Patient modesty concerns pertaining to surgery - page 2

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
    I think the hospital doctors and nurses are maybe just de-sensitized to the whole nudity thing. How could they not be after so many cases they worked on. And, consequently, it can sometimes seem trivial and unnecessary to ensure modesty at the standard of the still-sensitive, typical general public patient. The doc that popped in to talk about the TV show, he probably wasn't thinking anything about the naked patient. He probably wasn't looking at it from her perspective. That just means he was being careless, not abusive or anything beyond that.

    I hear and read conflicting points on this. On the one hand, I hear that staff do sometimes talk about a patient while he/she is under (breast size, penis size, etc.). Then, I also hear that everyone is always professional and strictly clinical. I suspect the truth lies somewhere in the middle
  2. by   brownbook
    This is way OT but Zacarias, really, that other surgeon seeing that woman's breast!!!! It was about as exciting to him as you or I seeing another car drive down the street!!! I don't think a little friendly camaraderie on the job is so bad. I'd be more concerned (but not too much) about infection control, staff shouldn't go in and out of OR's needlessly.
  3. by   Fiona59
    Wow, a nearly four year old thread is given CPR!
  4. by   morte
    Quote from tbrd450
    I think the hospital doctors and nurses are maybe just de-sensitized to the whole nudity thing. How could they not be after so many cases they worked on. And, consequently, it can sometimes seem trivial and unnecessary to ensure modesty at the standard of the still-sensitive, typical general public patient. The doc that popped in to talk about the TV show, he probably wasn't thinking anything about the naked patient. He probably wasn't looking at it from her perspective. That just means he was being careless, not abusive or anything beyond that.

    I hear and read conflicting points on this. On the one hand, I hear that staff do sometimes talk about a patient while he/she is under (breast size, penis size, etc.). Then, I also hear that everyone is always professional and strictly clinical. I suspect the truth lies somewhere in the middle
    but he should have been.....he had no business being there, certainly didnt have patient consent..
  5. by   TDCHIM
    Okay, a few years ago when I had my son, I had to have a cesarean. (And NO, before anyone yells at me, I did not "decide" to have one - my spine is such a mess that I had a high-risk OB, a top-shelf neurologist, and the anesthesiologist on my case all look at me individually and turn pale when I brought up the possibility of natural birth. Even I knew an epidural was out of the question from the start.)

    So I went back for prepping and was kept there longer than expected because my OB/GYN had some sort of emergency - which I didn't mind at all. I was shaved, and the nurse explained why; as a multiple surgery veteran, I knew that was going to happen and why. She also offered to wait on the cath until I was out, which I really appreciated.

    But then they took me out to the OR and another nurse yanked off my gown without so much as a word to me, let alone telling me why it had to go off then or how long I might have to lay there freezing and exposed to the world, without even so much as a drape over my nether regions. Then the same OR nurse put me in restraints and left me there - again without a word to me! I didn't even KNOW I had to have them - no one had ever said a word to me about that sort of thing! And the doctor was still busy with his emergency case, so I lay there for the nine longest minutes of my life (I got to watch the clock), no one talking to me and only one or two people around until the last second before I was knocked out! I was terrified, hurting (because I was having to lay totally flat, which is incredibly painful for me due to my disability), and I'd never felt so alone in all my life. When my doctor came in and saw the look on my face, he was furious.

    So unless someone can tell me why it's necessary to treat a patient like that, I'd like to register that style of treatment as officially traumatic for the patient.
  6. by   morte
    Quote from TDCHIM
    Okay, a few years ago when I had my son, I had to have a cesarean. (And NO, before anyone yells at me, I did not "decide" to have one - my spine is such a mess that I had a high-risk OB, a top-shelf neurologist, and the anesthesiologist on my case all look at me individually and turn pale when I brought up the possibility of natural birth. Even I knew an epidural was out of the question from the start.)

    So I went back for prepping and was kept there longer than expected because my OB/GYN had some sort of emergency - which I didn't mind at all. I was shaved, and the nurse explained why; as a multiple surgery veteran, I knew that was going to happen and why. She also offered to wait on the cath until I was out, which I really appreciated.

