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Care Opinion

Lack of dignity in radiotherapy appointment

Posted By Radioactiveboob

"Lack of dignity in radiotherapy appointment"

About: Beatson West of Scotland Cancer Centre / radiology

(as the patient),

I was recently diagnosed with breast cancer and after receiving surgery at the Golden Jubilee, I was referred to the Beatson Glasgow for radiotherapy. At my first appointment I discovered there would be male radiotherapists involved in my treatment, not when asked if I was comfortable with this but when I walked into the treatment room to find one standing there. I wasn't exactly thrilled with the idea of lying topless as it was, so to now have to do it in front of a male staff member was a blow. Just to add to the fun, this male member of staff came over and drew the marker dots on me as I lay there naked from the waist up, yay!

If I had any dignity or modesty left intact by this point, it was long gone after this. I remember thinking, if the cancer doesn't kill me, maybe the humiliation I have to endure being treated for it will! I had read the booklet I was given when I was referred for radiotherapy and also attended my appointment to receive my marker tattoo's and there had been no mention of male staff being involved. I assumed like with mammograms it was a female only environment and nobody had told me otherwise. What's the difference? A cancer diagnosis? You have no choice now, so...

I don't consider informing women who have to be naked for treatment that there will be men present an option. In fact, I believe it utterly disrespectful not to do so.

It's quite simple, all you need to say is, our radiotherapy teams are mixed sex are you ok with this? If not we will make sure you only have female therapists. Not, like my experience, be unaware, offered no choice and suddenly find myself in a situation where I felt pressured into lying topless in front of male staff members.

It made me feel more embarrassed, more uncomfortable and really pretty annoyed that no one had mentioned it to me. If there is simply no choice, then surely it's not too much to ask to be told they are there before being expected to go into a room and undress in front of them!

I obviously chose to continue with my treatment because without it there is a higher chance of my cancer returning and so there really was no choice. If I were the cynical type, I might wonder if this lack of choice over receiving treatment informed the lack of choice over who I am treated by? So while I thank you for my medical treatment, and it's certainly not my intention to imply or reflect that the treatment received by your staff was anything other than professional. On a personal level and in the way I was treated by them they were all quite lovely. What I take issue with, is the fact that in a unit were women in large numbers have to be naked for treatment, no one thought it relevant to mention that treatment would involve lying naked in front of male staff members. I find my feelings on this subject being so disregarded they weren't even asked for staggering!

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Responses

Response from Elaine Burt, Chief Nurse, Regional Services, NHSGGC 17 months ago
Elaine Burt
Chief Nurse, Regional Services,
NHSGGC

Submitted on 29/12/2022 at 13:25
Published on Care Opinion at 13:25

Dear Radioactiveboob

Please accept our apologies that you were not made aware that we have male radiographers and for the embarrassment this caused you.

We try to maintain our patient’s privacy and dignity and the information leaflet advises that patients will have to undress to the waist and that the Radiographers will cover you as much as possible. In each treatment room there is a changing area that has an extendable screen that provides privacy for patients to dress/undress and the Radiographers give each patient a sheet of paper towel to cover their top half when walking to and from the treatment couch. The Radiographers then need to pull this down to reapply pen marks to the tiny tattoos so they can see them in the dark to align these areas with lasers to ensure patients are in the correct position so that their treatment can be precisely delivered.

It should be made clearer to our patients that there are male radiographers in the Department. If patients have a concern about the gender of the Radiographer treating them, we will take this on board, however, this may result in appointment delays or a different treatment unit.

Thank you for bringing this to our attention and please accept our apologies.

Kind Regards

Elaine

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Update posted by Radioactiveboob (the patient)

Thanks for the response. If I believed this was merely an oversight or a mistake and not the unit's approach to treatment, I would have gladly accepted the apology and moved on. Unfortunately I can't, as it wasn't an oversight or a mistake but in fact the approach to treatment.

The response I received said it should be made clearer you have male Radiographers, as if there was some ambiguity or misunderstanding. Not the case. I wasn't informed at any point there would be male staff involved in my treatment. I walked into the treatment room fully expecting an all female staff team, completely uninformed and unaware you used male staff in breast cancer treatment. I then had the rather demeaning experience of lying topless on a treatment table, arms above my head, while a male staff member who, had I been given the choice would never have been there, removed the paper towel covering my breasts and drew marks on me with a pen. And the response is, it should be made clearer you have male Radiographers! May I suggest, oh sorry, did nobody mention that, as an equally inadequate response?

Thanks for explaining the procedure described in the leaflet. I read it before my treatment, there's no mention of male staff in there. Thanks also for explaining the need for marks being drawn on me. It was also explained to me when I had the tattoo's, where again there was no mention of male staff. Oh and thanks also for informing me of how you try to maintain your patients privacy and dignity. Considering my experience, I know this is no more than lip service, you'll forgive me if I don't feel you quite hit the mark on that one.

Now, thanking me for bringing this to your attention is to imply that the service was unaware this could be a problem! Is this why no one thought it important to ask me if I was comfortable being topless in front of male staff? I find that rather disengenious. I'm sure the service is well aware of the potential problems it raises for some women to lie with their breasts exposed in front of male staff. Particularly women who, like myself, have just received surgery and are already struggling with their physical appearance.

