An ethical question about closeted gay providers and patient requests

[ChrisA]

I got asked a question by a lawyer friend today. If a patient requests only female staff, and male staff is provided against that request, he says the law states that it could be grounds for treatment without consent.

If one were gay, and not out about it, and a patient requested that no gay staff treated them, would that staff member be required to sign himself or herself off the case? What happens if they treated anyway, and then it later came out that they're gay? Does the patient have grounds for a suit?

[fergus51]

I have never heard of a patient making that specific request. This is very murky territory. Changing staff assignments on the basis of sexual orientation could also be considered as discrimination against that staff member.

[NurseFeelGood]

That would be my feeling on the matter too fergus. I would think that is discriminatory against that staff member and at no time should a person be required to disclose their sexual orientation against their wishes.

[talaxandra]

What about if a patient requests only male nurses? The principle should be the same, but are facilities then obliged to ensure that male nurses are available? This seems like a really murky area...

[traumaRUs, MSN, APRN]

Gosh - it seems to me there was something in the papers about that recently. Something about a patient only wanting white nurses...and the end result was that it was discriminatory to staff. Where I live, we have a fairly large mid-east population and none of the males want their female relatives cared for by males. This makes it very difficult sometimes (and sometimes impossible) because we have many male nurses and doctors. It just seems to me that if you are sick enough to be in the hospital - you should be grateful that there is ANYONE there to care for you!

[rngreenhorn]

From the ANA's positition statement on cultural diversity: (paraphasing)

A nurses role as patient advocate abliges the nurse to understand and organize care according to the patients cultural practices. Nurses should ask: what is this patients belief in the life process? How does the patient define health and illness? What does the patient believe causes illness? How does being sick effect this patients cultural practices? etc. etc. yata, yata, yata.

Like all bureaucratic rhetoric (including state and federal laws) this statement provides miles of room for interpretation. And even more room for a lawyer and a money hungry member of society to make a buck.

I'm not a lawyer but I'd say your scenerio is pretty shaky grounds to base a lawsuit... but then again, these people (attorneys) go to school for many years to learn the fine art of shafting. So, who knows?

[fiestynurse]

...

[Nurse Ratched, RN]

As always, patients should have the right to expect a *competent* caregiver without specifying that the caregiver must also meet some other non-job-related criteria. As nurses, we need to continue to educate against the attitude that our jobs are sexual just because we happen to see body parts. I'm pretty sure most of us will agree that that's the LAST thing on our mind at work.

[rngreenhorn]

When a patient requests a nurse of a certain gender, race, weight, ethnic origin, religion, or sexual orientation, it is important to find out the reasons why. If the request is reasonable and not blantant discrimination, then I think that the facility should accommodate that patient. For instance, a patient can request that a female nurse perform a catheterization.

On the other hand, the facility has a duty to protect it's employees from discrimination in the work place. That means discrimination from managers, fellow employees and patients. It can't endorse a patient's obvious discrimination. I think it's best to have a Supervisor talk to the patient and attempt to dispel any myths or stereotypes that the patient might have.

P.S. As an RN/JD I don't remember learning the "fine art of shafting" in law school, however I have advocated and represented nurses who have been shafted. I would like to dispel the myth that all lawyers are bad people.

OK. OK. Not very PC of me. Not all lawyers are bad... only the ones that breath. Just Kidding! Just Kidding! No flaming please.

I agree with everything you said.

I guess my point is: If someone decided to sue because he/she had a gay nurse, I would consider that a frivolous lawsuit.

[fiestynurse]

,,,

[Monica RN,BSN]

RNGREENHORN:

OK. OK. Not very PC of me. Not all lawyers are bad... only the ones that breath. Just Kidding! Just Kidding! No flaming please.

I agree with everything you said.

RN Green Horn you were actually right i n the first statement... Lawyers are crooks...

We have a bumper sticker that says " Help Save America.. Don't Vote For Lawyers "

and yes I agree with the posters... staff have rights to not be discriminated to, and patient's have rights tooo... but choosing between sexual orientation is shakey ground as someone stated above.

In the LTC I recently came from we had several patients who would not accept a male CNA. Schedules were made to accomodate their request. We have a gay male who dresses as a female all the time.. dresses and wigs, the whole nine yards. We cannot discriminate against him (or Her?) because of his sexual preferences. HR says he does is job abd does it well, he can where what ever he wants.. and does. Most all of the LTC population accept him quite well regardless if he dresses male or female on any particular day.

I guess my point is: If someone decided to sue because he/she had a gay nurse, I would consider that a frivolous lawsuit.

[rngreenhorn]

Yes, I hope that a lawsuit such as that would be considered frivilous. But, given that 11 states just voted against gay marriage, I am worried about a backlash against gays in all areas. I am appalled that gays still have to remain in the closet for fear of discrimination.

Also, if a patient said to me that he/she didn't want any gay nurses taking care of him/her - I am not sure that I could hold my tongue. Even though I am not gay, I could not take care of this patient and I would ask to be reassigned. (Probably, a good thing that I left bedside nursing)

I voted against the proposition in my state. Not because I don't think gays should marry, but because I don't think there should be a constitutional amendment defining marriage.

The American ideal that "one man, one women and their offspring" defines a family unit is not an ideal held by all persons on this earth. Me included. And judging by the divorce rate, this "one man-one women" dogma is not very efficient.

But, as stated earlier, I don't feel it is the government's place to define marriage (or the family unit). I might even support a proposition abolishing government awarded marriage certificates altogether (including between men and women). I also don't think income tax (and other government) forms should ask your marital status. Taxes should be based on how much YOU make, period.

The concept of marriage is a cultural phenomena. I once knew a Hopi women who divorced her husband by putting his stuff out of the house.

Anyway... I wonder if there are others who voted against the gay marriage proposition because of this?

Last but not least, I think I would not be so nice to a patient who asks for a different nurse because s/he is gay either.

(damn this post is a grammatical and spelling horror show)