Thoughts of a gay doctor

[Sharp-edge]

Sometimes I believe sexuality can interfere with medical practice and different sexual orientations could mean different "clinical" knowledge. What I mean. 

1) The first time I saw female genitalia was during gynecology in my life (porn won't count). I "had to" touch them to see if there was bleeding (some liquid after labor actually). It was unpleasant. Well, when you see a patient it's not a matter of what you want but of what it must be done so I'm learning to get over this. But a woman knows the female genitalia, a str8 guy does to, a gay guy does not (usually).

2) When I had to put urinal catheters. It was easy with men. I know how to grab a dick (joking) and I know how sensitive it can be from personal experience as an owner of a dick. So I know which things hurt and which don't. In women however I just know there is a pee hole somewhere, I've seen the location from anatomy books etc but I've never made out with a woman so the only real contact that I've had with "a pussy" was only during medicine. Not from my sexual life. But str8 guys and str8 women have experience with both.

3) There were 2 dudes yesterday that came with rectal bleeding (they said they saw blood but we didn't). One of them in particular felt that he was lying. When talking about blood from the anus, especially in a young man I will think hemorrhoids or anal sex (or toy). He was insisting about a food poisoning theory that did not make sense. I tried to make it more private and nobody to hear us (because there are several pairs of ears willing to hear in the ER I'm afraid. During the rectum exam with my finger (it also feels very weird do something that you do during sex but for a medical purpose) I was pretty sure I found lube there. We discussed a bit. He eventually told me that he was having cam sex and he was using a dildo and saw blood. I think that it helped that I was gay. It's not that straight people are bad at this. But I think a gay guy may more suitable to make the patient feel comfortable and guide him.

4) I am not sure how sex drive works from after a certain age. Based on the physiology of female system, it should decline greatly. I don't know any women beyond menopause that I could ask that question, but I hope this is not true because it would be so sad. I also have the curiosity of whether very old men can get aroused. Especially those that are in elderly house I suppose they never ejaculate. It makes me sad. I feel that some people (who live long enough and who have dementia or related pathologies) end up forgetting what they enjoy, forgetting who they are, they beloved ones. They actually stop from being the person their loved ones thought them to be. Now that I think about it, this does not have to do with the title of my topic, but still it makes me sad. Maybe the fear that gays actually don't have kids to look after them and many end up alone is the reason I'm touched by this. Anyway. 

 

A final remark. We are told that (at least in my country) it is illegal for a guy to examine a female patient without the presence of another woman. I think this is sexism. I do not like to be viewed as a potential sex assaulter. And if law regards me as a potential one, along with all the male colleagues, why isn't the law the same for women examining a man? I also find totally ridiculous that I should need the presence of another female when I examine a female. I've never hit on a woman in my life but several women have hit on me.

 

These were some thoughts I'd like to share.

[tallslenderguy]

Great thread Sharp-edge, thank You for sharing Your thoughts!

i'm a critical care nurse in the US. It's actually a newish career for me. i spent most of my life in executive management. 14 years ago, i left the corporate management world, went to nursing school and got a BSN, and now am in my eleventh year practicing in a teaching hospital on a critical care unit.  In the US, and particularly in the hospital where i work, nurses are considered partners with the doctors. Here's some of my thoughts and experiences responding to the 4 topics You note.

1. i'm familiar with female genitalia from a couple of perspectives. i was married to a woman half my life because i was conditioned by religious culture from an early age that being gay was not an option. Longs story, but the end result is, my first experience with a vagina was my wedding night. i was a virgin and i actually missed the first time we had sex (really, i came, but my penis was not inside of her). Even though i was trying to be straight, all my masturbation fantasies and porn was of guys prior to marriage, so i didn't really know female anatomy at all.  i eventually learned female anatomy in order to make her orgasm, but even with as much time as i spent going down on her orally, i didn't really notice or pay attention to her urethra. I.e., my experience with her did not equip me to cath a woman.  my only real familiarity with her vagina was learning how to make her orgasm. In the last 11 years as a critical care  nurse, i have seen probably thousands of vaginas. Like any other medical procedure, there's a point where i simply got used to it and don't even think about it now... it's routine.

2. LMAO. i have put in more catheters than i can count, male and female. Whether you're a male or female practitioner, the consensus amongst my peers is guys are always easier. With guys, the only obstacle is the prostate, which we encounter a lot as the primary reason  for putting a cath in (urine retention from obstruction).  The only weird thing i've encountered putting a cath in a guy is having the cath loop back out while sliding it in the urethra. That only happened to me once, doing a straight cath for a UA. The straight caths we had were sort of thin and flimsy, and if they encountered a swollen prostate, they'd loop around and the tip would come back out. After that, i'd always find a coude' cath and have never encountered that sense. i did cath myself to see how it feels. Half the guys don't seem to care, half it's like the end of the world. i use lidocaine gel if the guy encounters pain.  

