Sexual Harassment In The Healthcare Setting [transcript] [audio]

Guest: Kate Fenner, Ph.D., RN

Presenter: Neal Howard

Guest Bio: A regular keynote speaker throughout the country, Kate has authored a leading college text on law and ethics in healthcare, co-authored other texts on a variety of healthcare issues, and currently serves on the editorial board of the Journal for Nursing in the 21st Century. As Managing Director of Compass Clinical Consulting, Kate uses her problem-solving and communication skills to help clients meet their clinical and cultural goals, focusing on organizational optimization, performance improvement, and regulatory compliance. Kate has led and participated in dozens of mock surveys to help healthcare organizations meet the standards and expectations of regulatory bodies such as the Joint Commission, the Centers for Medicare and Medicaid Services, and State Departments of Health, and guides hospitals and health systems through accreditation and regulatory compliance response and recovery efforts. You can contact Kate [email protected] or 800-241-0142.

Segment Overview: Kate Fenner, Ph.D., RN, Managing Director of Compass Clinical Consulting, discusses how to prevent, detect and remediate sexual harassment issues before they ruin your organizations’ reputation and drain critical financial resources.

Transcript – Harassment

Neal Howard: I’m your host Neal Howard, here on Health Professional Radio. Thank you for joining us. Our guest is Kate Fenner, RN and Managing Director of Compass Clinical Consulting. She’s joining us here on the program to talk about how to prevent, detect and remediate sexual harassment issues before they ruin your organization’s reputation and possibly drain critical financial resources especially in the healthcare industry. Welcome to Health Professional Radio.

Kate Fenner: Thank you.

N: I did say that you were Managing Director of Compass Clinical Consulting. You’ve not always been the Managing Director of Compass?

K: I’ve got a long history in health care, starting as a nurse and then moving into teaching and then administration, university work and then over to Compass Clinical Consulting where I’ve worked in accreditation and regulatory compliance. I have focused on a variety of those kinds of issues and the whole topic of sexual harassment. It has been always simmering in the background in health care as you can well imagine.

N: Well it’s not simmering anymore at least in many industries. How is sexual harassment first of all defined in a healthcare setting and is it any different in the health care setting from what we hear in the mainstream media?

K: From a legal perspective it certainly isn’t different. I should be clear that I’m not a lawyer, that my background is accreditation regulatory affairs but from the legal definition it is no different in a hospital except that it also extends of course to patients as well as employees and visitors in a hospital setting. Otherwise the definition of harassment is very much the same. Any unwelcome advances, any creating of a hostile work environment, any requests for sexual favors and implications that a person in power can adversely affect an individual, if they don’t cooperate. Those all fall within and happen in hospital environments just as they do in every other environment.

N: I would think that it’s a little bit more complicated being as you suggested that it trickles down to the patients, the visitors of those patients, support staff not just the people who are involved in taking care of the patients. How can you prevent sexual harassment in the health care setting in the first place, but then how do you address it going to your customers not just the people that work there, your clients, your customers?

K: Excellent question. The prevention side, is step one, of course and it’s very strong policy but more importantly than very strong policy, zero tolerance policy is communication and education of policy. So that as staff joins an organization, they have as part of their required orientation of the zero tolerance policy and education about their rights and responsibilities, every right usually has an attendant responsibility. That’s the prevention part. The prevention part is making sure that managers and medical staff leaders, all are aware and have a similar zero tolerance policy. It’s also making sure that people understand their rights to a harassment free environment whether it’s staff members or actually as patients enter hospitals. There’s a requirement that hospitals inform them of their rights and their right is to safe and competent care essentially. I see the whole issue of sexual harassment as being part of a larger ethical piece about why hospitals and healthcare facilities exist. We’re here to serve people when they’re needing us. That service includes making certain we observed their rights to dignity and self protection.

N: We’re talking about the rights and dignity of the patient as someone seeking care. We don’t often hear about someone say coming into the insurance agency to buy insurance and sexually harassing the agent or coming into the bakery and harassing the chef. Is it possible that these sexual harassment issues emanate from a patient whose being at the hospital for an extended period of time or for different types of mental or physical issues? How do we address those types of issues?

