Pt Sexual Assault

[ClimbingNurse]

This came up in clinical recently. (Believe me I'd love to go into details, but... Hippa might be watching. ) Thought I'd get some opinions.

What is your institution's policy on dealing with a Pt who sexually assaults staff? What is your personal policy? Would you consider pressing charges?

I'll put out a (purely hypothetical) case as an example:

Middle-aged quadriplegic with a C-6 fracture more than a decade ago. Pt has gross motor control of upper extremities. Pt uses what little motor control he has to grab the breasts of a female nurse while being moved for bed bath. (In fact, Pt has a Hx of said behavior.)

In this (hypothetical) case the staff basically just decide to have a male do his AM care. Pt denies services of one male staff member to do bed bath. Pt states he does not believe said male staff member knows what he is doing, possibly due to the fact that he is a student.

Staff then decide to offer Pt the services of a male tech to do his bed bath. Pt denies his services as well. Pt informed of potential risk for infection if he denies a bed bath prior to his surgery scheduled for that afternoon. Pt still denies services. All of the above is thoroughly documented.

OK, problem solved... Sort of. Except that you still have a dirty (pun fully intended) Pt and...

What about that first nurse? Should she have a right to some form of recourse? If that hapenned in just about any other workplace the groper would face serious repercussions. Jobloss, lawsuit, criminal charges, etc, etc.

Oh, and for God's sake, please don't anyone go turning this into a discussion about caring for ALL of the Pt's needs. :uhoh21:

[Marie_LPN, RN, LPN, RN]

If he's got motor control of the upper extremities, that'd make him a paraplegic?

I'd do the same thing i'd do if a co-worker did that. Report it immediately, and not let up.

[wonderbee, BSN, RN]

You bring up a good point. I think we all know the stories of staff having urinals thrown at them and verbal threats. Who of us hasn't been the recipient of verbal trash from disoriented clients. It's the ones who are alert and aware and still go about their trash mouth/hands business that scare me.

I once had an HIV positive patient threaten to throw his full urinal at me if I came near him. That, to me, legally falls under the legal definition of assault. Do I have the right to get the law involved or do I waive my rights because it is an assumed risk of my job?

I think your question is a good one. What legal protection do we have from aggressive patients?

[leslie :-D]

any male pt. who has groped me, i have let THEM know how i felt about it. some pts will see what they can get away with (acting out behavior) then there are the downright aggressive angry assaulters. i would tell the quad to knock it off and/or get social services involved. if he tried it again, then i would refuse to care for him....i cannot say what i would do re: pressing charges. each situation is unique.

[Nurse Ratched, RN]

If he's got enough gross motor control to grab at breasts, he's got enough gross motor control to grab a washcloth and wash himself .

Seriously, you are obviously in no way obliged to allow this to continue. Confront the client directly as a part of his plan of care that maximizing his ability to self care is your number one priority. Sexually touching staff is inappropriate and illegal and he *will* have charges pressed against him if it happens again. And make sure he believes it.

[traumaRUs, MSN, APRN]

I go with the pt bathing himself. In the ER where I work if we are spit on, hit, threatened, we call the police. No questions asked, no nothing. Doesn't matter if they are drunk or high or whatever - zero tolerance!

[sharann, BSN, RN]

Just because he is a patient doesn't mean he is not a citizen, and a citizen can be charged with assaut/and or battery. I would write this up, give him the verbal warning that next time you call the police. End of story(but follow through)Good luck to this hypothetical nurse:)

[Diaphoretic]

If he's got enough gross motor control to grab at breasts, he's got enough gross motor control to grab a washcloth and wash himself .

Seriously, you are obviously in no way obliged to allow this to continue. Confront the client directly as a part of his plan of care that maximizing his ability to self care is your number one priority. Sexually touching staff is inappropriate and illegal and he *will* have charges pressed against him if it happens again. And make sure he believes it.

AMEN!:rotfl:

[leslie :-D]

if it was tom cruise or tom selleck, i'd grope him back.

[Jailhouse RN]

Why be stupid and wait till it happened again? One time is enough. Report it, refuse to care for this assaultive pt., have the pt. arrested. No, your employer cannot stop you or fire you for doing so. It is your body, the law says so.