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Male modesty double standard

Posted

Has 3 years experience.

While working in the trauma room in a large US city I witnessed this scenario of the double standard of modesty for male patients many times.The police would routinely walk in the trauma room and were allowed to stand around and watch as patients were put through the necessary but extremely embarrassing ordeal required in trauma resucitation. If the patient was a female the curtains would be immediately closed and kept closed until the entire trauma procedure was complete. If the patient was a male the curtains were always left open and the police officers which often included female officers were allowed to watch as the patient was stripped naked, under went a digital rectal exam and catheterized. Allowing the police especially female police officers to watch this is blatant patient abuse. I think people should consider suing the hospitals as this double standard of modesty for male patients is an extreme violation of medical ethics and standards of decency that are supposed to apply to all patients. Police should not be allowed to enter the trauma room in the first place without permission or be allowed to " hang out " there while patients are being treated.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

I think people should consider suing the hospitals as this double standard of modesty for male patients is an extreme violation of medical ethics and standards of decency that are supposed to apply to all patients.

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Per our terms of service, members are to refrain from exchanging legal advice because it is out of the scope of this website. You are mentioning that people should consider suing for occurrences you've perceived as wrongdoings, and therefore, this constitutes indirect legal advice.

Wow, that does seem wrong

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Karou

Specializes in Med-Surg. Has 1 years experience.

I am not fully understanding...

"Trauma room" in the ED? "Resuscitation"? As in, live saving measures/coding?

Are these suspected criminals? Violent? Victims of trauma? I would expect police officers to be present and very watchful if these are suspected criminals that health care providers are performing life saving care on.

I don't understand your point very much. What was your role in this? Health care provider? Unless you were in the room as part of that healthcare team I don't think you are aware of the policies and procedures that dictate those circumstances.

Weird post, in my opinion.

Edited to add..

Although I do not work in the emergency department, I imagine that with trauma situations police officers could be necessary to be present due to the legal processes involved, for a police report. Especially if the patient is a suspect.

Does anyone else know more about this? I'm genuinely curious.

Edited by Karou

Although I do not work in the emergency department, I imagine that with trauma situations police officers could be necessary to be present due to the legal processes involved, for a police report. Especially if the patient is a suspect.

Does anyone else know more about this? I'm genuinely curious.

This would be exactly right. I'm assuming the police are there because it is a suspect that was arrested and then needed medical treatment. Once someone has been arrested, an officer must be with them at ALL times until they are brought in for booking. What if this suspect ended up assaulting a nurse, dr, or another patient? When under arrest, the police officer is responsible for that person and making sure as best they can that nothing happens to that suspect or by that suspect to another.

I really don't understand the complaint by the OP assuming they are talking about officers observing people they have arrested and had to bring in for treatment.

I work in psychiatric consultation & liaison in a large teaching hospital, and have often been consulted on individuals who are in police or corrections custody. Although no disrobing is involved, we typically speak to people privately for psychiatric evaluations because of confidentiality concerns, and I have asked police officers to leave the room (they can remain immediately outside the door, and there is literally no other way for the person in custody to exit the room because we are on an upper floor of the hospital) but have been told that the rules and regulations under which they operate require that they not let the person out of their immediate sight/vicinity for any reason. I have had correctons officers insist that, even though the person is shackled to the bed, they are required to remain in the room with the individual. The OP's scenario is probably a similar situation, and the issue is not "male vs. female" but "in custody vs. not in custody."

Individuals who experience this and feel that their privacy and rights have been violated are welcome to (try to) sue the hospital. However, the OP has no standing to sue on anyone else's behalf.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

I am curious as to your position in the emergency room/trauma center

in a large US city
Do you have personal knowledge of what the patient was brought in for? Were they a part of violent crime? Was the rectal exam looking for stashed drugs? Were you apart of the patients care?

Unless you are directly involved in the care of the patient with intimate knowledge of what is going on....it is impossible to judge the how's and why's of what is going on in that trauma room. If you do not have responsibility for the care of the patient it is a HIPAA (privacy) violation for you to be even standing around observing.

I am curious what has prompted you to post this today? Nurses try to preserve the privacy of EVERY PATIENT regardless of their legal status or gender. We protect the female as much as the male. If the police presence is necessary they are allowed in the rooms during exams and procedures to protect chain of evidence including the removal of bullets and drug in body offices. IN these cases the legal takes precedence over the medical privacy

caregiver111

Has 3 years experience.

In answer to some of the above questions. For example if you were in a care accident or were the victim of a crime and you were taken to the trauma room for medical treatment the police would need to talk to you about the incident. Only a small percentage of the patients in the trauma room were criminals or under arrest. The first thing the medical staff would do is cut all your clothes off to examine your entire body. The rectal exam is necessary to see if there is blood in your rectum. They would need to catheterize you to obtain a sample of your urine to analyse and detect the presence of blood. This is known as trauma resuscitation and is done to all patients. The police should not be allowed to just barge back into the trauma room and stand around and watch this necessary but humiliating procedure. If they need to talk to a patient or collect evidence they should knock on the trauma room door and ask if it's ok to come back. When I say watch this procedure I am referring to male patients since they always close the curtains for female patients and always leave them n for a male patients.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg. Has 16 years experience.

