Why Patient Dignity Is Not a Concern

What is patient dignity?  According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377527/ on nursing ethics and ethical issues in caring, it is a basic human right for all and fundamental to the well-being of every individual in all societies.  This article states that “dignity is fundamental to the well-being of every individual in all societies.  It is a basic human right for all….The concept of dignity has four defining attributes including respect, autonomy, empowerment, and communication.”  This article cites an analysis done by Griffin and Vanessa that “each of the four attributes consists of several dimensions:  Respect includes self-respect, respect for others, respect for peoples’ privacy, confidentiality and self-belief and belief in others.  Autonomy includes having choice, giving choice, making decisions, being able to make decisions, competence, rights, needs, and independence.  Empowerment includes a feeling of being important and valuable, self-esteem, self-worth, modesty, and pride.  Communication might be verbal or nonverbal and also includes explaining and understanding information, feeling comfort and giving time to the audience.   What is patient dignity?  According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377527/ on nursing ethics and ethical issues in caring, it is a basic human right for all and fundamental to the well-being of every individual in all societies.  This article states that “dignity is fundamental to the well-being of every individual in all societies.  It is a basic human right for all….The concept of dignity has four defining attributes including respect, autonomy, empowerment, and communication.”  This article cites an analysis done by Griffin and Vanessa that “each of the four attributes consists of several dimensions:  Respect includes self-respect, respect for others, respect for peoples’ privacy, confidentiality and self-belief and belief in others.  Autonomy includes having choice, giving choice, making decisions, being able to make decisions, competence, rights, needs, and independence.  Empowerment includes a feeling of being important and valuable, self-esteem, self-worth, modesty, and pride.  Communication might be verbal or nonverbal and also includes explaining and understanding information, feeling comfort and giving time to the audience.  

 At http://siasat.behdasht.gov.ir/index.aspx?siteid=291&pageid=34985, the Ministry of Health and Medical Education- Patient’s rights 2002 goes on to say that, “Observing dignity and privacy is essential for establishing an effective relationship between the healthcare professionals and patients. It also is critical for maintaining patient’s serenity. In contrast, many harmful consequences would ensue if the patients’ dignity is not observed….”  7. Nayeri ND, Aghajani M. Patients’ privacy and satisfaction in the emergency department: a descriptive analytical study. Nurse Ethics went on to say that “Failure to comply the patients’ privacy (as a measure of dignity) may not only make the patients to conceal some aspects of their medical history, or refuse medical examination, but also would increase their level of anxiety and stress…”

The above would also apply to anyone involved in patient care whether they are a doctor, nurse, tech, emt, etc.

Most hospitals have a Patient Bill of Rights that guarantee without any exclusions to having to personal privacy, to exercise your rights while receiving care or treatment without coercion, to participate in the development and implementation of your plan of care, to be free from all forms of abuse or harassment, to expect visitation privileges not be restricted, limited, or otherwise denied…., to expect all visitors will enjoy full and equal visitation privileges…, to be free from physical or mental abuse…., and to expect that restraint or seclusion may only be imposed to ensure immediate physical safety of the patient….This is part of the Patient Bill of Rights from a Patient & Visitor Information Book of Franciscan Health Indianapolis and Mooresville.  There are also federal guidelines that mandate Patient Bill of Rights. ��

According to a Gallup poll (news.gallup.com) in 2018 covering professional honesty and ethics, nursing again was number one.  Nurses rate higher than doctors, military, and clergy.  Why is this?  Could it be the public is not really aware of everything nurses may do or could it be the public is turning a blind eye?  After a recent hospitalization where some of the nursing staff were absolutely sexually abusive and violated most above noted items in the Patient Bill of Rights, I decided that information needs to be made public.

According to According to www.beckershospitalreview.com, more than 90% of nurses are female.   That means that if you are a male patient, most likely you will encounter a female nurse for intimate care.  If you are a male that wants only same gender care which you are entitled to have, it will probably not happen.  If you are a female patient, chances are your intimate care will be performed by a female nurse.  It is practically unheard of for a male nurse to provide intimate care for a female patient, especially if he is alone with her or if she is drugged.  For male patients, it is very common for this situation to happen.

Doctors only see patients for a fraction of the time that a nurse may spend with patient care duties.  During procedures, it is generally the nurse and/or techs that prep patients.  It is unheard of for a drugged female to be left alone with 4 male nurses/techs while prepping her exposed genital area.  However, it is standard practice for female nurses/techs to prep the genital area of a drugged male patient.  Are female nurses more trustworthy than male nurses/techs?  Do female nurses not exhibit any sexual feelings/desires  while all male nurses are viewed as being untrustworthy because they cannot separate their own sexual desires when left alone with an exposed, drugged female?  It is said that medical people view all genitals as just being another body part but is that really true?  There are plenty of cases in the newspapers and on the Internet saying otherwise.  Why is there greater care given to guarding the personal dignity of a female patient in general than that of a male?  What are some of the issues that may constitute sexual abuse?