    But then they took me out to the OR and another nurse yanked off my gown without so much as a word to me, let alone telling me why it had to go off then or how long I might have to lay there freezing and exposed to the world, without even so much as a drape over my nether regions. Then the same OR nurse put me in restraints and left me there - again without a word to me! I didn't even KNOW I had to have them - no one had ever said a word to me about that sort of thing! And the doctor was still busy with his emergency case, so I lay there for the nine longest minutes of my life (I got to watch the clock), no one talking to me and only one or two people around until the last second before I was knocked out! I was terrified, hurting (because I was having to lay totally flat, which is incredibly painful for me due to my disability), and I'd never felt so alone in all my life. When my doctor came in and saw the look on my face, he was furious.

    So unless someone can tell me why it's necessary to treat a patient like that, I'd like to register that style of treatment as officially traumatic for the patient.
    i hope the twit was reprimanded????
  7. by   TDCHIM
    @morte: I have no idea. I really hope so, because it was horrible. I do know the first thing I recall upon starting to wake up is begging for someone to make the pain go away (I have a high pain threshold when conscious, but when I'm under it drops like a stone until I'm back in conscious control again) and the SAME nurse snapping at me, "We'll get to it when we have time!" My husband told me the doctor heard her, gave her a death glare, and said, "No, you'll do it NOW. She NEEDS it." At that point, she shut up and got something for me. I don't remember that part, but I wish I did.

    Nearly all of the nurses I had during that time were thoroughly capable and professional, very respectful, and really nice as well. It's too bad I caught a not-so-great one at such a crucial moment.
  8. by   morte
    Quote from TDCHIM
    @morte: I have no idea. I really hope so, because it was horrible. I do know the first thing I recall upon starting to wake up is begging for someone to make the pain go away (I have a high pain threshold when conscious, but when I'm under it drops like a stone until I'm back in conscious control again) and the SAME nurse snapping at me, "We'll get to it when we have time!" My husband told me the doctor heard her, gave her a death glare, and said, "No, you'll do it NOW. She NEEDS it." At that point, she shut up and got something for me. I don't remember that part, but I wish I did.

    Nearly all of the nurses I had during that time were thoroughly capable and professional, very respectful, and really nice as well. It's too bad I caught a not-so-great one at such a crucial moment.
    her behavior was SOOOOO far over the top of "not-so-grt" especially the first part.....quite frankly i would have been thinking assault....
  9. by   cherrybreeze
    I know the OP is quite old, but I think the overall topic remains relevant, so I'll throw in my two cents.

    I don't work in the OR, but certainly am in situations daily where I need to promote modesty. Since I work in med-surg, I frequently (obviously) have to look at abdomens in addition to listening for bowel sounds, to assess dressings and incisions. Sometimes, especially the guys, are warm, and are laying in bed with no covers on (by choice) or sitting up in the recliner without a blanket. I CRINGE when I see nurses assess someone's belly in that situation, by just lifting up their gowns! I mean, from the chest down they're sitting there naked while the nurse listens to their belly and checks their dressings, and I think that's unacceptable. I always grab a blanket (or the sheet off their bed, if they don't have extra bath blankets in the room) to cover their laps before I lift their gown up. The majority don't say anything, or question it, a few will tell me it's not necessary, but I do it anyway (I'll just say, "there's no need to expose you to the whole world, I only need to see your belly" with a smile, and they understand) and I do think that even the ones that say it's ok if I don't, appreciate the gesture. It sounds like a small thing, but when you're leaning over them, close enough to have your steth on and listening to their belly, they may be uncomfortable having their privates just all hanging out there. If I need to assess the foley (for uro surgeries) I'll do that quickly and then cover them up to do the abdominal assessment, since it takes a little longer, and they don't need to be exposed for as long as it takes to do everything. While it doesn't phase ME to have things "exposed," (I've seen too many over the years for it to even register, at this point ), I try to always be cognizant about the patient's privacy and comfort level.

    I've had a couple of gynecological surgeries in my day, and have always been uncomfortable with the thought of having my legs up in stirrups, naked from the waist down, and unconcious, but I have never feared not being treated with respect while in such a compromising position. By far the worst surgery in that regard was having an infarcted hemorrhoid removed. Thinking of being upside down and jack-knifed on the table makes me shudder to this day. I even went to my hospital's counterpart, on the other side of town, when I found who the surgeon on call for mine was (I know he's a professional, but he's a generally disagreeable man, and I couldn't stand the thought of having to work with him every day for several years after having him operate on my tush)...or having all of the OR staff working that closely with my kiester, for that matter. I know they're professionals, and would have treated me and the situation as such, but it was just too much for me.