Putting a cath in a woman? Hole different ball game (pun intended).  i've been in situations where it took 4 or 5 people to put a cath in a woman, just to hold the various parts back to try and find the urethra. The common notion is "look for the wink."  i always have a woman nurse present with me when cathing a woman, and honestly, it's just as much a challenge for a woman to put the cath in as a guy.  It isn't you. Finding a woman's urethra is not easy, and often takes multiple tries by several people.

As far as pain is concerned?  From multiple conversations and tons of experience, the only people i have encountered who experience pain when putting a cath in are guys. Their urethra is much longer than a woman's, and they have a prostate which is often the reason for needing a cath. If the prostate is swollen, it is often painful to get the cath past that. 

3.  Rectal bleeds. That gets complex, eh? with 27 feet of intestine, not to mention esophageal varicosities, there can be a lot of places for a bleed. Frank red blood from the rectum is something i see usually  from hemorrhoids, coffee grounds are usually from further up. In my patient population, it's not unusual to see both. We do an H/H to test for active (major) bleed.  People with anal sexual activity is often reflected in other ways though. i've had a few patients with rectal prolapses that make me wonder. Also, we encounter lots of incontinence on our unit,  so we see a lot of anus.  As a nurse, i do not do digital rectal exams, but i do administer a fair amount of suppositories digitally. 

i had one woman patient, who was still pretty young and attractive, who had a connective tissue disease and here intestinal tract had lost most of it motility. i had to give her enemas 2x a shift.  At one point i think she felt a little awkward, so i told her i am gay so she would not feel any sexual. i still question whether or not i should have told her that, i just did it in the moment. Like you, i agree that as a professional, gender shouldn't figure in. But, the reality is, sometimes it does.

4.  From what i read and experience, sex drive is more individual than age related?  Reading up on it, some women experience increased sex drive after menopause? idk. i do know there are plenty of guys who are still plenty horny no matter how old. There is an online gay site called "Silver Daddies" that has 125k members aging all the way into the 90's, both Top and bottoms.  i don't doubt that age can be a factor, more to the point, health factors that may affect elderly more than younger guys, but i don't think one loses  their libido  just because of age?

[brnbk]

5 hours ago, Sharp-edge said:

Sometimes I believe sexuality can interfere with medical practice and different sexual orientations could mean different "clinical" knowledge.............................................A final remark. We are told that (at least in my country) it is illegal for a guy to examine a female patient without the presence of another woman. I think this is sexism. I.........'ve never hit on a woman in my life but several women have hit on me.. These were some thoughts I'd like to share.

It is very interesting to hear the perspective of a gay doctor. 👨‍⚕️ 

I would say it can influence a medical practioner but i am not convinced it interferes with medical practise, at least it shouldn't. 

I am assuming, you chose not to become a gynecologist, for the simple reason that female genetila is not what you prefer to work with, it actually puts you off. As a gay man I am not interested in it either. Not every medical practioner or doctor specializes in all parts of medicine and I would think that most doctors are comfortable with the area of practise including the specific body area that they usually deal with. 

Also, I Imagine different personality types likely make different choices. Some people might prefer to work with females just coz they find the male body too attractive and don't like the distraction or  interference it may bring. while others might feel more comfortable working with the gender they are attracted to rather than avoiding it. 

 

2 hours ago, tallslenderguy said:

Great thread Sharp-edge, thank You for sharing Your thoughts

4.  From what i read and experience, sex drive is more individual than age related?  Reading up on it, some women experience increased sex drive after menopause?  i don't doubt that age can be a factor, more to the point, health factors that may affect elderly more than younger guys, but i don't think one loses  their libido  just because of age?

 I believe it is a VERY IMPORTANT issue. From what i read, atleast according to a Havard Study, regular ejaculation reduces your risk of prostate cancer especially as you age. I do believe scientists and clinicians should be more open about this and be forthcoming as it affects the health of general public. 

Edited December 30, 2023 by brnbk

[Sharp-edge]

14 hours ago, tallslenderguy said:

i'm a critical care nurse in the US. It's actually a newish career for me. i spent most of my life in executive management. 14 years ago, i left the corporate management world, went to nursing school and got a BSN, and now am in my eleventh year practicing in a teaching hospital on a critical care unit.  In the US, and particularly in the hospital where i work, nurses are considered partners with the doctors. Here's some of my thoughts and experiences responding to the 4 topics You note.

