Nurses Face Harassment From Patients

  1. KANSAS CITY, Mo. - Nurse Sarah Andres is so used to male patients calling her "sweetie" or "cutie"-or even asking her for a kiss-that it rarely upsets her anymore.

    "I usually chalk it up to they don't feel good, a lot of them are confused," said Andres, who has been a nurse in St. Louis for five years and works in the critical care unit at St. Mary's Health Center. "I never really thought of it as sexual harassment."
    But nursing organizations say such treatment is common, and it is definitely sexual harassment.
    The American Nurses Association cites a 1982 study that reported that 60 percent of the nurses surveyed said they had experienced sexual harassment at work, though that included all cases, not just from patients. Still, nursing officials said it is clear that inappropriate behavior among patients is a widespread problem.
    "I suspect that if you ask nurses if they've been harassed by patients, a majority would say yes," said Belinda Heimericks, executive director of the Missouri Nurses Association. "Nearly every nurse will run into it at some time in their career."
    The harassment can run the gamut from offensive jokes or sexual comments to inappropriate touching. Sexual assaults are rare but do occur, nursing officials say. Some male nurses have reported being harassed, but the overwhelming majority of cases are between male patients and female nurses.
    Such harassment creates tension for nurses, who must walk a fine line between meeting their professional responsibilities to the patient and protecting themselves.
    Debbie Dougherty, an assistant professor of communications at the University of Missouri-Columbia, interviewed 29 nurses in four states to determine how they react to the harassment and how it affects their relationships with patients.
    She found that nurses usually crack jokes or sternly reject the patient's conduct. Most nurses said they continue to provide medical care, but the emotional support patients need from them sometimes declines, Dougherty said.
    "It probably makes the relationship a little more tense because there is a feeling of uncomfortableness between the nurse and patient," Heimericks said.
    Dougherty's study, which will be published in the spring issue of Management Communication Quarterly, found nurses are generally more distressed by harassment from co-workers or doctors. Heimericks agreed, saying patients come and go, while nurses have to see the co-workers every day.
    Federal and state laws protect nurses from sexual harassment by patients, and the institutions' written guidelines must reflect those laws.
    In most cases, the harassment stops far before a lawyer has to be called in or charges are filed.
    Nursing organizations say that if harassment from a patient continues, nurses can ask to have a second nurse stand by in the patient's room, refuse to care for the patient, ask that the patient be transferred to another floor, or report the behavior to a superior. Doctors and administrators are sometimes called in to talk to the patient.
    In extreme cases, institutions can "fire" patients and send them to another hospital, said Scotty Shively, an employment and health lawyer in Little Rock, Ark.
    But medical institutions are constrained by certain legal obligations to care for patients, Shively said. For example, patients needing emergency care must be admitted. And dealing with harassment becomes more complex if the patient is mentally ill.
    Andres said she has sometimes asked not to take care of a particularly troublesome patient. But usually, she said, "I just tell them that we are supposed to be professional here. I tell them we need to have mutual respect. Sometimes you have to talk to them almost like children."
    Dougherty's study found that nurses receive little training in handling sexual harassment from patients. Andres agreed.
    "It's something you learn as you work," she said. "I just try to keep the relationship professional. I call the patient `Mr.' or `Mrs.' whatever, and I expect the same thing from them. I don't expect to be called pet names at work."
    http://news.yahoo.com/s/ap/20051215/...NlYwMlJVRPUCUl
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  2. 50 Comments

  3. by   StuNurseUP
    LOM can be so nasty sometimes! LOM in a WC decided it would be funny to wave his new porn mag in my face when I was 8 months pregnant.Got a real kick out of the shock on my face. If he wasn't in a wheel chair and he wasn't my patient.....
  4. by   TheCommuter
    This is distressing.
  5. by   HeartsOpenWide
    I had a 60 something male patient ask me on a date (I was 21 at the time) When I told him I was married (and thinking to myself..."I've seen your medical reconds"...) he said "I am not surprised, I just had to ask, I was smitten":imbar
  6. by   DusktilDawn
    Well, let's define sexual harrassment:

    Sexual harassment is any kind of sexual behavior that is unwelcome and/or inappropriate for the work place. Sexual harassment can embrace verbal harassment (i.e. derogatory comments or dirty jokes under the right circumstances), visual harassment (i.e. derogatory or embarrassing posters, cartoons, drawing, etc.), physical harassment, and sexual favors (i.e. sexual advances, confrontation with sexual demands.)
    Sexual harassment is defined as "unwelcomed sexual advances or conduct". Sexual harassment also includes animosity that is gender-based and a sexually charged work environment. In the work place, sexual harassment can come from the owner, supervisor, manager, lead person, foreperson, co-worker and/or customer.
    However, sometimes sexual harassment does not restrict itself to the work place. Sexual harassment can come in many forms. Sexual harassment can also be found in schools.

    definition from this site: http://www.lawguru.com/faq/16.html
    Other sites that may provide useful info:
    http://www.equalrights.org/publications/kyr/shwork.asp
    http://www.articles911.com/Sexual_Harrassment/
    http://www.menweb.org/throop/harass/harass.html

    Sexual harrassment is only one form of harassment we deal with on the job. What concerns me is all forms of harassment: verbal, emotional, physical, and sexual.

    Part of the problem is that nursing is not viewed as a high-risk profession when it comes to abuse, especially physical and emotional abuse. How many of us have been spat on, hit, eliminated on, swore at, yelled at, degraded, humiliated, and victimized on the job.

