I am an American.

[UnionRN2]

In the last staff meeting, NM states Dr. A has complained because the female nurses make eye contact with him. We were instructed to respect his (and other doctors) culture and NOT make eye contact or appear assertive. When asked to clarify assertive we were told assertive was "asking or suggesting something for the patients".

Excuse me! I am American and I am living in America! How come these doctors don't have to respect my culture? How come they don't have to respect me (I am a woman)?

Of course I will continue to make eye contact and I will continue to request things my patients need and I will continue to suggest things that the patient needs. I will continue to advocate for my patients. If the doc doesn't like it... tough crap. I live in America and have the rights afforded American women. I am not giving them up to stroke the ego of a bigot.

[Taryn963]

MY country, MY culture. Why are the folks in the "new" country expected to cowtow to the imported views? Happy to oblige when the respect goes both ways. I am not a bigot, but I am tired of hearing all about "cultural diversity." Did anyone notice how in one sentence they say "cultural awareness" and in the next, chastise those for making ""characterizations" based on culture?? Exactly how can you have it both ways??? The days of subservient female roles is long gone....unless you go back to certain native countries....which would be my suggestion to Dr, A and those who share his chauvinistic attitudes. Adapt, or go home. To sum it up, "get over yourself, doc!"

[NocturneRN]

MY country, MY culture. Why are the folks in the "new" country expected to cowtow to the imported views? Happy to oblige when the respect goes both ways. I am not a bigot, but I am tired of hearing all about "cultural diversity." Did anyone notice how in one sentence they say "cultural awareness" and in the next, chastise those for making ""characterizations" based on culture?? Exactly how can you have it both ways??? The days of subservient female roles is long gone....unless you go back to certain native countries....which would be my suggestion to Dr, A and those who share his chauvinistic attitudes. Adapt, or go home. To sum it up, "get over yourself, doc!"

Well, first of all, it isn't "MY" country, but "OUR" country. Second, who's asking you to "cowtow" here? That's an assumption on your part, and has nothing to do with the facts that were given at the beginning of this discussion. Third, it serves no good purpose to let emotions overrule logic here, and start assigning blame without making some effort to understand both sides.

It's very possible that this doctor has no wish to force anyone to conform to his country's ways, but truly doesn't understand why nurses in the U.S. are treating him in a way that he's always been taught was disrespectful. In such cases, a little education and understanding goes a long way. Much more so, in fact, than jingoism and defensiveness.

In other words, you fully assess the situation before you make plans, and you make those plans before you implement them, or evaluate your progress. Sound familiar?

[Rensoul]

the problem with this is that it requires us to adapt to him when it should be the other way around.

any time we communicate with someone else we are adapting to each other as we learn the give and take point of each person. the goal here is not bludgeon the m.d. with our superiority because we are in our own country, the goal is to provide superior care for the patient. yes it seems counter intuitive for us not to make eye contact when asking questions or making suggestions, but if you won't give any ground at all then more than likely he won't give any either leaving your patient out in the cold. aside from being childish, it defeats the purpose of m.d./ nurse collaboration. the person to be chided here is the nm for allowing this behavior to continue w/o cluing him in that he will have to adjust too.

[NocturneRN]

the problem with this is that it requires us to adapt to him when it should be the other way around.

there are no "shoulds" here, except doing whatever is necessary to give the patient the best possible care. and, no matter how strongly you feel that foreign residents of the u.s. should act like americans, the fact remains that it takes time, effort and lots of insight before a foreigner can do this effectively. not only does he have to grasp the idea that, contrary to what he's been taught all his life, it is not a sign of disrespect for nurses to look him in the eye, but he also has to get a feel for how much eye contact indicates respect in our culture.

we americans know without being told that inability to make eye contact usually indicates shyness or deceptiveness. we know it, not because it's a universal truism, but because that's what living in the u.s., and interacting every day with fellow americans, has taught us.

but someone who hails from a very different culture might not read it that way at all, because his home culture has completely different ground rules. so he's confused, first of all when nurses appear to be staring him down (from his perception), and second when they're suggesting orders to him. he might be thinking, "why are they challenging me? why are they telling me what to order? don't they think i know what i'm doing?"

if he comes from a culture in which nurses are taught to obey the doctor unquestioningly (as was the case here in the u.s. not so many decades ago), he might feel that he's being attacked, or that his professional qualifications are being challenged. he might feel that the nurses are testing their limits with him, and that he's expected to assert his authority, in order to gain their respect. all of these reactions are perfectly natural ones for someone in an unfamiliar setting, but they can easily be misunderstood, if you're judging him by american cultural standards when he's still struggling with culture shock.

it seems to me that the best and easiest way to clear up this problem would be to improve communication. (other foreign doctors, particularly those from his native country, might be very helpful here.) as things stand from the original description, both the doctor and the nursing staff are feeling pretty defensive, when it might just be that they're not understanding the other side's expectations.