I've read your story before, I think you have said that this was due to your religious background? It's very interesting what you have experienced. So are you happy in nursing now?

 

14 hours ago, tallslenderguy said:

ntually learned female anatomy in order to make her orgasm, but even with as much time as i spent going down on her orally, i didn't really notice or pay attention to her urethra. I.e., my experience with her did not equip me to cath a woman.  my only real familiarity with her vagina was learning how to make her orgasm. In the last 11 years as a critical care  nurse, i have seen probably thousands of vaginas.

I've only see some porn with women (just because the dude was hot) or (even worse) I've seen fem porn so the genitalia were a bit altered due to hormones I guess. So I had a bit false expectations about the size of a clitoris which was not an enlarged as was expecting. I also had practical issues of identifying urethra from vagina but I got over it. But if I could chose to never see female genitalia I would pick it. Thankfully I did not chose to become a gynecologist.

 

14 hours ago, tallslenderguy said:

LMAO. i have put in more catheters than i can count, male and female. Whether you're a male or female practitioner, the consensus amongst my peers is guys are always easier. With guys, the only obstacle is the prostate, which we encounter a lot as the primary reason  for putting a cath in (urine retention from obstruction).

I know this may sound weird, but putting catheters on guys has helped me because I like sounding. I'm trying to help people who like that to do it in a safe way so as not to cause any harm. I think that many medical practitioners demonize some sexual practices. But in my eyes, whether they like it or not some practices exist and will exist and if we wanna do something useful we should teach the right way. My worst fear in a catheter is filling the balloon inside the urethra. I hope this will never happen.

 

14 hours ago, tallslenderguy said:

 Rectal bleeds. That gets complex

Of course it does. And that is why I want the patient to feel freely to say you know what I got fucked and I saw blood. It would be a crucial knowledge to have regarding where to search and what pathology I'm expecting. And I can't tell it's the patients to blame. How on earth do we expect patients to be sincere if we make fun of them being gay? And I don't know about USA or other countries, but in Greece I would be too skeptical of being sincere. And nurses are the worst on that. I don't know if this is a Greece's thing but a typical nurse is woman and religious and likes to gossip people. And I don't know what should I do. Put a flag on my head and say LGBTQ+ friendly doctor?

 

14 hours ago, tallslenderguy said:

Like you, i agree that as a professional, gender shouldn't figure in. But, the reality is, sometimes it does.

Most guys make me wonder how could they look when they were younger. Some guys make me feel that they were always sick and weird looking. And you can see others that are old but you can see it in their eyes that they are alive and have many things that keep them going. There was a patient who was straight and very good looking. Actually I think that I am rarely attracted by a "stereotypical hunk". I have some triggers. Shorter guys, lean, preferably gingers. I had such a patient who needed a central catheter. I was very stressed (it was my second time). Long story short we've been together many weeks in the hospital. He was very afraid (and I was very worried about the outcome). Eventually everything was okay. Since then he will always send me a gift during my birthday which is very touching and we may go out for a coffee once in a while. He thinks he owns me, I've told him that helping people is what we do in medicine. It was not personal because we help everyone but at the time it is personal because we are happy for each and every one that goes well.

[Pozguyinchi]

20 hours ago, Sharp-edge said:

Sometimes I believe sexuality can interfere with medical practice and different sexual orientations could mean different "clinical" knowledge. What I mean. 

1) The first time I saw female genitalia was during gynecology in my life (porn won't count). I "had to" touch them to see if there was bleeding (some liquid after labor actually). It was unpleasant. Well, when you see a patient it's not a matter of what you want but of what it must be done so I'm learning to get over this. But a woman knows the female genitalia, a str8 guy does to, a gay guy does not (usually).

2) When I had to put urinal catheters. It was easy with men. I know how to grab a dick (joking) and I know how sensitive it can be from personal experience as an owner of a dick. So I know which things hurt and which don't. In women however I just know there is a pee hole somewhere, I've seen the location from anatomy books etc but I've never made out with a woman so the only real contact that I've had with "a pussy" was only during medicine. Not from my sexual life. But str8 guys and str8 women have experience with both.

3) There were 2 dudes yesterday that came with rectal bleeding (they said they saw blood but we didn't). One of them in particular felt that he was lying. When talking about blood from the anus, especially in a young man I will think hemorrhoids or anal sex (or toy). He was insisting about a food poisoning theory that did not make sense. I tried to make it more private and nobody to hear us (because there are several pairs of ears willing to hear in the ER I'm afraid. During the rectum exam with my finger (it also feels very weird do something that you do during sex but for a medical purpose) I was pretty sure I found lube there. We discussed a bit. He eventually told me that he was having cam sex and he was using a dildo and saw blood. I think that it helped that I was gay. It's not that straight people are bad at this. But I think a gay guy may more suitable to make the patient feel comfortable and guide him.

