then follow through.
If there are no statistical outliers in the consequences of this "human rights wasteland" and the vast majority of patients have or are experiencing this misbehavior or legally worse, what exactly is being done by patients or patients-to-be to put an end to this and tidy up and set up a profession of civility and true attention to patient dignity?
Though I can't imagine this one blog thread for discussion to be the final origin of "tidying" or "setting up", I think the goal here is to be a "starter" or a "joiner" to begin to achieve these goals. ..Maurice.
PT, I am surprised with your dramatic "implorement" since you have actively participated in numbers of other subject blog threads over the years with no such advice. What is it that upsets you.. specifically exemplified by Biker's comment? Of course, via my medical education, I agree with your detailing the need for analgesia or more for the procedures brought up by Biker. I don't expect my visitors who write to be medically technical fully wise. And they may use technical misunderstandings to describe their experience. But does Biker's comment set the final example of the rationale for not continuing the thread or changing the title to "Establishing Patient Dignity"? I doubt it. If establishing patient dignity within the medical system an impossibility and will never benefit from discussion to change on any level even political or legal, then patient medical autonomy is gone and this blog thread becomes only an avenue for emotional ventilation to others--and if that can be of value then shouldn't that alone be considered in the value of this blog thread and its future? ..Maurice.
Maurice
The modesty (dignity) subject has deviated substantially from the original material to the point that the complaints of many have diluted the focus that no longer seems credible. How can anyone who has read the last 15 or so volumes come to any reasonable conclusion that discriminatory forces and unprofessionalism are at work here. You have non-medical people here recommending to potential patients to ask for no sedation as well as train yourself to minimize the gag reflex. Consider as an example the endoscopic procedure called an egd.
You are wearing a gown, in the rao( right anterior oblique) position on the table. An endoscopic tube almost the diameter of a garden hose is inserted down your throat, esophagus, stomach and eventually the duodenum to evaluate the lining. You are advised to refuse sedation, why? To ensure your modesty is protected? What’s to protect? You are covered the entire time. You are face down, wether you accept or refuse sedation is irrelevant. You need to keep your head down and try not to move. You are in no position to move around and look.
The moaning and groaning has gotten absolutely ridiculous and so off the track I believe that it’s detrimental to the goal of this blog for any outside readers to take seriously. Incidentally, to my knowledge of all CPT codes in healthcare which are thousands and thousands only one comes to mind wether a healthcare insurance company will pay for sedation. I believe they do not pay for conscious sedation for a radio-frequency ablation. Why, you are already receiving pain relief through injection prior to the ablation.
Folks, there is a reason insurance companies pay for you to have sedation and pain relief! Additionally, it’s a tradegy in my opinion that non-medical people on this blog are trying to give medical advice for medical procedures in an attempt to dissuade you from receiving medication when, the success of many medical procedures strictly relay on you being medicated. Enough said!
PT
Maurice
To answer your question, no. I am neither moved nor concerned by comments from other posters, particularly those with no medical background who ideas fester in the surreal or fantasy.
PT
PT, perfect! Now everybody on this blog thread understands or should understand why I need you! You are fully aware by your stated experience in hospital work of all the "ins" and "outs", the "necessary", the "unnecessary" of the multitude of various procedures which are performed every day, patient after patient.
As for me, as a physician who has had many years evaluating and treating patients in the office and a fraction of them requiring hospitalization (where I admitted and daily followed the patient from an internal medicine point of view but who may have been under direct care of multiple specialists who performed multiple studies and operative procedures---which I could not and did not attend. Most of the procedures I learned from the books and journals and not by direct observation.
But YOU, PT, have.
So, yes, you have a role to play on this specific blog thread.. to provide the facts of proper established medical and surgical care. This then can be communicated to the visitor here who has concepts which don't make practical sense in the proper practice of medicine and surgery.
PT, let them express their experiences and views and let them ventilate what concerns them and you are there, if you desire, to "set them straight" in a humane and educative way regarding errors in their clinic understanding. But let them ventilate.
However, this should not be the reason to direct the additional value of this thread to pick up, analyze misbehavior in the medical system, which we all know from various sources does exist. It should also not be the reason to give up an attempt to discuss ways to improve the medical system's attention to dignity of those humans who are under their power as their patients.
