dnp2004

One of the most common mistakes, even make by experienced clinicians, is forgetting to hold the member closed for at least 4 minutes to allow the lidocaine to actually work effectively (numbing and opening strictures). At the facilities I ran the use of lidocaine was SOP. Even then I had to make sure my staff would not attempt to insert before the lidocaine had time to work (expect in emergencies). I found the proper use of lidocaine also tended to make insertion easier because many patients would not tense up nearly as much as they would when the plain lubricant was used.

Thimerosal should be a non-issue by now. No one ever established a link between thimerosal and autism. Talk about an urban myth.

I noticed that everyone seemed to miss this point that AGATHA PREVOST was making or perhaps it is an uncomfortable reality for many. So let me add a few sobering thoughts to this silly illegals debate. Yes, the Europeans were illegal immigrants to North America who took over by military force and what today would be called terrorism. So, the United States was founded on illegal activity against the Native Americans. What do some of you on this thread advocate, denying healthcare to uninsured Native Americans? Much of the southern and western United States was part of sovereign Mexican land. Conflict arose because people from the U.S. were illegally entering Mexican Territory and causing problems. They were in fact undocumented U.S. aliens entering Mexico. The United States illegally seized land from Mexico. So is in undocumented Mexican really an illegal alien? The only reason undocumented aliens can thrive in the United States is because people like you use them for cheap labor. If you were to remove all illegal aliens from the United States right now the economy would collapse. The same people who complain about aliens costing too much are the same people who hire them to: Work their farms Act as maids/servants in their homes Work construction Stock the shelves in retail stores Performing dangerous chemical and industrial cleanup Etc. I guess some people on this thread think undocumented people are good enough to work 80 hours a week at low wages but not good enough for medical treatment. Before everyone questions my loyalty and patriotism let me remind them I was born in the United States and served as military officer for 25 years.

Since this is an anonymous international forum, I am wondering how many practitioners on this forum would be okay with removing what they might consider "nonessential" tissue from a female infant, with lidocaine/xylocaine of course?

The foreskin is about as functionally necessary as the clitoral hood. So let's recap. If you were to give birth to a baby you would remove it's tonsils, adenoids, gall bladder and appendix. For a boy the foreskin would be removed. For a girl, is it correct to assume the clitoral hood would be removed as well?

You made my point precisely. Healthcare isn't all about trying to please the patient. In administration I did not make it my policy to hire based on gender, race, religion, nationality, ethnicity, etc... It is a free market of course and the patient always has the option to transfer to another facility. Once you allow too much choice staff scheduling can become a nightmare.

As long as they are polite why would you call a person who requests a nurse of a certain race/ethnicity/nationality an "********". Would you call a woman who requests a female caretaker, such a name? How about a man who requests only males to perform "intimate care", does that make him a sexist? We have been taught a nurse is a nurse regardless of race/ethnicity/nationality/gender. However, we have to remember patients are frequently uncomfortable around certain caregivers for various reasons. My point is a caregiver request based on race should not be looked on any differently than one based on gender.

No need to walk on eggshells about this or any other medical topic with your patient. My point earlier on this thread was that it can be difficult for a nurse to give "just the facts" when the physician or managers at the facility they work in have a very strong opinion one way or another. Take me for example. Early in my career I was terminated from my job because I did not try to convince parents to circumsise their children. It was all good in the end because they somehow forgot I was an attorney, I filed suite and well, the rest is history...

Yes, the patient can go somewhere else if they are not happy at a facility. Likewise, I can discharge them if they want to be transferred elsewhere. I have done that many times in the past.

