Patient modesty concerns pertaining to surgery - page 17

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   tbrd450
    Quote from poetnyouknowit
    Okay, I'm probably going to get flamed for this, but I've gotta say it.

    While I agree that the situation with the skateboarder was completely inappropriate and never should have happened, it has nothing to do with the topic of this thread, which is patient modesty concerns pertaining to surgery. If you would like to discuss modesty concerns in general, please start a thread or do a search in the general nursing forum.
    Please don't take this the wrong way, but patient modesty concerns pertaining to surgery, or patient modesty concerns pertaining to operating rooms, or patient modesty concerns pertaining to emergency rooms, or patient modesty concerns pertaining to snack bars, all pertain directly to examining the root causes of why anybody, in any medical setting, on any medical floor, compromises patient modesty concerns.

    When it does happen, I don't think that it happens on the 7th floor for different reasons than it happens on the 3rd floor. To really examine it and come up with possible solutions, we have to dig past the surface. Why does it happen? From a patient's perspective, it is alll related and intricately connected; and attempting to parse it out, and attempting to compartmentalize an issue as complex and over-arching like "patient modesty," is not only futile, but also somewhat deflective -- deflecting from real, authenic analysis.

    Why keep it at the surface? What does that accomplish?
  2. by   SandraCVRN
    Quote from poetnyouknowit
    Okay, I'm probably going to get flamed for this, but I've gotta say it.

    While I agree that the situation with the skateboarder was completely inappropriate and never should have happened, it has nothing to do with the topic of this thread, which is patient modesty concerns pertaining to surgery. If you would like to discuss modesty concerns in general, please start a thread or do a search in the general nursing forum.
    Like most threads this did morph into something more than JUST surgery, but for some reason a couple days ago the thread was moved to this board with no notice or notification.

    I also agree that the skateboarder incedent should not have happened.
  3. by   Cul2
    I think I've had all I have to say on this subject. It's a good
    discussion. I hope it stays civil. I want to thank allnurses for allowing
    so many no mediical people to have thier say here. I think it's in everybody's
    best interest.
  4. by   advo-kate2
    Maybe we just need to get back to how simple the problem is. Perhaps it will inspire simpler solutions.
    Almost all human beings do not want and/or will refuse to expose themselves in public to the opposite gender unless it is thier choice. Simple.
    Yes it gets complicated when we speak of entitlements, expectations, the right to perform a job, whether a medical proceedure is beyond all expectations of the normal personal rights we have (and why), and well, unending possible explanations.
    Let's just be clear. We are all just human. We all have our own modesty,religious, moral, ethical values to contend with. These beliefs follow us wherever we go, and even if a person assess exceptions to thier own body it is hopefully and entirely their own choice.
    Fairly simple. I hope we can work together for resolutions.
  5. by   ImaWonderer
    http://www.nytimes.com/2005/08/16/he...pagewanted=all



    Okay so I found a very intersting article along the lines of where this discussion is going.
    I'm not particularly a fan of the NY Times but this article actually does seem to have some real meat to it and its nice to see this topic addressed. Some parts are more intersting than others but stick with it.

    What i find interesting is that it talks about a the patients experience. (I believe one of the patients is actually a nurse)
    There are some interesting things here....I'm going to do more research on this Plantree organization and its work. Also patient care representatives and what EXACTLYthey do and if they deal with modesty issues.

    The article also makes reference to ENVIORNMENTAL PSYCOLOGISTS.....(this is the first time Ive even heard of that) but it talks about the psycology of what happens to people entering medical care and how patients are effected by everything from design to noise to the infamous gown.....The most interesting thing is all the things we have been talking about (EXCEPT GENDER...yes I noticed) this article talks about.....complaints about people just walking in,coming and going, and many times not even SPEAKING to the patient or introducing themselves.

    I find it interesting that MANY "educated people" in the medical field seem to be shockingly ignorant at how having an univited group of observers just walking in ...... How not knocking or introducing themselves, opening doors carelessly,dismissing modesty issues...etc....effects care.

