Sexual Harassment May Adversely Affect Patient Care

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By Debra Wood, RN, contributor

At one time or another, most nurses have felt uncomfortable with a patient’s inappropriate sexual behavior. A recent study found when nurses feel sexually harassed by a patient, they tend to distance themselves from that patient, providing medical essentials but withholding emotional support.

“They withdrew completely the supportive care and would provide only the minimum of technical care the patient required,” said lead investigator Debbie Dougherty, Ph.D., assistant communication professor at the University of Missouri-Columbia. “Nurses see the emotional care and relational care as equally important [to technical tasks], but they would withdraw that from these patients. I think that affects the level and type of care people receive.”

While conducting a prior study about sexual harassment in health care organizations, Dougherty learned that the problem includes patients, not just hospital and medical staff. For this qualitative study, she contacted 17 female and 4 male nurses suggested by those in the first study and then affirmed the results by interviewing an additional seven nurses.

Participants ranged in age from 22 to 88 years and worked in a variety of settings. Most could recall incidents during which patients treated them in a sexually inappropriate manner, such as verbal innuendos, unwelcome touching and exposure of erect sexual organs.

Dougherty found nurses tend to laugh it off and then create distance between themselves and the patient. They may use humor or putdowns with the patient to try to get him to stop the behavior.

That may not be the best way to handle sexual harassment, but according to Dougherty’s findings, few nurses have received any training in how to deal with the issue. She suggests nurses meet to discuss what has worked for them and share successful tactics with their peers.

Health care consultant Patricia Trites, MPA, CHCC, CPC, CHP, recommends nurses tell the patient the behavior is inappropriate and to knock it off. Then the nurse should report it to a supervisor.

“The responsible person needs to have a conversation with the patient and say, ‘There are the rules here and this type of behavior is not allowed. We can only give you one warning and after that, we will have to dismiss you,’” said Trites, CEO of Healthcare Compliance Resources in Augusta, Michigan.

Trites admits this is easier in an outpatient setting, where a patient can be given 30 days notice to find a new provider, than in a hospital. Nevertheless, she said an alert and oriented patient should be informed of the consequences of such actions or they will not stop.

If an employer knows that a non-employee is sexually harassing an employee and does nothing to stop it, the employer could be subject to a sexual harassment claim, explained attorney Phillip R. Maltin, a partner at Silver & Freedman of Los Angeles.

Maltin encourages employers to compassionately listen and respond to employees’ complaints of sexual harassment by patients, because he has found most people who file lawsuits against their employers usually feel their supervisors or human relations professionals ignored them or treated they disrespectfully.

Attorney Teresa R. Tracy, a partner at Baker & Hostetler LLP in Los Angeles, said most employers are quite sensitive to sexual harassment in the workplace. She encourages employers establish a written policy and spend more time training nurses how to address inappropriate behavior, rather than bringing administration into the situation, unless nurses are subjected to extreme activity.

“Nurses and other who work in the health-care area are in a unique situation,” Tracy said. “Oftentimes, they are dealing with patients who are under a lot of stress, who are in pain or on a variety of medications. They may not have the same inhibitions, if you will. They may act differently in the hospital than in the outside world.”

Patients with dementia or other brain damage often cannot comprehend their actions are objectionable. In those cases, changing the nurse caring for the patient may help.

The American Nurses Association (ANA) has issued a policy statement, saying it “believes that nurses and students of nursing have a right to and responsibility for a workplace free of sexual harassment. Sexual harassment has an adverse impact on the health care environment.”

ANA recommends a four-phase approach: confront the harasser, report the harassment to a supervisor, document the incident while it is fresh in the mind, and seek support from colleagues, friends or an organized group, such as a state nurses association.

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