Patient modesty concerns pertaining to surgery

  1. 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 gown removed, etc? How much do you tell them? How do you handle pt that is concerned about students practicing pelvic exams on them without concent? How to handle the situation when after the surgery they realize they had been "exposed"?
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  2. 222 Comments

  3. by   Marie_LPN, RN
    We take a gown completely off for hip replacements and back surgeries (because of wrinkles). But the top half of the pt. is covered by a blanket and a forced air warming blanket.

    The lower half of a pt. is kept covered until the last second before prepping.

    Students never practice pelvic exams on our pts. in our OR. A 'practice' pelvic exam should be done in the office, where the pt. can be asked prior.

    We do explain to pt. prior about the position(s) they will be in for their surgery. And when the pt. is wheeled into the room, the nurse says "the people that are in here now will be the people in the room with you the whole time". If the pt. expresses concerns about 'exposure', we assure them that we are professionals, and we will do our best to maintain their modesty throughout the case.
  4. by   Antikigirl
    I had a pt yesterday that thought I didn't know what I was doing because I provided for modesty! LOL!

    I had to put a new gown on him, and I draped the clean gown over his lower area as I got the snaps ready for the top...he was pulling and tugging at the clean gown and saying "that isn't how you do this" and being a real pain in the keester and making matters worse!

    I told him, I do it this way to provide for modesty and keep people from getting too chilled as we do the required origami to put the darn thing on..LOL! He seemed shocked! Then he told me it was okay..he didn't care about being exposed...and I came back with a shy smile and said..."good, but what about me?"...

    I stared at him for a moment and giggled and said "I can say I have seen many peoples privates...but I still grew up knowing those are PRIVATES and unless I have to do treatment on them...I really don't need to go there!" LOL! It isn't that I am uncomfortable with them..heck I don't care...but why 'let the horse out of the barn' when you don't need to! LOL!!!!
  5. by   weekend warrior
    I recently was a pt when I had to have emergency abdominal surgery. I can tell you the things that went RIGHT in which being exposed was not a concern of mine.
    I was given a gown and blanket to keep warm while waiting to be taken into the operating room, which was gladly appreciated, as by then I had no underwear or anything on.
    Everyone came and introduced themselves to me before hand, even the ones that were observing. ( apparently I have a rare uterine abnormality that even the fellow has never really seen ).
    Everyone was careful to keep me covered and warm on the table while they were doing things like IVs, putting on leads etc until I was asleep.
    When I woke up I was all clean ( no betadine etc ) , had a gown on and tied , with warm blankets. I think if I would have woken up and felt I was in a disarray I would have felt violated, but I felt like I was cared for and respected.
  6. by   sirI
    Quote from Marie_LPN
    We take a gown completely off for hip replacements and back surgeries (because of wrinkles). But the top half of the pt. is covered by a blanket and a forced air warming blanket.

    The lower half of a pt. is kept covered until the last second before prepping.

    Students never practice pelvic exams on our pts. in our OR. A 'practice' pelvic exam should be done in the office, where the pt. can be asked prior.

    We do explain to pt. prior about the position(s) they will be in for their surgery. And when the pt. is wheeled into the room, the nurse says "the people that are in here now will be the people in the room with you the whole time". If the pt. expresses concerns about 'exposure', we assure them that we are professionals, and we will do our best to maintain their modesty throughout the case.

    Excellent explanation of the professional manner a patient is treated.
  7. by   Marie_LPN, RN
    I should also say that if the gown is on, and it gets prep, blood or saline on it, we change it in OR before the pt. goes to PACU. If there weren't any extra gowns in the room and the pt. went to PACU before the gown was changes, i go to PACU and change it. Who wants to wake up in a wet or dirty gown? Yuck. And half the time if a pt. is in a wet gown, they wonder if they peed or something, and who likes the feeling that they wet the bed? :stone

    We don't tie the back of the gowns after surgery though. The knots are uncomfortable.
    Last edit by Marie_LPN, RN on Dec 19, '06
  8. by   banditrn
    Quote from Marie_LPN
    I should also say that if the gown is on, and it gets prep, blood or saline on it, we change it in OR before the pt. goes to PACU. If there weren't any extra gowns in the room and the pt. went to PACU before the gown was changes, i go to PACU and change it. Who wants to wake up in a wet or dirty gown? Yuck. And half the time if a pt. is in a wet gown, they wonder if they peed or something, and who likes the feeling that they wet the bed? :stone

    We don't tie the back of the gowns after surgery though. The knots are uncomfortable.
    Marie - you should be cloned!!:kiss Wish all surgical nurses were as thoughtful as you!

