You Should Have a Personal Advocate For Surgery?
All patients should consider having
a personal advocate present in surgery with them. The advocate
could be a spouse, family member, friend, or a medical professional
not employed by the hospital where the procedure is taking place.
The advocate would be present in pre-op, surgery, and post-op.
Patients who are sedated or under anesthesia are totally vulnerable.
A personal advocate would help
to keep the surgical team accountable in many instances including:
not allowing the team to ignore patients’ wishes for modesty,
as well as protecting a patient's wishes regarding allowing
only same-sex personnel to be present for the surgery. With
any surgery, the doctors, nurses, and medical personnel enter
into an agreement with the patient; an advocate would maintain
those preferences and not allow any deviances from the agreement
unless medically necessary.
A husband in San Antonio told
a male scrub technician he could not come into the operating
room with his wife who was having a C-Section and the technician
followed his request. Having an advocate present would
also help to cut down on medical mistakes, sexual abuse, and
deaths because the surgical team would be observed by a personal
The patient advocate could also
require that the medical professionals wash their hands in front
of her/him to help decrease infections. Many hospital-acquired
infections are caused by medical professionals not properly
washing their hands.
Another instance where an advocate
present in surgery would be invaluable is when a specific doctor
is replaced—because of umpteen reasons—by another
For example: A patient was scheduled
to have a more experienced surgeon to do a balloon angioplasty
of peripheral arteries in her legs, but for some reason(s) an
inexperienced surgeon substituted him and operated on the patient
instead. The patient bled to death because one of her main arteries
ruptured. A nurse who was present in the OR told the lady’s
daughter what happened, but would not testify against the doctor
perhaps due to the possibility of losing her job. Check out
in Outpatient Surgery Magazine about a chief nursing officer
who was fired for reporting safety concerns at a hospital she
worked at. The surgery outcome could have been different if
the patient’s daughter had been her advocate, been present
during surgery, and been able to protest the change of surgeon.
An anesthetized patient cannot speak up for themselves.
Check out this article: OR
Crowd Control about letting too many people in operating
room. It seems ridiculous that many medical facilities have
policies prohibiting one family member or a friend from being
present for patients’ surgeries. Many facilities use the
excuse: “We cannot let you in because of germs.”
But then they let various people such as medical students and/or
non-medical professionals—a janitor or sales rep—come
into the operating room carrying germs.
For many years, husbands were
not allowed in the delivery room with their wife. Check
out this interesting article about how men ended up in the delivery
Did Men End Up in the Delivery Room? Women and husbands
actually had to fight to change hospital policies to allow husbands
in delivery rooms.
In the 1950s and 1960s men succeeded
in being allowed in labor rooms with their wife. Here—“alone
together”—couples shared intimate moments, holding
hands, reading together out loud, playing cards; husbands often
rubbed their wife’s back during contractions. In
the 1970s, hospitals and physicians gradually relented and permitted
men to be in delivery rooms where they were positioned
at the head of the table and could encourage laboring
women in their work. The men were happy to be there. With
women’s encouragement, men continued to press for change
in hospital policies and practices. Even so, some fathers
felt out of place in a delivery room which remained medical
territory. In the 1970s and 1980s, bowing to couples’—albeit
consumers’--wishes, hospitals opened birthing rooms and
combined labor rooms with delivery rooms; all were decorated
more like home bedrooms rather than operating rooms.
Medical care consumers need
to fight against hospital policies that discourage and/or forbid
a family member or another person patient chooses from being
present during surgeries. Choosing to have a personal advocate
present during surgery should be the right of every patient
entering the OR and for any other surgeries.
For example: a C-Section is
major surgery; to be present, husbands are asked to put on scrubs
and shoe coverings for their wife’s procedure. These same
requirements could be followed for other surgeries and procedures.
How to Respond to Arguments
By Medical Professionals:
1.) Will my family be
allowed in the Operating Room? (One hospital policy)
No, in order to maintain the highest level of sterility in the
surgical environment this is not allowed.
This is misguided. Overall, we should be more concerned about
medical professionals having germs rather than an outside advocate
who could easily shower with sterile solution and put on scrubs.
