Update: Check out this interesting discussion at EMS1.com
When I first began my medical career, I would get nervous around exposed patients. I was young, full of testosterone, and very curious about the opposite gender. It made me all hot and bothered, but other care providers would tell me that it wasn’t an issue for them. ”We’re all professionals,” they’d say. “It’s really not an issue.” So, why was I so bothered? Was I not a “professional?”
Maybe I was just a loser? Maybe I was a pervert? Maybe I was just weird?
I remember taking a 21-year-old unconscious female to the local trauma center. She was attractive, and just a year or two younger than me. As I gave my report to the receiving staff, they stripped this young woman down to her underwear. I got distracted by the polka-dots. But when I looked up, one of the nurses was glaring at me. Oops, the patient wasn’t the only one exposed.
Over the course of my career, and my own maturation, I learned to be more professional and more considerate of my patients’ privacy. I now realize that our patients are often in a very vulnerable position, and it is our responsibility to protect them during the time they are with us. Sometimes learning to be professional comes with time, and experience.
So, now that I’m older and wiser, what do I do with partners who haven’t yet learned this lesson – or matured as professionals?
A few months ago we responded to the home of a 40-year-old female who was complaining of chest pain. She met us at the door and appeared in no acute distress. However, upon questioning, she described new onset cardiac chest pain. It was appropriate to do a full cardiac workup on this young woman, but I was surprised when my partner asked her to fully unbutton her blouse. I didn’t know what to say, or how to respond – so I moved up front and drove the ambulance to the hospital.
Just the other day we treated a very attractive 40+ year-old woman who had experienced several syncopal episodes in the last 12 hours. Although there was no evidence of seizure activity, her family described a period of confusion after the event. Clearly, something was going on in this woman’s brain.
In both of these cases I was left irritated and confused…
During the relatively short transport, I watched my partner, in the rear-view mirror, prepare to do a 12-lead on this woman. I was, again, caught speechless. First, there was no indication that a 12-lead was necessary; second, there was barely enough time to give a radio report to the hospital, let alone further diagnostic tests; third, it is difficult to do an effective 12-lead in a moving ambulance; and finally, this patient’s care and treatment would not be affected by the results of this EKG.
In both of these cases I was left irritated and confused. I didn’t like what I observed and it seemed as if my partners were taking advantage of their position. It wasn’t professional, it was an invasion of privacy, and it could very well expose the company to unnecessary liabilities. Not to mention, it is degrading all of us when one of our own acts irresponsibly.
What would you do in this situation? Do you think it was appropriate for these men to expose these women in this manner? Could you justify a 12-lead? Is it possible to do a 12-lead without exposing a woman’s breasts? Is it possible to perform a 12-lead while protecting their modesty? Is modesty an issue?
After thinking about this for a while, and talking it over with a couple of trusted colleagues, I’ve decided on a plan of action for next time.
- In the first scenario, if my partner asked a woman to fully unbutton her blouse, here’s what I’d do next time. I don’t want to embarrass my partner in front of the patient, so I’d ask her to wait while I get a sheet. Then, after covering her with the sheet, I’d give her permission to continue. Afterwards, I’ll talk to my partner about the situation.
- In the second scenario, I’d ask my partner to poke his head through the crawl through passage. I’d ask him, in a non-judgmental tone, why he thinks a 12-lead is necessary. Then I’d probably ask him to refrain – and I’d definitely talk to him later.
What do you think? How would you handle these situations? How have you handled them before?