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I am a nurse. What does this mean? It means that I care for people’s physical needs and do for them what they, because of medical reasons, are unable to do for themselves. I am a man. What does this mean? It means I’m not a woman. Are these two states incompatible? Does the fact that I’m a man mean that I am somehow less capable when it comes to caring for people’s physical needs? I don’t think so.
I had a brief discussion at work tonight with another nurse about “male nurses.” She stated that she thinks it’s hypocritical of patients to refuse care from a male nurse when they allow a male doctor to care for them. I agreed.
She then shot herself in the foot by saying, “That’s why I don’t allow a male gynecologist to examine me. I don’t feel comfortable with a male gynecologist.” I told her she was a sexist. She denied it. I asked her what was it about male gyn’s that made her not want one. She said, “Just the fact that they are male.” I said, “That’s sexism.” She said, “No, it’s not.” I told her to change the word “male” to “black” and see how it sounded. She didn’t like that answer and refused to talk to me about it any more. For those of you who need it spelled out, I was asking her what’s the difference between saying, “I don’t feel comfortable with a male gynecologist,” and “I don’t feel comfortable with a black gynecologist.” I’ll tell you the difference: one is racism and one is sexism.
I get so tired of patients refusing care from me because I’m a man. I am happily married and have no plans to do anything to you that I shouldn’t be doing. I am a medical professional. That means that you should be able to trust me to be professional about our interactions and the care that I give you. If I haven’t given you any reason to doubt my professionalism, and you don’t want me to care for you simply because I’m a man, then you my friend are a sexist. You have prejudged me as unfit to care for you, and by refusing my care you have discriminated against me.
Some women have argued that they are “too modest” to allow a male nurse to care for them. I agree that modesty is important. Modesty is defined as “propriety in dress, speech, or conduct.” The definition of propriety that applies is “fear of offending against conventional rules of behavior especially between the sexes” So when people say they are “too modest” to have a male nurse, what they are saying is that they are afraid of breaking societal rules about men seeing them without any clothes. I wholeheartedly agree with this principle as it relates to daily life. However, in the medical field, it is sometimes necessary to see parts of the body that we don’t normally show other people, especially those of the opposite sex. Men seem to have no problem with this when they have a female nurse, I don’t see why women should have a problem when they have a male nurse.
I guess from now on when someone tells me they are “too modest,” I will simply agree with them. Yes, you are TOO modest. The word “too” means “to an excessive degree, to such a degree as to be regrettable.” You should be less modest when it comes to medical professionals. We are only trying to save your life.
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EDIT: Evidently there are those who feel that I am advocating forcing women to subject their naked bodies to male doctors, nurses, and other healthcare workers. I am not. I believe anybody who touches anybody else without their permission is wrong, no matter if they are a doctor, nurse, or anybody else.In my nursing career I have never forced any patient to be my patient against their wishes. Every single time a patient has requested a female nurse, I willingly stepped aside and found a female nurse that I could trade patients with (even the one man who refused me because he saw “male nurse” and assumed “gay” and he didn’t want a gay person near him.). I am not a rapist. I am not a molester.
The main reason I am upset when I encounter sexism is the fact that when a patient tells me on first meeting that they want a female nurse, it isn’t because now I don’t get the chance to see them naked. It’s because they have rejected me wholly as a person and not just for the intimate things. They are telling me, in effect, that my years of study to reach my current medical level were wasted.I have had many female patients in the past that were happy to have me as a nurse, let me give them medication, and other things, but when they needed to use the bathroom, get a catheter inserted, etc, they asked for a female, and I have had no problem with that whatsoever. The people reading my blog recently have confused my cry against their devaluing my nursing skills with some supposed desire to see women naked. I have a wife. I’ve seen many women naked in my career and most women in the hospital are not attractive. I don’t mean these women aren’t pretty, I mean that a woman wearing a hospital gown with tubes coming out of her is not a desirable thing, no matter what people think.
Again, one last time: all patients should have the right to decide if they want a healthcare worker of the same gender. I just think they’re wrong if they think that all men are rapists and molesters.
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SECOND EDIT: This is a blog. It is a place for me to list my opinions about things. If you want to let me know your opinion, feel free to email me or comment. However, if your words are vitriolic, hateful, or in any way insulting (such as calling me a rapist as one person did this week), I will delete it. If you can’t be respectful of other people, don’t bother. And so, for the first time in the 9 years I’ve had this blog, I get to test the “end comments” function of WordPress.
Words of Truth 
>I've been hospitalized many times in my life, especially in early childhood due to having to have multiple surgeries to correct congenital hip displasia. there are very few reasons that I will ask for a different nurse. one is if they are wearing a lot of perfume or smell strongly of cigarette smoke due to my allergies/asthma. if they are trying to start an IV/draw blood & can't find the vein after the 2nd try (I get vasovagal syncope when stuck). as long as the nurse is being professional I don't really have a preference as far as their gender, will even let students be my nurse as long as they seem like they know what they're doing with the exception of starting an IV. I've found that lots of times, the male nurses listen to my concerns better & provide more adequate answers than some of the female nurses.
>This was an excellent post. I've never had a problem with a male nurse – what's the difference really ? A nurse is a nurse – same training.
Steve,
I agree that it is strange that women would not accept intimate care from male nurses, but they are okay with male gynecologists. Male gynecologists and male nurses are the same since both are male. I think many women especially those who are older are accustomed to male doctors and think that because they have more medical training are morally above male nurses. I encourage you to read an important article about the historical progression of pelvic exams at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296153/. Male doctors were actually not allowed to do intimate procedures on women centuries ago.
Race and gender are different. I encourage you to take time to read this important article, Patient Modesty, Values, and Rights at http://patientprivacyreview.blogspot.com/2010/11/patient-modesty-values-rights.html. Pay close to number 3. Two of his paragraphs are very well balanced about gender discrimination and how you cannot compare it to race. We do not have public bathrooms that separate races.
