Sexual harassment has been a hot topic in the news the last couple of months. It is one that most nurses are all too familiar with. Surveys from the last ten years have shown a significant increase in the number of nurses, both female and male, reporting sexual harassment. A literature review indicates that at least half to as many as two-thirds of all nurses have been harassed by patients, visitors, supervisors, co-workers, or physicians at some point in their careers.
The U.S. Equal Employment Opportunity Commission (EEOC) defines sexual harassment as “unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature.” It includes offensive remarks about a person’s sex, creating a hostile work environment, and making employment decisions contingent upon satisfying sexual demands of any kind. Harassment can be between the opposite sex or same sex – a woman harassing a man or another woman or a man harassing a man is just as illegal as a man harassing a woman.
According to the EEOC, sexual harassment includes:
telling sexual jokes or anecdotes, terms of endearment (“honey,” “sweetie,” etc.)
inappropriate unwanted emails or calls, giving personal gifts
threats, blocking a person’s path, following him/her, trapping someone in a room, sexual exposure such as “clothing mishaps,” flashing or mooning
ogling, staring at body parts, “undressing with the eyes”, “wolf whistles” and other sexually suggestive or offensive behavior
inappropriate touching, including patting, slapping, pinching, rubbing, brushing up against, or any other purposeful contact with another person
making inappropriate sexual gestures
asking sexual questions, such as about someone’s sexual orientation or sexual history
making offensive comments about someone’s sex, sexual orientation, or gender identity
making sexual comments about body parts, clothing, or appearance
displaying sexually suggestive pictures or materials in the work area (such as “beefcake” or “cheesecake” posters), emailing sexual materials to co-workers or leaving materials out in the open for others to see
Remember that there are two categories of sexual harassment: Quid Pro Quo, in which employment (advancement, benefits, etc.) is contingent upon sexual favors or tolerating sexual conduct, and hostile work environment, in which the behavior is so pervasive or overwhelming that employees have problems performing their jobs. In addition, if the prohibited conduct is such that an employee feels it necessary to quit, this is constructive discharge and makes a hostile work environment claim into a quid pro quo claim because now the behavior has impacted employment.
Single instances of inappropriate or unwelcome behavior, unless they are severe or criminal (rape, assault), generally do not qualify as harassment but more than one instance, particularly repeated instances or a pattern of demands affecting work decisions (hiring, firing, promotions, demotions, advanced education, and other benefits) raises red flags. It does not matter that the harasser says, “but that’s not what I meant.” If the person subjected to the behavior – or others in the area who see or hear the behavior – finds it inappropriate or unwelcome, there are grounds for complaint and discipline. In suits, courts have consistently held that it is the plaintiff’s reasonable belief, based on all the circumstances, not the harasser’s intent, that sets the threshold.
Every medical facility should have an official policy addressing sexual harassment. The Joint Commission has mandated that each facility have a code of conduct that includes sexual harassment, and that applies to all staff members and physicians. Private medical practices affiliated with a medical center or practice management group should also have one. And every workplace should have posted information about reporting sexual harassment. If you are not comfortable reporting harassment within the organization, contact your nearest EEOC office or go to www.eeoc.gov for more information.
What to do:
All nurses should know the definition of sexual harassment and organization policies and procedures. Learn all you can about harassment, particularly some effective ways to speak assertively when faced with harassing behavior.
Speak up when you see or hear inappropriate behavior. It is usually better to talk to the person in private but a simple “stop” or “no” can signal the person to rethink his or her behavior.
Document inappropriate behavior in writing as soon as possible after an occurrence, even if you aren’t the direct recipient. Do not ignore or brush off inappropriate behavior. Our work is too important to tolerate unprofessional conduct.
If a patient, family member or visitor makes sexual comments or displays inappropriate behavior, speak up. Be polite, professional but firm: “Your behavior could be seen as sexual harassment. Please stop.” Document, report the behavior up the chain, notify the patient’s doctor, ask HR or security for assistance as needed, and have a colleague with you when you have to interact with the person.
If you are a leader, take every report of sexual behavior seriously, including reports from “problem” employees. As courts have said, “even a poorly performing employee is entitled to an environment free from sexual harassment.”
Investigate carefully and fully, document thoroughly, intervene promptly, educate, and motivate everyone to behave appropriately and respectfully.
No matter where you work, remember that sexual harassment is not part of your job description. Employers, as long as they are informed about misbehavior, have a duty to investigate and remediate. They cannot fix what they do not know about however so make sure the appropriate leaders know what is occurring. Employers who know about harassing behavior and who do not effectively address it can be held vicariously liable for misconduct, including that by patients and physicians.
Ignoring sexual harassment and any other type of inappropriate behavior doesn’t fix the problem. It only emboldens the perpetrator. Silence does no one any favors. Speak up and continue speaking until the behavior stops.