patient privacy - page 2

by naftali216 5,048 Views | 28 Comments

during my career i always did whatever i could to protect the patients modesty regardless of gender or age. i was recently a surgical patient at a VA hospital and had what i feel was a disrespectful experience. without... Read More


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    As students spending a day in surgery, we were required to personally introduce ourselves to the patient & ask their permission to observe their procedure. Put in that situation, I don't think I would have a problem. Being swarmed by strangers coming to watch just prior to my going under would probably tick me off!
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    I agree completely. At my last colonoscopy, I had 7 people in the room, 4 of whom were in training. This didn't bother me in the least, however, since I had volunteered to have students present. I figured that I had to go through the test, anyway, so why not let someone learn at the same time?

    However, had I not been aware that observers would be present, and had my explicit consent not been given beforehand, I would have had a much different reaction.
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    Let's do a little philosophy here, okay? Ontology -- no, this isn't about cancer. It's about the essence of what it means to be a "patient." What "is" a patient? And what "is not" a patient. A patient is a human being -- a person, an individual. Not just a body, but a mind and a soul. A patient, in essence, isn't a teaching tool to be "used" by professors and students. Now, many patients will agree to being used as a teaching tool if they are approached with respect and dignity -- if there's a clear understanding that it is the patient's right to refuse. Most patients do understand that doctors and nurses need hands on training in hospitals. But -- Hiding such consents in small print in documents, and putting people "out" quickly before inviting in the spectators -- that's not informed consent. It's a travesty, unworthy of the profession of medicine. It's an entitlement attitude, an us vs. them point of view, a complete disregard for the humanity of the flesh going under the knife. Frankly, it's an ethical violation. But apparently, it's so common these days that professionals have become oblivious to this disrespectful behavior.
    unclebda, ImAnORnurse, monkeybug, and 3 others like this.
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    Quote from NoviceRN10
    I don't think it's a big deal. The surgery you had was one that I was able to observe during nursing school and I remember the pt being draped during the procedure. He wasn't exposed or hanging out all over the place. I don't think you have the say of who is or isn't observing or in the OR during a surgery.
    The patient does have a say regarding observers anywhere in the OR and anywhereelse in the hospital. An OR transcript of whose presence is done at the beginning or endof each surgery case. That information is made available to the patient if requested.
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    I would be ENRAGED if I was you. That was a told violation of your rights. Even when I had my tonsils out, they had me fill out forms asking if I could be observed, filmed, or specimens from my body could be used for research. If I was you, I would file a complaint. Sorry if this seems a bit overboard, but my cut reaction is to be mad for your sake.
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    you know, whenever this sort of thing has come up, i do my best to make a teaching occasion out of it. if that's not possible, i think to myself, "well, plenty of people have seen this body, a few more won't make a damn bit of difference." then i smile to myself about some of those past occasions, and wait for the sodium pentothal to kick in.

    i hear you about asking permission, and i would do that for a patient. but i am not such a special snowflake that i really need to worry about what professionals are thinking about my corpus. they've all seen something like it before and will see a lot more of it before they retire, so what the heck. chill out.
    SNB1014 likes this.
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    "but i am not such a special snowflake that i really need to worry about what professionals are thinking about my corpus."

    i don't disagree with that point of view, but it is a point of view. as i see it, it's not about what the professionals are thinking or how they feel. it's about what the patient is thinking and how he/she feels.
    that's the crux of the issue. frankly, i assume that most professionals are so used to their work that they take it in stride. this is both good and bad. good if they don't ever forget how the patient may be feeling. bad if they become habituated or numb or routinized to such an extent that they just go through the motions without thinking. but the point isn't how the caregiver feels. it's how the patients feel. most patients don't have this done to them every day. indeed, many patients have never had this done to them before. this is were the abyss exists sometimes between the patient and the caregiver point of view.
    StayingFit likes this.
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    This is why you need to read everything very carefully before you sign it. Pretty much every consent for surgery I have seen includes a paragraph about photos for educational purposes and allowing observers, also for educational purposes. Quite honestly, if you don't take the time to read something as important as the consent for someone to cut into your body, then you've given that consent by signing that paper you didn't read. Let's be real, nursing isn't just about the patients, it's also about educating those who will one day take our places.
    nohika likes this.
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    Quote from poetnyouknowit
    This is why you need to read everything very carefully before you sign it. Pretty much every consent for surgery I have seen includes a paragraph about photos for educational purposes and allowing observers, also for educational purposes. Quite honestly, if you don't take the time to read something as important as the consent for someone to cut into your body, then you've given that consent by signing that paper you didn't read. Let's be real, nursing isn't just about the patients, it's also about educating those who will one day take our places.
    Truthfully, most nurses don' t even know that exists on the consent. You are in a hurry to getthe patient to sign it. And if the patient did sign that portion of the consent would you look for it and/or follow through. How about treating everyone like you want tobe treated.
    StayingFit likes this.
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    Quote from Sacred eagle
    Truthfully, most nurses don' t even know that exists on the consent. You are in a hurry to getthe patient to sign it. And if the patient did sign that portion of the consent would you look for it and/or follow through. How about treating everyone like you want tobe treated.
    Where I work, it is the physician's responsibility to obtain consent. My signature only says that I witnessed the patient sign that paper. It all boils down to personal responsibility. The consent is a legal document. It should be read in its entirety before being signed.

    That being said, if I have a student with me, I take them out to preop with me and introduced them to the patient. No one has ever had an issue with it that I've met. I've had one patient who did what responsible patients do and read the consent. He then crossed out the entire paragraph about photos and initialed next to it. No big deal, we followed his request and we didn't take photos (not that we would have anyway for the surgery he was having).

    Patients need to be active participants in their own care. That includes reading all required paperwork/consents/whatever as well as following recommendations that are accepted standards of care, such as coughing and deep breathing and getting out of bed to a chair soon after surgery.
    ~*Stargazer*~ likes this.


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