Male modesty double standard

Esme12, ASN, BSN, RN · Sep 30, 2014

the doc was only struck in self defense AFTER the patient made it clear he was refusing and the doc insisted on doing the exam, AGAINST the patient's stated wishes. up to that point, and including that point there was no behavioral issues that would belie a brain injury. if that exam was so important why wasn't it done first?

It wouldn't be done first...ABC...D Airway, breathing, circulation...disability. That is why trauma patients are left in the C-collar in the presence of distracting injury when admitted. Rectal tone is a part of C-spine eval. The resident said she did the exam then said she didn't...will we ever know? probably not. Out of all the rectal exams I actually have never heard a patient say they were sexually assaulted nor strike the MD because of one. From my personal experience I it is a part of the exam. Some docs might have deferred and opted for a CT but in teaching institutions it is by the book.

But is striking anyone ok? IMHO no. Not being there it's hard to know. I read about this case as it went along. IMHO they courts got it right

SionainnRN · Sep 30, 2014

He was charged with assault because he punched a MD in the face. He was combative which is common in head injured patients. If the trauma patient is uncooperative to the extreme (punching the MD in the face) they are sedated, intubated, given the trauma work up as per the standard of care, extubated (if nothing is found) and discharged.
I realize he walked into the ED....however I have had many patients walk into the ED that are gravely injured. I remember on case in particular a guy fell in the bathroom and said his neck was sore....something told me he had a problem even though first survey, in triage, revealed nothing significant. I placed him in a C-Collar. He had 2 cervical fracture nd needed a HALO traction for several months.
We rally all the time about violence in the workplace but when a patient, that was eventually deemed competent, is arrested we are offended. Patients scream and carry on in the ED ALL the time. If we listened every time we heard "NO. NO! NO!! You bunch of *&^(%*^#$%#%&^$%#$@#%"...there would be many lawsuits for delay of treatment and failure to diagnose.

I've had a pt who was in a MVA, cleared by medics at scene, brought in by cops for work up prior to jail for DUI and had.....a broken neck!! About 4 hours of this drunk dude walking around with a freaking broken neck. We got him in a c-collar ASAP but how he didn't sneeze and sever his spinal cord I'll never know. And of course keeping a drunk from taking off their collars is almost impossible so it's good the cops were by his side the whole time. Pts don't always preset symptoms in the way the books say.

banterings · Sep 30, 2014

morte and caregiver111,

Thank you for understanding and seeing.

I realize that cases like Brian Persaud are darn if you do, darn if you don't. Other than morte and caregiver111, people see what happened to him as acceptable. So what, all the Brian Persaud's are collateral damage?

morte was also the only one that dare call out his treatment. That is another problem, people not speaking up against abusive treatment. I know that between the physicians, administrators, and the whole hospital system, the cards are stacked against reporting. Take the case of Dr. Twana Sparks (link here:)

Dr. Twana Sparks, an ENT (Ears, Nose and Throat) surgeon, had just finished doing a tympanoplasty with mastoidectomy, a surgical procedure to correct a middle ear problem. The patient was a middle-thirties Hispanic man who lay stretched out before her on the operating table, still under anesthesia.
After applying a dressing to the surgical site, Dr. Sparks, who was also the hospital chief of staff, reached inside the patient’s boxer shorts without wearing gloves, fished out his member and pointed it at the ceiling. She observed fluid filled vesicles on the side of the shaft, indicating a sexually transmitted disease, and shouted “Oh Gross!” She then slapped the head of his member three times, saying “Bad boy, bad boy, bad boy!” with each strike, as her all female operating team erupted in laughter.
Well, all but one. The Certified Registered Nurse Anesthetist, Alison Garner, who was providing anesthesia for the case, found Dr. Sparks’ conduct to be so unprofessional that she reported it to the administration at Gila Regional Medical Center and eventually to the New Mexico Medical Board.
Reporting Dr. Sparks may not have been the best professional move for Garner. Sparks is a money maker for the hospital who will generate an estimated 20 million dollars in revenue over the next 10 years. She is also the only ENT surgeon residing within 100 miles of Gila Regional.
After an investigation, the state medical board issued restrictions on Sparks’ practice, including requirements that she not ever be alone with any patients and that she is prohibited from performing genital, rectal or breast exams for any reason. But she was allowed to keep her license and return to work.
One month after that, Garner’s practice privileges were terminated at Gila Regional amid allegations of incompetence, and she was shown the door. More pointedly, the doctor who was alleged to be sexually abusing patients still works for Gila Regional. The anesthetist who reported her is out of a job.

This is truly INDEFENSIBLE!!! I am not accusing anybody here of doing this, but it happens everywhere (maybe not to this extent, but it happens).