The biggest area that constitutes sexual abuse is the unnecessary exposure of the genital region.  This may be done by a nurse/tech while prepping a patient for a procedure.  This may be done in an emergency room when they strip off the clothes of a patient while not covering them first with a gown, blanket, and/or drawing a curtain.  This may be done by a nurse in a patient room while performing an intimate task for a patient or examining an area close to the genital region.  Many nurses feel pushed for time so taking the extra second to provide patient dignity as they swore to in their nursing oath is not a priority for them.  However, for many patients they feel dehumanized by this type of action.  Although this dehumanization of a patient may not always be done as intentional act of harm, sometimes it is.  In any case, it is harmful to the mental well-being of the patient.

In a cardiac catheterization lab setting, many of the pieces of fluff literature says patient personal dignity is maintained at all times.  But what happens when it isn’t?  Most cath labs give a misleading cocktail of sedatives describing them as having the patient awake during the procedure.  The cocktail usually given is a combination of versed and fentanyl.  Versed is a drug that is supposedly used for anti-anxiety purposes but its real purpose in a medical procedure is it causes amnesia.  That is its main benefit to the medical people.  Fentanyl is painkiller which is 100 times stronger than morphine.  Most patients will be in a light sleep pattern and will be arouseable by verbal or touch stimulation.  Versed also makes patients less inhibited while fentanyl makes them generally more compliant or submissive. 

What this cocktail in fact does is gives the prep team the ability to perform the prep in a manner in which they choose.  Some may choose to maintain patient dignity while others may strip a patient’s clothes off of them and leave them exposed without a gown or blanket for the entire time up to draping.  Leaving a patient exposed makes their prep work easier.  However, there is generally no reason for the lower genital region to be exposed as they can use a medical garment called Covr which will cover the genital region while allowing them to do the femoral prep.  For females, to cover the nipple area , falsies could be used.  The female patient could apply those herself.  However, it is the sad fact that medical people on a whole do not care about the dignity of their patients.  This is why such sexually abusive behavior as the exposure of patients is allowed to continue.  They only care if it were them or their loved one.

As we age, the side effects of the drugs may become more pronounced and lingering.  It may take many hours, days, or sometimes not all the effects go away.  Patients being transferred from the cath lab to the Cardiac CCU may still not be able to defend themselves against sexual abuse.  Surgery patients also may not be able to defend themselves from sexual abuse.  Nurses in these areas know and can recognize the signs of altered levels of response from patients.  Some will take advantage of this. 

Many times during transfer, patients are exposed unnecessarily as keeping the patient’s dignity intact is not a priority.  Oftentimes, a gown may just be thrown on them from the procedure area.  This gown may fall off during the transfer from the gurney to the bed.  Not only is the patient exposed to those in the room but many times to people in the hallway.  If a patient needs a gown and bed linen change, this is usually done without regard to patient dignity.  In the cardiac ccu if the patient needs to remain flat, they will strip off the gown and blankets.  They will wash the patient and change the bedding all the while the patient will remain naked and uncovered while the nurse is turning the naked patient from side to side to change the bedding.  Eventually, she will re-gown the patient and cover the patient with a blanket.  However, the patient will most likely be exposed unnecessarily as the nurse does not care about the patient’s dignity.  The patient is exposed to everyone coming into the room and to people in the hallway. 

Patients may be exposed to registration clerks, phlebotomists, clergy, social workers, housekeeping, etc.  There is an attitude by medical staff that patient dignity is not a concern especially if the patient is drugged.  If a patient is drugged, the nurse figures they will not remember how they are treated.  Since many are drugged during the time when the exposure occurs, this may be why nursing is the most trusted profession.  There is a different attitude towards patients who are able to defend themselves against this type of abuse.  Nurses in units not dealing with patients who have been given mind altering medications tend to be more mindful about personal dignity issues. 

For those patients who have suffered sexual abuse at the hands of medical staff, the memory never fades and the trust is forever broken.  Post Traumatic Stress Disorder (PTSD) is a common side effect from such abuse.  PTSD occurs more in patients who have been in a critical care unit.  Although the abuse that drug patients can remember is bad, it is often the abuse they do not remember as they were drugged that is really frightening.  There is always the thought of this is only what I remember so what else did they do to me that I don’t remember?  The exposure, the comments, the photos on a Smartphone, the being put on display to show others, who saw me, why did they do this to me—these are all questions a sexually abused patient will forever have on their mind.  A sexually abused will never trust any medical provider again as they now question their own ability of judgment as they never expected to be abused by the very people who were supposed to care and protect them when they were ill and vulnerable.  It may cause them to no longer seek medical care or hospitalization especially if a loss of control is involved.  It is beyond sad and sick when medical people abuse those who need care and are in an extremely vulnerable state.

Every patient needs an advocate to look out for them.  This advocate should not be an employee of a hospital as they are only going to protect the hospital.  An advocate is especially needed if there are drugs like versed, fentanyl, or any other drugs that alter mental capability involved.  Don’t allow yourself or your loved ones to become a victim of a personal dignity crime.  Take it from me, the pit in your throat and stomach along with the pressure lying on your chest never goes away.  The suffering for letting the abuse happen to them and seeing what damage it does to them forevermore will never go away or get any better.  The months since the medical and sexual assault have only grown worse for him.  He spends more and more sleepless nights thinking about what they did and what abuse might come if he would be hospitalized again.  Is this the kind of result modern medicine is so proud of?

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