As a Christian woman who believes in the sacredness of sex in marriage and that God intends for the husband of a woman to be the only man to see and touch her private parts and for the wife of a man to be the only woman to see and touch his private parts, I am very disturbed about our society has accepted that that it is different in medical settings. It is not appropriate for any man to see and touch private parts of women he is not married to. There is no evidence in the bible that God allows men (including doctors) to touch and see private parts of women to whom they are not married to. 1 Corinthians 7:1 makes it clear that a man should not touch the private parts of a woman who is not his wife. I have never been to a male gynecologist and I made a commitment many years ago as a teenager to never let any man who I was not married to see certain parts of my body. I will never let a male nurse touch or see certain parts of my body.
I think people tend to accept almost anything that the medical industry does because our culture sees doctors as the definitive “experts” on the human body. Often Christians fall into this trap; they submit to a doctor’s methods without questioning, but often doctor’s methods go against God’s nature. It is a blind spot in our culture today.
It is ridiculous about how moral standards do not apply in medical settings. What about men being professional bra fitters? Think about how clothing stores would label a man who wanted to be a bra fitter a pervert. Why are professional standards different for non-medical people?
The Bible makes clear that ever since the fall of man, nudity was meant to be associated with sexuality. After our innocence was lost, trying to regularize nudity can only happen through demystifying the human body and repressing our sexuality. God has same moral standards for everyone. Medical professionals are not exempt.
I agree that many male gynecologists have skills to perform surgeries and deliver babies, but that does not change my mind. I will not let any man unless he is my husband to see and touch my private parts. There are plenty of female gynecologists to choose from. I also agree that male nurses are capable of doing intimate procedures on women, but that it does not make it right.
You mentioned that you are a conservative Baptist so I assume you are very against abortion. The abortion issue reminds me so much of opposite sex intimate medical care. Abortion was not performed in the bible, but infanticide was. There are plenty of bible verses that indicate that life begins at conception and that an unborn baby is human. Look at this verse: “Before I formed you in the womb I knew you, before you were born I set you apart” (Jeremiah 1:5) We know murder is wrong based on God’s word so that is how we know abortion is wrong. Think about it this way: it is wrong for a man to shoot a pregnant woman in the stomach and kill her unborn baby, but it is okay for a doctor to kill an unborn baby through abortion in the name of medicine according to the pro-choice movement. Both the man and the doctor are equally guilty of murder. You may hear the argument that abortionists have professional training so it is okay for them do abortions. It is wrong for a person who is not in the medical profession to examine and touch private parts of a sexually mature person of the opposite sex she/he is not married to, but it is okay for a doctor or nurse to do that in name of medicine. It is ridiculous because God has the same standards for everyone including medical professionals.
I encourage you to prayerfully consider giving up doing intimate procedures on women and only do non-intimate procedures on women such as giving them medicines and other things that do not involve their private parts. There are many male patients who have strong convictions that no women except for their wives should see their private parts. I am sure you have been a blessing to many male patients and their wives who did not want female nurses. Many hospitals do not have enough male nurses so your job as a male nurse is very important. This statement: “Men seem to have no problem with this when they have a female nurse, I don’t see why women should have a problem when they have a male nurse” you made is misguided. Many men are afraid to speak up about how they feel about their modesty because hospitals often look down on men who do not want female nurses.
Please ask yourself this question: Does it glorify God for me to examine private parts of women who I am not married to? Why are moral standards different for medical professionals?
I encourage you to check out this article from a Christian perspective, Modesty and Your Physician at http://www.truthmagazine.com/modesty-and-your-physician. If I were a female nurse, I would refuse to do intimate procedures on male patients. It is against God’s will for me to touch and see private parts of an adult male who is not my husband.
Modest Christian Woman
Thank you for commenting! I always love to hear my readers’ perspectives. I’d like to address a few of your points, if I could.
You said “Race and gender are different.” I agree. I never said they were the same. I merely used race as an example to get the other nurse to see that she was indeed being “sexist” by refusing a male gynecologist solely because he is a man.
The second link you provided (patient privacy review) gives the proviso “I want make it clear that I’m limiting this discussion to non emergency, non life-threatening situations. I’m not suggesting that modesty has no place in these other areas…” Whereas the text of your comment seems to indicate you would not allow for this. Let me illustrate. I have been in several code situations. When I say “code” I am referring to a time when the patient’s heart stops, they stop breathing, or some other medical emergency. If we the medical staff do nothing, it is highly likely the patient will be dead very soon. And having been in these code situations, I can tell you it is often necessary to remove the clothes of the patient to allow easy access to the chest for compressions, EKG leads, defibrillator pads, etc, as well as removing the pants/gown so that a central line can be inserted into the femoral artery (in the leg, very close to the groin). In a code situation, there are anywhere from five to fifteen people in the room with this naked almost-dead person. They are not there to ogle. They are not there to lessen the dignity or modesty of the patient. They are there to save his or her life. As soon as the code situation is over (whether the patient is alive or dead at the end), the clothes are replaced to preserve the patient’s dignity.
All that being said, I think it’s important to note that the focus of my article was the hypocrisy of those who think it’s acceptable for women to have male patients but not vice versa. The nurse I was talking to was adamant about having a female gynecologist for herself, but did not see anything wrong with her caring for male patients.
Your point about bathrooms is taken. We also don’t have bathrooms differentiating religious preferences, but that doesn’t mean religious discrimination doesn’t exist.
I too believe in the sacredness of sex in marriage. I have specific views about what is right and wrong. However, I hold my views up to the Word of God and see if my view is merely a personal preference or if it is a directive or principle from God. Your main position is that you believe God does not want women to see naked men to whom they are not married, and vice versa. In defense of this, you quote Paul by saying, “1 Corinthians 7:1 makes it clear that a man should not touch the private parts of a woman who is not his wife.”
