patient privacy

  1. during my career i always did whatever i could to protect the patients modesty regardless of gender or age. i was recently a surgical patient at a VA hospital and had what i feel was a disrespectful experience. without discussion i over heard the surgeon and anesthesia resident invite a bunch of people in to "observe" my procedure. before i could respond i was put out. the procedure was a double inguinal hernia repair and umbilical hernia repair which meant i was totally exposed from the nipple area past my genitals for the prep. i also learned they placed a catheter at the time as well. the anesthetist and surgeon were male as was one of the nurses. the remainder of the people helping were two females and the balance "observing" were female totalling approximately 10. though i'm far from a prude, i was denied the courtesy and respect of being asked permission before hand so i could agree to observation and decide how many i would feel comfortable with. it was as if
    i was a slab of beef on the cutting table without any regard to my feelings, dignity, or modesty. it was like being a cadaver for an autopsy class but i understand even there the body is draped. it makes no difference how many naked bodies one sees or whether they titilate you or not; it's about that particular patient and their rights, feelings, and concerns. to dismiss their concerns with comments that you've seen it all is disengenuous and demeaning of their feelings. as a man in nursing i've heard peers talking about male patients on numerous occassions. though i would never discuss such things you know there is a double standard. perhaps, if we truly are professional, we should take the time to let the patient express what they would appreciate and then adhere to it. remember, there may come a time when you become that patient and if someone is unthinking you can be the patient exposed for all to see, in the room, surgical suite, etc. ask yourself how you'd feel
    having strangers gauk at your body and making comments.
  2. Visit naftali216 profile page

    About naftali216

    Joined: Mar '12; Posts: 1; Likes: 1


  3. by   Altra
    I've worked at two teaching hospitals -- it is a given that there will be a greater number of people involved with the care of a patient than at a non-teaching facility. Observation or teaching by/for someone is also a given.

    I don't know if your procedure was at an academic hospital. I'm sorry you feel the way you do about your experience.
  4. by   DixieRedHead
    I think that if people want or need to observe, they get to do that only with your permission, and after draping. JMHO.

    I know I was working in PACU once and saw a co-worker(through a window) who was having female surgery with her legs in the stirrups, as the procedure was being done. I was mortified for her and for myself.

    Unless I am having emergency surgery and have no choice, I will have my say before any surgery.

    It's just a sin, a shame, and a disgrace. We should stand up for ourselves and others.
  5. by   Sacred eagle
    Prior to your surgery you were asked to sign a consent. In the middle of the consent is a smallsection that says "do you consentto students or observers." Ifthat aspect of the consent wasnot brought to your attentionshame on the staff for notexplaining that part of the consentto you,that is their job. I wouldgo to administration and ask whywere observers brought in for your surgery.
  6. by   classicdame
    speak up next time and complain to admin this time
  7. by   NoviceRN10
    I don't think it's a big deal. The surgery you had was one that I was able to observe during nursing school and I remember the pt being draped during the procedure. He wasn't exposed or hanging out all over the place. I don't think you have the say of who is or isn't observing or in the OR during a surgery.
  8. by   Whispera
    I think a patient should have a say whether it's a teaching hospital or not. It's a right of human dignity and we should protect that. I wonder why no one present during your procedure said anything. I'm sorry you went through this.

    As far as the consent goes, if I see something on a consent that I don't like as I'm skimming it, before I sign it, I cross that part out, initial above it, and bring it to the attention of the person who asked me to sign.
  9. by   dudette10
    I'm torn on this issue. I was in the same position as the OP when I had my first baby. A gaggle of people--I don't even know why they were there--watched as I pushed out my first baby. I remember looking at them and quipping to my OB, "Any other people coming to watch my crotch?" I was puzzled and just a bit miffed, but the happiness of having my firstborn overshadowed it.

    My OB/GYN, the only doctor I see regularly besides my dentist, always has PA students with him. As a healthcare professional, I believe in providing these opportunities, and I would never refuse observation or even the hands-on. (One of his student PAs delivered my second-born's placenta and was doing a ****-poor job of it, btw.)

    That said, I can understand the argument that teaching opportunities for medical professionals need to be unfettered. Given the option, I think many more people would refuse to allow it.

    On the other hand, of course privacy, even with observers in the room, needs to be respected as much as possible. In LDRP rooms, PULL THE CURTAIN. On surgical floors that allow family members in pre-op or PACU, make sure pathways to and from to and from these areas do not go by surgical suites. Nurses can make the decision to allow family members in these areas, depending on what is going on with other people in pods.
    Last edit by dudette10 on Mar 24, '12 : Reason: clarified that the PAs were students
  10. by   anotherone
    Reason why I do not want to be a patient at my teaching hospital or any hospital I work at. It happens all the time. par for the course at most teaching hospitals I have been to. THe attending will be there, the r5,r,3,intern, med student, oh here comes a pa student, anesthesiologist, r3 for that service, scrub nurse, circulating nurse, one on orientation, nursing student of the day. Before you know it there are 15 people in the room.
  11. by   roser13
    Quote from NoviceRN10
    I don't think it's a big deal. The surgery you had was one that I was able to observe during nursing school and I remember the pt being draped during the procedure. He wasn't exposed or hanging out all over the place. I don't think you have the say of who is or isn't observing or in the OR during a surgery.
    You ABSOLUTELY have the ability to control who is in the OR during your procedure. And it IS a big deal to feel that your privacy was invaded without your permission.I'm guessing that the previous poster was correct - that a small paragraph in your consent mentioned the possibility of observers. However, at my facility, each observer must be named and specifically approved by the patient.
  12. by   RainMom
    As students spending a day in surgery, we were required to personally introduce ourselves to the patient & ask their permission to observe their procedure. Put in that situation, I don't think I would have a problem. Being swarmed by strangers coming to watch just prior to my going under would probably tick me off!
  13. by   StayingFit
    I agree completely. At my last colonoscopy, I had 7 people in the room, 4 of whom were in training. This didn't bother me in the least, however, since I had volunteered to have students present. I figured that I had to go through the test, anyway, so why not let someone learn at the same time?

    However, had I not been aware that observers would be present, and had my explicit consent not been given beforehand, I would have had a much different reaction.
  14. by   Cul2
    Let's do a little philosophy here, okay? Ontology -- no, this isn't about cancer. It's about the essence of what it means to be a "patient." What "is" a patient? And what "is not" a patient. A patient is a human being -- a person, an individual. Not just a body, but a mind and a soul. A patient, in essence, isn't a teaching tool to be "used" by professors and students. Now, many patients will agree to being used as a teaching tool if they are approached with respect and dignity -- if there's a clear understanding that it is the patient's right to refuse. Most patients do understand that doctors and nurses need hands on training in hospitals. But -- Hiding such consents in small print in documents, and putting people "out" quickly before inviting in the spectators -- that's not informed consent. It's a travesty, unworthy of the profession of medicine. It's an entitlement attitude, an us vs. them point of view, a complete disregard for the humanity of the flesh going under the knife. Frankly, it's an ethical violation. But apparently, it's so common these days that professionals have become oblivious to this disrespectful behavior.