Hospitals Being More Sensitive to Patient Modesty

Patient modesty should be a high priority at every hospital. Oftentimes, medical professionals are busy focusing on the actual procedure and protecting a patient’s dignity and modesty gets sidelined, especially in the ER and other busy departments. It is important to keep in mind many patients feel more comfortable with same sex medical professionals for intimate procedures.

So often, patients are more anxious about their modesty for medical/surgical procedures than the actual procedure itself; therefore, many patients have avoided procedures. Most patients welcome medical professionals of either sex for procedures and exams which do not expose their private parts. Intimate procedures are another story. Many patients prefer same sex intimate medical care such as assisted bathing, insertion of urinary catheters, and assisted dressing. For example, many women prefer a female nurse for intimate care. Many men are more comfortable with male nurses for intimate care.

Your hospital should strive for patient modesty to be taken very seriously. If patients have a positive experience at your hospital, they will likely return and recommend your facility. Some patients who have had traumatic experiences with patient respect, dignity, and modesty at certain hospitals will never return. For example, one man had a damaging experience at a hospital where female nurses made fun of him because he requested a male nurse for intimate procedures has decided he will not return to that specific hospital.

Modern medicine is gender neutral. This means providers, nurses and assistants are equally capable to offer care to all patients, despite gender.

While it may be true that the mechanics of medical care can be provided by either sex to patients of either sex, there are two important issues hospital administration should consider if “patient centered care” is truly a priority.

1.) Many patients have gender preferences particularly for intimate care.

2.) The potential for abuse during intimate care is great particularly when patients are compromised by medication, anesthesia, or by their physical condition.

Many patients and family members are totally unaware that gender-neutral intimate care has become the norm at various facilities. They find this out, oftentimes too late, when they or a loved one is hospitalized or admitted to a nursing home. Some examples include: male nurses in Labor & Delivery departments and male nurses / nursing assistants doing intimate care on women such as bathing, changing gowns, inserting urinary catheters, and vaginal prep for surgeries. There is no valid or specific medical reason for gender-neutral care.

It is difficult for a patient or his/her family to object to this gender-neutral care especially if the patient is in critical condition. Here is an example: One husband in New York was hesitant to speak up when male nurses and techs helped to dress and bathe his wife who had Endocarditis, a life-threatening heart valve infection that almost killed her. A male nurse washed his wife’s genitals because she had a horrible yeast infection due to the antibiotics she was receiving. The husband was completely focused on his wife’s survival. Her surgeon had said it would be a week before they would know if she would pull through. It’s sad that patients on the verge of possible death are randomly and routinely subjected to gender-neutral intimate care abuse and as well as modesty violations. Many women and their husbands assume that a female patient will always have a female nurse or nursing assistant help with dressing or bathing. This was the case decades ago but, things have drastically changed with today’s “modern medicine” becoming increasingly gender neutral.

Over the past decade there has been a big increase in male medical professionals - especially nurses and nursing assistants - sexually assaulting women because they perform intimate care on female patients. Check out www.sexualmisconductbydoctors.com to see a list of male medical professionals who have sexually abused women according to news sources.

Ironically, many women’s prisons in a number of states have policies that prohibit male security guards from stripping female inmates—even if they are suspected of hiding drugs—or watch them showering.

Hospitals and nursing homes need to address these concerns as well and enact similar policies by prohibiting male nurses and nursing assistants from doing intimate procedures on female patients to protect their dignity and safety.

Departments such as cardiac units, ICU, general surgery, orthopedic surgery, and psychiatry at in hospitals and nursing homes that serve both female and male patients should hire nurses of each sex. Accommodating the wishes of patients with same sex medical care should be a hospital’s priority—and same sex medical care should be the default where the wishes of the patient are unknown. For intimate procedures, many nursing departments and even nursing homes assign nurses to patients without considering the sex of the patient and without the patient’s or family’s consent.

Another problem with the gender-neutral approach in medical facilities, which has caused a problem with male patients who are more comfortable and less embarrassed with male personnel for intimate care, is assigning a male aide / nurse to female patients for intimate care. This limits male personnel’s availability to assist male patients.

In the 1970s and before the ‘gender-neutral’ era, men had intimate procedures such as urinary catheterizations done by male doctors or orderlies in hospital. The gender neutrality of the medical industry changed this and it is pretty common for female nurses and CNAs to do intimate procedures on male patients today.

Numerous male patients have been violated by female nurses who ignored their wishes for modesty. Cases attest to female nurses who have made derogatory comments about genitals of male patients, especially those under anesthesia.

Male patients should always have the option of an all-male medical team for intimate procedures. Medical facilities should give all male patients forms asking about their gender preferences for intimate medical care.

Interestingly, a number of male nurses refuse to work in Labor & Delivery, even if it is allowed, and are uncomfortable performing intimate procedures on female patients. Regardless, they are pressured into these duties by female nursing supervisors who do not seem to be sensitive to patient modesty.