I have to disagree with you here, because that is not what this verse is saying. In verse 1 Paul is commending the positive benefits of celibacy and abstaining from pre-marital sex, not marital purity. Reading the context (especially the next verse) will reveal very quickly that Paul means “It is good for a man to remain pure and unmarried, but to avoid immorality, men should marry women, etc…”
I agree that many times in our culture people view the doctor as the “expert” and do not question why he or she wants to do certain things.
It is ridiculous about how moral standards do not apply in medical settings.
I never said moral standards do not apply. Moral standards apply everywhere. For instance, it is always wrong for me to commit adultery. But is inserting a catheter into a woman’s urethra to drain her bladder because she just got out of surgery and is in intense pain from urinary retention….is that adultery? It is certainly different than being a “professional bra fitter.”
Why are professional standards different for non-medical people?
Because we aren’t trying to make your life more exciting, easier, more enjoyable, etc. We are trying to restore you to a state of health. At times we are trying to save your life.
Yes, I am wholeheartedly against abortion. Life begins at conception, and should not be ended by man, even in cases of rape or incest. However, I reject your comparison of the two. Abortion is a very black and white issue: is the baby human or not, and is it OK to kill the baby? Opposite sex intimate medical care is very different.
I lean heavily on the Bible to guide my choices, and you have not provided me with enough biblical evidence that God is displeased with male nurses helping women patients. And I will say this: there is not a hospital or nursing home in the country (at least not that I’m aware of) that would allow a female nurse to state, “I’m only going to provide intimate care of women” or for a male nurse to state “I refuse to provide intimate care for women.”
This statement: “Men seem to have no problem with this when they have a female nurse, I don’t see why women should have a problem when they have a male nurse” you made is misguided. Many men are afraid to speak up about how they feel about their modesty because hospitals often look down on men who do not want female nurses.
Do you have evidence for this? You state “many men” so I would like to know how many men you know personally (or have solid statements from these men to this effect) who have declared they are afraid to speak up. Or is this statement simply a reflection of your belief that it must be so? And I would imagine that hospitals would only look down on male patients refusing female nurses simply because female nurses still outnumber male nurses 9-1 (they make up 90% of the nursing force), so it would be difficult (and in some cases impossible) to fulfil this patient request for a male nurse.
Please ask yourself this question: Does it glorify God for me to examine private parts of women who I am not married to?
I believe it does. Jesus made it clear that sin does not start in the action but in the motive behind the action (Matthew 5:21-30). If I am examining a woman’s private parts because I get aroused by it, then yes, it is sin and does not glorify God. But if I am examining a woman’s private parts with pure motives, then I believe it is not sin, else I would never do it. How could I do otherwise?
Why are moral standards different for medical professionals?
I think what you are asking is this: why is it morally correct for me to see women naked to whom I am not married? Again, I refer you to motive. I am not lusting after them, but trying to help them. Also, I believe that Jesus taught in Luke 14:1-5 that while the Law (which is perfect and holy) prohibits work on the Sabbath, healing someone (which IS work) is acceptable, even if done on the Sabbath. I think this sets a pretty clear precedent that healing people on the Sabbath is a gray area. I don’t believe Christ was teaching that it would be OK for a Jewish doctor of His time to work in a medical clinic that is open every Saturday. The spirit of the law is the important thing.
If I were a female nurse, I would refuse to do intimate procedures on male patients. It is against God’s will for me to touch and see private parts of an adult male who is not my husband.
While I respect your standard, I do not hold to it, nor do I believe you would stay employed for long as a nurse with that kind of inflexibility. How great is He in that, with your convictions, God found something else for you to do!
I have cared for men, women, old people, young people, babies, people who are dying, black people, white people, hispanic people, (and many other ethnicities), obese people, skinny people, people with AIDS, people with Hepatitis, people with tuberculosis, transvestites, gay people, straight people, drug seekers, alcoholics, etc. And you know what? I try to show the love of Christ to them all, no matter their gender, race, age, sexual preference, addiction or disease. Because Christ died for every single one of them. I count it a privilege to care for them all.
Once again, thank you for commenting. I hope I’ve made my points clear. Please let me know if any of them are unclear or ambiguous. Thanks, and God bless!
So you mean to tell me, hand to God, that you would be able to give an attractive woman a pelvic exam and not have a single perverted or lustful thought crop up in your head? If so, please tell me what class you took in nursing school that helped you curb your male visual-oriented sex drive.
First of all, nurses don’t give pelvic exams, at least I have never done so as a nurse. My first pelvic exam came in nurse practitioner school, and every pelvic I’ve done has been in that context (as a NP student). And yes, I have given pelvic exams to attractive women without lustful thoughts. Because there’s a disconnect when the person is your patient. I can honestly say that not once have I viewed a woman’s genitals in a professional setting and had a lustful thought. Perhaps part of this is because the genitals aren’t really that attractive. And yes, this is the reason I’m not a lactation consultant.
You are allowed to disagree with my position. However, on my blog, you are not allowed to call me a liar.
So you’re basically admitting that you find breasts attractive, which is why you don’t do breast exams. However, this also implies that even if you’re in a professional setting, you can’t set aside those lustful (and normal) feelings that a man would have regarding seeing a patients (secondary) sex organs. Therefore, wouldn’t it be logical to assume that males who like butts, or even the males who like to see and insert their fingers into attractive women’s vaginas (which, let’s be honest, is ALL heterosexual men) would also be unable to separate their feelings of lust from the so called “professional” setting?
It’s great that you can be honest and admit the fact that you can’t handle being a lactation consultant because you’d have access to seeing many women’s breasts. However, just like you have your own sexual preferences (which I’m assuming are breasts), ALL men have a part of the female anatomy that they like. Gynecologists have access to ALL parts of a female’s anatomy, so logically it’d be reasonable to assume that they’re having lustful thoughts regarding SOME part of the anatomy (butt, vagina, breast, thighs, etc) when they give pelvic exams.
