How to Ensure I am never in ER Naked

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Hello, I have an Advanced Care Directive but in all of my research, learned the ER can ignore it (it is on file there). My concern is if I was ever transported to ER deemed incompetant, how can my wishes of avoiding any type of genital or breast exposure be legally heeded to?

I will not recover and my quaility of life will not surive it. Been there, done that and not a day has passed that I am happy to be here. I want to ensure it never happens again

I realize the REASON it is done is qulaity of life but I also realize I know myself better than anyone and wish it to NEVER happen. Despite all I did to prevent it, while Mtn Biking, I had an accident

The Doctor can choose to ignore my legal document on fiel with the hospital and suffer NO legal ramifications , I am not saying he would. MY brother in law owns a surgery center, sister in law was an OB GYN neither knew how to ensure this not happening. My mind is made up.

Thanks so much for any advice. I appreciate being a part of this forum

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When I say exposure, I mean nudity. I do not want to be exposed and moreso, do not want my private parts to be touched.

Thanks again

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Specializes in Complex pedi to LTC/SA & now a manager.

The only way I can think of to "guarantee" your wishes is to never be an ER patient. Never have a motor vehicle accident with chest trauma (requiring exposure of your chest to ensure there are no life threatening injuries or remove clothing that could interfere with obtaining a clear chest or abdomen X-ray). Never develop a condition that would necessitate bladder catheterisation and thus require exposure and medical contact to your perineal are to safely and cleanly perform a foley or straight bladder catheterisation

In a life or death emergent situation the rules change with the exception of a legal advance directive to withhold specific care and treatment (honestly the advance directives refer to life sustaining/prolonging care such as ventilators, ET intubation , feeding tubes, CPR & defibrillation , occasionally IV hydration, drugs, or antibiotics and life support and organ donation). I've never heard of a legal advance directive that 'prohibits' contact and/or exposure of specific body area(s).

In the absence if an advance directive or health care proxy the decision by the majority of physicians would be to preserve life & limb with minimal disability.

Good luck in your quest. Though I suspect the only way to sustain your desire would be to avoid the ER, OR, surgical centers and hospital all together

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If it's already on file, but they're allowed to ignore it with no consequences, then I'm thinking wearing a padlocked metal chastity belt & bra 24/7 with a "do not remove" sticker on them are likely your only option.

Sorry, couldn't resist the smart ass responce.

I know exactly where you're coming from as this is one of my only fears as well, and would also like to know the answer.

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Thank you JustBeachyNurse. I am a Mountain Bike rider almost out of necessity, depression sets in if I don't stay in shape. With that, I am extremely careful but it didn't stop a car from ramming into me at the top of the trail

You are correct about the Advanced Medical Directive. I "added" those conditions. The only other option I've thought of is a tattoo, I am stumpted upon the words of what to say...

If I knew for sure no matter how I lived my life there was a way to avoid ER, I'd do it in a heartbeat. In fact, even my husband supports this as he thinks it would put my mind at ease

What is bizarre to me is the Jehovahs witnesses can decide no blood transfusions, at any cost, yet there is no menchanism to ensure these simple wishes are honored.

Thanks for your reply

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Bryan How about you try it first then let me know? :p

I am thinking crazy glue :)

I suspect there is no answer...except get some tattoos with written instructions and sadly, they probably won't be heeded either. "Oh she'll get over it"...

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Specializes in LTC, Hospice, Case Management.

OK, I admit...I am a prude. But, with that said, this seems a bit extreme and I am trying to understand where this is coming from. As much as I would be very uncomfortable if exposed I certainly would never want to die because I don't want to be touched or exposed.

You are new to the forum (welcome). Not sure if you are a nurse or a lay person. As an individual who happens to be very modest but also a RN who has seen it all, I can assure you that when I have my nursing mind turned on - I couldn't care less about someone else's exposure. It's just body parts - the same as any other part and everyone has essentially the same thing and I don't have time to worry about specifics. I always have to remind myself of that when I happen to be the patient.

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- I couldn't care less about someone else's exposure. It's just body parts - the same as any other part and everyone has essentially the same thing and I don't have time to worry about specifics. I always have to remind myself of that when I happen to be the patient.

Sure, you may not care about my business hanging out... but I sure do. ( or will when I regain consiousness ;) )

As for not having time to worry about specifics, try using the keywords search "gossip about patients" or "innapropriate" and see whats being reported. You may not care, but others certainly appear to take notes.

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Specializes in LTC, Hospice, Case Management.
Sure, you may not care about my business hanging out... but I sure do. ( or will when I regain consiousness ;) )

As for not having time to worry about specifics, try using the keywords search "gossip about patients" or "innapropriate" and see whats being reported. You may not care, but others certainly appear to take notes.

