Inappropriate questions, sexualised comments, innuendos, wandering hands … Laurie Bickhoff contemplates sexual harassment of nurses by patients and wonders at what point to stop thinking of it as ‘harmless’.
Tell me if this sounds familiar. I was transferring an older male patient, let’s call him Bill, to another ward. I had cared for Bill over the past two days and he had always been very nice with no hint of inappropriate behaviour. As I was helping him pack up his belongings, Bill said “if the nurses in the other ward aren’t as nice as you, I’m coming back here” and then, much like a scene out of Mad Men, Bill gave me a couple of quick pats on my bottom. While I realise Bill was, in his own way, giving me a compliment, I still quickly moved myself out of arm (and hand) reach.
Initially, I laughed off the situation as ‘harmless’, but found myself thinking about it over the next few weeks and remembered some other situations I had also dismissed. I remembered being told how I must be lusting after certain doctors. I remembered suggestive comments about needing bed baths. I remembered remarks about how my partner and I must play nurse/patient games in the bedroom. I remembered being asked what underwear I had on underneath my uniform. Coming from a co-worker, these comments or questions would all be deemed sexual harassment. But none of these came from colleagues; they all came from patients I was caring for.
I talked to a number of my colleagues and was amazed at the stories I heard. Inappropriate questions, sexualised comments, innuendos, grabby hands and other inappropriate behaviours. These patients did not have dementia or delirium or any mental health issue. They were not all older patients, where ‘generational differences’ may have been at work. It wasn’t just the male patients. The male nurses were also on the receiving end of these comments and pinched bottoms. The patients were from across all age ranges, genders and cultures. Indeed, the only thing they all had in common – they believed this was 100 percent acceptable.
When these incidents have occurred, the first thing that used to pop into my head was ‘what have I done to make them think this is okay?. The answer has always been – nothing. I act professionally and appropriately and yet these situations still occur. However, the nature of our nursing profession and the cares we provide can lead to a false sense of intimacy. As nurses, we know a therapeutic relationship is a must. Being kind and caring, I believe, is also a necessity. We work hard at developing a rapport with our patients. Perhaps it is the mixing of this connection with the personal cares we provide which leaves patients believing these behaviours are appropriate.
On the other hand, perhaps it is the misleading public perceptions of nurses which create these beliefs. The media, including advertisements, TV shows and movies, continually perpetuate the myth of nursing being a sexualised profession. The inaccurate stereotypes pushed by the media can mislead patients into thinking their behaviours are acceptable, if not welcome. The Truth About Nursing has some great posts on this and I highly recommend reading them.
However, what causes these behaviours is not the focus of this particular post. The question I want to concentrate on is, at what point do we say these incidents aren’t harmless? Which ones do we laugh off and which do we act upon? Why do we accept these behaviours from patients when we would never accept them from anyone else? By failing to address the issue with the patient, are we condoning their actions?
There have been times when I have told patients their comments or questions were not appropriate or their actions were unacceptable. This has most often been met with a defence of ‘I was just having a joke’ and calls to ‘lighten up’. I have also been guilty of remaining silent when, in reflection, I should have spoken up. And to be honest, I can’t pinpoint exactly what made me decide between the two. I know how busy I was, how tired I felt, how many hours were left in the shift, when the patient was likely to be discharged all played their part in my decision, but it was made in such a split second, I don’t know which one had the greatest influence.
I do know that each time I didn’t educate my patients on where the professional boundaries were, I increased the likelihood of another nurse being subjected to these behaviours. The nurse who works the shift after me or visits the patient in the community or looks after the patient on the next admission, these are the people who will live with my decision. It is knowing this, knowing I will be protecting my nursing tribe, that will give me the courage to speak up next time Bill, or any other patient, chooses to treat me with anything other than the professional respect and courtesy all nurses deserve.