I cannot help but admit the last 9 months have been very challenging for me-in a way that intertwines professional life and personal life.
As many of you know, I live in Michigan. My family's home is a stone's throw from the campus of Michigan State University (MSU), which has been under a microscope lately in the wake of the Larry Nassar scandal. Resulting from this shame, beleaguered MSU Spartans across the country have experienced many heartbreaks. One such anguish is knowing that some of the tragic encounters that were endured by the young, trusting, and naive premiere athletes (and subsequently shared through the brave survivors' victim statements) took place on the beautiful campus of MSU.
For many people who call the state of Michigan home, Nassar's sentencing, which took place on a very public national stage, literally felt like it was taking place in our backyards. The young women athletes, many of them gymnasts, bestowed immeasurable strength for speaking their truth and talking about the horrific abuse they suffered.
Although much of the global media attention has been on the U.S. Olympic Committee and USA Gymnastics, MSU and the people working there have been completely shaken by this horrific tragedy. Nassar was just the first to go-not long after his lifelong prison sentencing, the Dean of the College of Osteopathic Medicine (Nassar's boss) was locked up for having his own history of sexual misconduct with many of the medical students under his charge.
Since the exposure of MSU's wrongdoings, many other universities including the school down the road in Ann Arbor-the University of Michigan, medical faculties across the country have faced their own sexual misconduct scandals. Perhaps, MSU was the spark that ignited this firestorm of abuse across the land. Clearly, we know this behavior is not exclusive to the state of Michigan. Unfortunately, deviant behavior happens and has happened on many college campuses. Most recently, another case of national media attention was brought forward to the University of Southern California. The now disgraced university has been accused of deliberately covering up one of its faculty gynecologist's sexual abuse of hundreds of students over the physician's 30-year career.
All this is honestly overwhelming for me. The magnitude of the physician-patient misconduct news reporting is something that has stunned me for months and unfortunately, because of where I live, engulfs me daily. It is now to the point where every day I turn on the local morning news I hear about perverse medical practitioners. I go to work in a field that I am so passionate about-yet I am constantly thinking of how we can ensure hidden sexual abuse never happens again. Then I come home only to turn on the evening news and continue to hear about the latest happenings at my community's beloved university as it rebuilds (and continues uncovering more alarming information!) and then.... I ruminate.
Like I said, this Larry Nassar-MSU debacle has been very challenging for my community. With this challenge, however, comes an incredible opportunity for nurses to think critically about our role in making sure misconduct of this nature does not happen on our watches.
Like many of you, I am a mother, and my heart broke hearing that many of the mothers of the child-athletes were in the rooms when Nassar was "treating" his young patient-victims. None of the mothers had any idea Nassar's "procedures" were not sanctioned, that he was breaking the law, or that their daughters were being traumatized before their very eyes.
But as a mother and a health care professional I am curious ... Where were the nurses? Where were the U.S. gymnastic chaperones? Where were the so-called health care professionals who understand patient needs and whose jobs are centered around communicating with patients and their families? I would wager no health care professional other than the then-physician and the young gymnast/athlete was in those examination rooms. Perhaps, if there had been an authorized chaperone of some sort in the room with the then-physician and the patient, some of these victim-survivors would not have had to endure what was so devious and methodically done to them under the guise of "professional medical treatment."
I believe with this scandal, a change must happen. As professional nurses, it is our responsibility-no matter the circumstance-to be present in an examination room with a patient during any type of physician visit or procedure, no matter the patient's age. Even for routine follow-up visits, having a nurse's presence in the examination room when the physician is present is imperative.
Beyond having a presence, we must be knowledgeable and forthright. While in the room, it is essential for the nurse to have complete awareness of all examination procedures and to follow through on implementing policies and protocol of making certain no physician is ever alone in an examination room with a patient. One would think this to be a common practice. But clearly, recent history has indicated that is not so. Considering the Nassar-Strampel disgrace, the state of Michigan has introduced House Bill 5793 (2018), which would mandate authorized chaperones to be present in an examination room with a physician or other health care provider performing a medical treatment, procedure, or examination on a patient. However, we, as nurses, should always be cognizant to promote patient safety and protect our patients by being present with the physician or any other providers in the examination room-state law or not.
For 20-some years, Nassar was getting away with abusing his patients. How could no nurse have caught onto something during the 20 years he was doing this? It totally flummoxes me! But this situation needs to be a wake-up call to all of us as patient advocates and health care professionals. This kind of unimaginable abuse cannot and should not ever happen under our professional care.
More often than in other areas of medicine, plastic and aesthetic procedures require patients to be in vulnerable situations. Patients are "exposed" for consultations, pre- and postoperative examinations, and during surgery when the patient is under anesthesia. As nurses, we need to protect our patients constantly by being acutely aware of the environment around the patient.
By no means should we assume our physicians and colleagues have ill intentions. However, our perceptions need to be sharper than ever before; our profession is being tainted by individuals who should never have had any type of contact with patients in the first place.
Being inundated with this news has been a struggle, but change is afoot. For institutions such as MSU and USA Gymnastics, this means administrative changes and strengthening policies and procedures to protect students and athletes. But we, as nurses, can be a part of this change from inside the medical profession. We can and undeniably should be patients' greatest advocates and the health care professionals who irrefutably inspire safety, trust, and integrity.
Georgia Elmassian, MSN, MA, APRN, CPSN, CFLE
ISPAN President