Pornographic movies

[Mrs. M.]

I'm wondering if anyone else has dealt with this and what the outcome was. We have a 59 year old quad (quad x 33 years) who likes to watch Mediaographic movies. Since he cannot put the movies on himself, employees have to assist if he's going to watch. Some staff do not mind this at all, but others are outraged that we would allow these movies in a hospital. I have set up a plan so that nobody who is uncomfortable with the movies has to go in to assist him, and a stop sign must be placed on the door whenever he is viewing to alert housekeeping, dietary, etc from walking in on this. The problem is that he is lewd and disrespectful toward the nurses anyway, and some of them feel that the Mediaography is contributing to his attitude. They are probably right, truth be known, but the bottom line is that he is an adult and what he is doing is not illegal. He has no family, so having a relative assist isn't an option. Any advice here?

[vashtee, RN]

Wow!

Maybe you can use the movies as a reward for "good" behavior. If he is lewd with the nurses, no Media movies that night. (And yes, I would probably want to limit the time of day these movies were being viewed out of consideration for other people.)

I don't see not allowing it at all.

[psalm, RN]

I would ask if he would like a chaplain to visit him sometime just to talk, since he doesn't have family. I would not put in the movies for him...he IS an adult but so are the hired help he has been lewd to. This is an example of entitlement...I'm entitled to view what I want. My feeling is if it isn't on the hospital TV channel, then you are out of luck. This may sound harsh, but a hospital is a controlled environment, we don't allow everybody everything...the diabetic doesn't get an ice cream sundae delivered from staff because" he is an adult and made an informed decision"...the smoker doesn't get to smoke in a smoke-free hospital/campus.

We use plastic utensils on the psych unit, no caffeine and no trash bags either, for safety of clients...and staff. Controlled environment.

[CT Pixie, BSN, RN]

When working LTC we had a 61 yr man with very severe Parkinson's. He too enjoyed watching Media movies. And like your staff, some had issues with putting it in the movies for him. (I personally didn't have an issue since all I was doing was putting the movie in for him and walking out the door. I never saw any of the movie)

Our DON told us we didn't have to put in the movies if we had issues with it (there was always one person on the shifts who was willing to put it in for him). We, too, put up a big red STOP sign on it, so that all staff (housekeeping, dietary, nursing, recreation etc) knew the movie was on, if the person had a problem with seeing such a movie, they knew not to go in when that sign was up.

He could watch it anytime he wanted, for any amount of time. His private room was his "home" and he was a consenting adult so we could not put any limits on the type of movies he watched, the amout of time he watched them, or what time of day/night he could view them. Our corporate lawyer informed the DON denying him his "rights" to watch the Media movies could land the facility in big trouble.

I don't think the movies make your resident lewd and disrespectful to staff, he was most likely a rude, lewd and disrespectful person his whole life and it was probably compounded when he became a quad at the age of 26. (I can only imagine how nasty I'd probably get having to rely on someone to take care of my most basic of needs at that age..would probably change me into a very nasty and bitter woman)

I think your ideas of the stop sign, and allowing your staff to choose if they want to put the movies in or not are good ones, and probably the only ones available.

*I just realized this was LTC DON/ADON forum. I'm only a student and can only offer up my personal experiences to this subject. **

[VivaLasViejas, ASN, RN]

A student you may be, but you are spot on when it comes to this topic. It sounds like you've had a lot of LTC experience.........you know your stuff!

I don't have much to add, other than the fact that residents don't check their rights at the nursing-home doorstep. They are adults and should be treated as such--even if their choices aren't particularly attractive---as long as they don't affect other residents or staff. Whether we like it or not, residents have to be afforded appropriate opportunities (and privacy) to satisfy their sexual desires, just like any other need or want; to deny this man his Mediao movies could even be considered a form of abuse.

After all, the LTC facility is his home, and behaviors like what Mrs. M has described don't really have much to do with what the law says. Yes, he needs to be discouraged from being lewd and crude with the staff, but treating him like a child by taking away a legal source of enjoyment is a violation of his rights. His care plan needs to include a behavior management agreement between him and the facility, and staff should be made aware of the care plan and how to report any unseemly behaviors on his part.

It's good that there are a number of caregivers on the unit who are willing to put the movies in the DVD player for him and put them away when he's through. But even if they weren't, you just can't NOT provide this 'entertainment' for him, it is his right as a U.S. citizen over age 21 to view and possess Mediaography.

I had to deal with this sort of thing as a resident-care manager on a "young-adult" ICF unit some years back; and even though I was rather revolted by some of what I saw there, I quickly learned there is no room for misinterpretation when it comes to resident rights.

Good luck with this man, he certainly sounds like a handful.

[Mrs. M.]

I would ask if he would like a chaplain to visit him sometime just to talk, since he doesn't have family. I would not put in the movies for him...he IS an adult but so are the hired help he has been lewd to. This is an example of entitlement...I'm entitled to view what I want. My feeling is if it isn't on the hospital TV channel, then you are out of luck. This may sound harsh, but a hospital is a controlled environment, we don't allow everybody everything...the diabetic doesn't get an ice cream sundae delivered from staff because" he is an adult and made an informed decision"...the smoker doesn't get to smoke in a smoke-free hospital/campus.