According to other hospital employees, Dr. Sparks’ “exams,” were not of the usual variety, especially for an ENT. She regularly performed genital inspections of male patients while they were under a general anesthetic and without their permission. These were reportedly a common occurrence and the butt of several running jokes.
One joke that frequently made the rounds among the operating room staff was, “Um, doctor, that’s a long way from the throat.” Another staff regular was “Now I realize that ENT stands for Ears, Nuts and Testicles....”
....His (Dr. Mark Donnell) alleged statement, “Oh, wait, is Twana doing one of her exams again?” would be 100% consistent with operating room humor, and what is considered common knowledge in that hospital.

It has been alleged that this was common knowledge and had been going on for over 10 years.

I don't expect any answers to this, but ask your self, "What do I know about or have seen that is inappropriate?" You cannot answer "nothing." The first step to change the culture is to acknowledge that there is a problem. The second step is not to allow excuses.

Do not judge your neighbor until you walk two moons in his moccasins.

--Cheyenne Proverb

"The only thing necessary for the triumph of evil is for good men to do nothing."

--Edmund Burke

Esme12, ASN, BSN, RN · Sep 30, 2014

May I suggest you do the same

Do not judge your neighbor until you walk two moons in his moccasins.
--Cheyenne Proverb

I am not saying that the behavior witnessed by the OP wasn't inappropriate however we weren't there... but to paint the medical profession, or nurses, with a single brush stroke isn't appropriate either.

Dr. Sparks, who was also the hospital chief of staff, reached inside the patient’s boxer shorts without wearing gloves, fished out his member and pointed it at the ceiling. She observed fluid filled vesicles on the side of the shaft, indicating a sexually transmitted disease, and shouted “Oh Gross!” She then slapped the head of his member three times, saying “Bad boy, bad boy, bad boy!” with each strike, as her all female operating team erupted in laughter.

If I was witness to this behavior I would have right there, in front of the MD, called the hospitals ethics department, risk management, administration, filled out an incident report, called the certifying board, called the state and reported their sorry behind.

I reported a physician for punching a patient, I have reported a physician for drinking. I am a good nurse and a moral human being. What you document happen...but are the extreme. Don't assume that all medical professionals are unprofessional and stand by and do nothing.

psu_213, BSN, RN · Sep 30, 2014

This is truly INDEFENSIBLE!!! I am not accusing anybody here of doing this, but it happens everywhere (maybe not to this extent, but it happens).

You have offered some logical, passionate arguments for your point of view. Sorry to say, you have jumped the shark on this one. Yes, it is truly indefensible, but there is absolutely no way that you can make a comparison between Dr. Sparks' perverted actions and a legitimate medical exam.

macawake, MSN · Sep 30, 2014

During my relatively brief time as a member on AN I’ve seen several different usernames who have one thing in common. Their very first post, and the only topic they show an interest in discussing, is about male genitalia and female nurse’s purported inappropriate fascination with the aforementioned appendix.

No matter how many nurses write and share their opinion and experience that this isn’t a common phenomenon in healthcare, the posters fixated on male genitalia and female nurses, never seem to budge on the standpoint that healthcare is rife with female predators.

In the light of my former career and experiences I’m instinctively suspicious when someone anonymously wishes to discuss sexual predatory behavior in detail, I automatically wonder about motivation. But since I can’t be sure if the motivation is sexual gratification, plain old internet “trolling” or if the person behind the posts is genuinely hurting from something they’ve experienced in their life, I try to tread carefully.

Generally speaking I don’t think it’s healthy to fixate on any one subject, it can take over your life. If a person suffers a trauma or an attack it may have significant psychological ramifications. That individual will often need professional support like for example therapy, for a long time following their life-altering event. If a victim instead focuses all their energy on negative, uncertain, frightening or threatening aspects of life instead, it is my belief that they will never be allowed to heal. That’s in my opinion a sure method to perpetuate the trauma and its’ negative effects.

Take the case of Dr. Twana Sparks

If this story is true then this surgeon’s behavior is obviously blatantly criminal and deeply unethical. I’m sure there are depraved and sick people in every profession on earth, so I can readily accept the possibility that an individual MD could be a completely rotten apple. If this story is true it’s my opinion that the surgeon should have her license revoked and face criminal charges.

What doesn’t ring true quite to me about this story, is that she’d be surrounded by an entire team (except the CRNA in this case) who all “erupt in laughter” at what must be considered by most, to be truly outrageous behavior.

When I think of all the nurses and physicians I work with every day, I can’t imagine a single one who would regard behavior like this as hilarious. I just don’t see it. The warped work culture and the large number of deviant personalities an incident like this requires to take place, is something I’ve never encountered. I do however acknowledge the fact that just because I find the scenario implausible, sadly doesn’t make it impossible. I wasn’t there, I can’t be sure.