K: You spot on with the problem in healthcare, because there are some fairly illustrative court cases where employees have been harassed by patients. And hospitals have not taken preventative measures, have not intervened and the employee has been found to induce merit of compensation because of it. Particularly with patients who may have an altered mental status. Think about patients with Alzheimer’s, patients with mental health issues in general but patients tend to particularly, if they’re in for a while, they can become disoriented and their world alters a little bit. It’s very important that we take steps when that happens when a patient harasses a staff member to intervene and explain to the patient that this is not acceptable and if need be reassign the staff member. So that they’re not exposed.

N: What would you say, are some of the underlying cultural and maybe communication issues that prevent, many of these sexual harassment issues from both staff members and possibly patients or even visitors of patients from even being reported in the first place?

K: Also a good question. Hospitals are hierarchies. There are centers of power and there’s also people who are in relatively powerless decisions. People who are in powerless positions frequently feel and feel impeded from reporting on situations where they feel degraded or harassed. But the typical example in a hospital is in the operating room, where it’s a very tense environment, where there are very powerful people and very powerless people. There are numerous instances where instances of harassment come out of ORs for that reason. It’s a cultural hierarchy and it’s hard to report up and not feel like you’re at risk for some sort of punishment retaliation. Hospitals are staffed that way. Patients frequently don’t see themselves as having significant rights. They are the recipients of care. They feel helpless. A lot of things are attacked in terms of what happens when you become a patient in the hospital. They may not recognize that certain behavior is inappropriate or they may not feel like they have the freedom to say anything about that behavior. Particularly that behavior comes from a very important caregiver. It’s a lot of tricky minefields in the health care and hospital environment that don’t exist in other environments to the same extent. I mean unequal power relationships are everywhere but hospitals are particularly structured.

N: When you have this perceived and very real imbalance of power in the hospital, the doctor-patient setting, how can you make sure that this is addressed in your organization that people feel that they do have the right to speak out and that someone will take whatever action is necessary? How do you build that within your organization?

K: I think the important part is to prove that your policy doesn’t exist on paper to live your values, so that no matter who is accused there is a thorough credible and fair investigation and that if the complaint is substantiated, that the appropriate steps are taken regardless of how important the individual is within the organization. There’s a great case that comes out of California where a transport person was accused of using inappropriate language in his responsibilities and he was terminated. In the same institution, a surgeon had been similarly accused and nothing was done. You can’t do that. You have to have to demonstrate that we’re all equal in the eyes of this standard. That it’s the fanciest neurosurgeons who may be tremendously skilled but it’s held to the same standards around decency and important as the lowest orderly leader, orders to safe.

N: Kate, where can we go online and get some more from about Compass Clinical Consulting and possibly some more about how sexual harassment is viewed and dealt with in a healthcare setting?

K: In Compass Clinical Consulting is that compass-clinical.com and we would be delighted to have people take a look at the website. This work is oriented towards our accreditation regulatory compliance area. If they’re specifically looking, that a great resource is the EEOC, Federal Equal Employment Opportunity Commission has tremendous documentation on definitions of sexual harassment and policies about saying what to do with it. Then also I’m going to use the acronym because I’ve used it so often I can’t remember what the name stands for sure, the Society for Healthcare Human Resources Management that’s it. It has some excellent training materials that people are interested in downloading for a really minimal fee some materials. But we’re delighted to talk with people about the whole prevention, detection, remediation – PDR which is if you’re a health professional that’s an old set of initials. The PDR for around sexual harassment. Be delighted to check.

N: Kate Fenner, Managing Director of Compass Clinical Consulting hope to speak with you again in the future.

K: Thank you Neal. It’s been my pleasure.

N: You’ve been listening to Health Professional Radio. I’m your host Neal Howard. Transcripts and audio of the program are available at health professionalradio.com.au and also at hpr.fm. You can subscribe to this podcast on iTunes, listen in and download at SoundCloud and be sure and visit our affiliates page at healthprofessionalradio.com.au and at hpr.fm.

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