    On the other hand, I had an abdominal surgery that required a couple days' stay about six months after I started on my floor. I needed a suppository, and normally, I would have done it myself, but I was in too much discomfort to think that I could (it ended up that I had an ileus). I was OK with the nurse I had on the day shift giving it, I knew she would handle it professionally, and she did. I doubt she even remembers it now, I still work with her! All of the nurses that I work with that took care of me treated me with respect, and upheld my modesty (I wouldn't have expected anything less, though).
  10. by   TDCHIM
    Quote from morte
    her behavior was SOOOOO far over the top of "not-so-grt" especially the first part.....quite frankly i would have been thinking assault....
    I wouldn't go with assault or anything, I'm sure she just thought she was doing her job. Maybe she thought I'd been told that I'd require restraints (I still don't understand why I needed them) and would have to be fully naked the whole time in the OR. I don't know. She was just so cold about the whole thing, not even telling me what was happening and leaving me like that for what felt like forever. I was already so keyed up about having my first child and whether he was going to be all right - my OB/GYN was a high-risk specialist and we had NICU on standby - that the experience just intensified all my anxiety. I didn't tell anyone about it for a long time, because I felt so humiliated by what had happened. It was a miserable experience, but the end result was well worth it - even on the days when he's being a stinker! And maybe it'll help someone here (not you, obviously, just someone reading this) to think a little more about how the patient feels, even though the procedure is old hat for those involved in performing it!
  11. by   cherrybreeze
    Quote from TDCHIM
    I wouldn't go with assault or anything, I'm sure she just thought she was doing her job. Maybe she thought I'd been told that I'd require restraints (I still don't understand why I needed them) and would have to be fully naked the whole time in the OR. I don't know. She was just so cold about the whole thing, not even telling me what was happening and leaving me like that for what felt like forever. I was already so keyed up about having my first child and whether he was going to be all right - my OB/GYN was a high-risk specialist and we had NICU on standby - that the experience just intensified all my anxiety. I didn't tell anyone about it for a long time, because I felt so humiliated by what had happened. It was a miserable experience, but the end result was well worth it - even on the days when he's being a stinker! And maybe it'll help someone here (not you, obviously, just someone reading this) to think a little more about how the patient feels, even though the procedure is old hat for those involved in performing it!
    Please don't make excuses for her actions, as they truly were INEXCUSABLE. She should know that her job entails explaining to you what she is doing, and why. This same nurse also snapped at you regarding pain medication, and she should know that giving pain medication is her job, and not a "when she has time" thing...you MAKE time for something like that, in that situation. Covering you up, rather than leaving you exposed and restrained, is a matter of common DECENCY (and is, indeed her job), and there is NO way to justify her actions. You said it was traumatic for you, and I have no doubt that it was, very much so....so don't make excuses for her! It saddens me that her actions made YOU feel humiliated, when SHE'S the one who should be ashamed and not you.

    People have bad days, and may not have a sunny, wonderful attitude all the time, but that nurse's actions that day went far beyond that. They were not ok, by any stretch of the imagination.

    Edited to add: I WOULD go so far as to call it assault. I don't see any reason, before you're sedated/anesthestized, to have restrained you, especially without telling you why. I couldn't just walk in to a patient room, put on wrist restraints, and walk out again, ESPECIALLY if they are alert and oriented (even when they're completely confused/combative, etc, you tell them what they are doing, whether they comprehend it or not). It doesn't sound like there was a reason to have them placed at the time that they were (and if there WAS a reason, you deserved to know why). Technically, I guess, it's not assault, but battery?
    Last edit by cherrybreeze on Apr 20, '10 : Reason: added info
  12. by   tbrd450
    My third and fourth cent: Just like in any profession I imagine in the medical community there are good, concientious professionals, mediocure ones, and bad ones. However, the medical field has to maintain a particularly high standard. Their mistakes or inconsiderations hold the potential to be far more damaging than the accountant's. They deal with with human suffering, pain, embarrassment and life and death situations. There is absolutely no legitimate excuse for not ensuring that a patient's privates are not covered at all times, unless medically necessary. It is really that simple, isn't it? The unnecessary doctor in the operating room or ER room or whereever, just to talk about a TV show, is just stupid, idiotic and unprofessional. There is nothing, however, about that made it necessarily "abusive." However, if he popped in under the pretext of talking about a show, and in fact was looking to check out some breasts to feed some perverted desire, then it is not only abusive but probably criminal on some level. But, to go there we need to enlist the thought police. Aint going to happen. I think the problem is that patients are never quite sure if something is medically necessary and, consequently, never really know if their modesty is being fully respected. Often we are left to assume the best intentions or, the worst. We don't know. Does my genitals need to be exposed for you to listen to my stomach? We turn our own, our daughter's, our son's, our husband's, our wive's bodies and very lives over to strange people we never met when we enter the hospital or emergency room. I would love to be able to say, upon entering, who in this room graduated from the most prestigious medical school? ... I want you working on me.