If any member of an OR team in my hospital did anything even remotely close to the incident described they would be escorted out of the OR suite as soon as it was practically possible, they’d undergo a mandated medical and psychiatric evaluation and charges would likely be filed. No one would condone or protect this kind of behavior.

psu_213, BSN, RN · Sep 30, 2014

What doesn’t ring true quite to me about this story, is that she’d be surrounded by an entire team (except the CRNA in this case) who all “erupt in laughter” at what must be considered by most, to be truly outrageous behavior.

I think you only need to look at the website and its mission statement(s) to realize this is not a news story. This is not an unbiased account of what happened. The website's purpose is not to provide an thorough reporting of the incident. Like most websites there is an underlying agenda; the purpose of the way this is presented is to create a furvor and feeling of anger in those who agree with the agenda of the site. The site/author wants us to think "these horrible female nurses just stood around while a female doctor humiliated a male patient," and I, for one, just don't buy it.

Of course we all agree this is a horrible situation, but it has nothing to do with maintaining dignity of trauma patients.

whodaman · Sep 30, 2014

No, I don't think he is just looking for a fight. What is happening is that everyone is dodging his question by citing the most extreme cases that can think of and using that as a reason to justify offering men less modesty and consideration than females.

I had to go to the hospital to get my tonsils out. Not even a trauma or ER situation. When I was taken back to some area with a bunch of curtains that allow the nurses to get multiple patients ready for surgery in this one particular area. I was taken into one of the curtain off-able areas. The nurse that escorted me in said I needed to completely disrobe and put on the gown that she offered me. I asked why I had to remove my underwear to have my tonsils out. I guess not wanting to go into a long explanation, she said it was procedure. I pause expecting her to leave, she did not but said we needed to hurry things along. I undressed in her presence, embarrassed, and put on the gown. She took my clothes and put them in a bag, opened the curtain, and left. There were other patients there waiting as well with family members. The way they were situated, the guy across from me was exposed to the whole room. Left me there for about 20 minutes. While waiting, I heard a nurse in one of the curtains down from me offer a female patient some "modesty panties" to wear. Don't know what they are but that didn't sound like standard procedure. I really don't remember much after that. I am sure it is an after effect of the anesthesia. I woke up in the recovery room. It was freezing. I felt like I was on a metal table but I am sure it was probably a gurney or something. My gown was hanging down in front of me and I was completely uncovered. I could see people walking back and forth. I tried to lift my gown to cover myself, but I was too weak. As a nurse walked by and saw me struggling, she grabbed my gown and tossed it over me. I don't remember anything after that until I woke up in a patient room. I spoke to a female friend that works in that hospital and she made the typical, "that shouldn't have happened to you but they are all professionals, its no big deal". It was a big deal to me, regardless. To Caregivers point, men's modesty is not even an afterthought.

As to the statement that they are all professionals, just look at the case of the ENT that after her male patients were under anesthesia, she was doing genital exams. (Dr. Twana Sparks, MD) The professional nurses joked that now we understand what ENT stands for ear nose and testicles. She was reprimanded and is back at work in the hospital. If that had been a male doctor doing that to female patients he would be in jail, but that is another discussion. To say that everyone who works in the medical profession is a professional and somehow they only get the ones that upstanding people and won't act inappropriately is ridiculous. Do I think many if not most of them are, yes, but there is too much evidence that there are plenty who do not adhere to all the standards of professional conduct. Even on this board there is a post where female nurses admit to talking about male patients genitals and even worse actions. There is a large void out there when it comes to male patient care and respecting their modesty.

Have you had a male patient request a male for sometyhing they needed that would be embarrassing? How did you respond when you told them no? And usually its a no....

As I posted this comment and it was pushed to the end of the list of comments, I saw that someone else posted a comment about Dr sparks. The typical responses, that this isn't true, blah blah blah.... you can read about it in the

outpatient surgery periodicals website. No, that website does not have an agenda.

http://www.outpatientsurgery.net/resources/forms/2010/pdf/OutpatientSurgeryMagazine_1001_ent.pdf

psu_213, BSN, RN · Sep 30, 2014

1. As to the statement that they are all professionals, just look at the case of the ENT that after her male patients were under anesthesia, she was doing genital exams. (Dr. Twana Sparks, MD)
2. Have you had a male patient request a male for sometyhing they needed that would be embarrassing? How did you respond when you told them no? And usually its a no....