So, PT, stick to what you are doing and saying..it IS important. You are the "book" which I used as the graphic here to symbolize the need for all to "become medically educated". With that learning, hopefully patients coming here will learn more about how to maintain their autonomy with no harm to themselves. But also, we much also move our discussions to how we can "upgrade" the medical system.
PT, again..thanks. ..Maurice.
Maurice,
I am simply saying that renaming the blog is a concession that what we are saying has infected medicine to a level that you are unaware of through your personal experience.
I am not trying to dissuade you or anyone else from trying to fix the system.
Changing the name of this thread to "SEEK SOLUTIONS the dismal failure of the profession of medicine's treatment of patients. It acknowledges that MOST physicians and other providers still espouse the morals and conscience and operate in a slightly better manner than those physicians who ran the Nazi concentration camps.
I do not dis agree. It is just satisfying to see your eyes are opened to what others here have seen.
PT,
The profession of medicine has shown that it is NOT capable of protecting the dignity or safety of patients. From J Marion Simms, to the Nuremberg physicians' trial, to Tuskegee, to PE on anesthetized women (today); NOTHING HS CHANGED.
Obviously the AMA and Flexner Report achieved its goal of standardized training for physicians. Unfortunately they lack the ability to empathize with patients OR to realize the expectations of society. They live in a sphere where they feed their narcissism and feed their deviance without consequence.
It is time that someone with a shred of common sense and empathy take the reins. Since these people are so intelligent, they will find a way to complete the procedures and treatments within the patient defined constraints.
We are at the dawn of PATIENT PATERNALISM. Patients are the customer and the customer is ALWAYS right.
Besides, non-medical personnel direct providers everyday how to practice medicine; they are called administrators. Physicians call them "BOSS."
-- Banterings
How about "Maintaining Patient Dignity..."instead of "Establishing Patient Dignity"? Every patient, in my opinion, already has dignity but the issue is one of "maintaining" that dignity when involved in the medical system. I think "Maintaining" is what is the basis of our (my) concerns as the patient enters that system. ..Maurice.
58flyer
Do you think that your reading this blog contributed to their changes? JF.
Dr. Bernstein, I don't need to be set straight. I know from experience that sedation makes me ill. I know that I have had 3 colonoscopies w/o sedation and none were a big deal. I do consent to having an IV for them just in case it turns out sedation is needed, but it hasn't. I know that I have had an EGD and a TEE w/o sedation and that fighting the gag reflex was only an issue during insertion, and while it is uncomfortable having the tube down my throat, it is far preferable to being sick afterwards. With them too there was an IV set up just in case I needed it, but I didn't. I am capable of making my own decisions in conjunction with my doctors in this regard, no matter whether PT has seen it done or not or whether he agrees with it or not.
My apologies if sharing my experiences has been considered inappropriate. It was not my intent. I won't share anything going forward.
An endoscope is not just some fancy flexible scope with a camera at the end of it. There are small openings that through the endoscope you can pass snares and lines to cauterize, cut,biopsy, flush, inflate small balloons to pull out stones in the bile ducts via the Ampula of Vater. I won’t go into all the details but appreciate the complexity and what can be done with the endoscope.
So, as an experiment go ask your neighbor to insert your garden hose down your throat. Cut the spout off and cover the blunt end with something so as not to cut the mucosal lining. Tell your neighbor to inset it about 2 to 2 and a half feet. They will be twisting it and pulling on it in and out to imitate a real endoscopic gastro duodenscopy( egd). Tell 6our neighbor you are practicing your gag reflex so you won’t need sedation. Of course those with sedation are even gaging and considerable mucus is coming out of the mouth. Make sure you are npo the night before because you will have the urge to vomit.
Now, in a real egd if the endoscopist sees something they need to cut or biopsy or in the case of an ercp, they will need to cauterize ( burn) structures within your stomach. It will be EXTREMELY painful so, practice somehow for that. But remember, during that time you must hold still. The endoscopist is taking many pictures so don’t move. You don’t want to have the study repeated do you?
