Hernia Repair Patient Dignity

Updated:   Published

Since my husband just had hernia surgery, I have been looking into patient dignity.   He went to a male Dr for the surgery.  When he went into the ACC it was all females.   Since we are in Covid restrictions still, I couldn’t go in with him.  He was very uncomfortable with all the females and thought the attitude of I’ve seen thousands of memberes was totally Unprofessional. He felt that while they did their “jobs” they didn’t care how uncomfortable they made him.  Believe it or not males do not want to expose themselves to you.  Just because some of you don’t care who sees what, others do.  You are so correct about the double standards that females wouldn’t put up with that but males have to.  Ladies,  think about how off putting you are to your male pts when you make those comments.  Males also tend to hide their emotions. But, you bet your butt if I was allowed in and saw how uncomfortable he was I would have said something.  He was already nervous and alone and just wanted to get it over. 

Specializes in Critical Care.

At this point I've lost track of what exactly Catfostermom is saying occurred, maybe she could clarify.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, Catfostermom said:

So, my question is why didn’t they relay this to HIM while he was there? Wouldn’t that have been the time?  You can obviously tell when someone is anxious or uncomfortable. Isn’t that part of the nurses job to make everyone comfortable in their surroundings?  I’m sorry I thought letting the professionals know that sometimes they come off as indifferent to what a patient might be feeling. Are you mind readers no.. but should you automatically think this pt is totally fine with what you are doing to their bodies without talking with them?  You certainly verify the information enough times, that you can’t  take another minute to talk with them while monitoring them. Just think about the pt. Go the extra step to comfort them... esp when they wake up with no familiar faces around them, not knowing what just happened. Is that really to much to ask! 

Actually you don't know what was done because you weren't there.  The drugs used in surgery affect memory and can take a few days to clear the system.  Patients often need to have the same information repeated.  That's where families come in but not during a pandemic.

You're keeping yourself worked up over your husband's account of things.  Why don't you suspend judgement until you've spoken to someone else who was there?

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48 minutes ago, JKL33 said:

I do know that some aren't. In the places I have worked, those who don't care are definitely outliers. I'm pretty particular about my interactions with patients and with people in general, which is why I'm here trying to get you to think this through a little more. ?

More common than the outliers who truly don't care, are situations where even those trying to do a good job are at a disadvantage due to the system itself. I would like you to please consider that there is a system behind the front-line experience your husband had, and it is not irrelevant to your concerns:

First of all, your husband did not only have one post-op nurse, but people running around trying to provide assembly-line care to as many patients as possible. You need to know that there has been a massive push for this type of delivery of health care. My primary area is in the emergency department and over the last 5-10 is has been a repeating theme that we're all responsible for all the patients. If some other nurse's patient is ready to be discharged than anyone is to walk in the room and do that. Likewise with delivering medications and everything else. This is a system that some healthcare institutions believe is necessary for "efficiency" and ultimately their bottom line. The ASC (ambulatory surgical center) puts patients through on a tight schedule to maximize profits.

It is VERY likely that the nurses knew that your husband was due to have his surgical site/area checked (which is timed according to a policy/protocol) and whomever was available walked in to do it--to make sure there was no swelling, no bleeding (which might manifest at "dependent" areas such as the scrotum, etc.). They came in and they took a peek to make sure everything looked the way it was supposed to. That is all. They were not trying to disrespect him, they were trying to provide the standard of care by checking on him routinely throughout his immediate post-op period. That is prudent nursing care aimed at keeping him safe. And yes, they were probably running in and out, because that is what our employers prefer.

I do think that we should err on the side of caution and assume that each patient prefers significant modesty unless/until they indicate otherwise, regardless of their sex. That is what I do. But then, I tend to do what I think is right and not worry about things like working faster than humans can work while taking care of other humans. I've been doing this awhile and at this point I care way more about patients and my interactions with them than employers' fantasies about efficiency. So that gives me an advantage on the patient rapport front. ???

I think you will get a lot further if you think some of this through before your meeting.

 

If nobody advocates for their loved ones then they don’t know there is a serious problem with their systems.   Be it pushing them through like cattle, over working the nurses so the pt doesn’t get that one on one or whatever policies they think works for them but not who they are there to take care of.  Will 1 person change their system, probably not. If enough complain about it maybe they will.  

 

 

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12 minutes ago, Hannahbanana said:

One of my midwives for my first pregnancy prenatal, delivery, and postpartum care was a man. He was awesome. Parenthetically, nobody seems to get fluffed up over the idea of men who are OB/GYNs. Times are changing. 

My office takes in students from Brown U.  You’d be surprised at the number of women who turn down having a male student do their exams. In a 10 provider office( 3 men 7 women) the women are booked 4-5 mths out while the men you can get the appt within a month.  

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46 minutes ago, TriciaJ said:

Actually you don't know what was done because you weren't there.  The drugs used in surgery affect memory and can take a few days to clear the system.  Patients often need to have the same information repeated.  That's where families come in but not during a pandemic.

