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.
Specializes in Labor/Delivery, Pediatrics, Peds ER.
The eye contact thing is bad enough, as I cannot imagine communicating to anyone without eye contact. How does a person know another is understanding what he/she says and that communication is effective without eye contact?
However, the biggest issue is being requested not to advocate on your patient's behalf. You aren't supposed to ask for needed medication, such as pain or nausea meds that may not be routinely ordered? This is ludicrous, and any NM who goes along with this nutsy thinking is not only missing a few marbles, but asking for trouble, legal and otherwise.
Specializes in Labor/Delivery, Pediatrics, Peds ER.
And what happens when this doctor goes to the grocery store, the movies, a restaurant, etc... It is considered good customer service to look your customer in the eye, giving them your full attention. This doc must be in a constant state of being offended when he goes out!
Yes, and I seriously doubt anyone could be in this country longer than a day or two without realizing eye contact is the cultural norm, or work in a hospital longer than a week or two to realize it is acceptable here for nurses to advocate. I just don't see how these things could have escaped him. Obviously, he has noticed to the extent that it disturbs him, so he would not have asked around to find out if these things were the norm or not? Seems like he would rather force the change of others rather than adapting to the situation HE chose. Sensitivity needs to be a two-way street.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
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Speak for yourself, please. I know exactly who I am, and what the U.S. is. It's a nation that has traditionally welcomed diversity, and fought hard to overcome the ignorance and bigotry of our slaveholding and Indian extermination past.
If we're truly a strong people, then it's not going to destroy the fabric of our society if we're forced to associate with (gasp!) non-Christians, or people with different ways of speaking, and different ways of doing things. But it might require that we actually examine problems, and determine causes and contributing factors, before rushing to condemn those who aren't conforming to our expectations.
You paint us as the xenophobes and the bigots. The intolerant. The first to condemn. Objecting to a job-mandated universal symbol for submission. ( Basically he wants the nurse to avert her gaze. It's a pro-active position), different from what another culture might do. What matters is what he believes it symbolizes.
I don't think you can extrapolate that to not accepting people who talk with an accent or are non-Christian. In reality, we are one of the least class-divided countries in the world, and the most likely to play the 100-0 game, meaning we expect ourselves to be 100% accomodating, and the new-comers (like this doctor) 0%. I think the irony of it is this behavior and willingness to buy into an American group-guilt is a reaction to those things you seem to be warning that we are in imminent danger of regressing to again.
Maybe the guy is in culture shock, and bewildered by our effrontery. Kind of hard for me to believe the man has the intelligence to become a doctor but somehow failed to notice all those thousands of women around him looking right at the men they are talking to. Unless his request applies only to female nurses, he'll probably want to talk to the managers of the local grocery store or any other place with female cashiers as well. Respect for other's culture in the abstract? Absolutely. But that is a far cry from the "compromise" approach applied to something so objectionable to our culture.
Yes, and I seriously doubt anyone could be in this country longer than a day or two without realizing eye contact is the cultural norm, or work in a hospital longer than a week or two to realize it is acceptable here for nurses to advocate. I just don't see how these things could have escaped him. Obviously, he has noticed to the extent that it disturbs him, so he would not have asked around to find out if these things were the norm or not? Seems like he would rather force the change of others rather than adapting to the situation HE chose. Sensitivity needs to be a two-way street.
Most foreigners visiting or moving to the U.S. would certainly notice that Americans are more inclined than many other cultures to make and hold eye contact with strangers, and to show their feelings (amusement, irritation, anger, boredom, etc.) on the surface. Those are features of our culture (among others) that non-Americans often tend to notice very quickly.