Another question, since you have a thing for breasts, would you ever act as a chaperon for a doctor during a pelvic/breast exam? I know 9 times out of 10, doctors have female nurses as chaperons, but I’m just presenting a hypothetical situation. Also, would you feel comfortable being in a delivery room with a mother as she has her breasts out waiting for her baby to make the journey into the world so it can latch onto her?
Yes, I’m admitting that I find breasts attractive. And the amount of attraction would make it difficult for me to be professional in a job where the breast is the main focus. The main point of my post however, is that there’s a huge difference between focusing on women’s sexuality and being a professional who is concerned about bringing them to optimal health.
Would I act as a chaperone for a doctor? I have. The point is to have a witness in the room to protect the patient from abusive doctors and to protect the doctors from lying and litigious patients.
Would I feel comfortable being in a room with a mother breastfeeding? Yes. Because I’m a professional. Would she be comfortable with me? Maybe not.
Well first of all, I want to applaud you for your honesty. I’m sure most other medical professionals would outright deny finding ANY part of the female anatomy attractive. At least you’re admitting that you’re a medical professional who finds breasts attractive.
With that out of the way, you do see to contradict yourself. You seem to be confused and offended that a woman would ask for a female nurse instead of you, but then you openly admit that you’d find seeing their breasts as a turn on. Based on that, you really don’t see why a woman would rather have a woman (who most likely WOULDN’T be attracted to her breasts) give her an exam that would entail being nude? At a certain point your post starts to become less about you facing a social injustice, and more you whining about women not wanting a man staring at her nude body (despite the fact that you basically admitted you’re attracted to breasts).
Also, how can you claim to be all for modesty when you’re open to being in the same room with a topless woman breast feeding, despite having an attraction to breasts. This means you don’t have a problem with going against your morals, and sitting in a room looking at a woman’s breasts in a “professional” setting all the while having lustful thoughts. Isn’t that a tad bit hypocritical?
See, that’s what really confuses me about the medical industry as a whole. Male doctors and nurses somehow have garnered this facade of god-like beings with no sexual interests or lustful thoughts, and have somehow infiltrated a moral blind spot with the ability to touch, watch, and examine female sexual organs. How in the world can a doctor or nurse claim to be a good and true Christian if they’re willing to put themselves in a situation that no doubt creates sexual thoughts under the guise of professionalism. Also, there are many instances where male doctors and/or nurses examining females has ultimately led to conflict and strife within these women’s marriages. As a matter of fact, when men were first trying to take over the field of gynecology and push female midwives aside, other doctors who objected said that it would basically become a crime against the institution of marriage. So a doctor/nurse’s unchristian-like behavior isn’t anything that’s exactly new. Don’t get me started on how these good God fearing doctors used to treat female hysteria.
So Steve, by that rationale, you must also be against the discrimination against men by all the male gyn’s who won’t treat members of their own sex despite having specialized experience detecting breast and rectal cancer and treating chronic pelvic pain and STD’s. Of course not. They have their own agenda and it involves initimate examinations of females. That’s really creepy and there are many men and women who think so. Unless it was an emergency I completely disagree with any intimate medical interactions with my wife by male gyn’s, male nurses, or male PAs. By the same token I don’t want any females intimately examining or treating me and I think there should be more male nurses to assist with full body skin exams, vasecectomies and other male urological procedures. People have a right to manage their own healthcare, and that also means choosing a provider that you are comfortable with for any reasons you choose, including sex.
Steve,
If you really care about your patients, then you will realize that it is NOT about you, it is about them. Somebody is ill, vulnerable, afraid, in pain, etc., so who cares? If something makes them a little more comfortable, then is that NOT what healthCARE is about.
As a patient, I do NOT care how YOU feel. I am sorry that is just the way it is. Of course, accusing a patient of being too modest, judging you unfit, etc. REALLY HELPS the healing process.
The courts have affirmed the choice of gender in healthcare: Veleanu v. Beth Israel Medical Center, 98 Civ. 7455 VM, 2000 U.S. Dist. LEXIS 13948 (S.D.N.Y., September 25, 2000):
A male OB/GYN physician brought a discrimination claim against Beth Israel, alleging that he was discriminated against on the basis of his gender because the hospital accommodated female patients who requested female doctors. The court distinguished Diaz and other consumer preference cases by noting the special circumstances of privacy concerns of health care patients. The court noted that “giving respect to a deep-seated feeling of personal privacy involving one’s own genital area is quite a different matter from catering to the desire of some male airline passenger to have…an attractive stewardess.” Id. at #22. “Because such care implicates the patient’s privacy rights, personal dignity and self-respect, the court believes that healthcare presents unique circumstances that may justify reasonable efforts to accommodate a patient’s expression of preference of doctor by gender and that female patients may have a legitimate privacy interest in seeking to have female doctors perform their gynecological examinations.”
Therefore it is your job to respect the patient’s wishes for gender choice WITHOUT question.
Banterings,
Yes, I realize that as a nurse I am there for them, not for me. I’m not disputing that. I’m also not disputing that it is my job to respect the patient’s wishes for gender choice. But it doesn’t change the fact that their refusing me for the sole reason of my gender is still sexism/gender discrimination.
I had not heard of “Veleanu v. Beth Israel”. Thanks for the interesting read. I will allow that there are cases (as I have said) when gender discrimination in this area is acceptable.
As an aside, I will say that my favorite clinical experience in both nursing school and NP school has been the time I spent in maternity/OB. The whole pregnancy and birth process just amazes me and I wish that I could have gone into that field. But I didn’t because I assumed that too many women would refuse me, so it would create extra trouble. Also, one hospital where I worked had an unwritten rule that male nurses and CNA’s were not allowed to work in the maternity department.
