Patient Modesty - page 5

Want to get feedback about how we all handle pt concerns about modesty and/or being naked as part of surgery. Concerns about who sees them and for how long? Why do they need to be naked? When is the... Read More

  1. by   Batman24
    If I ever had surgery I would like the staff to introduce themselves, be professional, kind, and protect my modesty the best they could. I can't see myself wanting to interview everyone involved. I'm modest and I might share that. I would also ask them to keep me alive because I'm petrified of surgery. lol I would of course spend ample time with the surgeon and adequate time with the Anesthesiologist. I realize that the level of privacy would depend on the surgery required.
  2. by   Batman24
    Question: How many people are usually in the room while the patient is being cleaned and draped?! Do other medical staff come in and out once the surgery starts or does it remain private barring an emergency?! Are the windows to the OR covered?! I think I read somewhere here about a very kind nurse putting up blankets and I wondered if that was based on patient request. I thought they would automatically be covered.

    Edit-I'm a nursing student and this field interests me. TY.
    Last edit by Batman24 on Feb 3, '08
  3. by   GadgetRN71
    Our door to the hallway for all the rooms has a shade that we pull down...the blanket thing was in an OR where there weren't shades. I will also not allow instrument/equipment reps into the room until the patient is draped. I've thrown out orderlies that I thought were immature/nonprofessional. We do try in the OR to protect the patient as much as possible but sometimes, a body part needs to be exposed. The requesting of a particular team that is a certain gender is not often doable either. Trust me, you want the most skilled/talented people in your room..it shouldn't go by what reproductive organs you happen to have.

    The OR is a great place...glad to hear you're interested!
  4. by   core0
    Quote from Batman24
    Question: How many people are usually in the room while the patient is being cleaned and draped?! Do other medical staff come in and out once the surgery starts or does it remain private barring an emergency?! Are the windows to the OR covered?! I think I read somewhere here about a very kind nurse putting up blankets and I wondered if that was based on patient request. I thought they would automatically be covered.

    Edit-I'm a nursing student and this field interests me. TY.
    Most ORs are set up with an outer unsterile hall and an inner sterile core. Think of a donut with the hall around the donut, the donut itself the rooms and the donut hold the core. Sterile and clean items and instruments are stored in the core and the patients are brought in through the unsterile part. Only personnel wearing scrubs and overgear are allowed in the core. This prevents accidental contamination of sterile and clean items.

    As far as windows there is usually a window in the door and some rooms have other windows into either the hall or core. Usually they either already covered or not. Non door windows are usually indicative of older ORs. It would be unwise to cover the windows in the door since that is how people know that a case is going and they cannot enter the room unless necessary (in most ORs there are only a few entrances between the hall and core and its common to cut through ORs if they are not in use).

    As far as who is in the room, there are always four people in a regular OR case a cirulator, a scrub, anesthesia and the surgeon. Other people who may be present are anesthesia techs, perfusionists, first assists and additional nursing personnel as required. A busy case such as open heart surgery may have as many as 10-12 people in the room. In an academic institution there also may be residents or other trainees. Generally once the case is started you try to limit the amount of traffic as that is one of the principles of aseptic technique. Depending on how long and how complex the case is you may need to bring in more instruments, blood products or medications all of which necessitate people coming in and out. If the case takes time then everyone but the surgeon may have relief for lunch or other breaks.

    As far as covering the patient, hypothermia is a problem in the OR so you try to keep them as covered as possible. You usually only uncover what you need to prep or what anesthesia needs access to. Once you drape its often hard to tell there is a patient under all the drapes. In a big case anesthesia will first need to get access before draping. Usually there is a minimum of people in the room but in a big case the patient may be asleep for more than an hour before the case actually starts.

    Hope this helps

    David Carpenter, PA-C
  5. by   dutch92602
    Quote from WitchyRN
    Our door to the hallway for all the rooms has a shade that we pull down...the blanket thing was in an OR where there weren't shades. I will also not allow instrument/equipment reps into the room until the patient is draped. I've thrown out orderlies that I thought were immature/nonprofessional. We do try in the OR to protect the patient as much as possible but sometimes, a body part needs to be exposed. The requesting of a particular team that is a certain gender is not often doable either. Trust me, you want the most skilled/talented people in your room..it shouldn't go by what reproductive organs you happen to have.

    The OR is a great place...glad to hear you're interested!

    This "trust me you want the most skilled/talented people in your room."