It seems to me that the unit relies on our embarrassment and our need for treatment to keep us quiet. What was it that was said in the response I received? ("If patients have a concern about the gender of the Radiographer treating them, we will take this on board, however, this may result in appointment delays or a different treatment unit.'') Does the unit believe this is an acceptable way to treat people? This reads like a veiled threat! The unit fosters a system that forces female patients who let's not forget may be struggling with their physical appearance, to be treated by male staff. And if they are uncomfortable and make the mistake of voicing their unease, their treatment could be (as stated earlier) delayed or even withdrawn. I believed it would create problems for me if I complained about the male staff and I needed the treatment, so I kept my mouth shut. The response shows how right I was to stay quiet! As if having cancer is not traumatic enough.

Why doesn't the service just openly accept how it provides treatment? The truth is, a patients privacy and dignity are of concern only up until the point where it becomes an inconvenience. I'd rather have been informed. If patients have a concern about the gender of the Radiographer treating them, we apologise but regardless of how innapropriate or unfair you believe this to be, we use male staff to treat female breast cancer patients. If you find this unacceptable, then you are welcome to seek treatment elsewhere. Because that's the reality of the situation. At least then, we'd know where we stand and know what to expect. At least then, I wouldn't have felt as ambushed when I walked into the treatment room and discovered I would have to undress and be exposed in front of male Radiographers!

Apologising to me as if it was unforeseen or has never been discussed is an insult to my intelligence. How about a little honesty! I asked in my original post and I ask again. Why the difference in approach between mammograms (where no men are allowed) and radiotherapy? (where no one even cares enough to ask how you feel about it)

Before diagnosis, in order to encourage women to attend mammograms, the NHS likes to assure us this is a female only environment, where the indignity of the whole procedure will not be magnified by the presence of male staff.

After diagnosis, like in your unit, not only was I treated by male staff, but I was given no choice in this whatsoever! For a unit that I am told tries to maintain their patients privacy and dignity, the disrespect shown to patients in this behaviour is incredible. To add insult to injury, your male staff do not even leave the close up moving and marking of female patients where your breasts have to be fully exposed for minutes at a time to the female staff.

So

You're sorry if I was embarrassed.

Thanks for the sentiment but this was more than simple embarrassment.

You should make it clearer to patients you have male staff.

Not, we should and of course from now on will, consult with female patients to ensure that they are comfortable being treated by male staff. And if not, ensure they are treated only by female Radiographers.

And of course, let's have another look at this!

"If patients have a concern about the gender of the Radiographer treating them, we will take this on board, however, this may result in appointment delays or a different treatment unit.''

Or in other words, if female cancer patients are uncomfortable lying with their breasts exposed in front of our male staff, they can feel free to bring it to our attention. But their will be a heavy price to pay for this. So, if they know what's good for them. They'll keep their mouth shut!

Response from Elaine Burt, Chief Nurse, Regional Services, NHSGGC 16 months ago
Elaine Burt
Chief Nurse, Regional Services,
NHSGGC

Submitted on 27/01/2023 at 14:26
Published on Care Opinion at 14:26

Dear Radioactiveboob

Thank you for your response.

At the outset I would like to apologise for the upset and distress this has caused you. We did not mean to cause you any further upset and are very sorry your experience of our service has been a negative one.

Please be reassured that we have taken your feedback very seriously and we will ensure that our patients are aware prior to treatment that we have male radiographers in the Unit. The Head of Therapeutic Radiography is currently ensuring the information leaflet is updated to reflect this.

The Breast Screening Service has a ‘genuine occupational qualification’ for radiographers to be female as an exception to the Equality Act 2010 which you highlighted in your feedback. I wanted to explain that there is no similar qualification that applies to Radiotherapy Departments including the Beatson.

Within the Beatson, we employ radiographers of all genders to provide a service to patients requiring radiotherapy. However, as a result of your feedback we will make this clearer to our patients so that they have the right to decline the examination/treatment and should not feel pressurised into continuing.

If a patient requests to be treated by a member of their own sex, we will do our very best to accommodate this, but it may not always be possible and we may have to reschedule. Please be reassured this was in no way intended as a threat but to highlight that there may be a delay. If it would help at all to discuss this further we would encourage you to please contact Eithne MacPherson on 0141 301 7174.

Kind Regards

Elaine

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Update posted by Radioactiveboob (the patient)

Hi Elaine

Thanks for your response.

I'm so pleased to hear you're updating the radiotherapy information leaflet and will now ask your female patients if they're comfortable with male staff prior to treatment. Not being made aware of, and being given no choice regarding male staff, is for me, the most unpleasant memory from my cancer treatment and I'm so happy to hear you are updating your procedures regarding this. Having cancer is no fun and anything that makes the experience less traumatic surely has to be worth implementing. Thank you for taking my experience onboard and acting upon it to change things for the future.

I do feel it's important to say again that my issue was never with the treatment I received from the staff and was in no way intended to reflect badly on them. Although I was clearly unhappy with the involvement of male staff, they personally did nothing wrong. It was not being either consulted about, or informed of them prior to treatment and how disrespected this made me feel that provoked my reaction. The staff themselves were model professionals and if I was judging the whole experience solely on the way I was treated by them, I would have had no complaints.

Again, thank you for acknowledging my experience and acting upon it. I'm quite sure this will be appreciated by your patients.and will prevent the distress I felt from happening to others.

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