    Another part of the problem is the belief that nurses have to tolerate abuse as part of their job, and it's not just the general public that believes this, it is our administrators and nurses themselves that believe this. Geriatrics is one area where abuse of caregivers is the highest. Part ot the problem here is that some of these patients are confused, or suffering from some form of dementia, yet when health team members recommend treatment designed to decrease aggression towards staff, they are often met with resistance. It's also an area of nursing that receives little attention in regards to staff abuse, yet it receives significant attention in regard to patient abuse.

    Another factor is the lack of support nurses receive on the job, how often are we backed up by our management when we are dealing with a patient/family member/visitor that is screaming at us or behaving inappropriately. Most situations are brushed under the rug. Often times we are made to feel at fault for these situations, somehow we caused it. How many nurses have been abused and then further victimized by management for being abused.

    The trend toward customer service is another factor, we are now putting up with behavior on the job that wouldn't be tolerate elsewhere. We are bending over backward to please the unreasonable with the threat of disciplinary action from our management if we fail. So not only are we abused in the name of customer service, we are now disciplined/harassed by management because of it. In fact because of customer service, abusive behavior is often times rewarded.

    When one starts tolerating abuse, it opens the door for continued abuse and the escalation of abuse on the job:
    1. There needs to be a zero tolerance for abuse.
    2. Staff and management need to be educated on what constitutes abuse.
    3. Staff and management need to be educated on how to deal with abuse.
    4. The public needs to be educated on what constitutes abuse in the health care setting. There should be guidelines established and presented to them upon utilization of a facility.
    5. The perpetrators of abuse needs to be properly dealt with, whether that involves prosecution for assault, or denial to the facility.
    6. Nurses need to have some recourse to address issues of abuse, whether it be from co-workers, patients, family members, visitors, etc. There are patient advocates, what about nurse advocates.

    Health care is failing when it comes to protecting nurses. We are the person who spends the most time with the patient. We are the ones who have to bear the brunt of peoples's frustration, whatever the cause. Be it long wait times, short staffing, or dissatisfaction with treatment received. We are at the bedside and we are the first to be attacked.

    The biggest problem nurses face in regards to on the job harassment is the lack of exposure the problem receives. There is plenty of exposure in regards to patient abuse, yet very little in regards to the abuse caregivers face on a daily basis.

    http://community.nursingspectrum.com....cfm?AID=13253
    http://archive.thisishampshire.net/2.../02/32462.html
    http://www.nurseweek.com/features/99-8/violence.html
  7. by   Katnip
    Another problem is that nurses often feel they have to take it because the perpetrator is a patient. Not so. Just because someone is sick or injured does not excuse poor behavior.

    More than once I've had to tell a patient that his behavior is inappropriate and will not be tolerated. Usually you just have to call them on it once.
  8. by   canoehead
    Nurses facing harassment is news??? I thought the public considered it their right.
  9. by   DusktilDawn
    Quote from canoehead
    Nurses facing harassment is news??? I thought the public considered it their right.
    No kidding. People do think it is their right to abuse us.

    Apparently nurses have no rights.
  10. by   Kabin
    I wonder what the nursing leadership's stance is on this problem? Maybe I'm wrongs, but from what I've learned in my BSN studies so far, nursing leadership tends to be concerned with esoteric issues rather than protecting nurses. If nothing else, nurses should be made aware of their rights.

    There needs to be data collection to close the loop so the problem is lessened. It should be hospital/facility policy that patients are warned about the possibility of denied service. I think many hospitals have these policies in place.
  11. by   eltrip
    Since when is this news? Those of us in the field know that it happens on a frequent basis...even if it's only that ONE time before we put a stop to it. The attempts are made because they seem to be socially acceptable in our society. That's my theory, at least.
  12. by   jonear2
    In school I had a patient grab my rear while I dropped my first NG tube! I was mortified and didn't know what to do. I was timid, but I was doing my day in the ER and the nurses down there are tough, God love them. The RN I was with told the patient that if he ever did that again she was going to put that tube farther down than he would ever want it. I felt vindicated but where is the line? I still am unsure what the correct response is in that situation. Part of me felt as though the RN was brave and right, but somewhere deep down I'm sure there was a better "nursing process" perfect answer that eludes me. Any thoughts???
  13. by   hipab4hands
    What leadership? There in lies the problem. Management blames us, the victims, of this type of behavior. Admin. just doesn't give a **** about us. We are nothing more than warm bodies, who are easily disposable.
    When you do complain about inappropriate behavior by patients, the upper echelon turns a deaf ear.
  14. by   sasparilla
    I am so glad that this isn't tolerated everywhere! This weekend while working on a rehab floor ( I am a nusing student working as unit secretary), one of our patients had been very abusive towards the nurses during her stay, always dissatisfied and complaining, firing 5 of them. Finally the charge nurse took her on and her verbally abusive behavior continued. She spat her coffee and threw her food at the charge nurse, who is a wonderful nurse and good person. After talking with the nurse manager, the charge nurse was told that she could let that patient know that if she was disatisfied with her care there, she was welcome to go to the hospital down the street and that they would be happy to make any arrangements she needed. That was that.

    Patients like that will never be happy, will always give a bad rating on any patient satisfaction survey no matter how much you bend over backwards to try to please them.

    I had a very old patient with dementia a few weeks ago in clinicals who asked me to lean over so that he could tell me something in my ear. Stupid me bent over and he kissed me on the cheek! I just let it go, it startled me and I didn't know what if anything I ought to do. After that I just kept my distance a little. I guess since he was 85, this 40 year old looked pretty good!:chuckle

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