One more thing: with only one exception (I was having a bad night), I have always been gracious towards my patients who refused me as their nurse because I’m a man (and this includes the one guy who refused me because he assumed I was gay). There was one female patient in a nursing home where I started that always refused male nurses and aides, so we just made allowance for it: the female aides just knew they would be taking care of her. If she got assigned to me, we would just trade her for another patient. I remember how it felt the day that she asked for help getting dressed, and I told her I would go get one of the girls, and she said, “No, you can do it. I trust you.” Felt good.
I also remember how it felt to care for another resident day in and day out, helping her do the things she couldn’t do for herself: helping her to the bathroom, getting dressed, combing her hair, holding her hair back while she threw up because of the chemo, walking with her in the hall to build up her strength. Until the day that her daughter happened to walk in on me helping the resident to the bathroom. She demanded that no men care for her mother. And that was the end of that. But you know what? As her mother (the resident) lay dying, she actually apologized to me for assuming I would do something wrong with her mother, and she thanked me for caring for her.
There were a couple other tid-bits I wanted to add to my commentary.
It is very easy to criticize the patient when YOU are the one that is NOT naked.
“Remember, when you point a finger to blame someone, there are three fingers pointing back at you.”
Perhaps part of the problem is that you carry that arrogant paternalistic attitude with you when you see patients, and that is the reason they do not want you to care for them. By that attitude, I mean that because you have that magic stethoscope or magic white coat that everybody should be just peachy-keen with letting you see and touch every inch of their body.
I bet you are trained to treat the genitals of either sex just as you would treat any other body part (like an elbow).
That is what I had a female nurse (with that arrogant paternalistic attitude) tell me once. I went off; how dare she lie to me in such a manner. She got very defensive about her professional status.
I simply said to her, “Then show me YOUR ‘elbow.'” She was offended.
I explained that providers are not taught to treat the genitals as any other body part, they are taught to OBJECTIFY the patient. (Source: Giuffre, P. A., & Williams, C. L. (2013). “Not Just Bodies: Strategies for Desexualizing the Physical Examination of Patients”. In McIntyre, Practical Skeptics: Readings in Sociology. New York: McGraw-Hill Companies)
The objectification of patients (as human beings) is so ingrained with healthcare education, that it led to physicians having been the largest professional group to join the SS (Source: http://remember.org/imagine/doctors.html). Their crimes were so great, that a separate trial took place in Germany for them.
Healthcare providers, especially doctors, are socialized to an almost sociopathy when dealing with patient dignity (Source: http://joannenova.com.au/2014/05/death-by-a-thousand-cuts-how-the-machinery-of-academia-enforces-conformity/). They do NOT know what is socially acceptable or what is abusive. I am sure that you are aware of the practicing pelvic exams on women under anesthesia purely for teaching purposes — not for the women’s medical benefit.
This is not a new practice. However, many may have assumed it had largely stopped, particularly after a 2003 study (Source: http://www.ajog.org/article/S0002-9378(02)71415-4/abstract) drew a lot of attention to the issue, causing many medical schools to clarify their policies and/or seek women’s explicit consent. Several professional medical organizations have also denounced the practice.
In the October 2012 issue of the journal Obstetrics and Gynecology (http://journals.lww.com/greenjournal/toc/2012/10000), a medical student writes of his discomfort with a practice many people may be surprised to learn still occurs — medical students practicing pelvic exams, WITHOUT explicit consent, on women who are under anesthesia for surgery.
The student, Shawn Barnes, writes that the practice left him “ashamed.”
“For 3 weeks, four to five times a day, I was asked to, and did, perform pelvic examinations on anesthetized women, without specific consent, solely for the purpose of my education,” writes Barnes. “To my shame, I obeyed.”
Did you know that medical procedures and exams (especially those dealing with intimate body parts), even when conducted professionally and according to guidelines, can feel like a sexual assault (Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2141611/) to the patient and lead to PTSD (Source: http://www.tandfonline.com/doi/abs/10.1080/02646839308403222?journalCode=cjri20&#.VLGAe3uqEuN)?
I KNOW THAT YOU WERE UNAWARE OF THESE FACTS. MOST PROVIDERS ARE (UNAWARE).
You can also see I back my statements with credible sources (National Institutes of Health, pubmed, journals, etc.). This is all REAL, I am not making this up.
I am sorry if you feel like I am attacking you. I had worked with survivors of abuse (domestic, physical, sexual, etc.) and I had seen the same behaviors in them (attributed to the abuse such as PTSD) as in people who were afraid of or abused by healthcare, or had bad experiences.
Finally, let me say that I do NOT paint ALL providers with a single brush, including you. While some are abusive, there are some that are extremely compassionate and respect the patient’s dignity.
The biggest problem is that most are unaware of the psychological toll that one’s dignity can have. People have refused life saving interventions because of the fear of the loss of control over their own body (Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803803/#__ffn_sectitle).
Let me finish with giving you some pointers that may overcome your patients objections (take these for what they are worth):
1.) What department do you work in? If it OB/Gyn, then this is a losing battle.
2.) Shave the beard. It harkens to the look of the “village” elder which portrays a very paternalistic look (which is the purpose especially in middle east culture and as seen in Leviticus).
3.) Do not use your faith as a defense, that may scare people more. Pastoral sex abuse happens in ALL denominations, some are just publicized more than others. Some people may misconstrue your faith as a paternalistic trait (attitude); they may think that you feel you have a moralistic high ground tipping the balance of power in your favor.
4.) If possible, meet your patients when dressed, introduce yourself. Ask both genders what you can do to help them feel more comfortable and how you can earn their trust. Be proactive, say that you know that both genders do not like strangers looking at their bodies. Give the patient control.
5.) Sell yourself; tell the patient things that you take for granted, or things they should/may know. You will announce yourself before entering the room, you will always COMPLETELY draw the privacy curtain, close the door, KEEP OTHERS OUT (especially unnecessary others), etc. Let the patient do as much for themselves as possible, can they wash themselves, put in their own suppository, etc. Don’t use a bed pan if with a little (or a lot) extra effort they can use a regular bathroom, and most importantly do not stand in there with them (but if medically necessary AND they consent, stand away from them, face the wall, turn on water to make noise, etc.)
