Re: TV scan male or female sonographer
From: Allen Worrall (jworrall@alaska.net)
Fri Jan 27 11:23:50 2006
Hi Sharon S.
I am an elderly male ob/gyn doctor who turned to ob/gyn sonography when I no longer wanted to actively practice ob/gyn. I practice in Fairbanks, Alaska.
My experience may not be helpful because I am 81 years old and a physician. It is extremely rare for an adult American female to refuse a transvaginal exam in my practice. Common amongst teenagers. Recently a pregnant Muslim physician did not want to be scanned by me TA or TV. I think it very likely that Muslim women would not want to have a male for any type of exam.
It is likely that Asian women who have not grown up in the US would be more likely to refuse a male sonnographer than American women.
It is primarily a cultural thing, and in the US, it is up to the patient. Here in the US no patient would be scanned transvaginally against her will. If the patient agrees to a transvaginal ultrasound in any culture, it is hard for me to believe that it is going to have an adverse psychological affect on the patient.
Level of cooperation is a little different. Occasionaly an adult patient will willingly submit to the transvaginal exam, but then is so "squirrley", jumping around, complaining of pain (when there is no reason to think that she should be that tender), generally carrying on and complaining, that I have to wonder if her husband goes through the same thing when they have intercourse. But this is quite rare in my experience.
Allen
> ----- Original Message -----
From: DuBose, Terry
To: Multiple recipients of list ULTRASOUND
Sent: Friday, January 27, 2006 7:12 AM
Subject: RE: TV scan male or female sonographer
Hi, I'm a radiation technology student from Singapore.
I'd like to seek the experts' views on male sonographers practising sonography - whether it should be practised in conservative Asian societies. Some examinations are particularly sensitive to the Asian patients, such as TV scans. Would it affect the emotional health of the patient, or level of cooperation during the scan? What is the common Western opinion on this issue?
Thank you very much
for your help.
Sharon S.
Sharon, you ask a difficult question for there is no consensus in the USA about "views on male sonographers practicing sonography". This was recently discussed on the SDMS Forums with little agreement. I have pasted some of the comments at the bottom. you might want to join the SDMS so you can access the large number of Forums.
In the sonographic labs I worked in over the last 30 years, I have performed both endovaginal and breast sonography, with a chaperone. In Austin, Texas it seemed to be less of an issue than it is in the more conservative Arkansas. However, I always find it interesting that no one ever seems to take issue with the fact that the local Veteran's Administration Hospital only employees female sonographers in the diagnostic area, and they do all the scrotal exams without chaperones.
It always seemed odd that there has been no or very little issue with male gynecologist/obstetricians, yet there may be a ferurer over a male sonographer doing these exams. You can find a number of messages discussing these issues on the Ultrsound@OBGYN.net forums. Go to this link:
http://forums.obgyn.net/ultrasound/
Scroll toward the bottom of the page and look for the search area (not the GOOGLE web search):
"use when must restrict search to only the ultrasound forum..."
Type in "chaperone" and you will get many messages. here is one exchange. Hope this helps. Terry
The position mentioned was not for a nurse, but for a sonographer (although he referred to himself as an ultrasound technologist even though he says he hold the RDMS credential). My OB ultrasound lab claims to hire females only as a BFOQ which I believe stands for bona fide occupational qualification. I know several male sonographers who are infinitely more qualified as ob/gyn sonographers than some females. I really don't know the legal ramifications of this issue but in a small practice I'm sure that the discrimination could easily be dismissed by claiming some other reason for not hiring a male candidate. Pretty blatant comment on the part of the receptionist in my opinion. Patty
>
>I am a male ob/gyn doctor. I have been in practice 51 years. My nurse has always been female. I really do not think a male nurse in an ob/gyn practice would work out, but of course I am an old timer.
>
>If a male nurse applied for the job as my nurse, as soon as I received the application I would consult with the Clinic attorney, telling the attorney (presently male, but it has varied over the years) that I think a male nurse would probably be the end of my practice. Also a male nurse probably would not be considered an adequate chaperone.
