Nurses Face Harassment From Patients
Nurse Sarah Andres is so used to male patients calling her "sweetie" or "cutie" -- or even asking her for a kiss -- that it rarely upsets her anymore.
"I usually chalk it up to they don't feel good, a lot of them are confused," said Andres, who has been a nurse in St. Louis for five years and works in the critical care unit at St. Mary's Health Center. "I never really thought of it as sexual harassment."
But nursing organizations say such treatment is common, and it is definitely sexual harassment.
The American Nurses Association cites a 1982 study that reported that 60 percent of the nurses surveyed said they had experienced sexual harassment at work, though that included all cases, not just from patients. Still, nursing officials said it is clear that inappropriate behavior among patients is a widespread problem.
"I suspect that if you ask nurses if they've been harassed by patients, a majority would say yes," said Belinda Heimericks, executive director of the Missouri Nurses Association. "Nearly every nurse will run into it at some time in their career."
The harassment can run the gamut from offensive jokes or sexual comments to inappropriate touching. Sexual assaults are rare but do occur, nursing officials say. Some male nurses have reported being harassed, but the overwhelming majority of cases are between male patients and female nurses.
Such harassment creates tension for nurses, who must walk a fine line between meeting their professional responsibilities to the patient and protecting themselves.
Debbie Dougherty, an assistant professor of communications at the University of Missouri-Columbia, interviewed 29 nurses in four states to determine how they react to the harassment and how it affects their relationships with patients.
She found that nurses usually crack jokes or sternly reject the patient's conduct. Most nurses said they continue to provide medical care, but the emotional support patients need from them sometimes declines, Dougherty said.
"It probably makes the relationship a little more tense because there is a feeling of uncomfortableness between the nurse and patient," Heimericks said.
Dougherty's study, which will be published in the spring issue of Management Communication Quarterly, found nurses are generally more distressed by harassment from co-workers or doctors. Heimericks agreed, saying patients come and go, while nurses have to see the co-workers every day.
Federal and state laws protect nurses from sexual harassment by patients, and the institutions' written guidelines must reflect those laws.
In most cases, the harassment stops far before a lawyer has to be called in or charges are filed.
Nursing organizations say that if harassment from a patient continues, nurses can ask to have a second nurse stand by in the patient's room, refuse to care for the patient, ask that the patient be transferred to another floor, or report the behavior to a superior. Doctors and administrators are sometimes called in to talk to the patient.
In extreme cases, institutions can "fire" patients and send them to another hospital, said Scotty Shively, an employment and health lawyer in Little Rock, Ark.
But medical institutions are constrained by certain legal obligations to care for patients, Shively said. For example, patients needing emergency care must be admitted. And dealing with harassment becomes more complex if the patient is mentally ill.
Andres said she has sometimes asked not to take care of a particularly troublesome patient. But usually, she said, "I just tell them that we are supposed to be professional here. I tell them we need to have mutual respect. Sometimes you have to talk to them almost like children."
Dougherty's study found that nurses receive little training in handling sexual harassment from patients. Andres agreed.
"It's something you learn as you work," she said. "I just try to keep the relationship professional. I call the patient `Mr.' or `Mrs.' whatever, and I expect the same thing from them. I don't expect to be called pet names at work."
You've got mail, and maybe gonorrhea
You've got mail -- and possibly gonorrhea, HIV or another sexually transmitted disease.
E-mail sent through Web sites launched in Los Angeles and San Francisco is providing people with a free, sometimes anonymous, way to tell their casual sex partners they might have picked up more than they bargained for.
Los Angeles County health officials launched www.inspotla.org this week in a bid to reduce the rapidly rising spread of STDs by encouraging sexually active men and women to get tested.
"This is another opportunity for people to disclose STD exposure to partners because sometimes people don't always have that face-to-face opportunity, or that level of relationship," Karen Mall, director of prevention and testing at the AIDS Healthcare Foundation, said on Thursday.
"Partner disclosure is where we really have the opportunity to break the chain of HIV infection," Mall said.
The site allows users to choose one of six free e-cards to send to their sexual contacts either unsigned or with a personal message that avoids awkward face-to-face disclosure.
"It's not what you bought to the party, it's what you left with," says one e-card featuring a picture of a bare-chested man. "I left with an STD. You might have one too. Get checked out soon."
"You're too hot to be out of action," says another.
The Los Angeles Gay and Lesbian Center, which runs its own counseling services for partner disclosure, welcomed the Web site program.
"Many of the people we are seeing are listing the Internet as the place where they are meeting partners, so the Web site is a really helpful tool for prevention and contacting them," said Tiffany Horton, manager of the center's sexual health program.
The site is modeled on one launched in San Francisco last year (www.inspot.org) that is generating about 500 e-cards a month. Both are targeted at gay men but can be used by anyone.
Health officials call the e-cards a "fast, free and flexible partner notification system" that also gives information and links to local testing sites.
Some 2,400 new AIDS cases were reported in Los Angeles County in 2003, along with more than 8,000 new gonorrhea cases and 830 new syphilis cases -- most of them among gay men.
The Web sites urge users to show respect and not to misuse the system. Mall said only half of 1 percent of the e-cards sent through the San Francisco site had been malicious or fraudulent.
"The sites do not give anybody the ability to do anything they can do already if they had somebody's e-mail," Mall said.
"It is something we can monitor. People can get hold of the Web master if they have concerns or want to complain.
"But I give the (gay) community more credit than that. I think the community really wants to get ahead of HIV and STDs and they realize that notification is really important," she said.
Food Fact:
Culture club.
When yogurt's live active cultures colonize your digestive system, they draw a line in the sand against disease. The cultures -- especially acidophilus and bifida - muscle out potentially threatening bacteria. Low-fat or fat-free yogurt has a lot of other things going for it: It's easy to digest, especially for those who are lactose-intolerant and have difficulty digesting milk and many cheeses; it's an excellent source of calcium, protein, riboflavin (a B vitamin), vitamin B-12 (which may be low in vegetarian diets) and vitamin A; and provides selenium, potassium and magnesium.
Fitness Tip of the day:
Take the stairs.
The key to cutting stroke risk may be right inside your house. Studies suggest that climbing just three flights of stairs every day can cut your stroke risk by 20%. If your house has a second floor, find excuses for going upstairs whenever possible. If you live or work in a high rise, make a habit of getting off the elevator a few floors below your apartment or office.
FAQ of the day:
Can certain foods prevent cancer?
No one can say with absolute certainty how powerful is diet in preventing cancer. But at least a third (and possibly more) of all cancers have been linked to diet. People who eat the most fruits and vegetables have been shown to have about half the risk of developing cancer as people who rarely eat them. Your genes and other lifestyle factors, such as smoking, have a strong say in your susceptibility to cancer. But it's likely that improving the typical American diet would make a big dent in new cases of cancer, the nation's second biggest killer after heart disease.
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