    ..How is a patient to know if they have the best or worst team? They don't ...it is pot-luck for a patient.
  6. by   dutch92602
    Here is another issue about dignity and privacy and modesty in the OR.
    Go to: http://creston.com/downloads/pdf/featured_articles/business/or_live_university_hospital_uab.pdf
    Go to: http://www.or-tv.net
    Go to: http://ucihealth.com/news_releases.asp?filename=or1.htm

    (between the word featured and articles there is the hyphen on the bottom of the line and between "or" , live, university and hospital)


    For about 7 yrs now this ORTV stuff has been going on. The thing that is not disclosed is that non-medical geek techs can dial into an OR. The cameras are not turned off, so a patient when fully exposed will be visible to anyone dialed into the OR from anywhere in the world. These video streams can be captured on the receiving computer. Comments, albeit inappropropriate comments, from healthcare professionals is nothing compared to this technology. This is voyeurism beyond words! The techs that support this AV computer system that enable remote functions to physicians and others all over the world also have the same remote access to the entire system.
    Last edit by dutch92602 on Feb 4, '08 : Reason: corrected text
  7. by   NoWaNrN
    I had a simple D&E done after a miscarriage, I had never had surgery where I was put under general anesthesia before and was nervous. As a nursing student observing in the OR I heard some pretty bizzare things being said. So in my room before surgery I told the Nurse anesthesist to tell everyone not to make fun of me or say bad things about me while I was "out". She told me awe sweety you are beautiful, they won't have anything to say about you. Thanks for the compliment but mean while in surgery in the lithotomy postion, wonder if anything was said. I was just uncomfortable knowing that things are said and how I was postioned while have a proceedure. I can simpothize.
  8. by   Jarnaes
    dutch92602, can you please post the hyperlink to that site. The only thing I can find is a virtual operating room tour... Give us the link that you are talking about.
    You seem set and determined to find something negative or controversial about the operating room, what's up with all the hostility???
  9. by   GadgetRN71
    Quote from dutch92602
    This "trust me you want the most skilled/talented people in your room."

    ..How is a patient to know if they have the best or worst team? They don't ...it is pot-luck for a patient.
    Most ORs will try to match the case to the staff who are most knowledgable or skilled in a given specialty or procedure. They do this primarily for the patient's benefit but surgeons like it too. For instance, in my specialty(orthopedics) there are nurses and techs who almost always work with the same doctor, doing the same types of cases. If you start saying "I want only males in my room" for example, you may very well get someone who is brand new or not experienced in the procedure. You've denied yourself the best staff merely because they are the "wrong" gender. That was my point.

    Give me an experienced, compassionate nurse or tech for my surgery...I don't care what they have between their legs!
  10. by   elizabells
    I'm not an OR nurse, but in re videostreams of surgeries:

    Every surgical consent I've ever seen has a separate section to consent for cameras to be present during surgery. Patients are free to deny consent for this. Nobody is sending OR videos out over the net without the patient's specific consent.
  11. by   dutch92602
    Quote from elizabells
    I'm not an OR nurse, but in re videostreams of surgeries:

    Every surgical consent I've ever seen has a separate section to consent for cameras to be present during surgery. Patients are free to deny consent for this. Nobody is sending OR videos out over the net without the patient's specific consent.

    A commonly used consent form patients' are asked to sign consenting to a blood transfusion also states in small print:

    Allow photos, videography, and others to be present and stand in

    The AORN also confirms these are standard forms widely used.

    The other caveat to this issue is that this form is handed to a patient while in bed in an OR holding area. The patient is without corrective lenses at this point in time and there is no adovcate or family member present to read the entire form. Therefore, the patient is signing this not knowing they are consenting to such things!!!!!
    Last edit by dutch92602 on Feb 5, '08
  12. by   Anxious Patient
    At the teaching hospital where I had my surgery, the general consent form was presented to me just before surgery. The form included vague paragraphs about patient photography, medical student participation, etc. Nothing specific. One signature covered everything. I asked if I could strike out the photography paragraph, but was told by the admissions clerk that the consent form could not be altered. If it was, it would be considered invalid, thus surgery couldn't be performed.

    I was told that I could make a verbal request to the circulating nurse that I would meet prior to surgery, which I did. (I would have made this request directly to the surgeon, but was already anesthesized by the time I was wheeled into the OR)

    My question is: Would the cir. nurse be obligated to pass on my request to the surgical team? And, if the request wasn't honored, what could/would she do about it?
  13. by   dutch92602
    Quote from Anxious Patient
    At the teaching hospital where I had my surgery, the general consent form was presented to me just before surgery. The form included vague paragraphs about patient photography, medical student participation, etc. Nothing specific. One signature covered everything. I asked if I could strike out the photography paragraph, but was told by the admissions clerk that the consent form could not be altered. If it was, it would be considered invalid, thus surgery couldn't be performed.

    I was told that I could make a verbal request to the circulating nurse that I would meet prior to surgery, which I did. (I would have made this request directly to the surgeon, but was already anesthesized by the time I was wheeled into the OR)

    My question is: Would the cir. nurse be obligated to pass on my request to the surgical team? And, if the request wasn't honored, what could/would she do about it?

    Personally speaking, I would obtain all consent forms at least 1 week in advance of a scheduled elective surgery. This would allow proper time to read everything. That way any issues could be addressed and if they could not accomodate to what a patient is willing to accept then you have the option of cancelling the procedure and going elsewhere.

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