6.) FOLLOW THROUGH ON WHAT YOU SAY.
7.) Call out coworkers who do not respect ANY patient’s dignity (be an advocate).
8.) Treat patients like human beings, NOT like patients. Ask what you can do make your care better for them. For example, do not just glove up to examine a patient or preform a procedure. I know that there are some where you need to, blood draw, suppository, and so on. Ask what the patient prefers. I personally prefer to be examined without cloves (if I ever were to allow an examination, but that is another story).
If you get a good reputation among patients, word will get around. Trust me. You may even get requested, starting with relatives of coworkers. Patients’ trusted doctors may even tell them get you.
If they request another nurse, don’t take it personally. Try checking back on them, ask if they are happy with the nurse they got. They may recognize this as good care and request you back if they are not getting good care from their current nurse.
“a couple other tidbits” he says, and then goes on to write a 2.5 page single spaced paper. I will address your points, but I think you need to recognize that ultimately you and I disagree, and that’s ok.
First of all, I have BEEN the patient, so I know what it’s like, and no, I have no problem with the nurses and doctors (of either gender) seeing my privates.
For me as a medical professional to show MY privates to the patient would be highly inappropriate, as well as unprofessional. Simply put: I’m there to do a job, not compare genitals with people I don’t know. They came to the hospital to be helped by me and other nurses because they currently cannot do these things for themselves.
“Arrogant paternalistic attitude”. Talk about arrogance? You don’t even know me and you assume I treat my patients like objects not people. You don’t know me, and you’ve never been my patient, so you are ignorant when you apply YOUR experiences with medical professionals onto me.
We are NOT trained to treat genitals like any other part of the body. We are trained to provide privacy as much as is possible while still carrying out the tasks that the patient needs (and has agreed to).
That brings up another thing: the patient is not a prisoner. I frequently tell my patients, “As a patient you have the right to refuse any medication, any treatment, and any test.” And I mean it. If I think the intervention is in their best interest, I will try to convince them, but if they ultimately say no, I don’t do it. Why? Because if I do, it’s called assault and battery.
I’m not so sure that objectification is a bad thing when it comes to caring for people who need our help. What is the alternative? What would you suggest I do when I am caring for a man who has urinary retention and needs me to insert a catheter to drain his bladder so he doesn’t suffer a rupture and need emergency surgery? “Sorry, man, but penises are sexual, so I can’t help you.” How about a woman who is going into cardiac arrest, and I need to remove her shirt to apply the AED? “Sorry lady, but breasts turn me on so I can’t save your life.” That’s ridiculous. I can’t explain it, all I know is that there’s a difference between seeing a naked woman and seeing a naked woman who is suffering from a health problem and needs my assistance and skills to help her get better. I’m sorry if you can’t understand that. Good luck with your future medical needs.
And Godwin’s law. So there’s that.
I don’t know anything about practicing pelvic exams on sedated women. I would think that would be unethical. I would never do it, since “informed consent” has always been a huge part of my education and practice. It has been ingrained in me that you don’t do ANYTHING to the patient without permission. I have only ever done pelvic exams on women who agreed to allow me to do it. The first one I ever did was actually at a medical school where there was a teaching clinic. They had a man and a woman that volunteered to allow students to give them a pelvic exam (woman) and rectal exam (man). They were very well compensated for their trouble (I think it was like $50 per exam, and they did 20-30 exams in a few hours). They were very helpful, and we all learned a lot about making the procedure more comfortable for the patient.
Attacking me? Why would I feel like you’re attacking me? I write a blog post giving my considered opinion after years of experience as a nurse, and you anonymously write several lengthy posts telling me how wrong I am. It is easy to throw insults and invective at others behind a wall of anonymity. So yes, I do kind of feel like you’re attacking me.
To those people who have refused life-saving interventions due to their fear of losing control or whatever I say fine, that is their right (as I said before).
As for your pointers?
1. I work in a nursing home, but I am currently in NP school, and hope to work in family practice after I get out (like in a doctor’s office).
2. No.
3. I don’t know what you’re talking about in regards to using my faith as a defense for my nursing practice. At no point in my original post did I reference my faith.
4. I always meet my patients when dressed. I’d be fired if I wasn’t dressed. Sorry, but that made me chuckle. I know what you are trying to say here, and I agree.
5. I already do this stuff.
6. Ditto.
7. Ditto.
8. Ditto until the gloves thing (I assume you meant to type gloves instead of cloves). I ALWAYS glove up to examine a patient. It’s called “universal precautions.” We treat every patient as if they have a life-threatening communicable disease because some of them do and they don’t always reveal this. So no, while YOU may feel more comfortable having the nurse wear no gloves, if you pulled that with me, I’d say that I would be happy to attempt to find another nurse who would be willing to break hospital policy and expose themselves to your bodily fluids without gloves, I would have to decline.
As for your last point, I have actually had patients request me. But your last paragraph? No. Once they refuse me, I generally stay out of their room, so as not to appear confrontational. If I see them out in the hall I will greet them and be friendly, but I would never pursue them.
Steve,
Thank you for the reply.
God bless you working in a nursing home. That was my hardest placement for one of my undergrad degrees. I also know the compassion that the providers had for my grandmother in her last years.
I was with her when she passed, and the owner (a nurse herself), described the event as “beautiful.” Which it was, I know that you know what I mean so I do not need to go in to detail.
The dynamics in a nursing home are also much different than in a hospital or a practice. I can understand why you may be unaware of some of the issues that I speak of.
I have to “write a paper” when I deal with providers because simply stating the obvious, we are dismissed as outliers or mentally disturbed.
I am glad that you have been trained to recognize informed consent as paramount. I guess you are unaware of the issues raised by Peter Ubel how physicians are trained to do PE. The problem is that this was still occurring in 2012.