In answer to some of the above questions. For example if you were in a care accident or were the victim of a crime and you were taken to the trauma room for medical treatment the police would need to talk to you about the incident. Only a small percentage of the patients in the trauma room were criminals or under arrest. The first thing the medical staff would do is cut all your clothes off to examine your entire body. The rectal exam is necessary to see if there is blood in your rectum. They would need to catheterize you to obtain a sample of your urine to analyse and detect the presence of blood. This is known as trauma resuscitation and is done to all patients. The police should not be allowed to just barge back into the trauma room and stand around and watch this necessary but humiliating procedure. If they need to talk to a patient or collect evidence they should knock on the trauma room door and ask if it's ok to come back.

When I say watch this procedure I am referring to male patients since they always close the curtains for female patients and always leave them n for a male patients.

You're angry about something. I suspect it's something to do with yourself, a friend, or a family member.

I'm sorry you witnessed something, or experienced something in the ED, that you perceive as discrimination.

I don't work ED, but I provide the same amount of privacy for all my patients regardless of their gender. I don't know a single nurse who doesn't.

The only thing that might change the equation is safety.

Edited by TheCommuter

If the police presence is necessary they are allowed in the rooms during exams and procedures to protect chain of evidence including the removal of bullets and drug in body offices. IN these cases the legal takes precedence over the medical privacy

This is my understanding as well. Once legal issues arise, the police become involved and will be present if the patient is a suspect or victim of crime. They can obtain necessary information from medical staff relavent to the case. My understanding of chain-of-evidence is that only authorized individuals may verify the validity of the evidence. So if the police are not present to protect the proper handling of the evidence, that could cause major problems during trial as the evidence may be thrown out. I honestly don't know if medical staff are ever authorized to handle evidence, although I would think forensic/rape nurses might be.

As far as protecting patient privacy, I haven't seen a difference in male/female.....we protect all patient's privacy the best we can.

caregiver111

Has 3 years experience.

In my last post I made a mistake in the last sentence, should have been "the curtains were always left open when it was male patient". I was a paramedic student doing my clinicals at that hospital and was required to assist in the trauma room as part of my training. I'd be more than happy to name the hospital and city the but don't know if I'm allowed to. I agree all patients should be treated with dignity but that's not what I saw at this hospital. I talked to the medical staff and they didn't like the police coming back and standing around but were reluctant to tell them to wait outside. Only once did I see a nurse try to protect the modesty of a male patient. A prisoner was brought in handcuffed and placed on the trauma table accompanied by four male policemen and one female police officer. The nurse in charge said " lets do this right" and she closed the curtains all the way while they did the trauma exam. If the police absolutely had to be present when a trauma patient was being treated it should be the same gender as the patient. Female police officers are not the same gender as a male patient.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

In my last post I made a mistake in the last sentence, should have been "the curtains were always left open when it was male patient". I was a paramedic student doing my clinicals at that hospital and was required to assist in the trauma room as part of my training. I'd be more than happy to name the hospital and city the but don't know if I'm allowed to. I agree all patients should be treated with dignity but that's not what I saw at this hospital. I talked to the medical staff and they didn't like the police coming back and standing around but were reluctant to tell them to wait outside. Only once did I see a nurse try to protect the modesty of a male patient. A prisoner was brought in handcuffed and placed on the trauma table accompanied by four male policemen and one female police officer. The nurse in charge said " lets do this right" and she closed the curtains all the way while they did the trauma exam. If the police absolutely had to be present when a trauma patient was being treated it should be the same gender as the patient. Female police officers are not the same gender as a male patient.
I worked at a very large very busy county hospital Level I trauma. We always covered the privates of male patients and closed the curtain whenever possible. Unfortunately, many times the police presence is required and the prisoners need to be physically seen by the officers at all times...including female officers for male patients. Yes there is a double standard for female patients will get a female officer called for that officer to be with the female...males get whomever...it is what it is.

Male patients that are involved in trauma tend to have a higher incidence of violence against the staff AND a danger that whatever caused the conflict that the person who shot them comes to finish it off in the ED. Curtains are left open most of the time to ensure the patients and staff safety. The officers cannot be at the bedside as there is NO ROOM hence the curtains are open.

In MOST cases there is a very good reason for things even when no one explains what that is to the student.

