'We’ve Got You Covered': Protecting Patient Modesty at Shriners Children’s Boston

Sometimes, the simplest act can have a meaningful impact on patient outcomes.

At Shriners Children’s Boston, as part of ongoing efforts to improve patient care and satisfaction, clinical staff considered the question: “How can we be more mindful of our patients’ religious, cultural and personal modesty and privacy preferences during exams and procedures?” This led to the We’ve Got You Covered initiative, a commitment to healthcare providers throughout the hospital to protect patient dignity in every encounter.

The project was led by Shriners Children’s Boston perioperative nurse Maureen “Mo” Hanley, BSN, RN, CNOR, CBRN, who was a patient at another hospital years ago. Mo felt embarrassed and disrespected when medical staff failed to keep her covered after she sustained serious injuries in a car accident. “My clothes were cut off so they could assess me, but after that, no one seemed to care that I was completely exposed. No one did anything to protect my privacy.”

It is not uncommon for healthcare professionals to become desensitized to privacy needs in a fast-paced environment. Mo noted that when asked, staff may reply, “I see it all the time,” or, “It’s during surgery, the patient is asleep and won’t know.” Her We’ve Got You Covered project encourages staff at Shriners Children’s Boston to be more mindful of patients' feelings and beliefs about modesty.

As an operating room nurse, Mo recognizes that many surgeries require exposing sensitive body parts. However, her philosophy of providing maximum coverage for as long as possible keeps patient dignity at the forefront. “Patients are vulnerable while under general anesthesia – unable to cover themselves – so I take my role as their advocate very seriously,” said Mo. She explained that there are many ways to limit what is visible – such as sterile towels, blankets, disposable underwear and even disposable hijabs – which demonstrate cultural competence and help reduce patient anxiety about body image and exposure.

Dan Driscoll, M.D., FACS, was an early supporter of the mindset surrounding patient modesty. “With the amount of volume we have at Shriners Children’s Boston, there’s always a sense we’ve just got to get the job done. You must balance that with the patient’s concerns,” said Dr. Driscoll. “It’s important in a pediatric hospital, especially for teenagers who are going through natural body changes, to let them know we are taking care of them, and we are respectful of their modesty.”

The outpatient clinic at Shriners Children’s Boston has also played a key role in advancing We’ve Got You Covered. The clinic is often where care begins, with checkups and preparation for surgery. “Modesty is at the top of the list of things that make patients anxious when coming to a doctor’s office. We let them know that their privacy will be maintained,” said Debbie Carlson, BSN, RN, CPN. “Mo has been able to change the climate in the operating room, where modesty is now the new norm. We’ve Got You Covered has been well received, especially from the outpatient clinic and patients.”

Child life specialist Brooke Allen, MS, CCLS, was also a champion of Mo’s efforts. “This is another way we can advocate for our patients and offer truly patient- and family-centered care,” said Brooke, who emphasized that protecting the privacy of patients makes them feel more comfortable with their clinicians. “This project is important for our patient population because of the variety of conditions we treat. Ensuring our patients can trust us as caregivers is an integral part of a positive patient experience.”

Mo submitted the We’ve Got You Covered initiative to the American Burn Association annual conference in 2024, and recently highlighted it at the Shriners Children’s Burn and Craniofacial Research Conference. She also attended the Association of PeriOperative Registered Nurses' national conference in Boston this spring, where she detailed the We’ve Got You Covered modesty project during a nursing research panel.

Positive feedback on Mo’s patient modesty project extends beyond colleagues and medical professionals to those it directly impacts: the patients she cares for, their families and caregivers. “Caregivers are so appreciative of our staff taking time to address their child’s modesty. If these are the things we’re doing to make these children feel better about coming here, it’s going to make them feel even safer while at Shriners Children’s Boston.”