    Granted, Yes, of course, our main concern is living and getting better. But, believe it or not, even very sick people are concerned about their modesty -- the human mind isthe most powerful force ever. A mind at peace is one of the most powerful healing agents available. The psychologicl impact of our experiences stay with us, effect us and help to shape our outlook.

    As exists in every walk of life, I'm sure some small percentage of nurses and doctors do get a thrill out of humiliating a patient unnecessiarily -- just as there some bad cops and correctional officers that drop an extra knee on a compliant arresstee just for the fun of it. With the medical community, we need to rely on the vast majority of the good ones out there to speak up on our behalf -- to tell the nurse to throw a blanket over somebody, to tell the doctor the comment or joke he just made about the patient's body was not funny and totally unprofessional regardless of whether or not he can hear you, to insist on advocating for the patient. I don't care if the excuses coming back are "just letting of a little steam," .. "I've seen a thousand vaginas and penises," etc. Just remind the bad apples out there that it is not about them. They should be embarrased for how they fail to care for the patient. Embarrass them when they act stupid. You guys and gals sort of have to police yourselves on our behalf. There should be one consistent standard that applies to patient modesty and followed by everyone. That would be to keep a patient covered unless necessary to not be covered. period. That should be the standard for male patients, female patients, and anything in between.

    My own experiences with the hospital, emergency room, operating room and doctor's office has been very good.
  13. by   TDCHIM
    Quote from cherrybreeze
    Please don't make excuses for her actions, as they truly were INEXCUSABLE. She should know that her job entails explaining to you what she is doing, and why. This same nurse also snapped at you regarding pain medication, and she should know that giving pain medication is her job, and not a "when she has time" thing...you MAKE time for something like that, in that situation. Covering you up, rather than leaving you exposed and restrained, is a matter of common DECENCY (and is, indeed her job), and there is NO way to justify her actions. You said it was traumatic for you, and I have no doubt that it was, very much so....so don't make excuses for her! It saddens me that her actions made YOU feel humiliated, when SHE'S the one who should be ashamed and not you.

    People have bad days, and may not have a sunny, wonderful attitude all the time, but that nurse's actions that day went far beyond that. They were not ok, by any stretch of the imagination.

    Edited to add: I WOULD go so far as to call it assault. I don't see any reason, before you're sedated/anesthestized, to have restrained you, especially without telling you why. I couldn't just walk in to a patient room, put on wrist restraints, and walk out again, ESPECIALLY if they are alert and oriented (even when they're completely confused/combative, etc, you tell them what they are doing, whether they comprehend it or not). It doesn't sound like there was a reason to have them placed at the time that they were (and if there WAS a reason, you deserved to know why). Technically, I guess, it's not assault, but battery?
    I'm just not all that great at calling people utter jerks, even when they deserve it. She was horrid, but I have no way of knowing whether she thought the doc was coming in from his emergency case before mine right away. I kind of thought I was being a wimp about being trussed up like that - I'd never had a child before, so I had no way of knowing whether it was perfectly normal. I don't like to make a fuss unless I'm absolutely sure I'm in the right. I don't want to be one of those people who freaks out over nothing. In fact, before I read this thread, I actually never knew for sure whether it was just business as usual to treat people like that - though after some of my classes, I was pretty sure the restraining a perfectly normal, calm patient for nine minutes with no explanation business wasn't appropriate.

    So I guess you can chalk up my rationalization to me being something of a shrinking violet in that department. But I really do hope she was nailed for it and pushed to change her way; I hate to think of anyone else being treated in such an excruciatingly embarrassing manner!

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