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  • Behind the curtain: Are same-sex rooms needed in public hospitals?

Behind the curtain: Are same-sex rooms needed in public hospitals?

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An intern at a major Melbourne public hospital recently gave me a choice: I could be admitted for a few days or go home if someone stayed with me and I could do my own injections. I grabbed the injection from the nurse standing next to the intern and plunged it into my lower tummy. ‘See,’ I said, ‘I can go home.’

My reason for desperately wanting to leave the hospital had nothing to do with the care I was given. It was first-class and the follow up in out-patients has also been tops. I particularly enjoyed talking to the emergency nurses, and one had a giggle when she was testing my cognitive capacity. ‘Where are you?’ she asked. I replied, ‘(Name of hospital) emergency short stay unit.’ She told me that most people just say ‘hospital’.

One of the biggest reasons I wished to leave emergency was because I didn’t want the possibility of being admitted to a hospital room that also housed men. That would have meant sleeping in the same room and sharing a bathroom with men I didn’t know. My mum spent a couple of nights at the same hospital sharing a room with a man with only a flimsy curtain to separate them. My late husband shared a room at another large public hospital with two other men and a woman.

I’ve since asked female friends, including a GP, how they would feel about sharing a hospital room with men. They answered with a grimace. We all agreed that when you’re in a vulnerable situation with little privacy, you don’t want to be sleeping in the same room as strange men.

Public hospitals around the country quietly introduced mixed gender rooms during the noughties to get patients to their rooms quicker after being in emergency. Patients going to hospital for elective surgery or other treatments have also been placed in mixed sex rooms, according to women who discussed the practice in a Breast Cancer Australia Network forum in October 2021.

One woman wrote that after ‘mastectomy + surgery’ in a public hospital she was placed in a mixed gender cardio ward and was later moved to a ‘two bedroom with a gentleman who was recovering from stomach/bowel surgery’. She said she did her ‘best at managing the bathroom sharing’. Another woman wrote that she had surgery on both breasts and stayed two nights. 

Next to me was a man with some prostate issue, was easy enough to hear the doctors talking to him.  Likewise I am sure he heard all about my breast concerns.  In the adjoining room there was mixed genders also, couldn’t they sort this out.. really it isn’t that difficult.  It has to do with staffing issues and not putting patients first!’

 

'Such a paucity of research was unexpected as maintaining patient privacy and dignity is a critical aspect of the nurse’s role and inextricably linked to quality of care and the care environment.'

 

In 2022, NSW Health released a policy directive stating that patients admitted to hospitals ‘must not have to sleep in the same room, ward or bay, use mixed bathroom facilities or pass through opposite gender wards to reach their own facilities’. There were caveats though. Patients needing ‘highly specialised or urgent care’ could be placed in mixed gender rooms. And a person’s admission to hospital could not be delayed when same gender accommodation was unavailable.

Last year, the St. George and Sutherland Shire Leader in NSW published letters to the editor about the practice. One letter writer wrote she was upset that her mother had to share a room with two men at the Sutherland Hospital in Caringbah, a southern suburb in Sydney.

Imagine your mum, sister, daughter, aunt, partner or friend...they are very ill and need hospital care. They are not frocked up with their best bra and undies. Then look across the ward - they are sharing with male patients, who frankly didn’t seem to care about what my mum had to endure. Are you nervous they are there at night alone with your mum?’

A spokesperson for the South Eastern Sydney Local Health District responded in the letters section that it was not always possible to accommodate people in same gender hospital rooms due to clinical reasons or if same sex rooms were unavailable. In the past, the Australian Medical Association has said that the prevalence of mixed gender hospital rooms was a sign of not having enough beds in public hospitals.

My concerns about mixed gender hospital rooms are reflected in research released in October last year by two New Zealand academics from the department of medicine at the University of Otago. Cindy Towns and Angela Ballantyne say in their paper, ‘Blowing The Whistle On Mixed Gender Hospital Rooms In Australia and New Zealand: A Human Rights Issue’ that mixed gender rooms are on the rise in New Zealand and the practice is used in Australia. 

