Female patients at risk because of male patient?

SouthpawRN · Aug 5, 2017

The patient could request police for a sexual assault report or battery, especially if the male patient made physical contact with them. Is the male patient mentally competent to know what he is doing.

I bet this would get the administration's attention.

allnurses Guide · Aug 5, 2017

You mentioned it's a locked facility! What kind of facility is it? Alzheimer's, psych, SNF. The facility should have adequate staff to insure patient safety. If not the treatment team needs to decide if this male patient requires a higher level of care/supervision.

Hppy

elkpark · Aug 5, 2017

This is a huge liability issue for the facility. I'm surprised the administration is so clueless about that. This situation is a lawsuit waiting to happen.

KRVRN, BSN, RN · Aug 5, 2017

Wouldn't a male pt touching a female pt that doesn't consent (or isn't capable of consenting) in a sexual way be a reportable event?

Major_Mira · Aug 5, 2017

It is a locked facility for wander risks or Alzheimer's/dementia. They say he is not competent BUT I do not know how they came to that conclusion as he is able to remember where his room is, stuff he has done, he knows specifically which rooms are female occupants, he remembers which workers won't let him touch them, and I have a feeling he can still read because I saw him staring at something that was his and his head was moving left to right as if he was. He is mobile but does not speak much or write/draw any longer. I'm not a doctor but I feel that he is extremely aware compared to the others there.

I don't believe that he has touched the other residents breasts/butt but he does the creepy behavior of staring at them in their beds and sitting on them, etc. He is CONSTANTLY attempting to harass or touch the young female workers though. Even saying sexual comments to us (can I touch your t***ies and the like). Administration is aware and it does get charted. I feel that it goes against the rights of the other residents. They are short staffed and are consistently. The families are unaware of this behavior and the other girls and I don't know what to do, that's why I'm here... I don't know where else to ask. I've only been there for a short time too so I don't know my options.

I have been called mean and stuff for not allowing him to touch me anymore. I feel like they expect me to allow him to touch my bits like some prostitute or something, I didn't go to school for that and pay that much money... I'm there to care for people.

JKL33 · Aug 5, 2017

It is a locked facility for wander risks or Alzheimer's/dementia. They say he is not competent BUT I do not know how they came to that conclusion as he is able to remember where his room is, stuff he has done, he knows specifically which rooms are female occupants, he remembers which workers won't let him touch them, and I have a feeling he can still read because I saw him staring at something that was his and his head was moving left to right as if he was. He is mobile but does not speak much or write/draw any longer. I'm not a doctor but I feel that he is extremely aware compared to the others there.
I don't believe that he has touched the other residents breasts/butt but he does the creepy behavior of staring at them in their beds and sitting on them, etc. He is CONSTANTLY attempting to harass or touch the young female workers though. Even saying sexual comments to us (can I touch your t***ies and the like). Administration is aware and it does get charted. I feel that it goes against the rights of the other residents. They are short staffed and are consistently. The families are unaware of this behavior and the other girls and I don't know what to do, that's why I'm here... I don't know where else to ask. I've only been there for a short time too so I don't know my options.
I have been called mean and stuff for not allowing him to touch me anymore. I feel like they expect me to allow him to touch my bits like some prostitute or something, I didn't go to school for that and pay that much money... I'm there to care for people.

I'm sorry you're faced with this and not receiving any helpful guidance on it from your administration. I have no doubt when you say that it makes you very uncomfortable. And yes, it very much is a big legal concern. Patients' rights are being violated, and it doesn't sound like anything therapeutic is being done with the patient's own plan of care as it relates to this.

Some things to understand (and nothing I'm about to say negates the fact that administration should address this issue ASAP) -

-Dementia doesn't follow a perfectly linear course - symptoms may wax and wane over the course of general progression. Additionally, behaviors may not even be consistent over a 24 hour period, as there may be times of increased and decreased awareness from baseline. Also, the dementia-associated behaviors you have noticed don't, in themselves, define what other mental abilities the patient may be capable of, which also likely wax and wane.

-One of the big problems I see (besides your administration's lack of action) is that caregivers are not providing consistent therapeutic responses to the behaviors.

