Sexual harassment by patients: Do you know what to do?

Presented by NSO and CNA

The deluge of sexual misconduct episodes recently reported in the media has put the workplace under the microscope when it comes to appropriate—and inappropriate—behavior. The healthcare setting isn’t immune to this workplace problem. An analysis of claims filed with the U.S. Equal Employment Opportunity Commission (EEOC) from 2005 to 2015 found that 11.48% of claims were from the healthcare and social assistance industry, the fourth highest and only slightly behind manufacturing at 11.72%.

That number may seem low, but remember it only reflects cases where a claim was filed. Far more often, no action is taken by the person being harassed, which means actual numbers are hard to come by. However, experts believe that sexual harassment is significantly underreported in healthcare. Nurses may also be unsure as to when a patient’s behavior crosses the line, particularly if the patient is perceived as cognitively impaired.

You have a right to protect yourself from harm by reporting inappropriate behavior, and, if necessary, transferring a patient to a new provider. If you need to transfer a patient, however, do so carefully to avoid charges of abandonment.

What is Sexual Harassment?

The EEOC notes that sexual harassment includes unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature. Harassment is illegal when it is so frequent or severe that it creates a hostile or offensive work environment or when it results in an adverse employment decision (such as the victim being fired or demoted).

The harasser can be a supervisor, a coworker, a client, or a customer, such as a patient, which is the focus of this article.

A Direct Approach

The first step in addressing sexual harassment is to speak directly with the patient, unless you feel there is a safety issue. (In that case, have a third person such as your supervisor or somebody from human resources present.) Set boundaries by making it clear that the comments or actions are unwanted. It’s important to be firm and note that if the behavior doesn't stop further action will be needed.  

Be sure to document the situation and any conversations that you had with the patient. Be specific, listing dates, times, verbatim comments, and any witnesses to the behavior. 

When You Need to Report

If your efforts to correct the patient’s behavior don’t work, report the problem to your supervisor. Previous court action by the EEOC indicates that it considers the employer responsible for addressing harassment by patients. The employer has to conduct an investigation and take action as indicated.

If you fail to obtain a satisfactory outcome to the investigation, consider consulting an attorney. Above all, remember that your responsibilities as a nurse do not include being the victim of sexual harassment.

If You Need to Transfer a Patient

If the patient’s behavior toward you doesn’t change, you may need to transfer his or her care to another nurse. Until that can happen, avoid being alone with the patient. Know your ethical responsibility is to provide care until a patient is transferred to another qualified nurse, so you cannot be charged with patient abandonment. Be sure to give the new provider a thorough report of the patient’s condition and document that you did so in the health record. 

Prevention

Employers and nurses can take steps to prevent sexual harassment. Organizations should have a policy in place that addresses harassment and outlines reporting steps. Patients should know the nurse is a professional and should be held accountable if harassment occurs. 

It’s also important for nurses and other employees to model the desired behavior in front of patients. If you do say something inappropriate, immediately apologize. You can also download a graphic of the American Nurses Association Civility Best Practices for Nurses.

Examples of Sexual Harassment Conduct:

Physical

• Unwanted touching, grabbing, patting, pinching, hugging, kissing
• Constantly brushing up against another’s body
• Touching an employee’s clothing, hair, or body
• Cornering

Verbal

• Requests for sexual favors
• Questions or comments about the person’s sexual fantasies or behavior
• Offensive jokes or language
• Referring to an adult as sweetie, babe, honey, etc.
• Sexual comments about a person’s clothing, anatomy, or looks
• Repeated cat calls, whistling

Other

• Offensive gestures
• Leering at a person’s body
• Sharing materials of a sexual nature

Protect Yourself

You have a right to protect yourself from verbal or physical harassment of a sexual nature. Know your organization’s policy and be sure to document the situation. Above all, be a model of respectful behavior for others. In doing so, you can help protect yourself from a liability lawsuit.

This risk management information was provided by Nurses Service Organization (NSO), www.nso.com, 1-800-247-1500.

CANP endorses the individual professional liability insurance policy administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an email to service@nso.com.