The problem is that people who didn't grow up where those behaviors are the norm don't always know how to read them. If a person comes from a culture where people are expected not to make eye contact, it can feel unpleasantly intrusive when a total stranger gazes at him. Even if he's been told that Americans tend to look people in the eye, his gut reaction might still be defensive----partly because lifelong habits are hard to break, and partly because he has no clear idea of how to tell the difference between assertive eye contact, and insolent eye contact. He might be thinking, "Why do these Americans always have a chip on their shoulder?" Or "This person keeps staring at me. Do I have food on my chin or something, and, if so, it's pretty rude to call attention to it in that way." Or even, "I've heard that a lot of Americans hate Muslims. Is that why these nurses keep giving me dirty looks?"
That's not as ridiculous as it might sound. I wish I had a nickel for every time an American has told me that French people hate Americans, and the proof of it is that they don't smile at strangers. In fact, if they'd talked their reactions over with a native French person (as this doctor did when talking over his concerns with an American nurse), they would probably have gained some insight, and felt less uncomfortable the next time it happened.
You paint us as the xenophobes and the bigots. The intolerant. The first to condemn. Objecting to a job-mandated universal symbol for submission. ( Basically he wants the nurse to avert her gaze. It's a pro-active position), different from what other culture has no one looking at anyone else's eyes.
I don't think you can extrapolate that to not accepting people who talk with an accent or are non-Christian. In reality, we are one of the least class-divided countries in the world, and the most likely to play the 100-0 game, meaning we expect ourselves to be 100% accomodating, and the new-comers (like this doctor) 0%. I think the irony of it is this behavior and willingness to buy into an American group-guilt is a reaction to those things you seem to be warning that we are in imminent danger of regressing to again.
Maybe the guy is in culture shock, and bewildered by our effrontery. Kind of hard for me to believe the man has the intelligence to become a doctor but somehow failed to notice all those thousands of women around him looking right at the men they are talking to. Unless his request applies only to female nurses, he'll probably want to talk to the managers of the local grocery store or any other place with female cashiers as well. Respect for other's culture in the abstract? Absolutely. But that is a far cry from the "compromise" approach applied to something so objectionable to our culture.
I'm not calling anyone a xenophobe or bigot. But it's unrealistic to assume that this man, who came from a different culture and (in all likelihood) mastered a different language in order to practice here, isn't making any cultural concessions. It takes a LOT of effort and patience to live and work in a different country, and it's unfair for you to assume that this man isn't doing the best he can with the knowledge and insight he has.
The thing to remember is, it's probably not just the eye contact thing and the suggesting of treatments thing that are frustrating him. In all likelihood, there are a million and one little things that we Americans know without being told, that he's having to figure out through trial and error. For example: do nurses prefer to be addressed by their first name or last name? Or is it intrusive to call them by name? Which ones are nurses, and which ones are CNAs, and what the Sam Hill is a CNA, anyway? If he needs a glass of water, is it acceptable for him to serve himself, or should he ask an employee for it, and, if so, which employee? (This might be further complicated if he asks the wrong employee for the water, and s/he reacts defensively, assuming the doctor is treating him/her like a lackey.) He might be trying to show respect to the nurses by not making eye contact himself, and getting puzzled when they don't return his gesture of respect. And so on.
I grant you, there's always the possibility that the man is, as you seem to assume, just an inconsiderate jerk who thinks he's too good for the nursing staff. But doesn't it make much more sense to consider other possibilities---particularly the possibility that he needs more information, better insight, and possibly some moral support---in order to better understand this new culture, before dismissing him as a jerk?
Some years ago, a new cardiologist (from Pakistan) came on staff at my hospital, and we started seeing a lot of him on the cardiac unit I was working on. Most of the nurses didn't like him---they felt he was too abrupt, too unfriendly, and not nearly as easy to deal with as some of the (mostly American) doctors they were used to. But, over time, they got to know him, and he came to understand them better. Eventually, he became the cardiologist that the nurses felt most comfortable with when they had clinical questions, and the one they usually chose for themselves or their families, whenever they needed a cardiologist. It just took some time for him to get used to their ways and their expectations. And, interestingly, he turned out to be a very pleasant person, once he got to know us individually, and understood where we were coming from.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I never called him a jerk or inconsiderate. I think a lot can be gleaned from his visit to the Nurse Manager. That visit tells you he was not confused, for he surely saw other doctors and nurses interacting with each other as we do before he went to see her. I hope the nurse manager averted her eyes as she assured him she would sell her nurses down the river instead of taking the opportunity to educate him.