>
>If the attorney said it is against the law to turn the applicant down because he is a male, and if there were no other applicants, I think I would have to try the male nurse. I suppose a male nurse with an incredibly good personality could do ok in an ob/gyn practice, with support from the doctor and the practice.
>
>If I did end up turning down the male applicant, I would have the attorney compose the letter or be present during the interview, or whatever was appropriate.
>
>I am not an attorney and cannot of course give you legal advice.
>
Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
Associate Professor & Director
Diagnostic Medical Sonography Program
University of Arkansas for Medical Sciences, CHRP
4301 West Markham St. Mail Slot #563
Little Rock, Arkansas, 72205 USA
501-686-6510
DuBoseTerryJ@UAMS.edu
http://www.uams.edu/chrp/sonography/
http://www.obgyn.net/us/panel/panel.htm
http://www.io.com/~dubose/
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sono2462
USA
8 Posts
Posted - 03/27/2004 : 14:11:03
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I would like to know how everyone is handling ev and scrotum =
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scanning of opposite sex patients. I noticed that the society stance for =
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these procedures has changed in that it used to state that it was strongly advised and now states that it is acceptable to have a chaperone of the same sex. Do you use consent forms or not. I personally feel that it could be a real issue but am finding more and more places where chaperones are not used. Other places say that a male needs a chaperone for TV exams but that a female does not need a chaperone for scrotum scans. I wonder why the society changed there stand on this issue.
Shmabs
1 Posts
Posted - 03/29/2004 : 22:42:25
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I am currently an sonography student in Omaha, NE and have =
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rotated through many clinical sites. I have not been to a site yet where =
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a chaperone has been needed/required for any type of exam.
At the beginning of my schooling we were told to have a chaperone in the exam room with us while performing transvaginal sonographys, and we are all females. I have never had anyone in the room with me while doing a transvaginal or scrotum exam, nor have any of the other sonographers who are teaching me at my clinical sites. I think most of the places I've been to are just too busy to take the time to be chaperones for these types of exams. But I do believe it is a good idea for safety and legal issues.
I have heard of cases where techs have been occused of rape after performing a transvaginal exam, so the idea of chaperones might need to be considered a little more. The idea of consent forms is a great one! Explaining to the patient the procedure of the exam and who will be performing the exam before it is done is a great way to set the sonographer at ease after the patient signs it. Plus it gives the patient an idea of what the exam entails. I have begun many transvaginal exams where the patient has never had this particular exam before. Consent forms could set everyone and the environment at ease!
rothgeb
USA
116 Posts
Posted - 03/30/2004 : 12:20:23
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Be careful of using the phrase, "everyone would be at ease". In =
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healthcare overall, there are more lawsuits with consent forms signed =
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than there are without. Remember what a consent form does; it informs the patient of the risk involved of the procedure, it does not give the sonographer the right to mess up. Plus for a consent form to be effective you have to list the risk involved with the exam. What can possibly be listed as a risk for EV sonography? You sure can't put down inappropriate behavior by the sonographer. I have never done an EV exam without a chaperone. Plus I document who my chaperone is on the hard copy. It's also advisable to have the chaperone sign a paper indicating that no inappropriate behavior was observed.
The bottom line is, protect your patients rights and privacy and then you protect yourself. Do the simple things before starting the exam. Explain the exam to the patient, tell them why you need to do the exam, get a verbal permission, introduce the chaperone to the patient as the chaperone and keep the patient covered up during the exam. If you are a male, step out of the room while the patient inserts the transducer. If you are a female sonographer, I think you definitely need a chaperone if you are inserting the transducer.
One final comment, have a policy listing these steps. In the event of a lawsuit, this will be the first thing the opposing lawyer will want.
In saying all of this I still believe the risk of something happening is extremely low and even lower if you follow some well thought out guidelines.