Why is a care provider request based on race, any different than a request based on gender? Think about this, years ago when I was out of medical school, many male and even female patients did not want/trust female doctors. We had male orderlies that looked after the daily care of the male patients. In 2009 many female patients don't want/trust male doctors. Many facilities try to have male nurses perform intimate procedures on male patients whenever requested. We even have "female only" staffed clinics that hire only women. Once again for patient comfort. So is asking for "white only" staff in a respectful manner really that different than asking for "female/male only" staff if the patient is obviously only comfortable around Caucasians? How many of you would oblige the request? Do you think this is a racist request. How about if the request was for "male only" staff? I had patients tell me they did not want to be touched my a women doctor. Would you call these patients chauvinistic pigs as did most of my female coworkers at the time? Now if a female patient requests "female only" staff I am sure most, if not all of you would assign me over my male colleagues. It is about patient comfort/choice right? I don't think anyone on this forum would call her a misandrist would they? So why do racial requests bother everyone here so much? dnp2004

To me it is all about the care I receive the, gender, race, height, nationality, etc. is irrelevant.

if you son has a healthy foreskin why would you want him circumcised at all? i am an ob/gyn and only have had to perform four medically necessary circumcisions in my whole career. i'm in my 60's. i never have performed them based on parental requests. when i was overseas it was considered a cosmetic procedure that was forbidden unless it was to correct a disorder.

Sorry, I was speaking about theoretical cases. I find prosecutors and to a lessor extent judges, are the biggest problems in cases like these. I was also speaking about what should be done with an executioner who kills a person who is later discovered to be innocent. As with war criminals, you can't use the excuse "I was just following orders". It did not work during Nuremberg and it really should not work now.

I think these people should be compensated at least $1,000,000 per year of false incarceration. The prosecutor should be automatically disbarred. In the case of a false execution, the executioner should be charged with at least 2nd degree murder.

What if the guy only had a short time to appeal? He would have been "fried" a long time ago. In my State we had a very similar case where someone was released after serving 17 years. Everyone had been complain that the guy had too many appeals and that it was unfair to the family of the victim to delay execution. DNA cleared the guy! Apparently he was in a different town when the rape/murder happened! Someone else had going away with it for 17 years. Meanwhile this guy was on death row.

man who spent 22 years on death row is cleared new evidence prompts judge to drop murder charges against paul house house, of tennessee, spent 22 years on death row for murder of carolyn muncey house, who uses a wheelchair, was released on bail in 2007 new dna testing helped raise doubts by bill mears cnn supreme court producer washington (cnn) -- a former death row inmate in tennessee has been cleared of murder, three years after the supreme court raised repeated questions about his conviction. state prosecutors on tuesday asked a judge to drop all charges against paul house, who was convicted of murder and sentenced to die in 1986. special judge jon blackwood accepted the request. house had been scheduled to be executed next month for the 1985 murder of carolyn muncey. he had been on death row for 22 years but was released on bail last year. he has multiple sclerosis and must use a wheelchair. the high court ruled in june 2006 that house was entitled to a new hearing. "although the issue is closed, we conclude that this is the rare case where -- had the jury heard all the conflicting testimony -- it is more likely than not that no reasonable juror viewing the record as a whole would lack reasonable doubt," wrote justice anthony kennedy for the 5-3 majority. house's appeal was championed by the innocence project, affiliated with the cardozo school of law in new york. "in the three years since the u.s. supreme court stepped into this case and sent it back to the trial court, substantial additional dna testing and further investigation have shown that he is innocent," said peter neufeld, the group's co-director. "each time a layer of this case was peeled away, it revealed more evidence of paul house's innocence."... find this article at: http://www.cnn.com/2009/crime/05/12/death.row.exoneration/index.html | 2008 cable news network

What do you mean you were told you were not allowed to apply in OB/Nursery?! That would be the same as those hospitals telling me I am not allowed to apply for a position in Urology because I am a female. Float nurse needed, except for Bill. What a slap in the face! So you were restricted from performing female catheterization as well. I have the feeling this restriction wasn't printed on your nursing license that you spend several years and thousands of dollars to obtain. The reason why this still happens to nurses is because employers think they can get away with it. They can, unless no one complains. ZiggyNoEar, in every case you just posted, you were treated like a second class nurse and/or potential predator. How would you feel if the above happened because of your skin color, nationality or religion? I assume you would not take it very lightly. No other nurse should ever tolerate this. If anyone of you is treated in this manner you should go directly over the head of the person(s) that discriminate against you. This may entail contacting Human Resources or upper management. If that does not work you next stop should be at a labor attorney's office. I had similar things happen to me years ago because I was female. I tried to reason initially but sadly, in the end the only real change was caused by litigation. Hopefully none of you will have to go that far. As a hospital administrator, I can tell you if more male nurses stood up for themselves, these discriminatory "restrictions" would disappear very quickly. Gentlemen always remember, medical facilities hate; bad press, accreditation threats, forced governmental oversight, labor litigation and costly payouts. Gender discrimination can cause all of these.

