Patient modesty concerns pertaining to surgery - page 8

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   advo-kate2
    "i thought this was it....

    seriously---let's please stay on topic here, folks. this isn't the place for discussions about changes in surgical teams or speculation about what else goes on during surgeries, it's a debate about modesty issues. thank you. "


    the title of the thread is "patient modesty concerns pertaining to surgery "
    when discussing these types of issues, potential patients are going to want to get technical. they will want to find out attitudes caregivers have regarding protection of their modesty during shifts change, unknown staff who may come in, and how to mitigate situations that may help in comfortably giving up that modesty.
    if it is indeed a place to discuss and try to solve all types of patient modesty issues, then i was mistaken about it's general intent.
    thanx for the clarification.
    potential patients these days are avoiding the care they need due to these issues which many here consider part of daily tasks, but others consider insurmountable obstacles. this is indeed the new health crisis that i would like to believe caregivers are concerned about and would like to help solve.
  2. by   sirI
    I was mistaken about it's general intent.
    Thanx for the clarification.
    Thank you for your understanding.
  3. by   advo-kate2
    I do not think that the modesty discussion will ever be debated to it's fullest extent. There are women (we know this) who do not want a strange male doing intimate medical proceedures. There are men (we know this too) who do not want strange women doing intimate medical proceedures. There are lots of reasons for modesty that goes with that person's body and mind. Moral? Ethical? Religious? Marital beliefs? All things that make a person want to protect thier nudity from strangers.
    Would it really be offensive to the nursing arena to mandate staff be available for same gender care? I just do not see why this issue is so hidden.

    "One person's most horrifying, embarassing nudity exposure imaginable is for someone else just a mildly awkward and discomforting experience soon forgotten."

    And so this is part of the problem: many do not "get over" horrifying, embarassing nudity exposure issues. They stop seeking care. If for no other reason than this, the medical community should start considering this as a dangerous precedent that needs mitigation and resolution.
  4. by   sirI
    Quote from advo-kate2
    I do not think that the modesty discussion will ever be debated to it's fullest extent.
    Would it really be offensive to the nursing arena to mandate staff be available for same gender care? I just do not see why this issue is so hidden.
    This issue, you are correct, will never reach a conclusion. Modesty issues will always be something that can be improved.

    Nurses here are discussing this. And, that is a 1st step. Personally, here at allnurses.com, I see that this issue is not "hidden". Members have expressed concerns as well as participated in discussions to try and find an end-result solution.

    Quote from advo-kate2
    the medical community should start considering this as a dangerous precedent that needs mitigation and resolution.
    These issues are being discussed here and that is a 1st step.
  5. by   advo-kate2
    Fair enough! Discussions such as these are certainly appreciated.
    I would guess step #2 would be a question regarding opinions ( if allowed) as to the actuality of facilities ever reaching easily available staffing for those reqiring same gender intimate care. Difficult in some situations, but perhaps not impossible. Would help mitigate modesty circumstances and allow potential patients to once again seek the care they need.
    ** After much debate..does anyone really consider this a viable option?
    Advocates would like to work with caregivers: not frustrate and offend them. It is not our (most of us) goal to disrespect any caregiver and their effort toward dignified care. They would also not like to keep seeking a solution that wastes more time than it does opening pathways.
  6. by   sirI
    As it applies to the OR and/or surgery (the thread topic), yes, I think further discussion is warranted.

    But, just beating a horse to death stating again and again that we as nurses are burying/hiding the issue of modesty concerns is unwarranted.

    Also, instead of posing the question to the nurses here on the boards to solely come up with the answer, how about come up with some possible solutions that are feasibly workable?? Again, as it applies to OR/surgery.