We use plastic utensils on the psych unit, no caffeine and no trash bags either, for safety of clients...and staff. Controlled environment.

I'm going to take a wild guess that you are not a Director in Long-Term Care. If a diabetic patient wants an ice cream, we educate, educate, educate - then give them their ice cream. Smoking is a different situation, because it puts others at risk.

Thanks everyone, I appreciate the feedback. He is a very intelligent man, and usually pretty easy going. He knows his Civil Rights, and can quote chapter and verse to any person who questions him. He's actually fairly reasonable in that he readily accepts it when nobody is willing to put the movie on, and will even say "I've got a movie on" when people he doesn't know start to come through the door. My problem is more with my staff than with the resident. I am repulsed by Mediaography personally, but I can't deny the fact that it is legal and he has a right to view it in his home.

[Freedom42]

Student here: Interesting thread. I understand the rationale behind allowing the movies to be screened: The patient has rights.

But what about the rights of employees to be free from sexual harassment? Does the employer not have a legal obligation to warn the patient that his behavior toward employees is unacceptable? What recourse do nurses have against sexual harassment by a patient?

It seems to me that there are two distinct issues here: screening the Media in the privacy of the patient's room and the harassment of employees. I don't see them as related.

[danh3190]

Student here: Interesting thread. I understand the rationale behind allowing the movies to be screened: The patient has rights.

But what about the rights of employees to be free from sexual harassment? Does the employer not have a legal obligation to warn the patient that his behavior toward employees is unacceptable? What recourse do nurses have against sexual harassment by a patient?

It seems to me that there are two distinct issues here: screening the Media in the privacy of the patient's room and the harassment of employees. I don't see them as related.

I was thinking along the same lines. Although the situation is OK now in that none of the employees have filed complaints etc., what happens when the next new employee is offended and decides to file a sexual harassment complaint because of being asked to put in the movie, or heard a bit of the movie outside the door etc.? Seems like you're between a rock and a hard place.

[Mrs. M.]

I was thinking along the same lines. Although the situation is OK now in that none of the employees have filed complaints etc., what happens when the next new employee is offended and decides to file a sexual harassment complaint because of being asked to put in the movie, or heard a bit of the movie outside the door etc.? Seems like you're between a rock and a hard place.

Sexual harassment laws don't protect employees from patients, they protect employees from other employees/authority figures. According to our attorney, the fact that I have informed them that they do not have to put the movie on for him will cover us. There is potential for all of us to overhear things that we don't want to hear, usually it's conversations between family members of the residents! My biggest challenge is trying to get the staff to understand that they aren't responsible for his soul, and moral judgments are just inappropriate in this setting.

[danh3190]

My former employer (at an industrial research lab) seemed to feel that the laws protected employees from sexual harassment by customers and not just other employees. I don't know if that was true or if they were just being paranoid. I was just viewing the patient as a customer in this situation. Of course it's possible that the laws are different in healthcare.

[Freedom42]

From what I've been able to find online, the employer does have a legal obligation to protect the nurse from sexual harassment by patients.

"According to the EEOC, an employer may be responsible for harassment by nonemployees in the workplace if the employer fails to take corrective action, within its control, once it knows or has reason to know of the harassing conduct. ... When faced with the novel issue of sexual harassment by nonemployees, several courts have specifically identified the EEOC guidelines as their authority for holding an employer liable."

Another article says that "federal and state laws protect nurses from sexual harassment by patients, and the institutions' written guidelines must reflect those laws." This article also says that in extreme cases, institutions can "fire" a harassing patient and send him to another institution.

I don't see how being asked to turn on a VCR or posting a sign could be construed as harassment. But it appears the institution does have a legal obligation to tell the patient to knock off the lewd behavior toward nurses; otherwise, it's allowing a hostile work environment to persist.

[Noryn]

Ok gonna post my suggestion first (so you dont have to read my rant). He does not sound like a high quad, as he does not sound like he is on a vent. He should have some arm, wrist or even limited hand movement. Occupational therapy should be able to come up with a solution, see I dont know is functional level so my recommendations may not be accurate. Regardless, I would look into buying or having him buy a voice activated remote from Best Buy or Circuit City. As far as loading the movies, I would get his permission but take the labels off, mark them with a number or very very vague description and even consider putting a regular movie in the mix. So staff just loads an unmarked movie, he pushes play when they leave and stop before they come in.

You could even brag to the state saying look at how we use technology to promote independence. Then have him give a demonstration. This way you will impress the state and give your administrators heart attacks who likely harass you quite often. Ok that may not be a good idea :trout:

I think the biggest challenge you are facing is trying to convince the staff that this is ok. I dont think you will be able to do that. This is a moral/religious issue for them and they are grown adults. Healthcare professionals or any worker for that matter should not have to be subjected to Mediaography (if they choose not to).

Yes, I know it is his private "home." I am actually thinking about being a weekend supervisor at a local nursing home, so when a patient wants to smoke, leave their soap out of bags or put a tv near the ceiling I am going to let them. After all it is their home, is that not what the state inspectors say? (No I am not really going to let them but the hypocrisy KILLS me)