Yours points are very valid about; worrying, invasive exams, cost and fear. In the United States I can understand why an uninsured person might avoid a physician's visit. They may not have the money for the exam in the first place. Even if they did they may not be able to afford cancer treatments, open heart surgery or a transplant. So what would the point of the exam be in the first place? To find out you have a disease that can't be treated? I agree with you BATMAN24, the Doc leaving the door open like 58flyer talks about has an easy solution. Send him back to kindergarten for reeducation! A person with 21 years of education (13:school, 4:premed, 4:med) who does not have the common sense and/or decency to close the door behind a naked person, yes even a male naked person, is pathetic. Most 5 year olds have more common sense! If any caregiver did that to me or my family I would say something to them alright, albeit in a firm but very politically incorrect, non-polite, way! As an OB/GYN I would never let anyone in my practice get away with showing such disrespect for a patient who is in such a vulnerable position. That is not to say it did not happen at my practice. Once someone on my team was working on a patient and left the room to take a personal call. This was against the rules. They then just left the door open while the patient was exposed. She yelled for someone to please close the door but no one was in earshot. I happen to walk by and heard what was happening. She was screaming and weeping at the same time. I immediately closed the door and went over to the patient and apologized. Since it was my practice I felt ultimately responsible. The worst part is when she cried, "why did she do that to me?!" The offending nurse came in the room about 3 minutes later. I asked what happened and she said, I had to get a call. When the patient asked about the door, she replied, "it is not a big deal, I am a professional, you don't have anything I haven't seen before." I immediately terminated her and made a report to the State BON. From what I heard the patient has not gone to an OB/GYN since that experience. So for the last 10 years she has had no GYN care. I have the feeling some of you will think I am extreme. Although after that I never had problems with idiots leaving doors open.

It is quite obvious the author of this article clearly doesn't understand men and the real reasons they don't see medical professionals. Since I was a military health care provider for years I have seen far more male patients than female. While her intent is good, based on what she is saying, I believe she has not communicated well with her male patients. For reason number two Dr. Orrange writes, "2) You are afraid we will examine your balls." Where did that come from! If she was a male doctor writing about us could she get away with writing, You are afraid we will examine your *****.:angryfire Can you imagine my reaction if a man wrote an article about why it is silly for me not to receive an intimate exam from him! Frankly I am surprised this article was even published and would never give it to my husband or sons to read and I hope no one else does either. I don't want them to feel these reviews respresent the majority of us. If I have the time I will post a more detailed "review".

I remember seeing an older thread about this but I forget the exact heading. I have never seen a male SANE but that does not mean they don't exist.

Yes indeed! In my State the supervisor or any other medical employee who observes abuse and turns a blind eye, is actually committing a felony. Thus they can serve prison time and lose there medical license.