Some facilities do not have enough male nurses and ultrasound technicians. This poses a problem for male patients who care about their modesty. Also, male nurses are usually best suited to lift patients.

*All hospital administrators and medical professionals are encouraged to watch the videos, Problems with Medicine Being Gender Neutral and Surgery and Your Modesty.

We encourage all hospitals to work on being more sensitive to patients. Below are some tips to use as a guide.

Tips For Hospitals

1.) Encourage all medical professionals to be more sensitive to patient modesty. They should never coerce a patient to accept opposite sex medical professionals for intimate procedures. Arguments such as “They are professionals,” “They’ve seen it all,” and “They are very skilled and have done this procedure many times,” should not be used.

2.) Hospitals should hire sufficient male nurses/assistants and male ultrasound technicians for all shifts in order to provide male personnel for intimate procedures. Also hire enough male scrubs for male surgery patients and male ultrasound technicians for scrotal ultrasounds. Always schedule male nurses and scrubs for male surgery patients. Many men are uncomfortable with having female nurses or scrubs see their private parts. Modesty is important to many men. Check out the male modesty web page.

3.) We strongly recommend all hospitals have enough female ob/gyns present for the birth of a child when women and their husbands request an all-female ob/gyn team. Hospitals should have at lreast one female ob/gyn on call at all times for female patients to be guaranteed a female ob/gyn for emergency or childbirth. Allow only female nurses to work in the Labor & Delivery department. There are many other departments to utilize male nurses.

4.) Your hospital should make a policy prohibiting male nurses and assistants from performing intimate procedures on female patients to prevent potential sexual abuse. Utilize the male nurses for intimate procedures on male patients as much as possible and use them for non-intimate procedures on female patients.

5.) Discourage all medical professionals from routinely performing intimate procedures, such as urinary catheterizations, on patients because it is more convenient. For example, a urinary catheter should never be used for incontinence. Adult diapers or Depends should be used instead. A bladder scanner should be used to measure urine output rather than a urinary catheter.

6.) Be sensitive to patients who enter the Emergency Room and do not wish to have certain examinations. For example, if a woman suspects she may be having appendicitis and she doesn't consent to a pelvic exam or rectal exam, utilize a CT scan instead.

7.) Encourage all medical professionals to knock on an exam door that is closed because an intimate procedure may be in progress. All medical professionals should be informed before entering in a room.

8.) Always allow the patient a choice of who she/he wants present for her/his intimate exams. Some patients, especially male patients, do not want any chaperones (ex: female nurse) to be present.

9.) Encourage all medical professionals to ask for permission before they touch certain areas of any patient’s body. They should explain in precise details what they will be doing, especially if the procedure involves private parts. A patient’s wishes should always be respected if he/she says “No” to something.

10.) Let the patient wear street clothes as much as possible. Many procedures and tests, including blood tests, blood pressure tests, stethoscope heart exam, eye, ear, nose, and throat examinations, as well as throat cultures can be done fully clothed.

Check out the articles about patients wearing their own clothes: Hidden Beneath the Hospital Gown and Keep Your Pants, and Your Dignity, at the Hospital.

11.) Encourage medical professionals especially nurses and nursing assistants to not dress or undress a patient especially when they want to do it themselves. Medical professionals should be patient with them no matter how long it may take them.

12.) Always strive to give patients maximum dignity and respect. They should never be unnecessarily exposed. For many surgical procedures that do not involve the genitals, hip, and groin, patients can wear 100% cotton underwear or disposable underwear/shorts as long as they do not contain metals. Check out Unnecessary Underwear Removal for Surgeries. If your hospital still has the “no underwear for surgeries” policy, abandon that policy. Utilize special garments such as Covr Medical Garments for procedures that require access to the groin, hip, and part of the back (ex: kidney procedure) and the Modesty Bra for women. All hospitals should have Covr Medical Garments, the Modesty Bra, and colonoscopy shorts available. If a rectal exam or colonoscopy is required, give the patient the option of wearing boxer shorts backwards or specialized colonoscopy shorts that only expose the buttocks. For patients who require assistance with bathing, the ‘Honor Guards’ from Dignity Resource Council are recommended for effective modesty.

13.) If your hospital cannot accommodate a patient’s wishes for a same gender team, suggest other facilities or schedule that procedure when a same gender medical team can be accommodated.

14.) During general anesthesia patients continue to expect dignified care. For patients who require surgery that involves exposure of their private parts commit to helping them get a same-sex surgical team if that is their preference. Be open to using local or regional anesthesia if that is the preference of the patient. This allows the patient to remain awake and alert during a procedure and gives many patients peace of mind. Also, patients should have the option of having a personal advocate such as their spouse present for surgeries and procedures. Check out this article, Why You Should Have a Personal Advocate?

15.) Treat compromised patients and those who suffer with dementia and Alzheimer’s with the same dignity as any patient. One female car accident patient was expressly traumatized to witness a male nurse removing her tampon while she was semi-conscious.

16.) Enact a policy to prohibit non-consensual genital, rectal, and pelvic exams from being done on patients under anesthesia without their consent.