[country mom]

Actually, the gut feeling I had reading this was one of sadness for how women get treated in other parts of the world. It gave me a chance to thank the good Lord I was born in the USA. I'm not disrespecting anybody else's culture. I'm just thankful for our basic constitutional freedoms and rights.

[Ruby Vee, BSN]

and, no matter how strongly you feel that foreign residents of the u.s. should act like americans, the fact remains that it takes time, effort and lots of insight before a foreigner can do this effectively. not only does he have to grasp the idea that, contrary to what he's been taught all his life, it is not a sign of disrespect for nurses to look him in the eye, but he also has to get a feel for how much eye contact indicates respect in our culture. .

i understand that it takes time, effort and insight for a foreigner to "act like an american." i also think, however, that it takes time, effort and insight for american nurses to act like the subservient women this man is used to. certainly we can cut him a bit of slack in the interest of patient care. but i submit that he should be cutting us some slack, too, rather than running to the nm to complain about how he's being treated. surely he understands that americans do look people in the eye and if he's spent any time observing nurse/physician interactions he's seen that it's not just him who gets the questions and suggestions. i have difficulty with the idea that all the bending should always come from the americans.

[NocturneRN]

i understand that it takes time, effort and insight for a foreigner to "act like an american." i also think, however, that it takes time, effort and insight for american nurses to act like the subservient women this man is used to. certainly we can cut him a bit of slack in the interest of patient care. but i submit that he should be cutting us some slack, too, rather than running to the nm to complain about how he's being treated. surely he understands that americans do look people in the eye and if he's spent any time observing nurse/physician interactions he's seen that it's not just him who gets the questions and suggestions. i have difficulty with the idea that all the bending should always come from the americans.

i'm wondering where you're getting the idea that americans "bend" more than anyone else, or that anyone expects them to. we're talking about a man who's uncomfortable with unwritten american workplace customs, and is having trouble figuring them out, not some angry tyrant saying "you're american----that means that you have to do what i say."

i agree that he should be cutting others some slack. what makes you assume that he isn't trying to?

[Ruby Vee, BSN]

i'm wondering where you're getting the idea that americans "bend" more than anyone else, or that anyone expects them to. we're talking about a man who's uncomfortable with unwritten american workplace customs, and is having trouble figuring them out, not some angry tyrant saying "you're american----that means that you have to do what i say."

i agree that he should be cutting others some slack. what makes you assume that he isn't trying to?

i assumed he wasn't trying to cut anyone else some slack because he went to the nurse manager and asked her to chastise the nurses because he was uncomfortable with their behavior.

[NocturneRN]

i assumed he wasn't trying to cut anyone else some slack because he went to the nurse manager and asked her to chastise the nurses because he was uncomfortable with their behavior.

it actually said nothing about him asking the nm to chastise anyone. it merely said he complained to her----the rest refers to how she chose to handle the situation.

[leslie :-D]

It actually said nothing about him asking the NM to chastise anyone. It merely said he complained to her----the rest refers to how SHE chose to handle the situation.

just by virtue of him complaining, shows an intolerance to the situation, wouldn't you agree?

leslie

[Cul2]

What needs to be clearly defined here are the differences, if any, between "culture"

and "power."And -- what kind of situations are a blend of a cultural tradition that

embodies a power grab, especially one involving gender relationships. From what I've

read here, this seems to be a control and power situation involving gender relationships,

that may be embedded within a culture. In situations like this, we need to just get all

this out on the table. "Why don't you want eye contact?" "What's the issue?" If the

answer is that it's a tradition in our country or that it's impolite or rude, then you ask

"Why is it a tradition? Why is it considered rude?" Get it out in the open. If it an example

of gender discrimination, that will probably become quite evident. As with many aspects

of culture, we may not be able to articulate our reasons for a tradition -- that's just the

way it is. If that's the answer, then, -- "Well, when you can articulate why you want this

behavior, we'll have another meeting to discuss it. In the meantime, we do things the way

we do things here." Let's sweep the assumptions out from under the rug and find out

what's going on exactly.

[NocturneRN]

just by virtue of him complaining, shows an intolerance to the situation, wouldn't you agree?

leslie

No more so than it shows "intolerance" to criticize his attitude.

We really have no way of knowing how rigid he was on this issue----whether he was complaining to the NM in hopes of getting some insight into the nurses' behavior, or whether he was behaving like a dictator, demanding that she force them to stop looking at him. In view of this, doesn't it make sense to consider all possibilities, before condemning him?