You're keeping yourself worked up over your husband's account of things.  Why don't you suspend judgement until you've spoken to someone else who was there?

He had a colonoscopy at the start of lockdown.  The nurse still brought me in explained his discharge stuff, what he needed to look for and had me sign off.  Nothing, nada, zilch with this one.  If information needed to be repeated to him why wasn’t I given this information or had to sign off from the car?  He’s been pretty clear saying the same stuff for the last 2 weeks, never mixing things up.  When it comes to who I am going to believe more it comes down to my husband.  

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Specializes in Critical Care.
12 minutes ago, Catfostermom said:

He had a colonoscopy at the start of lockdown.  The nurse still brought me in explained his discharge stuff, what he needed to look for and had me sign off.  Nothing, nada, zilch with this one.  If information needed to be repeated to him why wasn’t I given this information or had to sign off from the car?  He’s been pretty clear saying the same stuff for the last 2 weeks, never mixing things up.  When it comes to who I am going to believe more it comes down to my husband.  

So to clarify, what he found troubling was that the nursing staff treated the intermittent exposure of genitalia as though it was a routine part of post-operative care?

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11 minutes ago, MunoRN said:

So to clarify, what he found troubling was that the nursing staff treated the intermittent exposure of genitalia as though it was a routine part of post-operative care?

Its routine to you not to him.  You seem to be part of the problem that don't care of the comfort level of their pts.  Thanks for proving his point. 

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
54 minutes ago, Catfostermom said:

 

If nobody advocates for their loved ones then they don’t know there is a serious problem with their systems.   Be it pushing them through like cattle, over working the nurses so the pt doesn’t get that one on one or whatever policies they think works for them but not who they are there to take care of.  Will 1 person change their system, probably not. If enough complain about it maybe they will.  

 

 

That is true.  The people in charge do need to hear it from you because it falls on deaf ears coming from us.

If you receive a Press-Ganey survey you might want to tell them that your husband had a succession of caregivers.  Due to the intimate nature of his procedure it would have been helpful to have one nurse consistently.  Also that they seemed rushed and he didn't feel able to ask questions.

Maybe the powers-that-be will abandon the assembly line policies.  Patients and nurses would both be happier but I'm not holding my breath.

 

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Specializes in Critical Care.
14 minutes ago, Catfostermom said:

Its routine to you not to him.  You seem to be part of the problem that don't care of the comfort level of their pts.  Thanks for proving his point. 

I didn't mean to suggest it's not routine for him. 

I do find however that how a patient interprets a situation is largely based on how their nurse characterizes it.  If the nurse approaches an interaction as one where the patient should feel embarrassed or ashamed, then that will either establish or reinforce those feelings in the patient. 

It sounds as though the staff at this ASC lacks the compassion nurses should use with their patients, and that this lack of caring is remarkably consistent throughout the entire staff, but I'm not sure I completely disagree with the basic premise of communicating to a patient that post-op assessments are something that should make them feel embarrassed or ashamed.

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36 minutes ago, TriciaJ said:

That is true.  The people in charge do need to hear it from you because it falls on deaf ears coming from us.

If you receive a Press-Ganey survey you might want to tell them that your husband had a succession of caregivers.  Due to the intimate nature of his procedure it would have been helpful to have one nurse consistently.  Also that they seemed rushed and he didn't feel able to ask questions.

Maybe the powers-that-be will abandon the assembly line policies.  Patients and nurses would both be happier but I'm not holding my breath.

 

Thank you for the information about the survey.  I will certainly get it filled out ( if we get it) and hand deliver it during my meeting.  He got a list of 10ish doctors from his primary. The top name on the list was the head of the hernia department.  He only had 3 weeks to get this done with him before the Doc moved on to the Cleveland Clinic.  This Doc wanted to get it done so he could do the post op and not pass it on.  Hubby could have waited ( it wasn’t an emergency) and went to another using a different ASC.  You’d hope that the best of the best would do his surgeries in an environment that also had the best of the best. In this case it wasn’t so. 

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2 hours ago, MunoRN said:

At this point I've lost track of what exactly Catfostermom is saying occurred, maybe she could clarify.

I’m just seeing this one, sorry.  Do you still need it clarified or are you good? 

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1 hour ago, Catfostermom said:

He had a colonoscopy at the start of lockdown.  The nurse still brought me in explained his discharge stuff, what he needed to look for and had me sign off.  Nothing, nada, zilch with this one.  If information needed to be repeated to him why wasn’t I given this information or had to sign off from the car?  He’s been pretty clear saying the same stuff for the last 2 weeks, never mixing things up.  When it comes to who I am going to believe more it comes down to my husband.  

To add to my other comment if he knew enough that he had 4 different nurses  check on him and he said this isn’t a spectator sport.  I’m pretty sure he would know if they told him anything.  He didn’t say I should buy you flowers, take you out to dinner.  Right then there shouldn’t have been any doubt about him being uncomfortable.  The nurse had the opportunity to explain to him what was going on and they didn’t. 

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