NP train side-by-side with physicians, please read the literature about how 3rd & 4th year physicians are socialized to protect your own (mental) well being and to be aware of some things that still happen.
As to “comparing genitals,” that is a way for providers to take a personal inventory of what they believe and what they say. Your statement below shows that this does not apply to you.
I REALLY liked what you said here:
“We are NOT trained to treat genitals like any other part of the body. We are trained to provide privacy as much as is possible while still carrying out the tasks that the patient needs (and has agreed to). ”
I INTEND ON USING THIS AS AN EXAMPLE OF A CORRECT TRAINING.
As to the objectification of patients (which you said sounds like a good idea), I cited sources. This is part of the “hidden curriculum” of any medical education. I hope that you are aware of what the “hidden curriculum” is.
Just because you are comfortable with either gender caring for you, does not mean everybody is. You stated this as an obstacle that you face, but instead of trying to understand the problem, you say you are a nurse and there should be no problem.
As to your faith, you referenced that as part of your moral decision making in the comments and in other posts on your blog. The end points were just suggestions, and GOOD FOR YOU that you are already doing them.
As to Goodwin’s Law, the topic was referenced in the Ubel and Barnes paper (I referenced above), and others with regard to the socialization of physicians and examined. Others whose research has been used include Diener, Festinger, Downing, Lewin, Asch, Milgram, Goffman, Bandura, and Zimbardo.
By mentioning Goodwin, you are either attempting to discredit me as an internet troll, you did NOT look at any of the sources I cited, or you just don’t care about the dynamics of healthcare that lead to the issue you posted on, you just feel entitled.
I think that you reacted emotionally without looking at the sources I mentioned. Perhaps after looking at the related literature, you will understand more what I am talking about.
One problem with healthcare is that you are judged by patients’ experiences with other providers.
You write:
“I write a blog post giving my considered opinion after years of experience as a nurse, and you anonymously write several lengthy posts telling me how wrong I am.”
I support my position with evidence. Your point of view that your gender does not matter is the same attitude that Ubel writes about.
As to your statement:
“I don’t know anything about practicing pelvic exams on sedated women. I would think that would be unethical. I would never do it, since “informed consent” has always been a huge part of my education and practice.”
READ UBEL! READ BARNES!
The research conducted by Ubel, et al. and published in the American Journal of Obstetrics and Gynecology (“Don’t Ask, Don’t Tell: A Change in Medical Student Attitudes after Obstetrics/Gynecology Clerkships toward Seeking Consent for Pelvic Examinations on an Anesthetized Patient”). In this article, the authors cite high-ranking physicians in the hospitals studied who give several specious justifications for allowing medical students to perform nonconsensual pelvic exams on unwitting anesthetized patients. Read what Ubel says in Psychology Today: https://www.psychologytoday.com/blog/critical-decisions/201208/inappropriate-touching-in-the-doctor-s-office
Many people think that is unethical BUT as of 2012, it still occurs (Barnes).
Read about Dr. Twana Sparks in Outpatient Surgery Magazine: http://www.outpatientsurgery.net/resources/forms/2010/pdf/OutpatientSurgeryMagazine_1001_ent.pdf
Let me finish (again) with something I said in my 2nd post (incase you missed it):
Finally, let me say that I do NOT paint ALL providers with a single brush, including you. While some are abusive, there are some that are extremely compassionate and respect the patient’s dignity.
–Archie Banterings
Steve,
There are reasons not yet discussed here why a female patient would only want female doctors or nurses. You stated:
I get so tired of patients refusing care from me because I’m a man. I am happily married and have no plans to do anything to you that I shouldn’t be doing. I am a medical professional. That means that you should be able to trust me to be professional about our interactions and the care that I give you. If I haven’t given you any reason to doubt my professionalism, and you don’t want me to care for you simply because I’m a man, then you my friend are a sexist. You have prejudged me as unfit to care for you, and by refusing my care you have discriminated against me.
I trusted my family doctor when I was a teenager and he repaid that trust by molesting me many times when I presented with severe abdominal pain. He used my pain and my inexperience with breast and pelvic exams to physically molest me with his hands and fingers. Why would I trust a male doctor or male nurse when I have been personally assaulted and hear about literally hundreds of doctors and nurses who have sexually abused their patients. The latest practice by perverted doctors is to take pictures of patients genitals with spy cameras placed in watches and pens. You don’t have to take my word for it, just google doctors who sexually abuse patients, and you can see what I am talking about. I will never go to a male doctor again or have a male nurse attend me no matter how good a nurse you might be. It is not worth taking the chance again.
You say that by refusing your care we have discriminated against you like that is a bad thing. I looked up discriminate and it says as an intransitive verb it means:
a, To respond selectively
b, To use good judgment
So in my good judgment, I am selecting only female caregivers. I hope you can understand my choices.
Jan,
First of all, I am sorry that you were abused. it is truly sad that so many have been sexually abused in our world. I do not mean in any way to minimize the lasting psychological effects of sexual abuse with my original post.
That being said, your refusal of male healthcare workers is still sexism, and I’ll tell you why. You are assuming that all men are like those doctors/nurses that sexually abuse. You imply that somehow male medical professionals are all lecherous ogres who will jump at the first opportunity to abuse a woman, whereas female medical professionals are all sainted angels that would never dream of such a thing. You imply that you are in constant danger when male medical professionals are around, but with female medical professionals, you are completely safe. You completely discount the existence of women who are sexually attracted by other women (lesbians and bisexuals), and female rapists and abusers.
And I stand by my statement about discrimination. You are correct in saying that discrimination can simply mean to use good judgment. However, the word in my original post that you should perhaps focus on is the word “prejudge.” As in, you have prejudged me as unfit to care for you based on my gender. That’s prejudice, and that’s never good. You see my male gender, and you stick me with the label “sexual abuser.” That’s the definition of sexism.
