I don’t know where it comes from, but most doctors seem to have lost the concept of patient privacy. Doctors are quick to walk in on patients using the bathroom, despite being told by the nursing staff that the patient is unclothed. Or, they will do an assessment on a patient (including pulling their gown up to their head) without closing the curtain first – and our doors are big glass walls.
We had an extreme example of this happen to us awhile back. We received a patient who went emergently to the cath lab with an acute MI (heart attack). He came to us in the ICU with his femoral sheaths still in place and was unable to urinate while laying flat in the bed. So, the nurse was in the room getting ready to place a foley catheter in his bladder which left the patient without any covering over his lower half as she was prepping his with iodine to sterilize and prevent infection. Little did the nurse know, the patient’s physician was in the next room speaking to another patient’s family members about the Steelers (which happened to be both of their favorite football team). The physician then decided to take these family members to meet his patient next door, who was also a Steelers fan. The physician pulled the curtain wide open, exposing the half naked patient and without a second thought started talking about football. The nurse, who had sterile gloves on, started saying something along the lines of “You need to get out. We’re in the middle of a procedure” and the physician kept talking over her. She then took off her gloves and pulled the curtain closed again in front of his face and the physician started screaming for the charge nurse because of the nurse’s “attitude”.
If I were that nurse, I think I would have had a hard time keeping my cool in front of the vulnerable patient, the idiot physician, and the family members who got pulled into this awkward situation. And, even after speaking to the charge nurse and the nurse involved, the physician still insisted that he did nothing wrong and the nurse needed an “attitude adjustment”.
Whew.
I find that physicians often don’t respect toileting needs of the patient especially. They come in to discuss procedures (which will eventually require the pt to sign a consent form) while the patient is positioned with the urinal in bed, or is on a commode, or a bedpan. I’ve also had physicians walk in while I was washing a patient and start discussing their care. While I understand that the physician will be seeing the patient’s body anyways, it doesn’t put the pt in a place where they can feel somewhat dignified in the hospital environment, and it definitely doesn’t help them to think about what’s being discussed with a clear mind since they’re busy being embarrassed about their toileting needs or the fact that they’re unnecessarily exposed.
Whatever happened to “knocking”. There was a recent article I read somewhere (sorry, do not remember) but one of the points that sticks out clearly in my mind was the patients loss of dignity while in the ICU; for that matter, in the hospital I believe.
One of the things it said to help preserve the patients privacy and dignity was as simple as knocking prior to entering. That applies to nurses, docs and ancillary staff as well. It is SUCH a small thing, takes no extra time and helps the patient feel like he/she still has some control while in the hospital. I know; some people knock, are told “just a minute please” and STILL come in anyways. You can lead a horse to water, but you can’t make it drink.