Jennifer Flynn, a representative from Nurses Service Organization (NSO), discusses sexual inappropriate behavior against nurses and other caregivers by patients.
Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you so much for joining us on the program. Well our guest today is a returning guest,
she’s been here with us I think a couple of times now. Jennifer Flynn, she’s a risk manager for Nurses Service Organization or the NSO and she’s going to talk with us today about a very important topic, very important subject especially today – it’s sexual harassment between patients and caregivers. Welcome back to Health Professional Radio Jennifer.
Jennifer Flynn: Thank you Neal, thanks for having me today.
Neal: For our listeners who may not be familiar with you and as I said, you’ve been here before, give us just a little bit of background about yourself. I know that you are risk manager at the Nurses Service Organization but give us just a little bit of background about yourself.
Jennifer: Sure. I’ve been with NSO just over 17 years and I really feel it’s important to look at some of the issues that nurses face today. And my main responsibility is to make nurses aware of some of the liability, the risks that they face in their practice today and really provide some strategies or risk control information that they can incorporate into their practice to prevent the likelihood of a malpractice lawsuit and even increase patient goals and outcomes.
Neal: In light of what’s been going on in recent years as far as sexual harassment especially in the workplace, when it comes to to nursing healthcare facilities, they’re a special type of facility. You have sick people, you have demented people, you have people who have been in accidents, all kinds of things are going on – what constitutes sexual harassment in that environment and does it differ at all from sexual harassment in any other environment?
Jennifer: Yeah, that’s a great question. I really am happy that Health Professional Radio is tackling this issue. I don’t need to tell you that there’s been a deluge of sexual misconduct episodes recently reported in the media but this topic also affects healthcare and nurses so I’m happy to talk about the prevalence in healthcare and how nurses can protect themselves. So that first part, the U.S. Equal Employment Opportunity Commission, the EEOC really defines sexual harassment as unwanted, unwelcome sexual advances, requests for sexual favors, other verbal and physical harassment of a sexual nature. And harassment can even become or be considered illegal if it’s so frequent or so severe that it creates a hostile work environment or it results in adverse employment decision. So this would be such as if the nurse was fired or demoted because of this.
Neal: There is a difference between inappropriate and illegal, that might be some clarification that many of our listeners may not be aware of.
Jennifer: Right. So the EEOC defines those two categories of harassment. But beyond that, the EEOC also did an analysis of sexual misconduct claims. They looked at from 2005 to 2015 and found that 11.5 percent of claims were from the healthcare and social assistance industry. Now that’s high compared to other industries and that number may seem low but actual numbers are really hard to come by because experts think that sexual harassment is really significantly underreported in healthcare.
Neal: Being underreported, what are some of the reasons in healthcare that they think it’s more under reported than in some other industries?
Jennifer: Right. So I believe the reasons nurses might not report is really multifactorial. Nurses have a right to protect themselves but unfortunately, I think that nurses too often consider harassment as quote-unquote part of the job and they even might be unsure as when a patient’s behavior has crossed the line so there’s a misperception as to what constitutes harassment. Another reason nurses might feel they don’t report is because they might feel it poorly reflects on them or their performance. There might not even be a clear reporting policy at their facility so they don’t know who to talk to or what next steps to take in their organization. And lastly, I think there’s also the slight fear of retaliation especially if the aggressor is in a position of authority, a notion of quid pro quo. National reporting found that only about a third of nurses reported incidents and in some cases, it was found that the nurses were so intimidated or demeaned in their environment that it negatively affected their job performance. So no matter who the harasser, whether it be a supervisor, a co-worker or a patient or someone else, nurses can take steps to address harassment in their workplace.
Neal: As a risk manager, you would say that all harassment should be reported if it makes you feel in the least uncomfortable or threatened. Is that what you would say to a young person starting out their nursing career?
Jennifer: Sure. So I definitely would say the first step in addressing harassment is to do a few things. One, you might actually speak directly with the harasser. Let’s say it’s a patient, that is unless you feel there’s a safety issue. In that case, have someone else there during that conversation like a supervisor or someone from human resources. Nurses should address it with patients to make clear that their comments or actions are unwanted and really if that behavior doesn’t stop, further action will be taken. So if you think about having this discussion with your patient, it may not have been intended that their actions or behavior were meant to be offensive, so this gives the nurse an opportunity to understand the patient and the behavior. And nurses would definitely want to document this conversation they had with the patient noting specific date, the date they had this conversation, the time, any verbatim comments the patient made and who may have been present for that conversation. But I would also say that if that behavior doesn’t change despite your trying to correct it, you should then be reporting that to your employer because employers are responsible for investigating and addressing harassment by patients. I would note on that though that if the patient’s behavior doesn’t change, another strategy a nurse might take is to possibly transfer that patient or that care to another provider but with that, it’s important to note that a nurse’s responsibility to provide care to that patient until the transfer is completed to avoid allegations of abandonment and you’ll be documenting this as well in the record.
Neal: Is it the transferring nurse’s responsibility to relay the reason for the transfer to the receiving nurse or facility?
Jennifer: S yes, the nurse will want to give that transferring nurse the full picture but that would also include the status of the patient’s condition and any other things that the facility would require during that hand off, the communication during that handoff.
Neal: Would a dementia patient fall into the same category as any other patient as far as inappropriate behavior or behavior that is so intense that it requires a transfer with lack of policies in place in some facilities? Of course not all, would we expect there be to be some policy that deals directly with dementia patients when it comes to harassment?
Jennifer: So dementia patients, yeah, that’s a great question. Really dementia patients or any patients that are perceived to be as cognitively impaired may need even additional step or a different approach to engaging with them to address this behavior. So you might, with a dementia patient, still be having those discussions that their behavior is inappropriate so you may need to use more nonverbal cues as well as the verbal information that you’re saying. So making that patient aware of the inappropriate behavior, but maybe being firm, “Stop. I don’t like when you do that.” Or redirecting their behavior to focus their attention in some other way and definitely using those nonverbal cues as well. Shaking your hand and letting them know “No, no, no.”
Neal: Well where can our listeners go online and get some more information about the NSO? And I’m certain that the NSO’s website has some resources that deal directly with sexual harassment and/or give some direction, pointing the way to get more information, am I correct in assuming that and can you give us that website?
Jennifer: Sure. We have information such as articles and even a webinar information that they can listen to on www.nso.com but there’s also resources available to nurses even from the American Nurses Association. ANA has best practices for nurses and civility, so a good resource for nurses to not only engage in self care, self respect, respect for other colleagues and really showing that harassment will not be tolerated. It’s really vital to a nurse’s professional effectiveness and help can contribute to a civil work environment. So happy to provide those resources to nurses and they can always even reach out to NSO if they have any further questions.
Neal: Great. Jen, always a pleasure. Thank you so much for coming back on the program.
Jennifer: Great thanks Neal, thanks for having me.
Neal: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com.au. You can subscribe to this podcast on iTunes, listen and download at SoundCloud and be sure and visit our Affiliate Page at hpr.fm and healthprofessionalradio.com.au