    We have along way to go...when the people "caring"for us considers all these issues hangups, and phobias but the good news is that their is NO doubt in my mind that these changes Are coming!!!!!
  6. by   CaDad
    Hi Again:
    There is an excellent article in this monthly nurses magazine and it hit it on the head on several areas. What I found amazing is that several of the behavioral characteristics discussed apply to other industries lol. Like the one characteristic of becoming mechanical , treating th pt like an object, etc. Great and telling article.
    I also want to clarify the advocate role, perhaps they might be attached to HR, where the patient is talked to during and after the stay, like just routine visits-not staying in the room during sensitive tasks, specifically making sure their modesty needs were respected or accommodated without any repercussions from the staff. Even providing training or refresher courses on new research or polls, etc. I know, what? more training? But I think that this kind of training is sadly lacking. Maybe we even have cyclical evaluations to detect burnout so maybe a rotation can be utuilized into anothr department. This advocate can even be the person where anonymous personnel can discuss the actions of another employees without reprecussion or disclosure so than any incident can be looked at and perhaps addressed, not in an adversarial way, but in a caring diplomatic fashion so everyone wins. We do not need a hospital cop lol. But someone who would have the power to initiate change where necessary.
    My brother recently went in to have his prostrate examined because of the higher readings on the test he as given and he requested , yup, a male crew, well guess what, there was an all female staff ready to help lol-he declined the test and gave his doctor you know what and his Doctor told him more and more men are requesting this, so I guess it worked and information is getting out to more and more men. I have to say I am sincerely grateful to the female nurses on this discussion, it is gratifying to hear you understand, comment, and address the issue. I know this blog was about the OR room , but it is more than that, I sincerely believe that most of the damage is done prior to the operation, it everything that happens up to that dreaded moment and afterward that is the worst.
  7. by   tbrd450
    Wonderful article. I really like that it gets quickly to the irony of the issue:

    "At the hospital where Ms. Duffy was a patient and at many others the small courtesies that help lubricate and dignify civil society are neglected precisely when they are needed most, when people are feeling acutely cut off from others and betrayed by their own bodies."

    While little (relatively) has really been proven about just how powerful mental health really is to the recovery process, we all know it is. It is sort of a no-brainer. How Ms. Duffy internalizes the indignity of the situation is probably as important to her recovery as whether or not she actually passed gas. Whatever happened to "hello Ms. Duffy, how are you feeling today?" The nimrod in the story just enters the room, with a crew of 20somethings in tow, ignores the patient, circles her bed, then asks her: "Have you passed gas yet?" I don't care, sometimes a nimrod just has to be called a nimrod. We just have to make some noise sometimes. Granted, I would refrain from calling the biker dude such a derogotory name as he sits at the stop light one lane over having just cut you off in traffic a few miles back. But this guy... yea, ... nimrod!

    No, the article does not address the double standard. Frankly, it isn't a popular facet of the issue to address, and it often gets sidelined. Let's face it, if someone wants to make a point about a topic such as patient care, patient modesty, patient dignity, patient well-being, cross-gender strip searching, equal employment rights, discrimination, etc., it is always best to put your message out there with a female in the victim role. Society is just more sympathetic to female victims. You will always have a much better chance of getting support for your cause.

    Many of the rights and quality of life improvements boys and men enjoy these days came only well after the cases were made and won on behalf of girls and women. Example, a short man is allowed to be a police officer today because women demanded the right to become police officers, decades ago. Because it was deemed appropriate that women should be allowed to serve as police officers, the height standard had to be lowered. As an after thought, short men benefited from the fall-out.

    Imagine the story in the article slightly different. Imagine the physician is female and the patient is Mr. Duffy. Does that drive the message of the article home quite as well as if the patient is Ms. Duffy and the physican is male (as it is)? Do you see my point?

    In much the same way the Pentagon recognized that public knowledge of systematic, standardized, sexual humiliation, degradation, forced nudity and abuse on detained females would never be tolerated by society, it rationalized that such things done to detained boys and men would likely be tolerated, albeit mildly troublesome for the PR folks to deal with. To this day you can still surf the talk shows, the radio programs and the roundtable discussions and still find a significant number of people that think what happened to those boys and men in Abu Ghraib was fine...because... well... we are at war!. I think Rush Limbaugh once said that it was just like "fraternity hazing."

    Advocacy for things like patient modesty are best done in the context of, or on behalf of, female victims.

