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.

[JacobK, ADN, EMT-I]

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?

He didn't go the NM in the hopes of gaining insight, the NM wouldn't have specifically requested nurses stop making eye contact and being assertive unless he had specifically asked her to or made a big issue out of it.

I can almost chalk up the "don't make eye contact" thing to a cultural habit. The amount of culture acceptance either way is up for debate.

However, instructing the female nurses not to be "assertive," is going to far. Should the female nurses just go around heads bowed and meekly following orders? How does this apply to male nurses? Female physicians? No eye contact can be a cultural norm adjustment, being meek(aka "not assertive") is a sign of submission, and NOT acceptable.

[NocturneRN]

He didn't go the NM in the hopes of gaining insight, the NM wouldn't have specifically requested nurses stop making eye contact and being assertive unless he had specifically asked her to or made a big issue out of it.

I can almost chalk up the "don't make eye contact" thing to a cultural habit. The amount of culture acceptance either way is up for debate.

However, instructing the female nurses not to be "assertive," is going to far. Should the female nurses just go around heads bowed and meekly following orders? How does this apply to male nurses? Female physicians? No eye contact can be a cultural norm adjustment, being meek(aka "not assertive") is a sign of submission, and NOT acceptable.

You know what? You just admitted (however obliquely) that we don't have enough information to know for sure what was motivating the doctor's complaint. You're also attempting to read more into the original post than it actually said, since the word "meek" was never used, and since avoiding eye contact is NOT universally a sign of submission. In some cultures, it's merely a sign of respect, as lengthy eye contact may be regarded as intrusive or truculent.

It sounds to me as if the nurse manager could have been a little more pro-active with the doctor, instead of just directing the nurses to do as he wished. But, again, we don't know the details of the situation, and it's possible that she did talk to him about American behavior and nurse/doctor etiquette, and maybe even made some suggestions to him. It's also possible that he took them!----We just don't know. And that's why I keep saying that it doesn't do to get too judgmental here.

[JacobK, ADN, EMT-I]

You know what? You just admitted (however obliquely) that we don't have enough information to know for sure what was motivating the doctor's complaint. You're also attempting to read more into the original post than it actually said, since the word "meek" was never used, and since avoiding eye contact is NOT universally a sign of submission. In some cultures, it's merely a sign of respect, as lengthy eye contact may be regarded as intrusive or truculent.

It sounds to me as if the nurse manager could have been a little more pro-active with the doctor, instead of just directing the nurses to do as he wished. But, again, we don't know the details of the situation, and it's possible that she did talk to him about American behavior and nurse/doctor etiquette, and maybe even made some suggestions to him. It's also possible that he took them!----We just don't know. And that's why I keep saying that it doesn't do to get too judgmental here.

If you read my post you will see that I specifically said that not wanting eye contact can be a cultural thing, and not necessarily something that is bad. However, you can debate whether or not the nurses should have to adjust to his culture or not.

However, my issue is with this part of the original post:

"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"."

The opposite of assertive is meek, so when he requests that nurses "not appear assertive" he means they should appear meek. Being meek is showing submission. In addition to that he asked only that FEMALE nurses do this, and that I really have a problem with.

[mammac5]

I wonder what you might say in Nicaragua, getting cat-called by all the male docs, and when you asked for a change, they responded, "We're Nicaraguan! This is our country! We don't have to humor your culture!"

Just saying....it goes both ways.

Well, if I decided to go work in a country where I was well aware that female nurses are generally treated with disrespect and that "all the male docs" are allowed to act like asses by call-calling in their presence, then I get what's coming to me! If I decided to go work in a country that spoke a different language from English, I would expect to learn the language. If I decided to go work in a country where women are expected to cover their heads when outside their homes, I would follow suit. NOT because their language or customs are more important than my own, but because I made the choice to practice in a different country.

Here in the good ole U.S. of A., nurses (many of whom are female) have worked for generations to try and get a little respect from the general population and the medical establishment. We've raised the bar repeatedly as medical advances have required greater knowledge for nurses to practice safely and effectlively. Women here can own property, have bank accounts without a man's signature, and even (gasp!) function their entire lives without a man unless they just happen to really enjoy having one around! Sure, our culture and customs are strange to people from other parts of the world, but we like 'em okay and plan to keep them. So if others want to come work with us, we respect that but we do expect them to at least pretend to like us! We don't ask them to worship with us, love hotdogs, or understand American television, but they can at least try to get along with us at work...and not run to our nurse manager like a baby to whine about how all the nurses look him in the eyes! Sheesh!

[kcochrane]

Culture aside, it really comes down to patient safety. If you are not allowed to advocate for your patient, then you are not allowed to do your job as a nurse. Being "assertive" by asking or suggesting something a patient is part of our job description. Patients could be hurt if a doctor is not willing to listen to the nurse who actually knows the patient. I would not work for a NM or a unit that allowed this type of behavior - a behavior that is risking my patients health and my license at the same time.

[Future O.R. Nurse]

WOW!!

[BluegrassRN]

NocturneRN, I like you a lot. Just thought I'd share.

[rn/writer, RN]

If there is a real villain here (and I'm not at all sure there is), it's the nurse manager who asked her staff nurse to "tone down" the assertiveness and accommodate the doc by not making eye contact.

IMO, she would have done better to meet him where he was ("I'm sorry that direct eye contact makes you uncomfortable and that you don't like the nurses making suggestions. It must be a challenge when you're used to something different"), and then take him someplace new (In this culture, we use eye contact as a sign of paying attention and showing respect. As for the nurses making suggestions, that is what they are expected to do, and patients benefit when they communicate their concerns).

She could have asked what she could do to help make the transition easier (short of backing her nurses into a subservient and diminished role) and perhaps found a doc from his own culture (a well-adjusted one!) to offer him encouragement and direction.