4) I am not sure how sex drive works from after a certain age. Based on the physiology of female system, it should decline greatly. I don't know any women beyond menopause that I could ask that question, but I hope this is not true because it would be so sad. I also have the curiosity of whether very old men can get aroused. Especially those that are in elderly house I suppose they never ejaculate. It makes me sad. I feel that some people (who live long enough and who have dementia or related pathologies) end up forgetting what they enjoy, forgetting who they are, they beloved ones. They actually stop from being the person their loved ones thought them to be. Now that I think about it, this does not have to do with the title of my topic, but still it makes me sad. Maybe the fear that gays actually don't have kids to look after them and many end up alone is the reason I'm touched by this. Anyway. 

 

A final remark. We are told that (at least in my country) it is illegal for a guy to examine a female patient without the presence of another woman. I think this is sexism. I do not like to be viewed as a potential sex assaulter. And if law regards me as a potential one, along with all the male colleagues, why isn't the law the same for women examining a man? I also find totally ridiculous that I should need the presence of another female when I examine a female. I've never hit on a woman in my life but several women have hit on me.

 

These were some thoughts I'd like to share.

I have a gay Dr and it does make things very easy. From the explaining of HPV to STI diagnosis and treatment gay men have a whole host of “issues” that can come up that straight men do not. I don’t take my Dr’s comments as criticism where I have from straight Dr’s. He has also related to me that he is in a dom sub relationship and as a sub what I should look for with a dom in regards to body mods. He never told he he was the dom in the relationship but I figured it out. Lol. I am also HIV positive and there is also not that under lying perception that he is judging me. 

[Sharp-edge]

53 minutes ago, Pozguyinchi said:

I have a gay Dr and it does make things very easy. From the explaining of HPV to STI diagnosis and treatment gay men have a whole host of “issues” that can come up that straight men do not. I don’t take my Dr’s comments as criticism where I have from straight Dr’s. He has also related to me that he is in a dom sub relationship and as a sub what I should look for with a dom in regards to body mods. He never told he he was the dom in the relationship but I figured it out. Lol. I am also HIV positive and there is also not that under lying perception that he is judging me. 

That's good to hear.

Maybe the world needs a specialty about sexual health. But not one where I'm going to give advice to gay women because I've no idea what they do between them. But advising gay guys, that I can do it well.

16 hours ago, brnbk said:

Also, I Imagine different personality types likely make different choices. Some people might prefer to work with females just coz they find the male body too attractive and don't like the distraction or  interference it may bring. while others might feel more comfortable working with the gender they are attracted to rather than avoiding it. 

Wish I had that dilemma. You will rarely meet someone attractive. I think that str8 gynecologists tend to have lots of appealing women because every woman needs a smear test, an ultrasound or whatsoever once every year or more, but not every health young man needs a doctor to check his dick. So the ones we check are not appealing.

I'm an anesthesiologist trainee so the body parts that I touch are the hands for a catheter (the genitals are usually the nurse's part) and I have to pass down a tube from the throat and that's pretty much it. Unless it's trauma. But everything is too bloody there to even have the time to think.

[tallslenderguy]

5 hours ago, Sharp-edge said:

I've read your story before, I think you have said that this was due to your religious background? It's very interesting what you have experienced. So are you happy in nursing now?

 

i was raised in a religious culture, and i also went deeply into religion for a long time.  i think American culture has a lot of overt and subtle religious influence. i'm guessing the same is true in Your country (Greece?), though it seems You were able to get free of much of that influence at a younger age than i did, and come to a place of self acceptance.

Being in healthcare as a nurse is mixed for me. i'm nerdy, read a lot of medical journals, have professional certifications. i love physiology and am endlessly fascinated with how the body works. i also love connecting with and helping people, and i get a lot of that in my position. The healthcare system in the US is broken. i work with amazing, caring people. i love working in a teaching hospital, the doctors i work with are beautiful people and we all get along very well. The policies of the healthcare system make the job very difficult and exhausting. Also, shortages of healthcare workers mean we are often functioning in triage mode, which can get tiring very fast.  i am "happy," though i (and anyone in this profession i think) have to develop and maintain coping skills to keep going. 

