sharkdiver

This is a good point, and I don't disagree - but don't you suppose that there are similar subjects that males would be just as uncomfortable discussing with a female? It cuts both ways......

I never said that they couldn't. That said, as RNator alluded, there is a double standard. A female that requests same gender care, particularly if intimate exposure is involved, is almost always accomodated without comment, while males do not get the same consideration. I have no problem with this type of request being accomodated if it makes the patient more comfortble. The point I was making is that the overwhelming ration of females to males in nursing makes this difficult to do for male patients, and an increase in the number of male nurses would make this option more viable for male patients as well.

I agree that the double standard you referenced does exist - all the more reason we need more males in the nursing profession, so the same sensitivities can be granted to male patients as well.

Not everywhere - several states have removed both the male genital and hernia component from their sports physical exam forms.

You might want to rethink this.... Whether you like it or not, instances of sexual abuse of patients by nurses and other health care workers do occur. If you don't think so, just google "Jeffrey McCallister"....health care facilities have very valid reasons for instituting chaperon policies in opposite gender care situations, and while women can and do commit sex offenses, over 90% are committed by males (FBI statistics).

This! My sister has worked in L&D most of her 30+ year career and is currently the L&D/postpartum nurse unit manager. We've discussed this in the past and they only hire RN's for L&D for these reasons.

You have to look at the whole chronology.... 1. It started with an AAP policy endorsing pediatricians asking these questions. 2. Then, when some patients in Florida declined to answer, some overzealous pediatricians dismissed them from their practices. Additionally, some of these physicians were rather rabid gun control fanatics and took advantage of the AAP policy to push their own personal agenda. 3. Constituents complained to their legislators and the Florida law was the result. 4. The publicity from the Florida situation resulted in similar laws being passed in some other states. So you see, it had nothing to do with "delicate sensibilities" and everything to do with a violation of their constitutional rights to privacy and being discriminated against for exercising those rights. It would have been so much simpler and there would have been no problem if instead of demanding answers to firearm ownership questions, physicians would simply state to all patients that unsecured firearms in the home are a known potential hazard to children, offer them a pamphlet on how to secure firearms safely, and offer to answer any questions they might have. Doing it this way accomplishes exactly the same goal they espouse of "educating patients about firearm safety", without invading the patient's privacy. It would seem to me that any physician or HCW that would refuse to accept this approach and still insist on the patient answering an ownership question either has a demigod complex or some other ulterior motive. Regardless of what they may think, physicians and other health care workers do not have any legal right to any information that the patient does not choose to share.

As I said way back on page one, you can ask, but the patient doesn't have to answer. A provider has no legal right to any information the patient doesn't choose to share. So instead of asking about firearm ownership, simply make a statement to the effect of "Improperly secured firearms in the home have been shown to be a hazard to young children. We are providing this pamphlet on firearm safety to all our patients. If you have any questions please feel free to ask us." You accomplish exactly the same goal without asking a question that is potentially confrontational or unnecessarily invading the patient's privacy.

1 2:10 pm by jrwest Quote from springchick1 Remind them that in most cases, insurance won't pay the bills if they leave AMA (assuming they have insurance). We were told we are not allowed to say this( not sure why) Most of the time they are medicaid anyway, or have no insurance ( maybe thats why they want to leave Because: A. It is false B. By lying to the patient you are engaging in an act of coercion, which invalidates any subsequent consent - exposing both you and the facility to possible legal repercussions This kind of stuff drives risk management folks nuts! Please, Please, Please - just play it straight and do your job!

LOL! Actually it's "bear arms"....or in the case of your pic, arm bears... Seriously, I don't think that anyone here will dispute the idea that keeping firearms and ammunition safely secured is a good idea. Likewise, I don't have a problem with health care workers offering something like a generic firearm safety pamphlet to all their patients. However, asking about firearm ownership and recording that information in the health record crosses the line. With the exception of specific psych situations where it may be relevant, it's simply none of the provider's business. With the implementation of EHR's and the rabid information sharing that goes on, many patients are more concerned with their privacy being violated, and are far less candid with what information they will share with their providers.

You are certainly free to ask - the patient is also free to tell you that it's none of your business, or as Annie indicated they may just lie. IMHO, unless health care workers are thoroughly trained in firearm safety, they're better off leaving it to those that are.

AuDDoc: FYI, Federal law permits recording telephone calls and in-person conversations with the consent of at least one of the parties. See 18 U.S.C. 2511(2)(d). This is called a "one-party consent" law. Under a one-party consent law, you can record a phone call or conversation so long as you are a party to the conversation. vid123: The key word is "audio" - doesn't apply to video if the audio is not recorded. The laws vary from state to state.....the following link is a couple years old so there may be some changes, but it will give a general idea... https://www.rcfp.org/reporters-recording-guide

There have been some very good comments on this thread. There is a very distinct difference between a patient requesting a specific caregiver and one who either "fires" a specific caregiver or requests an accommodation for same gender care for intimate procedures. In the first situation it's pretty easy to resolve by simply explaining that while you would like to assign someone they request, it's not always possible to do so, and the vast majority of patients would accept this. When a patient "fires" a caregiver the best solution is to assign another caregiver. The reason doesn't have to be something egregious - it might be as simple a personality conflict.....or someone that is a dead ringer for your wicked stepmother or something similar. I can't for the life of me understand why anyone would want to care for someone that doesn't want them there. It's going to create a tense situation for both the caregiver and patient, and the likelihood of a patient filing a complaint probably goes up by an order of magnitude. The situation where a patient refuses opposite gender care is a little more complicated. As others have stated there could be any number of reasons from cultural beliefs to prior abuse that a patient might do so......it really doesn't matter and the patient doesn't have to justify it to you. The tricky part is that they're not really refusing care, just a specific caregiver.....gotta be real careful here. Forcing an opposite gender caregiver on someone that doesn't want one is a recipe for disaster, especially where intimate care or exposure may be involved. You create an adversarial situation and the likelihood of a complaint again goes up by an order of magnitude. If they say no, and you touch them anyway, you are doing so without their consent and as someone stated earlier, committing a battery (a criminal act in all 50 states), and if intimate care or exposure is involved, you're now potentially looking at a sexual battery complaint, which is a whole lot more serious. In a male caregiver/female patient situation, the male caregiver is going to be assumed guilty until proven otherwise - it's not right, but it is the reality of the world we live in. The only way to protect yourself is to include a chaperone of the same gender as the patient, which ties up another staff member. It's simpler and easier to just assign a same gender caregiver in the first place. The bottom line is this: in the US, when push comes to shove, a patient has the absolute legal right to refuse any caregiver for any reason and a facility only has three options: 1. Accommodate their request 2. Discharge them if their condition permits, or 3. Transfer them to another facility if it doesn't

Whoever told you that is flat wrong - ask them to produce written confirmation of what they told you....and that they might want to consult the legal dept. In the U.S., a patient has the absolute right to refuse any test, treatment, medication or procedure as established by all or part of the 1st, 4th, 5th, 8th, 11th, and 14th amendments to the constitution, and has been repeatedly upheld by case law. To proceed anyway after a patient's refusal is an act of battery and is a criminal act in all 50 states. Anyone who does so opens themselves to the potential of both criminal prosecution for the battery and civil action for the rights violation. I have never seen anyone fired or otherwise disciplined for complying with a patient's right to refuse - I have more than once, however, seen an employee fired or disciplined for attempting to force something on a patient that they have refused. Attempting to coerce or intimidate a patient is also a major violation of CMS rules governing patient's rights, and can result in the facility being penalized.

Agree - rarely will something like what was described happen purely out of the blue. What was the trigger event?