Being More Sensitive to Patient Modesty
Patient modesty needs to be a
high priority during all medical procedures. Nurses are often
so busy focusing on the actual procedure protecting a patient’s
dignity and modesty gets sidelined, especially in the ER and
other busy departments. It is important to keep in mind that
many patients are more comfortable with same sex medical
professionals for intimate procedures.
Oftentimes, 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.
Modern medicine is gender neutral
which means providers, nurses and assistants are equally able
to offer their services to all patients no matter the sex of
the patient involved.
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, nursing homes, and medical professionals should
consider if “patient centered care” is truly a priority.
1.) Many patients have
sex 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 many 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
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’s an example:
one husband in New York did not feel he could speak up at first
when some 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 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
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
There is another problem with
the gender-neutral approach in medical facilities that has caused
a problem with male patients who are more comfortable and less
embarrassed with male personnel for intimate care. When a facility
assigns a male aide / nurse to some female patients for intimate
care, it limits their availability for helping 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
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 the 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 department even
if it is allowed or are uncomfortable with doing intimate procedures
on female patients, but they are pressured by their female nursing
supervisors who do not seem to be sensitive to patient modesty.
Some facilities do not have enough male nurses and this poses
a problem for male patients who care about their modesty. Also,
male nurses are usually best suited to lift patients.
*All nurses are encouraged to
watch the videos, Problems
with Medicine Being Gender Neutral and Surgery
and Your Modesty.
Here are some examples of nurses being sensitive to
1.) A female head nurse helped to honor a man’s
wishes for an all-male team for colonoscopy and colonoscopy
shorts by scheduling a male technician and ordering colonoscopy
shorts before his procedure.
2.) A female nurse went to find a male nurse
to do a urinary catheter on a man who was more comfortable with
a male nurse.
We encourage all nurses to work on being more sensitive to patients.
Below are some tips to use as a guide.
1.) Never try
to convince a patient to accept opposite sex medical professionals
for intimate procedures. Don’t use arguments such as “they
are professionals”, “they’ve seen it all”,
and “they are very skilled and have done this procedure
2.) If any colleagues make derogatory comments
about patient’s private parts, report them to the administration.
Do not tolerate this behavior.
3.) Put a ‘Do Not Disturb’ sign
on the exam door so other medical personnel do not randomly
enter during intimate exams.
4.) Never walk in a room that is closed because
the doctor may be doing an intimate procedure. Be sure you ask
the doctor what he/she is doing before entering in a room.
5.) Let the patient have the choice of who
she/he wants to be present for her/his intimate exams. Ask the
patient. Some patients, especially male patients, do not want
any chaperones (ex: female nurse) to be present. If you have
to be present for an intimate exam with a doctor, you should
consider standing at the patient’s head so you can avoid
seeing the patient’s private parts.
5.) Ask for permission before you touch certain
areas of any patient’s body. Explain in precise details
what you will be doing, especially if the procedure involves
private parts. Always respect a patient’s wishes if he/she
says “No” to something.
6.) Let the patient
wear their 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:
Beneath the Hospital Gown and Keep
Your Pants, and Your Dignity, at the Hospital.
try to dress or undress a patient especially when they want
to do it themselves. Be patient with them no matter how long
it may take them.
8.) Always strive
to give patients maximum dignity and respect. Do not unnecessarily
expose them. For many surgical procedures that do not involve
the genitals, hips, 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. 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. 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 their buttocks.
If a patient requires assistance with bathing, look at getting
the honor guard garment from Dignity
9.) Never push
a patient to accept nursing or medical students against their
10.) If you cannot accommodate a patient’s
wishes for a same sex team, suggest other facilities or schedule
that procedure when a same sex medical team can be accommodated.
11.) Educate your nursing staff to be sensitive
to patient modesty and privacy. For example, a man may not want
to discuss his health issue with a female nurse.
12.) 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?
13.) Treat compromised patients and those who
suffer with dementia and Alzheimer’s with dignity and
respect for their privacy. Always assume that a patient wants
to be treated by a medical team of the same sex if the patient
is unable to communicate her/his preference. One female car
accident patient was traumatized when she witnessed a male nurse
removing her tampon while she was semi-conscious.
14.) Never routinely perform 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. Check out Unnecessary
Urinary Catheterizations and Lack of Informed Consent.
15.) Encourage your facility to make a policy
prohibiting male nurses and assistants from doing 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