-Last thought, and please accept this open-mindedly in the spirit with which it's written: You mention "harass" and "creepy". Believe me when I say I understand these feelings. But I think you will be in a better position to handle this therapeutically if you try to think in more neutral terms. The patient's intentions have to be considered in deciding how we allow ourselves to feel about something, and the likelihood that his intentions are nefarious is decreased significantly in the setting of dementia. In fact, it is quite well-known that dementia behaviors may have nothing to do with previous lifestyle or the behaviors that the patient would've considered normal prior to developing dementia.

-If you search online or in scholarly databases, you will be able to read information very pertinent to the situation. Try terms like dementia, alzheimer's, ISB (inappropriate sexual behaviors), nursing home. You should be able to come across suggestions for things like using enhanced verbal techniques and body language like saying "NO hands" or "NO you can not touch my body" while making good eye contact and shaking your head "NO". Your facility, though, MUST deal with this, and although I've offered a couple of suggestions please don't think that this is all on you to figure out, OR that you just have to tolerate it. For the sake of yourself, all the other patients, and even THIS man, the facility must address it.

Good luck ~

elkpark · Aug 5, 2017

It is a locked facility for wander risks or Alzheimer's/dementia. They say he is not competent BUT I do not know how they came to that conclusion as he is able to remember where his room is, stuff he has done, he knows specifically which rooms are female occupants, he remembers which workers won't let him touch them, and I have a feeling he can still read because I saw him staring at something that was his and his head was moving left to right as if he was. He is mobile but does not speak much or write/draw any longer. I'm not a doctor but I feel that he is extremely aware compared to the others there.
I don't believe that he has touched the other residents breasts/butt but he does the creepy behavior of staring at them in their beds and sitting on them, etc. He is CONSTANTLY attempting to harass or touch the young female workers though. Even saying sexual comments to us (can I touch your t***ies and the like). Administration is aware and it does get charted. I feel that it goes against the rights of the other residents. They are short staffed and are consistently. The families are unaware of this behavior and the other girls and I don't know what to do, that's why I'm here... I don't know where else to ask. I've only been there for a short time too so I don't know my options.
I have been called mean and stuff for not allowing him to touch me anymore. I feel like they expect me to allow him to touch my bits like some prostitute or something, I didn't go to school for that and pay that much money... I'm there to care for people.

Whether or not he is aware and able to be responsible for his actions, it is the responsibility of the facility to protect other residents from being sexually assaulted by him.

If the facility leadership is unwilling to take any action to protect other residents, you can file complaints with your state agency that licenses healthcare facilities (that agency has a different name in every state, but it is usually a division of your state department of health and human services), and your state has an ombudsman for the disabled who would be interested in hearing about the situation.

Of course, even though you can usually make complaints to those offices anonymously, there's no guarantee that your employer wouldn't figure out somehow that it was you who made the complaint, and you could lose your job or face other kinds of retribution.

I used to be a surveyor for my state and CMS, and it was not uncommon for staff people to contact us to complain about dangerous situations in their facilities that the administration was refusing to address.

It's less clear-cut for the staff, but there are definitely state (whatever state you're in) and federal regulations that apply to your facility that require the organization to provide a safe environment for residents. There needs to be some kind of behavior plan for this resident to at least systematically attempt to ensure that he is not able to intrude on and possibly assault female residents.

macawake, MSN · Aug 6, 2017

I work in a locked unit and have for a few months now. What I have noticed is one male resident will intentionally go into the female rooms and sits on them or just stares at them.

He also chases me around the facility trying to touch my breasts or butt, I've talked with the other female workers and he does the same stuff to them. I will not let him touch me if I can avoid it as it makes me uncomfortable for him to be sexually touching me, I am not there for that.

The behavior has been reported but they refuse to do anything about it, they (the nurses and administrators higher up) actually encourage it and think it's "cute". What can I do about this? I'm extremely uncomfortable with it all.

He is CONSTANTLY attempting to harass or touch the young female workers though. Even saying sexual comments to us (can I touch your t***ies and the like). Administration is aware and it does get charted.

I have been called mean and stuff for not allowing him to touch me anymore. I feel like they expect me to allow him to touch my bits like some prostitute or something, I didn't go to school for that and pay that much money... I'm there to care for people.

