Let me tell you about one of my pet peeves. And it isn't drug seekers, migraineurs or fibromyalgeurs, it is patient privacy or the lack there-of.
I'm in a room with a patient with a vag bleed. The door is closed. The GYN cart is parked right outside. What would you imagine might be going on in there? Probably a pelvic right? So who in world would think it is OK to just barge right in through the closed door without knocking first? You would be surprised. That is why I always pull the curtain around the bed also, even though the doc's complain.
We're in the room with a code. The patient is naked and fully exposed as it is hard to do CPR through a blanket. Every person that enters the room or leaves pulls the curtain back and leaves it open. Lab, nurses, registration, residents, techs, Xray. There are a lot of them. Every time I reach out and pull it closed again. Each time with a little more irritation. If that was your mother laying there would you want her displayed naked for every looky-loo in the ER to view?
I have an elderly lady with a hemorrhagic stroke, she is pretty obtunded but I always assume the patient hears and might know what is going on. A resident enters the room, flips back the sheet and gown leaving her fully exposed and listens to her heart. He never speaks to her or tells her who he is and why he is there and then leaves the room leaving her gown up and breasts exposed! I flip out completely. Is that how you want to be treated if it was you laying in that bed?
For God's sake people, take a minute and do the right thing, pull the curtain, speak to the unconscious patient, keep people covered. Some day it might be you or your mother.
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- ERnursey
- A hardworking ER nurse trying to survive until retirement and if I can have little fun or have a positive impact on someone's life, all the better!
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13 comments:
Thank you "ER" for thinking about patients in this way.
I'm sure it's hard for some med professionals to grasp; they see 100 naked bodies every day. It's routine for them. On the other hand, it's not routine for me to be naked in front of anyone but myself, Hubby and God in any given day (ok, the dog does tend to be a voyeur, as well). I understand I'm in an ER and certain people are going to see certain parts of me that maybe aren't my best feature. If it's a doc or nurse seeing those things, I can deal with it. I don't need Peeper McNosey looking in and seeing all my naughty bits.
My favorite, by far....going to the ER with chronic back pain (I swear, I only go in for it when I can no longer get upright and can't get in to my pain manamgement doc until after the next full moon). The nurse hands me a gown with the same approximate dimensions as a dinner napkin and asks me to get changed. The doc comes in 18 seconds later and opens the door while knocking on it. I'm half bent over, fighting with a pair of uncooperative underwear that are hard enough to get on and off when I can't bend much less when I"m ass towards the door and someone walks in saying "HI, I'm doctor so-and-so". I can only imagine what an inviting picture that must be for Doctor So-And-So.
Anyway, the point of my long rant is, thank you for thinking of your patients dignity at the same time you attend to their health crisis.
I am right there with you. I think that it removes us from the humanity of what is going on so that patients are thought of not family members but as objects, the tools of our trade. A nurse or doc has to willfully rise above this to do the right thing and find a place to set aside the pain behind what is really going on in a code. Keep a-closing that curtain!
We often forget the need for privacy in PICU. With most of our patients being babies who get diaper changes in public routinely, some nurses forget to pull the curtain for the 12, 13 year olds who then need the same. If we can't teach dignity by example to the docs and specialists, our patients will bear the brunt of the exposure!
This is a great rant. Patients already feel powerless and frightened. This kind of objectification only emphasizes their helplessness.
I recently met my new PCP for the first time for my annual exam. She didn't ask me to undress until she needed to examine me. She's a keeper.
Privacy is meaningless in a critical situation.
Twice this week I've been in a code where the patient wasn't on the monitor because the nurse didn't want to expose the pt's breasts.
I really don't think that's appropriate. Dead people need to be naked until they are stabulized or pronounced dead.
If this offends the patient or their family so much, they need to be DNR.
I've spent a lot of days in hospital - on both sides of the bed. Trust me, there is no dignity when you're bleeding out of your ass. But a few days after the surgerons fix the ulcer, you sure are glad they exposed your wound to the world.
Funny thing is - I work at that hospital (many great docs, even more great nurses) and no one really cares that they saw my naked ass (least of all, me).
But I'm very happy they ignored my privacy and rescusitated me so I could come back to work!
I partially dissent on the naked-during-a-code business. ABSOLUTELY, everything needed should be exposed to work. But nothing prevents us from covering some parts back up a little later. I've noticed in our ER, at least at night (when I work) there is a culture of respect during codes. Once all the first interventions are done and some of the people attending are a little free, someone will inevitably cover the patient's lower body back up if medically appropriate. A patient's breasts may be lightly covered with a gown laid over, if it doesn't interfere. It is simply a result that so many on our staff - techs, nurses, docs - care about the patient as a human being. That is a culture to be cultivated in the institution, and passed on to every new person who hires on. I was pleasantly impressed the first time I saw it in a code in our ER, and didn't forget it.
Amen ER Nursey. You can be my nurse any day!
Dear ER nursey good on you... nursing 101 and it's a simple thing called CARING .
You go girl!
Anonymous: I do not think that ERNursey was saying that the patient should not be undressed during a code (or any other situation in which undressing them is necessary. I think she said that she wanted the curtain pulled to conceal the patient from other atients, family, and personnel not caring for the patient. This is a good idea, not only for the patient, but also for other patients and family members passing by. We for get that, to lay people, what we do during a code is terrifying. They don't need to see us doing that stuff, and then have us walk into their bay to take care of them. Routine to us. Very scary to them.
Sid Schwab: No more and no less a human being than my patients
natural empathy
http://www.kevinmd.com/blog/2008/06/sid-schwab-no-more-and-no-less-human.html#comments
On my Blog (spanish blog)Empatia
http://salud-informacion-hoy.blogspot.com/2008/06/empata.html
amen ERNursey!
Countryrat - exactly. I realize we need to expose people to take care of them in a crisis but that does not extend to leaving the privacy curtain open so that everyone in the ER can look on. Wouldn't that be a wonderful sight for the five year old with the earache right down the hall?
Thank you, thank you!
We were just talking about this yesterday. By chance, we had a seminar group on our unit and one day, some of them were assigned to nurses. I suddenly had one assigned to me and she wanted to see my new admit.
I never, never, never bring someone in with my patients without telling them what's going on and asking if it's okay. Some of my collegue's may think I'm crazy, but I always talk to my patients if I think there's any chance they can hear.
If they say no, which is rare, I respect that.
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