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,
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
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
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
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
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.