5 hours ago, Sharp-edge said:

I've only see some porn with women (just because the dude was hot) or (even worse) I've seen fem porn so the genitalia were a bit altered due to hormones I guess. So I had a bit false expectations about the size of a clitoris which was not an enlarged as was expecting. I also had practical issues of identifying urethra from vagina but I got over it. But if I could chose to never see female genitalia I would pick it. Thankfully I did not chose to become a gynecologist.

 

lol... In school, i did very well on my maternity rotation, but cannot imagine being a maternity nurse or midwife.  i think we probably agree that a woman has some advantages to working with women because they have the same equipment and can better relate to how it feels and works.  But even with that, as you note, the people we care for-male or female- are often unwell or not in the best condition, so they are not always beautiful to look at. 

5 hours ago, Sharp-edge said:

I know this may sound weird, but putting catheters on guys has helped me because I like sounding. I'm trying to help people who like that to do it in a safe way so as not to cause any harm. I think that many medical practitioners demonize some sexual practices. But in my eyes, whether they like it or not some practices exist and will exist and if we wanna do something useful we should teach the right way. My worst fear in a catheter is filling the balloon inside the urethra. I hope this will never happen.

It doesn't "sound weird" to me at all. i get it.  i've written some things on kink sites about how to use more sterile technique when sounding or using catheters if they are part of ones sexual practice.  i agree, i think we can help people much more when we do not stigmatize those who are different, and even show familiarity and acceptance. i've been able to establish rapport with patients who realize i'm familiar and accepting, so i think it's wonderful that you do this.  Oh yeah, me too on the catheter balloon.  For me, once i  get urine return, i know the tip is in the bladder, i always slide the cath in about two inches more after i get urine return before i inflate the balloon, then i gently pull it back until i get resistance. I've had both male and female patients with altered mental status who pulled their catheter out. Ouch. 

5 hours ago, Sharp-edge said:

Of course it does. And that is why I want the patient to feel freely to say you know what I got fucked and I saw blood. It would be a crucial knowledge to have regarding where to search and what pathology I'm expecting. And I can't tell it's the patients to blame. How on earth do we expect patients to be sincere if we make fun of them being gay? And I don't know about USA or other countries, but in Greece I would be too skeptical of being sincere. And nurses are the worst on that. I don't know if this is a Greece's thing but a typical nurse is woman and religious and likes to gossip people. And I don't know what should I do. Put a flag on my head and say LGBTQ+ friendly doctor?

A part of me wishes You want to be a hospitalist instead of anesthesiologist,  think people would benefit from Your caring attitude, Your desire to understand and relate. i was accepted into a nurse practitioner program and many NP's become hospitalists or anesthesiologists.  i'm mixed. i'd like to have the added education and understanding of diagnosis, but also like being with the patient for 12 hours vs 15 minutes.  

You are so right about the effect of stigmatization on being able to provide effective care. We experience it often when it comes to alcohol. We ask how much alcohol the person consumes on a daily basis, but because of stigma, many lie. They come in for one issue, and while they are in the hospital, they start to withdraw from alcohol, and we end up having to treat that as well.  If a person is alcohol dependent, and they have no desire or intention of stopping drinking when they leave, we will make sure they have alcohol while they are in the hospital for whatever they are being treated, so they do not withdraw. If they want to quit, we can implement CIWA protocol and make sure they have meds like ativan to smooth the process. 

About 25% of the nurses i work with are male, the other 75% female.  Almost to a person, they are awesome, amazing people.  i find the people who are as you describe, gossips or religious in a way that judges, do not last very long in our setting. The continuous realities of what we do usually changes them or drives them away because reality does not aline with their ideas of how things are or should be.  What i do is very hard, the people i work with are what keeps me doing it. i'm very fortunate to be in a place where the culture of those providing the care is exemplary.  The hospital i came from was not like that, so i know what i have is rare.

[Sharp-edge]

1 hour ago, tallslenderguy said:

i was raised in a religious culture, and i also went deeply into religion for a long time.  i think American culture has a lot of overt and subtle religious influence. i'm guessing the same is true in Your country (Greece?), though it seems You were able to get free of much of that influence at a younger age than i did, and come to a place of self acceptance.

Well in Greece things were always weird with religion. A bit of a long story but even though in terms of law government and church are separate entities, in practice they are not. We've seen many times priests blessing with holy water sterile equipment in ICU during the pandemic, we've seen priests talking against gay people and even saying they will ban from the church (maybe the word is aphorized if i use the greek one with a bit of imagination) whoever votes in favor of some laws that support gay people. But in our capital (more than half of our population) you will not have to marry for religious reasons

 

1 hour ago, tallslenderguy said:

The healthcare system in the US is broken. i work with amazing, caring people. i love working in a teaching hospital, the doctors i work with are beautiful people and we all get along very well. The policies of the healthcare system make the job very difficult and exhausting. Also, shortages of healthcare workers mean we are often functioning in triage mode, which can get tiring very fast.  i am "happy," though i (and anyone in this profession i think) have to develop and maintain coping skills to keep going. 