Wow ImMrBill3, that is a rather loaded post. but your questions are valid. It will just take a while to answer them. I am an attorney though my specialty is not employment law. I am also a female in her 60's that faced a great deal of discrimination years ago when I transitioned from RN to physician. As I mentioned in other posts I was usually the only women in my med school classes. In order to keep this post readable I will create brief answers after each of your questions. Here it goes! What about situations where the staff is almost entirely male. Is the facility required to hire more female nurses? That depends on why the staff is almost entirely male. If it is because management systematically excluded female applicants based on their gender, the facility may have a very big problem under Federal & State laws, rules and regulations. If a gender ratio like you suggest existed it could leave the facility open to lawsuits and/or government sanctions if they were not careful. The reason being that only about 5% of nurses are male. If the situation were reversed it most likely would not raise alarms because 95% of nurses are female. Isn't illegal to hire based on gender? It is illegal to disqualify or terminate on the basis of gender in almost all instances. Even a private/religious facility has to be careful if they accept any form of government funds (Medicare, grants, etc.). Most government contracts have rather strict anti-discrimination clauses in them. What about race if patients in an area are more comfortable with white nurses can facilities hire only white nurses? The facility would have to be extremely careful with such a hiring policy. It could open them up to lawsuits by applicants and possible breach of agreement issues with government agencies they may receive funds from. They could also be fined and may possibly lose accreditation(s). Any non-white nurses that worked at the facility would have a much stronger case if they sued claiming they worked in a 'racial hostile environment' and/or were denied promotion based on race. All in all very bad scenarios to say the least! What about advanced practice if the culture of an area is patriarchal and patients don't trust in the competency of female nurse practioners should the facility hire only males? Oh, as in what happened to yours truly, dnp2004 years ago?! There were several times I was denied employment for the same reason you just list. Another time I was fired for refusing to perform circumcisions. I had no choice but to exercise my legal training and sued. In all cases, it was a very expensive lesson for these facilities. So to answer your question ImMrBill3, facilities should be extremely careful when using 'patient comfort' claims when deciding who to employ. Their heart maybe in the right place but they might be unknowingly violating the laws. My legal battles were years ago so hopefully someone reading this knows current employment law regarding any 'patient choice' exemption/waiver(s) that maybe in place. I think a deeper examination of the concepts of racism and sexism would produce a discussion that addresses some really important issues. I totally agree with you. Though you will find many people are very uncomfortable discussing such issues with regards to medicine. Especially if the issues are; male nurse discrimination, opposite gender peri-care, intimate exam chaperones, male modesty, patient choice, etc. Many times the posts become emotional charged and quite personal. Nevertheless the subject matter is very important as more and more males get in to nursing. The reason I am so interested in the subject is because I had the same issues being a female years ago. I learned the hard way you have to fight for fairness. There was a time when almost all doctors were male and females were not accepted, should that have been continued in the interest of patient preference? No it shouldn't have been because it was very discriminatory. Though I think I understand where you are coming from. With regards to gender, the whole 'patient preference' issue is much more of a medical industry issue than a patient one. When female physicians like me were not accepted in medicine I would always hear that patients, especially male, did not prefer a female physician. That was patently false. I am willing to bet male nurses on www.allnurses.com find over 99.99% of female patients are quite comfortable with their care, even intimate care. Several males on this forum say they have had gender reassignment requests less than 5 times in their whole multi-year careers. So that would be better than 99.99% actually! I feel as a male nurse you may receive more apprehension from other healthcare providers than patients. It was like that for me as a women in a 'man's field. Though things are rapidly improving as more and more men are accepted in to nursing. Oh, now to answer your unwritten questions. No, I never had a provider preference (M/F) as long as they were respectful, knowledgeable, proficient and had good bedside manner. I hope my brief answers helped. Ha,Ha,Ha

So have I! I don't care how long they were employed, they did not last 2 minutes after such hurtful, disrespectful nonsense. I had to terminate them immediately because I believe it takes a certain type of person to abuse (verbal, physical, sexual, etc.) a defenseless senior citizen or anyone else for that matter. If they can do that to a person they are liable to do anything to them when they feel no one is observing them. BTW, I did not even waste the time and money giving employees like that 'sensitive training' in lieu of termination. IMHO such cruelty is like a social cancer that one has to cut out of an organization.

I appears the remaining targets in this 38 year WAR ON DRUGS are our own children. Where does it stop?! How can anyone justify strip searching a 13 year old honor student that has no previous arrests or even school disciplinary problems. Because someone claimed they obtained ibuprofen from her? If the school wins this case will it open the door to body-cavity-searches of our children based on Salem-Witch-Trail type allegations?:angryfire Who were these nurses who participated and why would they do such a thing? Oh let me guess, 'they were just following orders in good faith'. That excuse did not work for medical personnel in the post-WW2 Nuremberg trails. Though apparently it works in Abu Grab, Guantanemo, CIA secret prisons and now your local school system.

I still go back to the point that the program is inherently flawed if there is no requirement that all the healthcare workers be tested on a regularly schedule as well. Can anyone else see my point?