Male modesty double standard

[caregiver111]

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.

[Esme12, ASN, BSN, RN]

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]

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]

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]

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

[Spangle Brown]

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]

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.

[Esme12, ASN, BSN, RN]

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.

Yup towel over the genitalia....the gold standard.

I once had a prisoner who came in for alcohol poisoning...the Hooch he made was bad. When it was time to be discharged one guard went to get the car and the mental giant left with the prisoner un-handcuffed the prisoner to use the bathroom. The prisoner crawled up into the ceiling crawled into another room took that patients cell phone and called for his escape ride. I was the supervisor...I was NOT HAPPY with guards. I locked down the BUSY ED and that side of the facility to corral him he eventually took a wrong step and fell breaking both legs...so we were stuck with him for another few weeks.....

That is why we watch them with open doors.

[banterings]

caregiver111 good for you for showing concern for a patient and humanity (that seems to be lacking in healthcare).

it seems first of all that everyone acknowledges the double standard between male and female but just brush it off. sure it is no big deal, but then again you are the one wearing clothes.

as for the police, does anyone bother to inquire why they are in the room? just because they say they need to be does not make it so.

caregiver111 was the only one who showed any concern for the emotional and mental well being of the patient. if this person is a victim, then they are being victimized again by having gawkers in the room. what if they decline to press charges?

even prisoners are human beings possessing basic human rights such as dignity. where does everyone work, gitmo?

has anyone not ever noticed how overzealous the police tend to be? just like many physicians and nurses they assume that because they have a uniform, they can do anything they please.

let me pose this to you; police accompany a trauma patient in to the ED. for sake of argument we will say that she is female and they are male. ed staff is a mix of male and female. there are clerks present as well. they stay in the whole time and no one questions why they are there. it is later found that she was the victim of an accident, not a suspect, not in custody, no evidence to collect from her. you are present throughout this whole ordeal. she also expresses that she does not want to be exposed and refuses treatment. as a result of the experience, she suffers PTSD.

my question to you, what do you owe her morally and ethically for not caring for her completely?

i am not saying legally. what do you say to her to justify that you did nothing when you could have?

the PTSD is a result of the accident and the ed. ptsd is funny, there is no set formula because we are all different. generally there is a "cumulative threshold," a "shock threshold," and a combination of both. for example; the accident caused 20 points of mental trauma. the paramedics 10 pts, in the ed being needlessly exposed, 10pts, clerks there 2pts, etc... when we get to 100 pts ptsd interferes with a normal life. (i know that ptsd is not on or off, there are degrees. let's assume i am talking about the point that it interferes with a normal life)

OR if a person experiences an event with a value 75 pts, ptsd interferes with a normal life. a cumulative of 60 pts and a shock value of 50 pts, and ptsd interferes with a normal life.

saving her life is no excuse because mentally she is a mess.

what if it was your sister, mother, daughter, what would you say to the ED staff?

what if it was you, what would you want?

even if the ed performed life saving measures, even if the patient was male, do they not deserve dignity? remember 2 things:

"do unto others as you would have done unto you,"

AND

"karma is a *****!"

[psu_213, BSN, RN]

1. caregiver111 was the only one who showed any concern for the emotional and mental well being of the patient. if this person is a victim, then they are being victimized again by having gawkers in the room. what if they decline to press charges?

2. even prisoners are human beings possessing basic human rights such as dignity.

3. has anyone not ever noticed how overzealous the police tend to be? just like many physicians and nurses they assume that because they have a uniform, they can do anything they please.

4. let me pose this to you; police accompany a trauma patient in to the ED. for sake of argument we will say that she is female and they are male. ed staff is a mix of male and female. there are clerks present as well. they stay in the whole time and no one questions why they are there. it is later found that she was the victim of an accident, not a suspect, not in custody, no evidence to collect from her. you are present throughout this whole ordeal. she also expresses that she does not want to be exposed and refuses treatment. as a result of the experience, she suffers PTSD.

5. i am not saying legally. what do you say to her to justify that you did nothing when you could have?

6. the PTSD is a result of the accident and the ed. ptsd is funny

7. saving her life is no excuse because mentally she is a mess.

8. "karma is a *****!"

1. Who ever said anything about gawkers? Yes, it is wrong for a gawker to be in the room, but that does not seem to be the issue here.

2. Sorry, when someone is a prisoner they give up certain rights. I don't want to get into a debate over how prisoners are treated in general, but many don't have privacy when they use the toilet or take a shower. For the safety of staff, these suspensions of some rights will extend to the ED.

3. Everywhere I have worked, doctors and nurses do not wear uniforms. More importantly, they cannot do, nor do they think they can do, anything they please. You seem to have some issues with the police....I respect them and have no issue with them--I see no need to defend them. As for nurses, if the nurses where you work think they can "do anything they please," fine, but don't paint all nurses (or many) nurses with the wide brush of lies.

4. I'm confused as to your use of genders and "theys." It sounds like the police officers are females. The patient is male. Later "she does not want to be exposed" and "she suffers PTSD." Did they just expose the police officer? Plus the OP was about not providing for the dignity of male patients.

5. I have no idea what you are asking here.

6. When I think about PTSD I just end up rolling on the floor laughing. I find your entire statement ridiculous, and a bit insulting to both ED staff and to people who have PTSD as a result of an accident, rape, war, etc.

7. Plaintiff's attorney: "Why did you not try save her life?" Nurse: "I was afraid of causing ED-induced PTSD if I tried to treat her. Yes, it's a real diagnosis! Someone on the internet told me about it!"

8. I'm sorry if I insult someone's religious beliefs, but I do not believe karma exists...certainly not in the way intended in the above post. A nurse treats someone poorly in the ED, so they are destined to be treated poorly by a nurse? Maybe the patient loves his/her dog...does that mean the nurse is destined to be eaten by a dog? Maybe they will turn into a rat and be put into a snake's cage. I know these example are kinda silly, but so is the whole negative karma concept, as it relates to care provided by an ED nurse.

[banterings]

psu_213,

You said "when someone is a prisoner they give up certain rights." They are still entitled to basic human rights which you conveniently ignore. The OP did not state whether they were in custody, a victim, suspect, etc. which goes to my point. Unless you know, don't assume.

All you are doing is justifying ill treatment of other human beings. That is the point of my mention of the Golden Rule and karma.

As for PTSD, do you think that Justina Pelletier is not suffering PTSD from her treatment in a hospital? PTSD resulting from ill treatment by healthcare providers is very real. Here are some links:

medical trauma

Post-Traumatic Stress Disorder After Genital Medical Procedures

PTSD in children

You also avoided the "elephant in the hospital;" the double standard that male patients experience regularly.

When I say uniform for doctors and nurses I refer to scrubs, white coats.

You said:

When I think about PTSD I just end up rolling on the floor laughing.

I will not even dignify that comment with a response. That says what you believe.

[psu_213, BSN, RN]

I will not even dignify that comment with a response. That says what you believe.

It's called sarcasm…so I apologize for using it, but you were the one who said "ptsd is funny."

[psu_213, BSN, RN]

You said "when someone is a prisoner they give up certain rights." They are still entitled to basic human rights which you conveniently ignore.

So you believe that someone in prison is entitled to every basic human right that a non-criminal is entitled to? But back to the original topic, of course ED nurses are going to make their best efforts to make sure that basic dignity is protected. However, as pointed out by many experienced ED nurses, this is not often possible. Yes, there is a dilemma here--"basic" human rights of a prisoner versus safety of ED staff. Safety wins.