Again - as modest as I am and as much as I hate someone laughing at my expense....just save my a$$ first. This can easily become a life or death manner and I'm not willing to die because of a fear of someone making fun of my boobies.

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Specializes in LTC, assisted living, med-surg, psych.

After five children, eleven surgeries and Heaven only knows how many medical exams and procedures, I have NO modesty anymore. :lol2:

Seriously, I do understand why others may be more modest than I, and am zealous about protecting my patients' privacy; but the idea that death would be preferable to being "exposed" during a medical evaluation seems a little extreme to me. I hope the OP has not suffered some traumatic event associated with being handled inappropriately, and if she has, that she gets some help to overcome it. I can't imagine that her husband and family would worry more about the ER staff seeing her without clothes on than about whether she lives or dies.....

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After five children, eleven surgeries and Heaven only knows how many medical exams and procedures, I have NO modesty anymore. :lol2:

Seriously, I do understand why others may be more modest than I, and am zealous about protecting my patients' privacy; but the idea that death would be preferable to being "exposed" during a medical evaluation seems a little extreme to me. I hope the OP has not suffered some traumatic event associated with being handled inappropriately, and if she has, that she gets some help to overcome it. I can't imagine that her husband and family would worry more about the ER staff seeing her without clothes on than about whether she lives or dies.....

I've walked out of the ER due to this issue.

I was on a construction site (high school summer job) and got hit in the shoulder by a piece of lumber that fell off of the pile.

It hurt a bit, but stopped after a few minutes, so I forgot about it.

The next morning I couldn't lift my arm more than 1/8 the way up... a bit of a sharp pain, but not major. So I went oth e ER to see if something was broken or if it just was some kinda funky intnernal sweling or something that would go away.

I expected an exray, and that I'd have to take my shirt off. That would have been fine,

Except the nurse who was in before the doctor kept insisting I get undressed and she was going to put in a cath. when I refused she tried to "order" me. I still refused and asked he to explain WHY I needed a cath, or to be naked at all for my SHOULDER. she gave me the "my way or the highway" routine.

I chose the highway, and walked out.

(by that evening, my arm was fine, and never had another episode of it)

Sure, it wasn't life or death, but I still had to refuse medical treatment for a nurses ego? power trip? inability to break from routine?

I still don't understand the medical profesions obsession with nudity. (yeah, yeah... the leg bones connected to the hip bone, the hip bones connectedto the back bone... I get that many things effect many other things, but to treat everyone on a "strip 'em and probe 'em assembly line" regardless of the injury has always bugged me.)

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Bryan Your lucky it is just a fear for you. No, I am not a nurse. But it took years to mentally recover from the accident, no broken bones but just from what took place. I had a nervous breakdown, pretended I was tired but knew my brain went somewhere. Lost my job and we lost our home. All because someone felt there was a risk to my spinal cord.

I am able to type, communicate but most everyone saw the difference as I still cannot do what I used to be able to do. Wasn;t able to help my son with his homework and never fully recovered. My husband ended up with half of me...

So despite the fact that I am thin, probably considered good looking, no one I've seen even on the Media websites has breasts as morbid as mine. They are drastically different sizes incl. nipple and the closest thin is called puffies. We don't even watch tv, so it was kinda weird looking at Media (free) but it did verify that I could probably make a ton of money. Gotta have a sense of humor...:)

Luckily for years, I never knew but everytime a new Doctor sees them, you can see he wants to know what the hell?? THere are Plastic surgeons online now, sent some photos and the three that answered told me they hadn't done such a severe case or something to that effect but could help me. I have no desire to do anything, my husband is fine with it. Pretty much got over the self pity of me realizing there are people who look weird who cannot hide it, I am very lucky. But it's far beyond just a fear of being made fun of...and nothing I can control. It will happen again under certain circumstances, and it will be beyond my control. THey call it a wormhole, once you've entered the hole is there and it's easy to go back. I don't bother telling Doctors or Nurses in real life, they just think I am exaggerating about the mental aspect. We'd like to be able to choose for me to die before going thru that, including my husband. It would be unfair for him to take care of a vegetable. It took so long to get this far, and I cannot think right to this day. So many things I cannot do, but so many I can do so it's all fine. Just want reassurance we won't ever go thru it again. Oddly I don't consider myself modest but out of respect, I will remain clothed. Even if my chest is covered, it terrifies me to think my genitals will be exposed though it looks like everyone elses. So who knows...At least I have my health and a loving husband. Others aren't so lucky.

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