I've heard terrible stories about people adjusting their insulin dose because they can't afford the needed quantities, is this true? 

In Greece things are broken in the healthcare section for other reasons. We have public hospitals where every citizen can receive the help he needs (and even expensive drugs such as antiviral drugs for HIV/HBC/HCV etc). BUT.. we have many shortages in stuff because nobody actually hires. We have people migrate to find better salaries and work environments. There can be patients not in beds but in portable beds outside the rooms because clinics can be too full. I could be going on and on forever about this.

1 hour ago, tallslenderguy said:

but cannot imagine being a maternity nurse or midwife.  i think we probably agree that a woman has some advantages to working with women because they have the same equipment and can better relate to how it feels and works

when I had gynecology I was like oh my, this is how this system works? I feel lucky to be a man.

 

1 hour ago, tallslenderguy said:

I've had both male and female patients with altered mental status who pulled their catheter out.

two days ago there was an old guy who had tremor and a bit of dementia. He would grab anything. My stethoscope, my arm, the sphigmomanometer and any catheter.

 

1 hour ago, tallslenderguy said:

A part of me wishes You want to be a hospitalist instead of anesthesiologist,  think people would benefit from Your caring attitude, Your desire to understand and relate.

thanks for that. but doesn't hospitalist means someone who works inside the hospital and not in private practice? Cause anesthesiologists almost excusively work in hospitals. I think it's easy to care and it doesn't take time to just cover with a blanket a patient who complains instead of getting to the other doctors and complain altogether about the complaining patient.

 

1 hour ago, tallslenderguy said:

i'd like to have the added education and understanding of diagnosis, but also like being with the patient for 12 hours vs 15 minutes.  

I didn't know that doctors spend considerably less time with the patient compared to the nurse. But now I see how this happens. I get you on wanting to have that knowledge. My first degree was in dentistry and my desire was medicine so I did medicine after dental school just for that.

 

1 hour ago, tallslenderguy said:

withdraw from alcohol, and we end up having to treat that as well

Also true. But some people don't even realize their addiction. Plus, I'm not a drinker myself so even a glass of wine surpasses my semester intake.

 

1 hour ago, tallslenderguy said:

 i find the people who are as you describe, gossips or religious in a way that judges, do not last very long in our setting.

Unfortunately in my hospital they last. And they make us acclimated with the toxic behavior. And another unique thing. Nurses here don't feel like drawing blood. We tend to do it. Or even medical students. We have even some not measuring pressure because it's a doctor's thing. lmao

[tallslenderguy]

2 hours ago, Sharp-edge said:

Well in Greece things were always weird with religion. A bit of a long story but even though in terms of law government and church are separate entities, in practice they are not. We've seen many times priests blessing with holy water sterile equipment in ICU during the pandemic, we've seen priests talking against gay people and even saying they will ban from the church (maybe the word is aphorized if i use the greek one with a bit of imagination) whoever votes in favor of some laws that support gay people. But in our capital (more than half of our population) you will not have to marry for religious reasons

 

In my hospital, i admit the patient after the doctor admits them. One of the questions i ask is if they have any beliefs they want us to honor or be aware of.  i have an average of 150 classes of continuing medical education  (CME) that i have to take every year to maintain my license. i also take more classes to maintain critical care certification.  Classes that we all must take, include classes on awareness of bias against things like weight, body habitus, sexual identification/orientation. Of course, this does not change who  a person might be, but the policy of acceptance is there.

Funny story. i had a crush on a doctor when i first started working at this hospital. He was cute, shy. i came back on rotation one day, had not seen him in awhile, and he had transitioned and was  now Julie. i marveled at their courage, but everyone was open and accepting to her. She is one of two transpeople  l know of who work at my hospital. Also a nurse who recently retired and worked in hospice wore rainbows on his badge lanyard. The hospital also has several married gay couples and they can get insurance like  any other married couple. 

We still have bigots and bias, but it is not openly tolerated. 

2 hours ago, Sharp-edge said:

I've heard terrible stories about people adjusting their insulin dose because they can't afford the needed quantities, is this true? 