1. As I said before in another thread…there are creeps in all professions. There are nurses who are creeps, doctors who are creep, teachers who are creeps, lawyers who are creeps, etc. They make up the vast minority of individuals in a given profession, but they do exist. Dr. Sparks is a creep, but it is pretty inconsiderate to decent healthcare professional to then assume that all healthcare professionals condone and accept her behavior.

2. It happens all the time that a female nurse comes to me and says Mr. R needs help with using the urinal, but wants a male to help him. Sometimes there are no male nurses available, just as sometime there is no female doctor on duty when a female patient requests a female doctor to do her pelvic exam.

whodaman · Sep 30, 2014

Not saying they all condone it, but there is no real outrage. And it is hard to ignore the gender of the perpetrator and the victim and see the outcome as anything but a double standard.

Do I personally think you all condone it, no, but I personally do think you feel it is no big deal and it undermines my faith in the medical profession. I will not go to the doctor until it is absolutely necessary and I certainly don't go for "routine exams" because I have a concern about my treatment and my perceived lack of concern for me as a male.

You can act offended all you want but at the end of the day, men avoid hospitals and doctors because we perceive that we are not respected and valued like they do their female patients. Ever seen a Men's Wing in a hospital?...

psu_213, BSN, RN · Sep 30, 2014

Ever seen a Men's Wing in a hospital?...

Well, it is technically not a "wing", and, true, it is technically not all male patients, but my hospital does have a dedicated urology unit. It happens to be one of the nicest in the hospital--all private rooms, mini-fridges in the rooms, HD TVs in every room. This certainly does not prove that there are not a few nurses out there who don't care about patients privacy, but predominately male units do exist.

One of our (male) nurses calls it "The member Palace"….uh oh, did I just insult the dignity of the male patients on the unit. :blink:

macawake, MSN · Sep 30, 2014

I woke up in the recovery room. It was freezing. I felt like I was on a metal table but I am sure it was probably a gurney or something. My gown was hanging down in front of me and I was completely uncovered. I could see people walking back and forth. I tried to lift my gown to cover myself, but I was too weak. As a nurse walked by and saw me struggling, she grabbed my gown and tossed it over me. I don't remember anything after that until I woke up in a patient room. I spoke to a female friend that works in that hospital and she made the typical, "that shouldn't have happened to you but they are all professionals, its no big deal". It was a big deal to me, regardless. To Caregivers point, men's modesty is not even an afterthought.

What jumps out at me as a PACU nurse isn’t primarily a modesty issue. It’s a question of thermoregulation.

The body temperature can drop from different heat loss mechanisms. They are radiation, convection, conduction and evaporation. All these can also occur in the surgical setting. Conduction is the reason why a patient wouldn’t/shouldn’t be laying directly on a metal table in the PACU, and I’m sure they wouldn’t be even though one might have felt very cold. Feeling cold and even shivering is something that can happen after anesthesia and surgery. Convection is the reason why we cover our post-op patients with both gowns and blankets.

If the patient is normothermic, preventative warming measures and insulations like those I’ve mentioned are used. If the patient is hypothermic then active warming will be added to the above measures.

Anesthetic drugs impair normal thermoregulatory mechanisms. Postoperative return to normothermia occurs when the concentration of the anesthetic drugs decrease sufficiently to allow a normal thermoregulatory response. (There are other factors that have an effect on this too, not only the anesthetic drug/s). Anyway, this is why I and other PACU nurses and nurse anesthetists continuously assess for hypothermia both intra- and postoperatively.

Also, if a patient has removed their gown and/or blanket I would ask myself why the patient has done this and assess accordingly. I wouldn’t just toss the gown or blanket on the patient and leave. I don’t leave unless I’m relieved by another nurse, I always have eyes on my patient or patients in the PACU.

This above isn’t medical advice or commentary on your specific case, since I wasn’t present. It’s just a little background information to help you understand where I’m coming from when I say that your account of the nurse’s behavior surprises me. It really does. Again, it's not behavior I recognize from my own experience, to me it feels alien. I am sorry if this happened to you though.

Not saying they all condone it, but there is no real outrage.

I’m scientifically trained and my nature is analytical. I’m not prone to big, flashy and loud expressions of emotion. I also don’t think that most healthcare workers are perpetrators but if and when patients are genuinely mistreated it upsets me greatly and I attempt to alleviate or rectify the situation. I think that many of the posts I’ve seen here by non-nursing members are rather emotionally charged and nurses are trained to calmly assess and reflect. I think that this may be part of the reason for the discord present here.

You can act offended all you want but at the end of the day, men avoid hospitals and doctors because we perceive that we are not respected and valued like they do their female patients.

I don’t believe that this is a problem of the magnitude that you seem to believe it is. I think that there are many reasons why men and women might hesitate to seek medical attention, I personally think modesty is pretty far down on that list. We’ll have to agree to disagree.