I am an American.

mamamerlee, LPN · Jul 26, 2010

This doc only requested that the FEMALE nurses avert their eyes and not offer any suggestions. This is BLATANT discrimination. Either he works in the American COLLABORATIVE health care system, or he can go back home.

As for the NM - she needs to grow a pair!

APRN., DNP, RN, APRN, NP · Jul 26, 2010

STANDARDS OF COMPETENT PERFORMANCE

Excerpt From California Code of Regulations

Title 16 - Chapter 14

......Acts as the client's advocate, as circumstances require by initiating action to improve health care or to

change decisions or activities which are against the interests or wishes of the client, and by giving the client

the opportunity to make informed decisions about health care before it is provided.

http://www.rn.ca.gov/pdfs/regulations/npr-i-20.pdf

_____________________________________________________________________

If this was happening in California, I would be approaching my Nurse Manager about her breach of duty to ensure that the RN's are allowed to perform to recognized standards of practice in this state.

What state is this happening in? Is there similar wording on your State Board of Nursing website?

NocturneRN · Jul 26, 2010

as usual, we americans have taken things above and beyond to an extreme. our country was based on the rights and freedoms that others craved and wanted. did they have any idea it would turn out like this? i think not.
so, as a nursing student, let me ask all of you wise and wonderful veteran and current nurses... when i walk up to anyone (because remember we are not supposed to stereotype and assume) i am to look like a downtrodden wimp as i stare at my tootsies? look at the ceiling? waiting for someone to tell me, "it's ok child; i am also culturally sensitive and will allow you to look upon me as you are speaking because i know your culture does this"? yeah right! it will never happen! nobody thinks americans have a "culture". aren't we all supposed to blend???
i am american... i was born here. my grandfather was an irishman and my grandmother was a blackfoot indian (dont make me mad! my eyes turn red and i can bring the rains upon you!)... i love my heritage but i also know that i am first and foremost an american!!!!
omg, i am mad... lol, please allow my anger, it is within my culture
of course americans have a culture (with many subcultures!), but it isn't necessarily true that we always "blend" (i.e., agree 100% on the way to interact with others).
i certainly agree that this doctor needs to be set straight about american style communication, as well as the role of american nurses in health care. but, instead of scolding him, or getting someone else to scold him (as some here seem to be suggesting), wouldn't it make more sense for some of his peers (especially those from his own area of the world) to sit down with him and clue him in to cultural differences? chances are he's already on the defensive, possibly even wondering why the nurses are so hostile toward him.
that's the weird thing about cultural differences: when you're in another country, interacting within another culture, you can easily annoy or offend or bewilder the natives, without even realizing you're doing it. especially when you have no idea where to draw the line. for example, this guy might be thinking to himself, "okay, the other doctors are telling me that the nurses aren't insulting my professional competence if they suggest orders to me. i can accept that to a point----but how far is it likely to go? if i say, yes, i can order the prns you requested, and if you think we need another cbc i'll order that, too....will they lose respect for me as a physician, and walk all over me in the future?"
of course, there's always the possibility that he already has a good handle on american nurse/doctor relations, but chooses to be a jerk anyway. but i wouldn't assume that, without making every effort to find out if it isn't just a matter of being unfamiliar with american hospital culture.

RN1980 · Jul 26, 2010

not to make eye contact?? that got to be about one of the dumbest things i've heard. Your manager is retarded.

chloecatrn · Jul 26, 2010

not to make eye contact?? that got to be about one of the dumbest things i've heard. Your manager is retarded.

Wow. Could we not use the r-word, please? http://www.r-word.org/

netglow, ASN, RN · Jul 26, 2010

Huge case of discrimination, harassment and intimidation in the workplace.

Ha. Love it to leak out to the media. Awesome. I am sure it would be so easy to get him to screw himself so royally. All you have to do is have someone ask him WHY? The answer would be that women are inferior and should always take a submissive stance in the presence of men. Real bad marketing for the facility if they allowed him to stay on staff. This is such a slam dunk. OP, are you unionized? or better yet...

US EEOC Home Page

flashpoint · Jul 26, 2010

I don't think they eye contact thing is really a submissive thing...in some cultures, NO ONE makes eye contact...man-to-man, woman-to-woman, man-to-woman, doctor-to-housekeeper, whatever. I work in an area that has a pretty high Native American population and a lot of them don't make eye contact at all...it is offensive...and some view it as a challenge. While I really think that people need to follow the practices of the country (or even area of a country) that they choose to live in, I'm not too put out by not making eye contact with someone if it bothers them. I'm much more aware of my bad habit of swearing in around people who I know it offends, I can watch they eye contact thing too when I have to (and when I remember).