    The problem with the double standard is that it sets up false perception, and false premise. We begin to actually think Mr. Duffy, in the same situation, isn't really hurt by the indignant treatment. Why? Because the stories, the articles, the outrages, the newscasts, the soundbytes, the abuses are always seen in the context of female victims. We eventually begin to even think it only ever happens to females.

    The male teenage skater stories become unworthy.

    I think the article, however, clearly presents the issue from a patient perspective. And, that is wonderful. But is seeing through the patients' eyes really enough? I suspect that is not really all that will be needed to trigger true change.
  8. by   CaDad
    I agree , the article did not address the huge difference between male and female modesty issues but did point to some of the reasons and observations on how some in the profession behave in a very stressful environment. It was not condoning but exploratory and it did cause me to pause .None the less, at the end of the day, it was drawing upon the conclusion, based on lots of research, that a Patient/Caregiver relationship needs to be developed and maintained for the benefit of both and when the modesty of the PT is trivialized it demeans the relationship, extends the recovery and both parties suffer. You cannot take the the relationship out of the care process like many do. ort wish they could do. It is against the very nature of what Nursing is all about.
  9. by   orsonic
    The "double standard" is very common in american medicine and alive and well in the ultimate form, male genital mutilation on helpless babies who never give consent, commonly called circumcision because it sounds a lot less barbaric. Of course we all instantly realize how horrible it is it it is done to baby girls. I imagine this comment will be quickly removed with the excuse that it doesnt fit with the thread (but it does). It is just too horrible to face the fact that millions of men have had their genitals forcably mutilated by the medical profesion. They would not ever submit to it as an adult so it is forced on them as a baby and the doctors pretend that it was "informed" consent from their parent. Of couse the doctor wouldn't cut of any other healthy body parts of the inocent baby with the parents consent, just the most pleasurable part on a male baby, the frenulum of his penis. too bad he wasn't born a girl!
  10. by   CaDad
    hmmmm-your right-and personally, I am a Dad and me and my sons all preferred the circumcision. I did take the time to ask them what they thought and so you have it, Most guys prefer it also-it would be different if it was otherwise.
  11. by   morte
    Quote from CaDad
    hmmmm-your right-and personally, I am a Dad and me and my sons all preferred the circumcision. I did take the time to ask them what they thought and so you have it, Most guys prefer it also-it would be different if it was otherwise.
    but it is not an infomed dec......and it is "preferred" because the person knows no other way to exist/feel.
  12. by   advo-kate2
    good article imawonderer. we should note:
    "without a word, one of them - a man - leaned over ms. duffy, pulled back her blanket, and stripped her nightgown from her shoulders."
    so, to me, the article does begin with a bit of a gender overtone. not carried throughout, but present.
    i would have liked to have seen incorporated here an obsevation from a male point of view, but perhaps at the time the article was written the newness of gender issues still seemed predominately/only/most importantly/ female.
    i hope things are changing.......
  13. by   tbrd450
    Quote from advo-kate2
    good article imawonderer. we should note:
    "without a word, one of them - a man - leaned over ms. duffy, pulled back her blanket, and stripped her nightgown from her shoulders."
    so, to me, the article does begin with a bit of a gender overtone. not carried throughout, but present.
    i would have liked to have seen incorporated here an obsevation from a male point of view, but perhaps at the time the article was written the newness of gender issues still seemed predominately/only/most importantly/ female.
    i hope things are changing.......
    yes!.. good point.

    the relevance in mentioning that it was "a man" (not a "nurse," not a "doctor," not a "medical student") was because in so doing it drives the message home better. it is clearly recognized that when an indignity is endured by a female victim at the hands of a male perpetrator,.. well, it is just understood to be far worse than the reverse.

    honestly, i believe that if this were a story about mr. duffy and his female physician, the qualifier "a female" would not even be mentioned. instead, the author would have to make the case absence any gender reference. if a gender reference were attempted in the story, then the author runs the risk of having it backfire.

    the false perceptin for many is that males are supposed to be "getting lucky" when they are mistreated by females. and, what is really scary is that even seems to apply to boys (children) being mistreated by women (adults). but, i digress.

    when the sufferer/victim is female, and the inflicter/perpetrator is male it is perceived to be far worse than when the genders are reversed. that is just the culture. it is the same thinking that ultimately leads to males arriving in trauma centers uncovered, remaining uncovered, and just generally having modesty concerns minimized relative to female patients.

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