Again, I sympathize with you concerning your past experience, and it is certainly your choice to be prejudiced against men, but let me ask you: do you wear some kind of identifying bracelet so that if you are in an accident the male paramedics and ER nurses will know not to treat you? Face it: you are a sexist.
That being said, your refusal of male healthcare workers is still sexism, and I’ll tell you why. You are assuming that all men are like those doctors/nurses that sexually abuse. You imply that somehow male medical professionals are all lecherous ogres who will jump at the first opportunity to abuse a woman, whereas female medical professionals are all sainted angels that would never dream of such a thing. You imply that you are in constant danger when male medical professionals are around, but with female medical professionals, you are completely safe. You completely discount the existence of women who are sexually attracted by other women (lesbians and bisexuals), and female rapists and abusers.
NOPE – What is being said is that a man WAS the abuser and that men are typically the abusers. You have made this ALL about you, when in fact you are supposed to be caring for people and making it all about them. You cannot even see your narcissism.
Steve,
I was trying to be nice by saying my doctor physically molested me. But the truth is that just because he was my doctor doesn’t mean it wasn’t rape. My mother consented to a physical exam for me, not digital rape.
Rape me once, shame on you.
Rape me twice, shame on me.
If you want to call me a sexist for not wanting to try other male doctors to see which ones rape me and which ones don’t, then I gladly accept the term. I would much rather be a sexist in a safe environment then a stupid woman being raped over and over again.
Jan
Jan: molest…rape….same thing. I would wholeheartedly agree that if a man touched you inappropriately, no matter if he was a doctor, nurse, or just someone you work with, that he should be held accountable under the law for that action, because it’s wrong.
I would say that for you to exercise discrimination as you defined it, you would not go to THAT doctor anymore. But you are applying the actions and motivations of one man to the other 4 billion men on the planet.
Again, I’m sorry you had that experience, but I think it’s a mistake for you to hold all males at fault for the actions of one man, and to ascribe his actions to the rest of us.
Go in peace and may that never happen to you again.
You think that every time a medical “professional” steps out of line they are held to account? Not so, they are peer reviewed…meaning they are protected, it takes several instances and several complaints to even get the review and in most cases they get moved or just ordered to follow existing laws (use an advocate) or they retire.
Good for you Jan. Someone has to stand up for your rights, it might as well be you!
Steve,
Before I go in peace, I must correct you on your statistics. Since being raped, I have talked with many other rape victims and done considerable research. Reliable studies show that around 1 in 10 doctors have ADMITTED to sexual misconduct in anonymous surveys. The rate naturally tends to be higher among physicians, such as ob/gyns, who have regular access to females. And since doctors are not likely to admit sexual misconduct, even in anonymous surveys, the actual rate of sexual misconduct is undoubtedly much higher. There are 568,000 male doctors in the USA, so even using the lower number at 10% of the doctors admitting to sexual misconduct, there are 56,800 male doctors admittedly molesting patients in the US. I am not concerned about all 4 billion men on the planet, only the male doctors in our country who are molesting patients.
So for every 10 women who pick a doctor, odds are that one of them will pick one of the 56,800 rapist doctors. That is 1 in 10, not the 1 in 4 billion you quoted. And that’s not counting all the other health care professions where men have molested their patients. Why would I roll the dice and chance getting one of those rapist doctors when I can pick a female doctor and be practically 100% safe. Female doctors who have been caught molesting their patients is miniscule compared to their male counterparts.
Jan
My wife would never allow any man to touch or see her private parts.A male nurse or male doctor is still a man even he has an education and are having that stupid white coat on.My wife is soon 50 years old and no man,except me,has ever seen her naked.
And that is your right. And you are a sexist.
How is he sexist? Because he’s not comfortable with a man seeing his wife naked or touching her genitals?
Would you let him see your wife naked? Would you let ME see her laying naked on a table with her legs in stirrups? If not, why? The only real difference between me and you is a white coat. Unless you took a class in nursing school that taught you how to switch off your male desires/thoughts. If so, what’s the name of that class?
How is he sexist? Perhaps you should look up the definition of sexism. If the only reason he won’t let a healthcare provider see his wife is that the provider is a man, that’s the definition of sexism.
As far as letting him or you see my wife naked, I would not have a problem with it if you or he were her nurse or doctor. But if you aren’t looking at her in order to help her health-wise, then no.
Steve,
With your latest amendment to your blog, you’ve now shown that you need psychological help. You evidently have an inferiority complex (perhaps because you wish you were a doctor?). No one is questioning your skill as a nurse when they request a female. They simply want to head-off any intimate care issues that may arise in the future. Sometimes it’s best to state a preference at the outset rather than waiting until it becomes embarrassing to request a female. We’ve become an immodest society and modest people are now ridiculed–just as you are scorning and calling sexist, women who want a female to attend to intimate functions. This sort of ridicule of patient preferences is epidemic on nursing internet boards.
I speak from first hand experience that many nurses have attitude problems–you included. Fortunately, my wife who is a registered nurse is the most gentle, considerate, compassionate and kind person I know–and I’m still trying to figure out how I snagged her.
John
John, I don’t feel you are qualified to make that assessment. I am a perfectly well-adjusted person with no psychological problems. What you call an “inferiority complex” is me thinking that as a medical professional I should be treated as a medical professional. I could turn the tables and say you are suffering from delusions of grandeur because you think you know what I’m thinking, you think you know what my patients are thinking, and you think you know what my fellow nurses are thinking.
Yes, many nurses have attitude problems, because nurses are just like everybody else: we are human. That means we aren’t perfect. I have bad news for you: your wife isn’t perfect either.
At the risk of repeating myself, I am all for modesty. I get irritated when I see women walking around displaying their cleavage for everybody to see. But there’s a difference in my mind between a woman immodestly displaying her breasts for everybody to see, and a woman who is lying on a bed naked because she is having a heart attack and a room full of people are trying to save her life.