Why are janitors, medical students, and sales representatives—who
may be “dirty”—allowed in the operating room?
Many have handled other patients prior to that particular patient.
Sometimes, doctors and nurses will take a break during surgery
and then return. Also, many surgical staff members eat in the
hospital cafeteria throughout the day wearing the same scrubs.
Think about how the cafeteria is full of germs and how these
same surgical personnel could bring germs to the operating room.
Another issue to consider is
that many surgery staff members take bathroom breaks. How
unsterile is a hospital’s restroom? Every time
a person flushes a toilet with an open lid, bacteria spray into
the air from that toilet. Check out this article
about how toilets spread germs. Most toilets in public restrooms
do not have lids. Most nurses are not told that flushing a toilet
can spread germs.
Maintaining a sterile operating
room does not hinge on forbidding a patient to have his or her
advocate present during surgery. Generally, having more people
in the operating room produces more germs.
would caution those who are unsophisticated in an operating
room environment such as a family member as an "advocate"
to be present during the patient's surgery since a vaso-vagal
reaction such as fainting from observing what was going on will
cause them to become a "second patient" needing attention
or provide, by making verbal complaints at the time, perhaps
a disruption to what should be a routine procedure.
(One doctor’s argument)
Our rebuttal: There
are some family members who can handle blood and surgery. Any
patient can find out surgery and operating room information
and then determine who would be a good personal advocate. For
example: if a husband does not handle blood well, it probably
would be best for his wife to have a friend who can better handle
the OR setting be her advocate instead. Or maybe the patient
can hire a male or female nurse from another hospital to be
his or her personal advocate. It is very important to have advocates
present for surgeries to make sure the patient’s wishes
are honored. Surgery patients who are sedated or under
anesthesia cannot speak up and advocate for themselves.
One of the main reasons hospitals
do not want family members to be present for surgeries is because
they do not want them to see any medical mistakes which may
occur. This is provider-centered healthcare rather than patient-centered
healthcare. A patient may be promised that his or her underwear
will not be removed, but once the patient is under anesthesia
the medical personnel could remove the underwear regardless
since the patient cannot speak up. Medical malpractice suits
are very difficult to win because only medical professionals
are present during surgeries. Most medical professionals are
not willing to testify against a negligent medical professional.
A woman from Minnesota required
a hysterectomy, but she did not want to be put under general
anesthesia and she wanted to be 100 percent guaranteed that
she would have an all-female surgery team; also, that her husband
could be present for her surgery. This patient was completely
upset when her first female gynecologist said those wishes could
not be accommodated. She decided to find another gynecologist.
She shared her view with Medical Patient Modesty: My husband
found Medical Patient Modesty after I decided to walk out of
the first doctor’s office and it gave us the positive
motivation to look for the right doctor. My husband
kept researching doctors and found one he was sure was a good
doctor, then called the doctor for me. During our first meeting,
I actually felt comfortable with this doctor. She was so confident,
and answered everything in straight-forward, frank terms. She
guaranteed me an all-female staff. After consulting with hospital
management and anesthesia, they agreed to allow my husband into
the OR. The staff respected my wishes. I was allowed to keep
my gown on. They covered the windows, and no males—other
than my husband—were allowed in. I would never
have gone through with the operation if it were not for finding
this one remarkable doctor who had both compassion and was a
master of the healing arts. She didn`t put me through unnecessary
The above case’s scenario—explaining
how a female patient was allowed to have her husband present
for her hysterectomy—shows that we as medical
care consumers can fight to have our chosen personal advocate
protect us during surgery. Surgery is a big moneymaker
for hospitals. These facilities will give in to demands if patients
stick together and demand these choices. For those people who
are passionate about having a personal advocate present for
surgery, consider starting a petition at your hospital which
allows each patient to have his/her choice of an advocate present
during surgeries. Please use this sample
petition and modify it.
Medical Patient Modesty would
love to hear from people who have successfully championed to
have personal advocates present for their surgeries; similar
to the hysterectomy patient from Minnesota. Please
Underwear Removal For Surgeries
Did Men End Up in the Delivery Room?
and Your Modesty