The rude and abrupt doctors are so plentiful we eat 'em up for breakfast and spit 'em out for lunch hahaha j/k. I place the gaze avert mandate and the ridiculous no questions mandate in the discrimination column, it's gender specific. Rather than the clashing mores. Any words or behavior from anyone that falls into the protected category laws is unacceptable no matter what culture someone has come out of.
I'm not advocating being harsh or hostile to the man at all. Her nurse manager made the wrong call. Now, she has very likely lost the respect of her staff nurses. No good.
One last thing! You are doing a rockin' job of explaining your position calmly, repeatedly and without malice- I appreciate it!! :)
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.
My two cents...
The NM needs to speak to the MD, and explain that such blatant bias (in that he makes this request of FEMALE nurses and not male nurses) is not socially, legally acceptable practice in this facility and in this country. She should also explain that the guidelines of nursing practice REQUIRE nurses to advocate for their patients, and this will require them sometimes appear "assertive".
This is not optional behavior, it is required behavior, by most of our BONs. And requiring different behavior from females than males is not acceptable here.
And then the NM needs to call a meeting with the Medical director to discuss the issue.
Then NM should have never brought this up to staff, prior to doing the above.
Obviously, the NM is inappropriately cowed, or works for a facility that walks all over its staff in pursuing pt/MD satisfaction at the cost of good pt care. I have worked for some of those, and have chosen not to do so.
As I suspect that the NM is too much of a wimp to do so...or knows that s/he works for a facility that throws its staff under a bus if they do not kowtow to such demands....there is the nuclear option. Find some way to make it known to the general public what this MDs requests are regarding female nurse behavior. I suspect, barring him being a urologist, that substantial number of female pts, many of whom do not properly "lower their eyes" when dealing with him. Not to mention other female MDs that have been making referrals to him - I suspect that they do not "lower their eyes". Yet, amazingly I suspect he deals with them without making that unacceptable request.
I have a feeling that his business would be a bit affected, not to mention that the public, including many of the male MDs that work closely with him, would explain in no uncertain terms why that is inappropriate.
And if he is so adamant in making sure that "females" behave properly in his presence, he should have no problem having it publicly known what he expects of us.
Of course this requires a great deal of risk to the OP (whistleblower) but it is interesting to imagine.
Something else to consider--many times when people emigrate from another country, they live near and socialize with other immigrants from the same area. They recreate as much of their home country as they can. Americans do it too when living abroad. If this is the case with the doc in question, he would probably have little interaction with women outside the job. The female members of his family would take care of his needs and do so in a comfortably submissive manner.
He may have seen all kinds of examples of women making eye contact and having the audacity to question men and speak directly, but he may not believe that this is a good thing. If that is so, he wouldn't be terribly motivated to adapt. Especially since, in his experience, women are the ones who do the adapting.
He doesn't have to be a creep or a selfish jerk or anything else that's bad. He may be just a person who was brought up with a variety of experiences and expectations that have kept working for him everywhere except on the job. The possibility that his family members and social circle abide by these same rules only serves to insulate him from the reality that he is going to be the one doing the larger amount of accommodating if he wants to be successful here.
Many foreign-born professional men in this kind of situation can find themselves expressing frustration and worrying that a desire for the kind of freedom and respect we women take for granted will infect their wives and daughters. To that end, they get a little edgy and take it out on those who exemplify that which they fear.
He needs to be brought up to speed, most definitely, but the best way to do it is without anger or judgment. If he's really a decent chap, he'll eventually get it.