As far as not suggesting orders...yikes! The hospital I work at gets a lot of patients from the nursing home that I used to work at (I still pick up a few hours a month there), so I know some of our patients very well. It would really bother me not to be able to say, "Percocet works really well for her" or even to ask the doctor if they want an x-ray or lab or whatever. On this issue, he needs to remember that nurses are not bobble-headed task maidens. I love how our doctors and nurse practitioners view us as colleagues.

NocturneRN · Jul 26, 2010

Huge case of discrimination, harassment and intimidation in the workplace.
Ha. Love it to leak out to the media. Awesome. I am sure it would be so easy to get him to screw himself so royally. All you have to do is have someone ask him WHY? The answer would be that women are inferior and should always take a submissive stance in the presence of men. Real bad marketing for the facility if they allowed him to stay on staff. This is such a slam dunk. OP, are you unionized? or better yet...
US EEOC Home Page

More likely, his answer would be that he's merely asking for professional respect from the nursing staff. Different norms for different cultures: that doesn't mean that he's wrong and we're right; just that he's conditioned to expect different behavior from nurses than what he's experiencing here in the U.S. He might have a completely different attitude, once he learns that it isn't a sign of disrespect for American nurses to look doctors in the eye. (Quite the opposite, in fact.)

There are all kinds of examples (both clinical and nonclinical) of cultural misunderstandings causing hard feelings on both sides. One example: it's a common belief among Americans that French people are rude and unfriendly, and don't like us. Whenever I hear that belief repeated, I ask the person, "Where did you get that idea?"

Almost invariably, I'll hear some variation of this story: "When I was in Paris, I made a point of smiling and making eye contact, even saying hello to people around me. And, do you know, not one single French person smiled back, or would even look at me? Americans did. English and Irish and Australian and German and Italian people did. But the French people would just look away and ignore me. It's so obvious that they don't like Americans!"

In fact, this behavior has nothing to do with liking or not liking Americans. In France, it's considered intrusive to make eye contact with total strangers, unless you have a reason for doing so. And smiling is something you do only when there's clearly something to smile about (for example, if something funny is happening). Smiling just for the sake of smiling can easily be perceived as ridicule ("why is that man laughing at me?") or hypocrisy. So, when a French person unsmilingly averts his eyes from a smiling stranger on the street, s/he's just doing what s/he's always been taught is polite behavior. Meanwhile, the American feels snubbed, because, in our culture, when someone smiles at you (even a total stranger), you're usually expected to smile back.

That's the odd thing about being immersed in a foreign culture: you often take it for granted that people will react to your behavior in the same way that people back home do. But every culture has lots of unwritten rules, and it can be quite easy to give offense, when you're just trying to behave in the way you've always been taught is proper in a particular situation.

kcochrane · Jul 26, 2010

More likely, his answer would be that he's merely asking for professional respect from the nursing staff. Different norms for different cultures: that doesn't mean that he's wrong and we're right; just that he's conditioned to expect different behavior from nurses than what he's experiencing here in the U.S. He might have a completely different attitude, once he learns that it isn't a sign of disrespect for American nurses to look doctors in the eye. (Quite the opposite, in fact.)
.

I totally agree with you with respect to understanding other cultures and what might feel rude to us is not rude to them. I also lived in another country for few years and it was a great learning experience.

I'm not sure this MD is going to change much and my issue is not really the "looking in the eyes" , but this { When asked to clarify assertive we were told assertive was "asking or suggesting something for the patients".} Really? That is the job of a nurse. He had to have been trained here and know a bit better that that's what nurses do. I highly doubt he just landed in this country and has no understanding how things work. I think this is beyond misunderstanding and a need to learn the culture here. But I'm just going on what was posted here.

I think the biggest problem is that the NM has not called him on this and actually is re-enforcing that behavior.

ZippyGBR, BSN, RN · Jul 30, 2010

The afraid and opressed card would have been definitely pulled out, and used. All gone about the 'smart' way and very diligently. The group of girls I work with are angels indeed but don't rub the halo the wrong way or you will regret it. Try THAT for assertive.....tee hee!

nurses have halos , yes, but the are diamond tipped tungsten carbide saw blade edged halos ...

like oddjob's bowler hat in the Bond film ...

Otessa, BSN, RN · Jul 30, 2010

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 question-

Why isn't the ACLU on OUR side???????

You would think this is something they would jump right on......

NocturneRN · Jul 30, 2010

My question-
Why isn't the ACLU on OUR side???????
You would think this is something they would jump right on......

Well, for one thing, what civil liberty is being violated here? No one's been fired; no one's being forced to do anything s/he is morally or ethically opposed to doing. It can also be argued that this physician is entitled to ignore nurses' suggestions if he chooses. In essence, his expectations are a nuisance to the nursing staff----but being a nuisance, in and of itself, is not a violation of others' rights.