Sexual harassment by a confused patient

[rootsie]

I am a new grad nurse and have already had my fair share of confused patients in my 4 months working on a neuro unit. During my shift last night, I had a patient w/ dementia who was just weened off a 1:1 for impulsiveness. Everything was normal during my initial assessment until I was removing the blood pressure cuff. The patient abruptly grabbed me by the collar of my scrubs, trying to pull my towards him and put his hands down my top while saying "you have such beautiful breasts." I immediately grabbed the patient's hands and removed them. I tried to be as stern as possible and told him that what he was doing was not appropriate and that I would have to leave if he continues to speak to me like that. I was able to finish the assessment without any other issues, trying my best to stay a little more than an arm's length away whenever possible. I informed my charge nurse of what had happened and she told me to document everything that happened and asked if I wanted to switch patients. Instead of switching assignments, I made sure to bring our male NA. I tried to shake it off and attribute his actions to the confusion, but I couldn't help but feel vulnerable and almost embarrassed by what had happened. The whole scenario has been replaying through my mind all day, and I can't help but wonder if there was something more I could have done. Has anyone else experienced sexual harassment by a confused patient? How do you set professional boundaries with a confused patient?

[Double-Helix, BSN, RN]

I'm sorry this happened to you. I can understand why you would feel threatened and violated when you were physically touched without consent- whether the patient is confused or not. It's not your fault, and your feelings are completely valid. If you think you might benefit from discussing this with a professional, see if your employer offers an Employee Assistance program and please utilize it if you need to.

I think you handled it exactly as you should have. Document the behavior, bring a witness into the room, maintain a safe distance, and stay on guard. It would also be helpful to keep this patient with 1:1 observation. It's hard when patients have a verified diagnosis like dementia because it may be difficult to separate their lucid actions from the confused ones. But confused or not, that behavior is entirely inappropriate and you were not wrong for saying so.