I never called him a jerk or inconsiderate. I think a lot can be gleaned from his visit to the Nurse Manager. That visit tells you he was not confused, for he surely saw other doctors and nurses interacting with each other as we do before he went to see her. I hope the nurse manager averted her eyes as she assured him she would sell her nurses down the river instead of taking the opportunity to educate him.
The rude and abrupt doctors are so plentiful we eat 'em up for breakfast and spit 'em out for lunch hahaha j/k. I place the gaze avert mandate and the ridiculous no questions mandate in the discrimination column, it's gender specific. Rather than the clashing mores. Any words or behavior from anyone that falls into the protected category laws is unacceptable no matter what culture someone has come out of.
I'm not advocating being harsh or hostile to the man at all. Her nurse manager made the wrong call. Now, she has very likely lost the respect of her staff nurses. No good.
One last thing! You are doing a rockin' job of explaining your position calmly, repeatedly and without malice- I appreciate it!! :)
Thank you. I feel strongly on this issue, because I've been on the other side, and know how confusing it can be to deal with a foreign culture that doesn't act or react as one has been conditioned to expect. And the thing that's so frustrating about it is that, unless you've been clued in beforehand, sometimes you don't even recognize it as cultural misunderstandings----you just assume that you're rubbing the other person the wrong way, but have no idea how to go about fixing the problem.
And I do agree with you that, if the NM simply told her staff to do what the doctor wanted without making an effort to explain American nurse/doctor customs to him, she handled it badly. Bad example of both leadership and problem solving skills.
something else to consider--many times when people emigrate from another country, they live near and socialize with other immigrants from the same area. they recreate as much of their home country as they can. americans do it too when living abroad. if this is the case with the doc in question, he would probably have little interaction with women outside the job. the female members of his family would take care of his needs and do so in a comfortably submissive manner.
he may have seen all kinds of examples of women making eye contact and having the audacity to question men and speak directly, but he may not believe that this is a good thing. if that is so, he wouldn't be terribly motivated to adapt. especially since, in his experience, women are the ones who do the adapting.
he doesn't have to be a creep or a selfish jerk or anything else that's bad. he may be just a person who was brought up with a variety of experiences and expectations that have kept working for him everywhere except on the job. the possibility that his family members and social circle abide by these same rules only serves to insulate him from the reality that he is going to be the one doing the larger amount of accommodating if he wants to be successful here.
many foreign-born professional men in this kind of situation can find themselves expressing frustration and worrying that a desire for the kind of freedom and respect we women take for granted will infect their wives and daughters. to that end, they get a little edgy and take it out on those who exemplify that which they fear.
he needs to be brought up to speed, most definitely, but the best way to do it is without anger or judgment. if he's really a decent chap, he'll eventually get it.
i do not believe this is the problem. i believe that too many non us citizens almost demand "we" become like the women from their countries and when that does not happen they take a trip to the supervisor's office; because as you know many doctors have the god like attitude. it makes me sick to see how other cultures treat the women of their countries and if they love that so, or were raised in this environment, then they should have a doctors intelligence to say "hey, i'm going to america, so i ought to learn their customs, etc."; but no, they want us to accommodate their customs and i will not ever do this as this is our culture so learn it or leave it! enough is enough!!!!!
it's like the old saying says: when in rome, do as the romans do. wake up everyone and stand up for what is right because if you were in their country, believe me, you would be read the riot act if not worse!!!
:yeah:
RetRN77
153 Posts
The eye contact thing is bad enough, as I cannot imagine communicating to anyone without eye contact. How does a person know another is understanding what he/she says and that communication is effective without eye contact?
However, the biggest issue is being requested not to advocate on your patient's behalf. You aren't supposed to ask for needed medication, such as pain or nausea meds that may not be routinely ordered? This is ludicrous, and any NM who goes along with this nutsy thinking is not only missing a few marbles, but asking for trouble, legal and otherwise.