In Greece things are broken in the healthcare section for other reasons. We have public hospitals where every citizen can receive the help he needs (and even expensive drugs such as antiviral drugs for HIV/HBC/HCV etc). BUT.. we have many shortages in stuff because nobody actually hires. We have people migrate to find better salaries and work environments. There can be patients not in beds but in portable beds outside the rooms because clinics can be too full. I could be going on and on forever about this.

Medicine in the US is capitalist. There are laws, a hospital cannot reject anyone because they cannot pay, and we have had more than a few unhoused people long term because there was no place  to place them. 

There are ways one can get the medicine that they need, but it's not always easy and there are hard choices, not always viable. Drugs in the US are ridiculously expensive, and the same drugs can be gotten in other countries cheaper.  Insulin and other meds get skipped to keep money for other things, not unusual, but not unheard of either. Short acting insulin for prandial and corrective dosing is about $170 for 100 units. 

The hospital where i work is always full. We had to go on divert on Christmas day because we were full. On the floor, we have a running joke that they are going to put bunk beds in the patient rooms so we can fit more in. 

2 hours ago, Sharp-edge said:

thanks for that. but doesn't hospitalist means someone who works inside the hospital and not in private practice? Cause anesthesiologists almost excusively work in hospitals. I think it's easy to care and it doesn't take time to just cover with a blanket a patient who complains instead of getting to the other doctors and complain altogether about the complaining patient.

 

A "hospitalist" where i have worked is a general practitioner who cares for a patient. They come in with most illnesses and they get a doctor/hospitalist assigned to them. The hospitalist takes complete care, or may consult and add additional doctors depending on the issue. For instance, if the patient has a heart attack, the hospitalist may consult cardiology, and they may do a heart cath and a stent, or start them on a heparin drip, or___________.  The anesthesiologist works in the operating room (OR), we never see them on the floor where the patients are staying. A patient may go for open heart surgery for an aortic valve replacement or bypass, the anesthesiologist sees them in the OR and cares for them during the four hour surgery, but not before or after, and the patient usually has only a minute or two interaction with them while they are putting them under  for the surgery.  

2 hours ago, Sharp-edge said:

I didn't know that doctors spend considerably less time with the patient compared to the nurse. But now I see how this happens. I get you on wanting to have that knowledge. My first degree was in dentistry and my desire was medicine so I did medicine after dental school just for that.

Unfortunately in my hospital they last. And they make us acclimated with the toxic behavior. And another unique thing. Nurses here don't feel like drawing blood. We tend to do it. Or even medical students. We have even some not measuring pressure because it's a doctor's thing. lmao

In the hospitals where i have worked, both teaching hospitals connected to a medical school.  One was big 850 beds, 3 helicopters, certified in 14 specialties. i worked on a heart unit.  In a large hospital, one specialize more. We put in our own IV's.  

Where i work now, is 180 beds, a teaching hospital, but to small to specialize, so as a critical care nurse i get everything, not just hearts. Not unusual to have 3 or 4 co-morbidities to juggle. A patient with an MI who  also has end stage renal disease, diabetic and a history of stroke with residual deficits. Actually, this sort is usually the rule, not the exception,  so nurses have to be familiar with all of this in critical care. They are on telemetry, so we have to know how to read rhythms, etc.. At this hospital, we have to pull femoral sheaths after surgery, but lab draws blood using phlebotomists who do nothing but draw blood. Everyone gets blood work daily, CBC and Chem panel at least, with a bunch of add ons like liver enzymes or A1c, CRP, lactate, etc, etc.. Part of my morning routine is checking what meds my patient gets, checking vital  signs (every 4 hours) and checking labs/blood work.  I/O.  We have certified nursing assistants (CNA's) who take vital signs every 4 hours, a nurse takes them if there is a question.  

We also have IV nurses at this hospital, cuts down on infection rates.  We give blood, though. Monitor drips, pressers, nitro, anticoagulant. The list goes on and on. 

Nurses and doctors get along very well where i work, we depend on each other. i am a doctors eyes and ears. One advantage of working for a long time at the same place is you get to know each other.  i have some doctors who we know each other so well, i page them with info, reasons and ask for some med or intervention, and they will simply put in an order for it.  They know i see so much being with the patient all the time, i can spot things like fluid overload and they put in an order for furosemide.  Or heart is looking irritated or tachy, maybe start metoprolol, or go up on the dose. Tons of stuff like that, we work as a team. They may ask for reasoning, they make the decision, but they also listen and there is mutual respect for each other. i LOVE the doctors i work with... and there are several i wish would fuck me lol or Who's cock i would suck in a heartbeat. 