PT
I know many physicians who used to make house calls 60,70 years ago. I knew a physician who would WALK to his patient’s houses every day. He was too old to drive, the state of Kansas revoked his driving privileges because he was legally blind! But it did not stop him from making house calls.Many of his patients were elderly and bedridden so he walked and walked.
Today, there are urgent care centers on every street corner, people go for dumb and ridiculous reasons, it’s called abuse of the healthcare industry but it’s rampant at emergency rooms. It’s pathetic to see people with tattoos all over their body but they can’t handle the flu shot, I didn’t mention The piercings did I? No one was claustrophobic until the MRI unit came along. Any thing to get some Ativan or rather create a torrential downpour of Drama.
My point is everyone these days must create some stupid barrier prior to getting a study, oh I can’t do that or I need this first. Back in the day there wasn’t all this Drama. People didn’t flock to hospitals like they do now. An Er visit for the sniffles. Oh I’m allergic to toroidal but you can give me fentanyl. The new one I suppose now is I don’t want sedation cause nobody going to abuse me, I’m watching all of you.
PT
Biker et al: In visitors reporting and expressing ones intent, experience and emotions on this blog thread, it is not my duty as moderator to be critical or limit how this reporting is displayed to the other visitors here. Each such visitor has their own philosophy of self and their own basic medical knowledge and their own way of expressing what happened. That's how this process of "ventilation" is carried out to be effective--expressing one's understandings, experience and feelings.
In all presentations, I really don't want ad hominem rebuttal by others denigrating personal descriptions of those who write based on that individual's personality or behavior. Discussion should be about the facts of the story without attacking the story-teller. I am not saying that ad hominem rebuttals have occurred here but I just wanted to emphasize that discussion deals with the experiences presented and not the individual presenter.
Now, it is perfectly appropriate, after having read a visitor's experience to suggest ways the reader believes the described experience could be altered to the benefit of the visitor. That was my intent when I suggested after Rick had written about his personal urologic clinic experience, that prior understanding of the nature of the procedure and its preparation (having been educated in this matter) could have allowed him to "take over" the experience and "protect" his self-dignity. This is not an ad hominem presentation about the visitor personally but a suggestion for all patients. Obviously, this was not a pertinent simple suggestion to Rick who, I found out, has had a emotionally traumatic past history.
With regard to Biker, his history and his views, PT's description of the nature and usual necessities of the procedures themselves is appropriate to present as education but still Biker knows himself better than anyone else on this blog thread and his beliefs, experience and outcomes are worthy to "ventilate" or simply describe here as a contribution to the discussion.
So, in conclusion, as you see I am satisfied with PT as an "educator" and Biker as a describer of his own personal experiences to the visitors of this thread.
..Maurice.
p.s.- As you see from the introduction to this Volume 102, I still feel that prior education is worthy in personal medical decision-making as it is in areas such as legal matters, investing, buying a car, etc, etc. ..Maurice.
As we think of expressing our disfavor of medical system behavior, we should also be aware there are "patients" who are out to attack innocent elements of the medical system. Here is an example . ..Maurice.
JF asks;
"58flyer
Do you think that your reading this blog contributed to their changes? JF."
JF, what this blog has contributed is my realization that I am not alone. From that I have found my voice in expressing my concerns to my medical staff to effect the changes I need to go forward. For my right hip surgery I was able to get a mostly male team. For my left hip surgery I was able to get an ALL male medical team. For my recent round of urological procedures I was able to get a male nurse practitioner to perform the intimate care stuff. There have been other things to that I have been successful in speaking up for myself to have a better outcome.
58flyer
Is there agreement here that the ongoing goal of all patients is, despite the "cracks" or worse in the medical system, the goal for each patient is to "maintain" their inherent patient dignity? Thus the new title of this blog thread should be approaches to see that each patient's dignity is kept from being taken apart because of intentional or otherwise behavior within the medical system.
I have a major suggestion: potentially all United States Congressional legislators are returning home for the next month or so and many will be having "Town Hall" sessions.
Wouldn't it be potentially constructive for a goal of appropriate changes in the medical system's behavior to take the story to those sessions and with the added voice of others challenge the legislators for attention to the issues described here but also for effective change. This, I think, would be the most immediate and possibly effective way to get your points across to the legislators and to other potential patients who haven't yet faced the "bad behavior" within the medical system.