Joe
Edited by - rothgeb on 03/30/2004 12:23:07
rothgeb
USA
116 Posts
Posted - 03/31/2004 : 08:45:02
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Rich,=20
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Maybe it is bizarre. But I try to do everything to make the patient feel comfortable. Its simply respecting the patients privacy. Some women are extremely modest and I don't see the harm in respecting that. Maybe it wouldn't matter to 8 of 10 women but I think its respectful for the 2 who may appreciate and respect that. Stepping out of the room doesn't make anyone feel uncomfortable but staying could. The problem is we don't know who those few are.
Joe
Joe
Edited by - rothgeb on 03/31/2004 08:53:27
CLARS
USA
3 Posts
Posted - 04/23/2004 : 05:27:36
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I am new on this forum and found this an interesting subject. At =
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the facility I work at we do not use chaperones most of the time. There =
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are 5 female techs (part time, casual and 2 full time) and one male tech. Our male tech used to use a chaperone all the time but it was hard to always find someone that could help. He will ask the patient if she would like another person in the room, and usually the person is comfortable not having a chaperone. Our scheduled patients receive a prep sheet when the appointment is made that explains the sonography procedure, so most of the patients know what is going to happen. But we also verbally explain the procedure before we start. I also ask the patient if she wants to insert the probe or have me do it. Many patients ask me to insert the probe. Except in emergency room situations on call, some patients that have received a prep sheet in advance have requested a female tech and we do accomadate whenever possible. If a female tech is not available, the patient has the choice to reschedule, have a chaperone or choose to go ahead without a chaperone.
As far as scrotal sonographys, we have never used chaperones either. Sometimes on younger patients a parent will come in. Again, on occasion a patient has asked if there is a male tech available, we accomadate whenever possible.
We are professionals and in my opinion if you treat the patient with respect, explain the procedure, talk to the patient while scanning ( this puts many patients at ease) things should go well.
wgreenhut
USA
59 Posts
Posted - 04/28/2004 : 18:44:55
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Have you never encountered a patient who behaved =
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inappropriately? I have, many times. As a male sonographer I reacted =
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incredulously to anyone who told me I didn't need a chaperone for a TV exam (I am now an applications specialist who often gets excluded from the room by patient choice). I could tell you terrible stories of a staff member being led out of the department in handcuffs, deservedly so...and so on and so on.
I explained the procedure and gave my patients the choice of inserting the probe while they were covered or having me do it. I was very conscious and solicitous of their comfort, their privacy and their rights. And I always had a female chaperone, a staff member, in the room.
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------------------------------------------------------------------------- From: Terry DuBose [mailto:terrydubose@sbcglobal.net]
Sent: Friday, January 27, 2006 7:43 AM
To: DuBose, Terry
Subject: Fwd: TV scan male or female sonographer
Lea Harth <lea@medispecialty.com> wrote:
From: "Lea Harth" <lea@medispecialty.com>
To: "'sharon s'" <benxiaohai99@yahoo.com>,
"'Terry DuBose'" <terrydubose@sbcglobal.net>
Subject: TV scan male or female sonographer
Date: Thu, 26 Jan 2006 08:39:12 -0800
Sharon,
I am forwarding your excellent question to the chairman of our sonography
editorial advisory board, Terry DuBose.
Lea
Lea Harth
Operations Manager
OBGYN.net
reply to: Lea@obgyn.net
http://www.medispecialty.com
http://www.obgyn.net
http://www.endometriosiszone.org
http://www.oblink.com
http://www.firstvisit.org
http://www.ivstunneller.com
-----Original Message-----
From: sharon s [mailto:benxiaohai99@yahoo.com]
Sent: Thursday, January 26, 2006 1:20 AM
To: editor@obgyn.net
Subject: Fwd: question
Hi, I'm a radiation technology student from Singapore.
I'd like to seek the experts' views on male sonographers practising
sonography - whether it should be practised in conservative Asian societies.
Some examinations are particularly sensitive to the Asian patients, such as
TV scans. Would it affect the emotional health of the patient, or level of
cooperation during the scan? What is the common Western opinion on this
issue?
Thank you very much
for your help.
Sharon S.
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