[Heir2012]

I've not had a problem with a doctor or nurse when it comes to their gender... for the most part. My first urologist was a man, but I then had a woman years later. I've found it difficult at times to explain certain issues with her, knowing only another man could connect fully with what I'm saying. Sometimes things are hard to explain, and if the doctor/nurse doesn't also have those parts, the connection is weak. 

Please don't view any of this as sexist. It isn't meant to be. I have had several doctors all over the gender spectrum, and I've loved them. Truly great. But, at times, it's good to discuss your cock and balls with someone who also has cock and balls. I'm sure it can be the same for women. At times, only another woman can understand. 

It's complicated.

[Sharp-edge]

30 minutes ago, Heir2012 said:

Please don't view any of this as sexist.

No it's not. Especially when it comes to a patient reaching out for a doctor, he should fine the one he thinks most appropriate. A large part of medicine is the connection between the doctor and the patient (in older books I have found it referred as the therapeutic alliance)

[Sharp-edge]

1 hour ago, tallslenderguy said:

In my hospital, i admit the patient after the doctor admits them. One of the questions i ask is if they have any beliefs they want us to honor or be aware of.  i have an average of 150 classes of continuing medical education  (CME) that i have to take every year to maintain my license. i also take more classes to maintain critical care certification.  Classes that we all must take, include classes on awareness of bias against things like weight, body habitus, sexual identification/orientation. Of course, this does not change who  a person might be, but the policy of acceptance is there.

I always thought highly of ICU nurses. I've met many nurses who were ehm.. bad. But every ICU nurse I've met.. well they feel fully skilled for whatever comes and I suppose this comes from the extensive training it requires. ICU is a weird place imo. It sometimes feels as a limbo on earth for me. I just try not to cry when somebody dies. I don't think I've seen any sexism/racism there. It's the OR that sexism derives from.

 

1 hour ago, tallslenderguy said:

A "hospitalist" where i have worked is a general practitioner who cares for a patient. They come in with most illnesses and they get a doctor/hospitalist assigned to them. The hospitalist takes complete care, or may consult and add additional doctors depending on the issue.

Sounds like an internist or a GP to me, I don't think we have someone else for these. When I show up in the patient room, it's because something bad is happening.

 

1 hour ago, tallslenderguy said:

but lab draws blood using phlebotomists who do nothing but draw blood.

wish we had them too. Here, the residents draw blood, or students. Nurses just refuse to do so. It mostly depends on who is bullying who. I can't bully anyone to draw blood but if the professor bullies nurses they will draw blood. Seriously. This is how it works. I don't draw blood an anesthesiology resident but they call me when every other attempt has failed.

 

1 hour ago, tallslenderguy said:

take vital signs every 4 hours

usually I do that too 

 

 

1 hour ago, tallslenderguy said:

Nurses and doctors get along very well where i work

That's a joke here. The worst combo though is doctors + midwives

Nurses here will either spot a mistake you've done and instead of finding a way to fix it/tell you they well the professor (this is the arc-nurse who does that). They may call you useless behind your back, gay/slut (depends on the mood) and they will not draw blood. 

1 hour ago, tallslenderguy said:

They know i see so much being with the patient all the time, i can spot things like fluid overload and they put in an order for furosemide.

This is invaluable. I have an anesthesiology nurse with me (he's actually still a student in his internship but this is as far as the help I receive can get) who had almost no knowledge of anything practical. I noticed that the problem with him was his fear. So I was always cool with him and I guided him in many procedures. He can even intubate now and he is the best nurse I could have around.

 

1 hour ago, tallslenderguy said:

Funny story. i had a crush on a doctor when i first started working at this hospital. He was cute, shy. i came back on rotation one day, had not seen him in awhile, and he had transitioned and was  now Julie. i marveled at their courage, but everyone was open and accepting to her. She is one of two transpeople  l know of who work at my hospital. Also a nurse who recently retired and worked in hospice wore rainbows on his badge lanyard. The hospital also has several married gay couples and they can get insurance like  any other married couple. 

I've never met a transgender in my life. I've only seen in the street. I always wonder where are all these people here. I don't know their numbers but I should have seen them somewhere. We are not as open minded I'm afraid. Male surgeons tend to talk about football and female parts (with a particular interest in boobs). There is a particular one who says that it's not possible for a man to like another man.

[Willing]

Be hot to go to the doctor and he feeds you meds straight from the tap that he knows you want and definitely need and you pay for it 💋

[hntnhole]

Interesting thread ...

All I can say is, thank Whatever there are folks like you guys ... just the subject matter gives me shivers, threatening light-headed-ness.  

It's lunchtime here, and I was hungry ... but I think I'll give it a little while before I try to eat anything ......  🤢