    It is not our (most of us) goal to disrespect any caregiver and their effort toward dignified care.
    Thank you.
    Last edit by sirI on Jun 4, '10
  7. by   Cul2
    I agree with both advo-kate2 and sirI. The issue is being discussed here. But
    perhaps we should be asking different questions. Assuming that we'll all
    basically on the same page regarding patient autonomy and dignity (and I
    realize that may be a faulty assumption for some) -- then perhaps we should
    be asking what are the specific obstacles within healthcare preventing patient
    gender choice. We must assume that we agree that, when possible, patient
    should have gender choices when possible and approprite. What, then, makes this impossible
    or less likely. And then, what steps can be take to make it possible and more
    likely. And, what can no medical professionals, patients, do to help the medical
    community make this happen? For those who want to see things change,
    perhaps we need to stop complaining and start coming up with specific
    plans of actions -- plans that involve doctors, nurses, techs and patients
    working together. To some extent this is a political ad economic problem.
    It may involve more financial resources and political activism. To some
    extent this is a cultural/social problem. How do we get a better gender
    balance in medicine without discrimination against either gender, and at
    the same time getting the best people into training programs. How do we
    get this issue embedded more into the training of medical professionals. I'm
    not saying it isn't in the curriculum now. But like all academic programs, the
    issues is always moving from classroom theory into practical application.
    I have some ideas, as I'm sure many people do. Perhaps we should be
    discussing practical solutions to this issue.
  8. by   sirI
    And, that's exactly what I suggested in my post above.

    Ones who come here and are actively advocating for patient modesty need to post some suggestions. Suggestions that are feasible........but, these suggestions must be as they apply to the OR/surgery (this thread topic).

    This thread was bumped up to discuss Patient Modesty, but no one (advocates for) has posted any potential solutions.

    So, I again ask, what do you, as the ones bumping this thread and asking nurses here on the site, suggest as possible solutions...............as it applies to the OR/surgery?

    Our members can then take these suggestions back to their respective employers and once again..............have a very nice 1st step.
  9. by   rn/writer
    One option, perhaps, is for a specific hospital or out-patient surgical facility to arrange staffing to allow for same-gender care on a trial basis to see if, a) there are enough patients for whom these issues are of paramount concern to warrant the extra effort, and b) to see if it is economically/practically feasible to make and sustain such arrangements.

    It could be that the modesty issues matter this much (as has been discussed in this thread) to a specific percentage of the population and not as much to others.

    A surgical unit within a hospital or an out-patient facility would need to have extra staff (either working in some other capacity/on call) to be able to accommodate every patient, and that would not be inexpensive. On the flip side, this option might have a built-in clientele in addition to those whose modesty concerns are personal. Orthodox Jews, Muslims, and others might choose such a facility and the volume could possibly offset any extra expenses.

    Every unit and facility should be able to treat patients with dignity and respect, regardless of gender issues. (Many people are okay with surgical staff of mixed gender, so long as they are cared for properly.) But if same-sex caregivers are a primary concern, it seems like having a dedicated venue would be a good test market and offer an assurance to patients that would be difficult to mass produce without some kind of business and practice model to use as an example.

    Rather than challenge the entire medical community to bend to wishes that are voiced by a limited segment of the population, it might be better to start small and proceed from there. If patients flock to the trial settings and the new measures could be shown to work well, it's likely that the medical community would take notice as they did when many of the birthing practices that are common today (mom being awake for their deliveries, fathers at the births, epidural anesthesia, minimal medication, nurse-midwives, to name a few) were first introduced. Initially many docs had a fit and predicted all sorts of problems. Then some hospitals tried the new ideas. In time, what was once an intrusion became an attraction and many of the changes have now become standard operating procedure.
    Last edit by rn/writer on Jun 5, '10
  10. by   Scrubby
    Quote from rn/writer
    One option, perhaps, is for a specific hospital or out-patient surgical facility to arrange staffing to allow for same-gender care on a trial basis to see if, a) there are enough patients for whom these issues are of paramount concern to warrant the extra effort, and b) to see if it is economically/practically feasible to make and sustain such arrangements.
    The whole idea of same gender teams is absolutely ridiculous. We have enough trouble staffing the OR as it is with adequate nursing skill mix most days. Same gender teams is not and should not be an option for anyone at all. I'm going to sound like a mean OR nurse here but quite frankly we don't care about naked bodies at all, we see them everyday. We do our best to promote patient dignity by ensuring that the patient is covered up until it's time to prep. I'm actually kind of militant when it comes to leaving the patient covered until it's time to prep and drape.
    Last edit by Scrubby on Jun 4, '10
  11. by   Laurab14
    Here is my perspective... I had a d&c and tubal ligation last summer, it was my first surgery ever. I am a RN, have been for 16 years. I have faith that modesty/dignity issues are followed 99% of the time, but I have witnessed "jokes" about patients, specifically about their body parts.