Edited by Esme12

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

In answer to some of the above questions. For example if you were in a care accident or were the victim of a crime and you were taken to the trauma room for medical treatment the police would need to talk to you about the incident. Only a small percentage of the patients in the trauma room were criminals or under arrest. The first thing the medical staff would do is cut all your clothes off to examine your entire body. The rectal exam is necessary to see if there is blood in your rectum. They would need to catheterize you to obtain a sample of your urine to analyse and detect the presence of blood. This is known as trauma resuscitation and is done to all patients. The police should not be allowed to just barge back into the trauma room and stand around and watch this necessary but humiliating procedure. If they need to talk to a patient or collect evidence they should knock on the trauma room door and ask if it's ok to come back. When I say watch this procedure I am referring to male patients since they always close the curtains for female patients and always leave them n for a male patients.
I am a Trauma nurse.

Here is the thing. IF the trauma MVC a possible criminal investigation there is chain of evidence that needs to be maintained which includes the serum and urine toxicology screens especially if there is another car with injuries or a fatality involved.

I know it seems like an unfair prejudice against males...but trust me it is the majority of the situations it is necessary. I have never had an issue with asking the officer to step out or move. Most ED nurses don't have an issue either.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

This. There is a chain of custody involved that the LEO has to maintain. This happens very frequently when drugs or EtOH are suspected in an MVC, or the patient is also a suspect in another crime. Say they're suspected of a murder-suicide attempt, or were driving erratically before the collision. We also had a pt in my ICU once who was a prisoner who'd attempted suicide. Two guards were required to be with him at all times, in addition to his ankle being shackled to the bed. They couldn't even leave when he had a bath, or couldn't leave to take breaks, so they ate pizza in his room even though he was NPO and awake.

We at least put a towel over a man's genitalia when it's not necessary to be uncovered (putting in a femoral line, exams etc.) But law enforcement can't violate their legal P&Ps. And I'm sorry, but actions have consequences. Get drunk and cause an MVC, and one might end up needing to deal w/ a trauma code and police.

I am a Trauma nurse.

Here is the thing. IF the trauma MVC a possible criminal investigation there is chain of evidence that needs to be maintained which includes the serum and urine toxicology screens especially if there is another car with injuries or a fatality involved.

I know it seems like an unfair prejudice against males...but trust me it is the majority of the situations it is necessary. I have never had an issue with asking the officer to step out or move. Most ED nurses don't have an issue either.

psu_213, BSN, RN

Specializes in Emergency, Telemetry, Transplant. Has 6 years experience.

Nurses are professionals. The police officers are professionals. The nature of the jobs require that those professionals see some things that may be considered "sensitive" and things that may make non-professionals uncomfortable. So there is a female officer in the room while a male trauma pt is evaluated (including cath, rectal exam, etc….oh, to the OP, there are multiple reasons why a urine or rectal are done--not just to check for bleeding). That officer is not there to be a peeping Tom--she is a professional and she has a reason to be there. The same way a professional male nurse can straight cath a female and a professional female doctor can do a rectal exam on a male patient.

liberated847

Specializes in CEN, CFRN, PHRN, RCIS, EMT-P. Has 10 years experience.

Modesty must be preserved, with that said, I agree with most here, there are circumstances that would require modification of that view. We do not live in a black and white world, besides, we are not born with cloth on, why? Because we are part of the animal kingdom and the concept of modesty is cultural and imposed on us during our early programming in society. This whole conversation would be alien to a tribe in the amazon who doesn't wear cloth LOL

Thanks for all the answers. But none of them explained why it was closed for the females. And it was mentioned that not all the cases were criminal investigations. Just cops waiting to talk to the persons. I totally get chain of command (which should be the same for males and females) and the prisoner issue.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

Thanks for all the answers. But none of them explained why it was closed for the females. And it was mentioned that not all the cases were criminal investigations. Just cops waiting to talk to the persons. I totally get chain of command (which should be the same for males and females) and the prisoner issue.
But I did ....
Male patients that are involved in trauma tend to have a higher incidence of violence against the staff AND a danger that whatever caused the conflict that the person who shot them comes to finish it off in the ED. Curtains are left open most of the time to ensure the patients and staff safety. The officers cannot be at the bedside as there is NO ROOM hence the curtains are open.

In MOST cases there is a very good reason for things even when no one explains what that is to the student.

it isn't chain of command it is chain of evidence. In emergency nursing it is not only the medical and nursing expertise you must have but also a grasp of the legalities that are involved to maintain a crime scene and evidence so it can hold up in a court of law...whether that evidence is to protect the victim and prosecute the perpetrator or you care caring for the perpetrator and they are going to be prosecuted.

I have worked at many emergency over the 35 years I have been a nurse. Every place I have worked work very hard at maintaining the patient privacy as much it is allowed with the surrounding circumstances.

The view of a trauma situation for a student observing and not directly involved with all the information available about the patient it is diffucult AT BEST to understand the how's and why's of what he staff is or isn't doing. Are there bad nurses, doctors, staff, and police officers? Yes but they are not the norm by a long shot.

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