It was her job to the be the intermediary, and it sounds like she missed what could have been a good opportunity to build a better connection.

He could have been an obstreperous mule anyway, but the fault would then be his alone.

[Taryn963]

Topic: CHAUVINISM. The original post by UnionRN2, stated very clearly that Dr. A. had complained that the FEMALE nurses "not make eye contact, or act assertive; ie: ask or suggest something for their patients." The doctor in question did not complain of the MALE nurses making eye contact, only the FEMALE nurses.

Understanding? Education? Like this idea of equality is a new concept?? I cannot imagine that with the advent of that contraption called a television set, or computers, or even newspapers, that our "Western culture" of equality of males and females has escaped the educated physician's notice, no matter his country of origin! Seriously....you think it came as a surprise, when he got off the plane?? We had women running for President for Pete's sake! How could he have missed that news?!

I think that we have come this far as women, and nursing as a profession to refuse to allow outdated, and truly arrogant, elitist, sexist views to be allowed to enter the professional arena. (His home is his and his wife's business.)

And lest you think otherwise, I have always been a staunch supporter of the men who are nursing professionals! I did not include them in the previous sentence as again, it is a purely anti-woman issue at hand. Sadly, there are still many female nurses who treat the men in our field abominably...sexual discrimination, is a two way street.

My point was simple....stop coming to, as you say "OUR" country and trying to impose offensive views onto others. It just happened to be chauvinism, in this case. What he believes, or practices is HIS business. How he behaves toward me, a woman, and as my patient's advocate, makes it MY business.

"When in Rome..."

[NocturneRN]

Topic: CHAUVINISM. The original post by UnionRN2, stated very clearly that Dr. A. had complained that the FEMALE nurses "not make eye contact, or act assertive; ie: ask or suggest something for their patients." The doctor in question did not complain of the MALE nurses making eye contact, only the FEMALE nurses.

Understanding? Education? Like this idea of equality is a new concept?? I cannot imagine that with the advent of that contraption called a television set, or computers, or even newspapers, that our "Western culture" of equality of males and females has escaped the educated physician's notice, no matter his country of origin! Seriously....you think it came as a surprise, when he got off the plane?? We had women running for President for Pete's sake! How could he have missed that news?!

I think that we have come this far as women, and nursing as a profession to refuse to allow outdated, and truly arrogant, elitist, sexist views to be allowed to enter the professional arena. (His home is his and his wife's business.)

And lest you think otherwise, I have always been a staunch supporter of the men who are nursing professionals! I did not include them in the previous sentence as again, it is a purely anti-woman issue at hand. Sadly, there are still many female nurses who treat the men in our field abominably...sexual discrimination, is a two way street.

My point was simple....stop coming to, as you say "OUR" country and trying to impose offensive views onto others. It just happened to be chauvinism, in this case. What he believes, or practices is HIS business. How he behaves toward me, a woman, and as my patient's advocate, makes it MY business.

"When in Rome..."

I challenge you to spend six months living and working in Rome (or any foreign town or city), without once irritating, offending or confusing the natives through cultural misunderstanding.

It's easy to say "when in Rome," when you're the Roman. It's a lot tougher when you're the foreigner, trying to negotiate an unfamiliar culture where you can't read facial expressions or body language, where social rules are completely different from what you've always assumed them to be, and where people keep getting irritated with you when you try to understand what they expect of you.

Quite simply, it takes time to get used to another culture, much less to earn the trust and cooperation from others within it. And, no, you can't pick up all their unwritten social rules and expectations just by watching TV.

I might be underestimating the level of this guy's chauvinism (then again, I might not), but I maintain that no purpose is served by heaping blame on him, without making any effort to understand where he's coming from.

[rn/writer, RN]

Topic: CHAUVINISM. The original post by UnionRN2, stated very clearly that Dr. A. had complained that the FEMALE nurses "not make eye contact, or act assertive; ie: ask or suggest something for their patients." The doctor in question did not complain of the MALE nurses making eye contact, only the FEMALE nurses.

Understanding? Education? Like this idea of equality is a new concept?? I cannot imagine that with the advent of that contraption called a television set, or computers, or even newspapers, that our "Western culture" of equality of males and females has escaped the educated physician's notice, no matter his country of origin! Seriously....you think it came as a surprise, when he got off the plane?? We had women running for President for Pete's sake! How could he have missed that news?!

There is a big difference between being aware that something exists and being influenced by that knowledge on a deep and heartfelt level.

For instance, nurses from the US and Canada have long been recruited by countries in the Middle East. When they go, they are given detailed cultural information about their place in that society. Do you think that such drastic changes come naturally? I doubt it. No matter how much preparation is put in ahead of time, the actual atmosphere can still be a shock. Especially if you find yourself in philosophical disagreement with the culture.

Add to that the idea that this is a male doc being asked to shed customs and attitudes that favor males and you have a double whammy of unfamiliarity (in practice, if not in knowledge) and the temptation to cling to a way of life that gives him a distinct advantage over women.

The fact that we find such dominance disrespectful and abhorrent (especially in a professional setting) does not render the subject matter any less shocking or difficult for him to deal with. Nor does it justify heaping condemnation on the guy's head.

He needs to be encouraged to adapt. Then strongly encouraged, if need be. Then and only then, perhaps disciplined if he shows no inclination to change.

[Kooky Korky, BSN, RN]

He is in your country it is up to him to adapt to you. This really makes me mad. He should go home if he doesn't like assertive women.

The only problem with suggesting that he be the one to adapt is that he is a physician.

Does OP want to keep her job or not?

I guess her economic survival is at stake, right?

Simple. Not pleasant or right to have to accept but simple.

Doctor, nurse. Job, no job. Survival, . Reality, fantasy.