    For three of my last four surgeries, I was awake, at my insistence - two were on my left foot, and I had a spinal - it was the dept. I worked in, and I was comfortable with everyone there, and I knew that THEY knew that I was keeping a close eye on them. :wink2:
    The third was to put an implant in my brain for my tremors, so I had to be awake for that. The last was a week later for the controller for the implant, and it went in my chest, and I believe I had the same gown on when I woke up.
  9. by   zacarias
    I was observing in an OR during school and and was horrified by the following event: A woman was bare-breasted as they were doing a biopsy on several discrete areas of the breast. That part I can understand. Except, then comes in this doctor with a mask who says to the surgeon, "Hey, did you tape '24' last night? Oh man, you have to see it!!", they exchange a couple sentences and then he leaves the OR. I know for sure he saw the patient's breasts; He had NO REASON to be there.
  10. by   penguin2
    One of my pet peeves is we go to great lengths to preserve a person's modesty in pre-op & then they come out of the OR w/their gown off or down around their waist, betadine on everthing- blankets in a jumble-- and they're waking up exposed!! It seems the OR crew doesn't have to be in THAT much of a hurry & so worried about turnover times.
    Last edit by penguin2 on Dec 21, '06
  11. by   jenrninmi
    Quote from TriageRN_34
    I had a pt yesterday that thought I didn't know what I was doing because I provided for modesty! LOL!

    I had to put a new gown on him, and I draped the clean gown over his lower area as I got the snaps ready for the top...he was pulling and tugging at the clean gown and saying "that isn't how you do this" and being a real pain in the keester and making matters worse!

    I told him, I do it this way to provide for modesty and keep people from getting too chilled as we do the required origami to put the darn thing on..LOL! He seemed shocked! Then he told me it was okay..he didn't care about being exposed...and I came back with a shy smile and said..."good, but what about me?"...

    I stared at him for a moment and giggled and said "I can say I have seen many peoples privates...but I still grew up knowing those are PRIVATES and unless I have to do treatment on them...I really don't need to go there!" LOL! It isn't that I am uncomfortable with them..heck I don't care...but why 'let the horse out of the barn' when you don't need to! LOL!!!!
    OT, but Triage, is your avatar a picture of you? Do you really wear a nurse's cap?
    Last edit by jenrninmi on Dec 21, '06
  12. by   jadegypsy
    I have been an OR nurse for nearly 30 years, and one thing I have always done is insure the privacy and dignity of my patient. I have worked in hospitals from california to florida, and have only met a few nurses who didn't.
    With the 9-25 year olds, I am particularly careful to assure them pre op that they will be covered except for those areas we need to see. I even tell the teens that I will be exposing a thigh for the bovie pad. And about the concern for quick turnover times, you gotta be on the receiving end of the push for quick times to understand just how much stress is put on us to get em out quick, and get the next one in quicker. Its downright scary sometimes, how much of the assembly line mentality administration and surgeons have.
  13. by   midcom
    I had two cosmetic surgical procedures last year & both times, in the surgical suite, I had to stand on a pad while the nurses painted me from the waist down with bentidine before climbing up on the table. I knew it was necessary & also that it would be embarrassing & I was right. It also was one of the coldest things I have had done. I just stood the & shivered & shook. The heated blanket felt so good afterward.

    I never even considered that I would be treated with anything but respect while I was out, with areas not needed to be uncovered, covered modestly & from what I understand that was the case. I have photos taken (at my request) by one of the nurses. I was covered.
    Dixie
  14. by   jenrninmi
    Hey! Triage, you still haven't responded to my post. :uhoh21: LOL

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