Apart from the obvious potential liability for management for allowing these incidents continuing to take place on a regular basis, despite having been made aware of them... I have to wonder... Who are these people?? Their reaction (the parts that I bolded) is bizarre. I simply can't understand their response the way you've described it.

Are you seriously telling me that they think a man trying to touch women's breasts or behinds against their will, is cute? And that they actually encourage that behavior? (That is beyond bizarre). The cute factor is zero. Dementia doesn't magically turn unwanted sexual attention or sexual assault into something quaint.

You say that you feel that they (senior nurses and administrators??) expect you to permit this resident to touch/fondle/grab your private parts? Who specifically called you mean for not letting this man touch you? A member of management or staff? If someone had said that to me, I'd have a serious no-nonsense conversation with that person. I would be super clear that it's not an appropriate or normal expectation for that person to have, and that I find his/her position unacceptable.

What has made you believe that they think you should allow the sexual touching? Have they actually expressed that? Or are they just simply refusing to take your and other staff's concerns seriously? Both are in my opinion unacceptable, but the former would be outrageous.

Both you, other staff and residents have a right to not have your breasts or other private body parts touched against your will. Healthcare professionals and residents of a healthcare facility have the same legal rights as a person in the "outside world", to not be subjected to sexual assaults. I realize that it's more complicated when you're dealing with dementia or traumatic brain injury patients, but that doesn't in my opinion let management off the hook completely. They still have a responsibility towards other residents and their employees. And on a slight tangent, prostitutes also have a right to not be touched against their will. Whatever touching that goes on happens after the parties involved have agreed on what will happen (and payment has been made).

You've said that management are aware. They need to do what they can to protect their other patients/residents and to the best of their ability keep them safe from harm. I would also expect them to provide working conditions that are reasonable and safe for staff. Management needs to come up with a plan that addresses this.

While we can't eliminte all risks involved in our profession since we deal with people who can have "diminished capacity" for medical reasons, that's not in my opinion a valid excuse for an employer to not do everything in their power to minimize the risks to staff. A supportive attitude towards staff should be a given.

twinsmom788 · Aug 6, 2017

From another former surveyor, this situation is an immediate jeopardy as you well know. What an unsafe situation for everyone concerned. I also did complaint investigations and in my experience, the individual (male) in this case was "sent out" to an acute pysch facility and usually was not allowed back until the behavior was addressed and a care plan put in place.

To the OP, please know that you have the right not to to be bullied or shamed by your co-workers by not wanting to comply with this patient's behavior.

twinsmom788 · Aug 6, 2017

From another former surveyor, this situation is an immediate jeopardy as you well know. What an unsafe situation for everyone concerned. I also did complaint investigations and in my experience, the individual (male) in this case was "sent out" to an acute pysch facility and usually was not allowed back until the behavior was addressed and a care plan put in place.

To the OP, please know that you have the right not to to be bullied or shamed by your co-workers by not wanting to comply with this patient's behavior.

Kooky Korky, BSN, RN · Aug 6, 2017

Unfortunately, you have openly complained about this monster. Yes, I know he's a patient and has an illness and he

was probably a perfect gentleman when in his right mind, but that doesn't negate the menace he is now.

If you want to keep your job and also be able to work anywhere else where people in HR or Admin know the staff at

your current job, you can't openly file any complaints. Maybe not even file on the QT - anonymously.

But whoever thinks it's cute should be crucified - at a minimum. And should become his roommate. Then we'd see

just how cute they think it is.

No advice here except to report it to CMS (Medicare), your state department that regulates and licenses facilities

like the one where you work (sounds like skilled nursing, long term care, something of that nature). I guess you

could somehow manage for family members of other residents to see him in action. Police could get involved. Don't

take the word of the officers who tell you nothing can be done because he is not mentally competent, either. Get to the

news media, get to the City or County Council. Best wishes.

Do you have a buzzer of some kind? Some little hand-held thing that he could touch and feel a buzz? Nothing that

would hurt him, just something that would distract him? Or a flashing light? Some flashlights actually flash on and off.

Again, a distraction. Does he have a music box? A little ballerina dancing around in a jewelry box when you open the

box? Or a twirler of some kind? You blow on it and it twirls. How about a harmonica? Cheap, small, musical, keeps

him occupied for a while?

is there an alarm on his chair and bed that would warn you that he is up and likely going prowling?