Within such Town Hall meetings, you may get an idea as to whether your views are seen by other patients or potential patients as some "statistical outliers" or common and unwanted experiences. Do it! Get started! ..Maurice.
I have never said or thought this blog wasn't doing any good. My question to 58flyer was just for clarification. Its tangible evidence that the blog IS doing good ( if this blog had influence in what he accomplished.)
Where I differ from most on this blog is I know that female patients are embarrassed and humiliated also. Not as often for sure. But I've told of instances. Mine and those of friends.
JF
Before going on to the next Volume. We all must read the following experiential study about anesthesiology nursing students and what they actually observed going on in the operating rooms and their reactions. What comes out of this study truly explains the experience and reactions of patients such as Biker and 58flyer with "no ifs, ands or buts" along with approaches for resolution. You all must, must read the January 2018 Nursing Open article of the study titled "Nurse anesthetist students' experiences of patient dignity in perioperative practice---a hermeneutic study" . The student's (who, you must understand are professional nurses and not nursing students) set forth the following conclusions:
The new understanding of how NA students experienced patient dignity can be summarized into the following presumptions:
Allocating time and communicating implies allowing the patients to express their distress, anxiety and concerns, and preparing them for pending procedures.
Inviting the patients to participate implies that the patients feel reassurance, trust and control of the situation.
Shielding patient bodies implies that the patients get a feeling of well‐being and that they are treated as human beings.
Alienating and ignoring the patients implies that patient needs and preferences are ignored.
Backbiting implies disrespect, allowing depreciation of the patient integrity.
Invasion of the body's intimate sphere implies that the patients may feel objectified and demeaned.
Learning a profession relies on approaches not only theoretical but also clinical. Thus, positive role models are essential to provide the NA students different tools; how to perform with delicacy and discretion in different situations (Grob, Leng, & Gallagher, 2012). The experiences in this study may be an incentive to further reflection to develop awareness and take a stance of this important issue. In addition, the findings of this study could serve as a basis for interventions on how to promote an ethical and dignified culture and how to deal with undignified care in perioperative practice.
Read the entire study. The Conclusion ends with this:
The experiences in this study may be an incentive to further reflection for developing a stance and awareness of this important issue. Furthermore, the findings of this study could serve as a basis for interventions on how to promote an ethical and dignified culture and how to deal with undignified care in perioperative practice.
Again, what this study does is it tends to be quite supportive, through non-prejudicial observations by nurses learning to become a professional administering anesthesia, of the concerns and reactions of patients such as Biker and 58flyer.
What do you think? ..Maurice.
JF,
I agree that women experience modesty/dignity violations also. Just last week my wife had her annual mammogram. The female tech asked her if she was OK with just removing the gown. Since it was just her and the tech she agreed. My wife told me how once she thought about it, it didn't seem right. As is usually the case, those thoughts come after the fact. I explained to my wife that the gown is a comfort measure. I think she should have challenged the tech as to why she(my wife) was being denied a comfort measure. My wife has never been asked to completely remove the gown during a mammogram. That clinic will be getting a letter from me this week.
Just this past January I took my son to a small stand alone ER because he had developed flu like symptoms. The place was packed with other kids with similar issues. It was so crowded that we didn't get a room and had to sit in chairs in the hallway. A lady in one of the bays had heart problems and they needed to move her to another bay that had the proper monitoring equipment. The staff just rolled her out of one bay down the hall right in front of me and my son to get to the other bay. Her chest was exposed with some leads attached and she was only covered from the waist down. Her eyes were closed so I don't know what her level of awareness was. Still, how much effort would it have taken to just simply put a sheet over her?
58flyer
Maurice
After reading the experiences of the nursing anesthiology students in Norway I felt what they saw was quite lame compared to what actually happens in operating room suites in the US. The good news is that no mention was made of surgeons throwing surgical instruments across the room, calling the surgical tech a Bitch and hitting the surgical tech in the hand with a mallet.