    It was not necessarily for the part of being draped, or naked during the surgery. It was the fact that I don't REMEMBER any of it. I can't identify any of my surgical staff. It was a very weird experience to wake up in the recovery room and swear they hadn't even touch me yet. I guess I am more of a control-freak than I thought (most nurses are).

    I consider myself a pretty modest person, 3 people have seen me naked in my adult life- my husband and 2 doctors. I don't like NOT knowing who those people were, and if I see them on the street (we live in a very rural area) are they thinking about me with naked with my legs in stirrups?

    Now, here is where it gets funny... I know professionally they are not, just as I do not when I see former patients. But, as a patient, it makes me feel uncomfortable. If I was awake, and met these people and I had some control over the situation it might make a difference. It is the UNKNOWN that is always worse.

    Not sure what we can do about it as nurses, but thanks for giving it a second thought, I hardly did until I became the patient.
  12. by   TDCHIM
    Quote from Scrubby
    The whole idea of same gender teams is absolutely ridiculous. We have enough trouble staffing the OR as it is with adequate nursing skill mix most days. Same gender teams is not and should not be an option for anyone at all. I'm going to sound like a mean OR nurse here but quite frankly we don't care about naked bodies at all, we see them everyday. We do our best to promote patient dignity by ensuring that the patient is covered up until it's time to prep. I'm actually kind of militant when it comes to leaving the patient covered until it's time to prep and drape.
    I definitely understand your concerns about staffing, and I'm not entirely sure about the whole same-gender team option idea. It sounds like it would be tough and costly to maintain.

    However, I have to take issue with the whole "we don't care about naked bodies at all" statement. There are many instances already noted on this thread alone where medical professionals were less than considerate of patient modesty issues. In addition, isn't the patient's comfort level more important than yours? I mean, as a patient I'd be perfectly content being covered up as you describe, but there are cultural issues in many populations that make same-gender treatment an important option to offer.

    Those are just my somewhat muddled thoughts....
  13. by   Cul2
    "The whole idea of same gender teams is absolutely ridiculous."

    I wouldn't use the word "ridiculous." That's a value judgment based
    as much on emotion as anything else. We might say it's unworkable
    in most situations as staffing exists currently. People's feelings are
    people's feelings. You can't quantify "ridiculous." What's "ridiculous"
    to you may be quite serious to someone else, and both of you can'
    be quite sane and normal.

    Having said that -- I think the "control" factor mentioned above is
    significant. I recall having surgery recently, and the anesthesiologist
    just knocked me out without giving me a warning our countdown.
    That bothered me. I felt tricked. My point? Good communication.
    Don't assume too much about the patient. Ask preferences. Frankly,
    I think it's important for many patients to know precisely who will
    be in the OR and who will be doing what. Best practice is to make
    sure the patient has been introduced to everyone, even briefly.
    The patient may want assurance that these people, and only
    people will be in the OR during the operation -- that, unless specific
    permission has been given, no non essential observers will be there, esp.
    non medical professionals, like medical hardware salespeople. Talk the
    patient through everything, if that's what they want. No real surprises
    if the patient wants to know things. Give a countdown before putting
    them out. Explain specific prep and positioning if they want to know.
    But you've got to ask if they want to know. They may not tell you. Some
    may just want to be knocked out and not remember anything. But not
    everyone.
    Now, some of you will say, we do that already. No, you don't. Not all
    the time. This needs to be protocol. This needs to be part of the
    checklist that's now being used in some OR's. Has the patient been
    asked about what they want to know? Has the patient met members
    of the OR team? Etc.
    I realize we're talking about same gender OR teams, but my contention
    is that most people, they feel safe, if they feel respected, if they feel that
    they have at least some control, if they feel their dignity is being observed --
    most people may go along with mixed gender teams. Granted, some may
    never want it. But I don't think they are in the majority. And I'm not saying
    we shouldn't try to accommodate them if possible. But in my mind this
    modesty issue is more about good, open, honest, communication than
    it is really about modesty -- for most people.

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