‘However, neither country has a specific national policy on the practice, and rates are not reported,’ they write in the Journal of Medical Ethics, published by the British Medical Journal.

Other research cited in their paper shows that the practice of putting females and males in the same room increases distress and fear of assault among women in New South Wales hospitals In 2018, a Victorian survey of mixed gender rooms in mental health wards revealed that over two-thirds of female patients are fearful.

The researchers argue that mixed gender hospital rooms violate fundamental human rights outlined in the Universal Declaration of Human Rights in Australia and New Zealand. ‘We argue that the practice breaches the right to personal security and dignity and that the characteristics of hospital in-patients significantly increases the risk for harm,’ they write.

‘We advocate for national, publicly reportable healthcare standards that specifically prohibit mixed gender hospital rooms in non-critical services. We recommend that hospitals in the future be designed with single rooms as the standard of care.’

There has also been little quality research on the issue, according to Monash University nursing academic Allison Williams who wrote a 2016 paper advocating for single sex accommodation.

Such a paucity (of research) was unexpected as maintaining patient privacy and dignity is a critical aspect of the nurse’s role and inextricably linked to quality of care and the care environment,’ Williams wrote in Collegian Journal of The Royal College of Nursing Australia.

It’s time that the practice was put on the agenda for the psychological health and safety of women. I suspect some men also feel uncomfortable in mixed gender rooms. My late husband thought it weird that a woman was in a room with him and two other men. They all shared the same bathroom.

My experience in the emergency short stay unit has further cemented my belief that same sex rooms are needed in non-critical areas in public hospitals. While lying on my bed, I noticed a middle-aged man walking past my cubicle wearing his hospital gown untied at the back. The white linen flapped around exposing his backside. ‘I wouldn’t want to be sharing a room with him,’ I remembered thinking.

 

 

 


Dr Erica Cervini is a freelance journalist and sessional academic.

Main image: (Getty Images)

Topic tags: Erica Cervini, Hospital, Mixed Gender Rooms

 

 

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Existing comments

Friend's mother was in a mixed-sex ward after she had had a stroke, which meant she could not move from her bed. Night after night a man in the room wandered around touching the women. Nurses would usher him back to his own bed, but they seemed unable to find him accommodation away from women. The whole experience was terrifying for my friend's mother.


Janet | 01 February 2024  

This is an important issue that can cause great stress and anxiety, in what is already a stressful experience. Well done for raising the issue Dr Erica!


David Marlow | 01 February 2024  

Furiously agreeing with this. Thinking of a female patient long awaiting a place in a rehab-cum-mental health facility. She left after three nights spent in an unlocked room with an aggressive ‘suitor’ next door, who spent his nights shouting to her about his desires. 100% of the women there had been abused by men, so males were scary for them. Crucial research is needed and it could start with some solid numbers about the female ‘quitters’ who just can’t hack severe anxiety about how safe they are in such places.


Kathleen Hughes | 01 February 2024  

We all have a right to feel safe. To put people in this potentially distressing position when they are sick and already feeling vulnerable will put people off seeking necessary medical help.
This is an important issue that needs to be addressed.


Diana | 02 February 2024  

The security of a female patient is a contingent feature of the issue, not an intrinsic one (to use the analytical tools so kindly shared by Associate Professor Holly Lawford-Smith in her recent contribution to ES). Better staffing and supervision and sensible legally-enforceable regulations will fix the problem of stalking and groping.


What is intrinsic is the breaking down of taboo by normalising the mixing of males and females in intimate spaces such as bathrooms and dormitories. But there is no mixing in dormitories, you say. Well, there used to be no mixing of sexes in hospital wards which are a kind of dormitory.


Mixed spaces also enables the authorities to avoid the issue of whether trans-women are really woman enough to participate in traditionally women-only spaces.


roy chen yee | 09 February 2024  

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