During heart surgery the surgeon and the anesthiologist step out of the room to engage in a fist fight. The circulating nurse tells the surgeon the patient is an attorney with the surgeon responding that “ ok, he gets no pain meds after the surgery” . The anesthiologist makes light of a surgical patient’s breasts size and another patient the surgical nurses make fun of how small the patient’s penis is.
I have seen and heard the above and much much more. Therefore I wonder if in Norway the behavior was toned done because of the presence of the student nurse anesthetists. One can’t help but wonder, maybe when I need surgery I might consider traveling there, they sound very professional compared to here in the US.
PT
Good Evening:
Dr. Bernstein, in regard to the study "Nurse anesthetist students' experiences of patient dignity in perioperative practice---a hermeneutic study".
3.2. Sample/Participants
The participants were 23 NA students partaking in their clinical practice at five hospitals in the eastern part of Norway. You'd never see studies like this in American hospitals with American participants. They'd all have to lie thru their teeth.
Many countries treat their patients much better than we do here in the US. There, they make a conscious effort to treat patients like people first. One of the ingredients sorely missing here in the States.
Now if you wanted to talk about our way of handling patients, all ya have to do is check out section 4.2. That sir is the "American Way" of doing business in our medical institutions.
In America it's all about time and money. Time is money and when you waste time you waste money.
Here the "system" wants you to do more with less so it's no big deal if a patient is moved from one place to another & she's partially exposed. Taking the time to cover her up is wasting time which in turn is wasting money. Something that the greed mongers at the top won't stand for.
Take'em to the OR, knock them out, strip'em, clean'em so they're ready for the surgeon. Don't worry about covering them up so nobody sees their birthday suit, or sweet talking to them to make them feel better.
Get'em in & get'em out. Time is money & when you waste time you waste money.
THAT is the AMERICAN way of doing business these days. It's ALL about the almighty $$Dollar.
GREED is the cancer that has killed the American healthcare system. Care is gone from healthcare. It's just a health system now.
If those NA's in Norway follow this study, they will without a doubt one day be a credit to their profession.
Regards to all.
NTT
To PT and NTT, I appreciate your review of the Norway study I presented here and I agree. It is of interest that the concept of "human dignity" in medical practice is with regard to Norway relatively new:
Human Dignity in Norway
Before arriving with the next Volume which I decided to title "Preserving Patient Dignity (Formerly Patient Modesty) Volume 103, I want to present my visitors with a formal article regarding the concept of Human Dignity in patient care. Though written by 3 authors from Tehran University of Medical Sciences it covers the matter as written "world wide". ..Maurice.
Maurice
I know a few Americans who have had emergency medical care with long term hospitalization in a middle eastern country. Their impression was that compared to the US, the middle eastern hospital ( turkey),( Iran) respected human dignity more. But this brings up some interesting questions. Here in the US each state has the health department, then there is the Joint Commission, then Medicare as well as other state regulators that oversee hospitals.
My point is in the US there is much regulation by which a patient could arc their concerns to potentially if necessary but to what success. Middle eastern hospitals certainly don’t have the level of regulation that we do. I know many people who travel to Mexico exclusively for their healthcare and they say it is just as good if not better than ours. Have we been hoodwinked in thinking that at $4 Trillion dollars annually we can expect the best.
Is it society that sets standards for human dignity based on that societies culture. Do we assume now as it appears that excessive hospital regulation has little or no effect on how human dignity is dispensed,that education with all the nursing programs and all the prestigious medical schools has little or no effect on the value set for human dignity?
PT
PT, I think I will bring up in the 103 Volume, the matter of whether certain elements of what are considered part and parcel of human dignity are detrimental to the effective diagnosis and treatment of an ill patient. The point, then being, if these elements of what is considered patient dignity are followed based on the patient's request, does the profession consider that hazardous for the patient but also for the physician who will bear the legal burden, perhaps set by family members, if damage is done to the patient? ..Maurice.
NOTICE: AS OF TODAY JULY 29, 2019 NO FURTHER COMMENTS WILL BE PUBLISHED ON THIS VOLUME #102. COMMENTS WILL CONTINUE NOW TO BE PUBLISHED ON VOLUME #103 NOW TITLED
Preserving Patient Dignity (Formerly: Patient Modesty):Volume 103
..Maurice.
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