As students, we have to learn to create the correct patient-carer relationship. This is to ensure no boundaries are crossed. However, it can be quite a challenge, as some patient’s push back and do not give up on trying to find out as much as they possibly can about you.
But, it is highly important that we are able to navigate this type of situation and still get our job done. This is so the patient can still benefit from our treatment, without any lines being crossed by either party involved. Unfortunately, in some situations harassment can occur, and in my case, it was the patient who was the harasser.
The World Health Organization states, “Harassment is an unwanted behaviour directed at another identified person that:
- is repeated or pervasive (although a single incident may be viewed as harassment), and • has the purpose or effect of violating an individual’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that person.”(World Health Organization, 2017)
In my particular case, the patient’s behaviour was quite sexual in nature. Recently, on my general hospital block, I had a patient who was flirty during my treatment session. He kept complementing me in ways which made me feel quite uncomfortable and even started asking me very personal questions. I ignored all of his remarks and rather focused on getting my treatment done. Luckily, this patient just needed to be checked and I was able to discharge and later that day. However, I still had other patients in the same room as him to treat throughout the week. The treatment of my other patients became difficult, as every time he saw me, I would get some sort of side comment.
On one occasion, while I was with another patient, he entered the curtained off area to tapped me on the shoulder, and lifted his gown, proceeding to show me his genitals. I could see on his face he looked pleased with himself. I turned around and walked straight out of the room. I informed my clinician as to what had occurred and I was no longer allowed to treat any patients in that room.
When I reflected on the whole situation I realized how extremely uncomfortable I had felt and how unsafe I felt in that environment. It then occurred to me that I had experienced a form of sexual harassment.
Sexual harassment can be defined as, “Unwelcome sexual advances, requests for sexual favours, and other verbal or physical conduct of a sexual nature when:
- Submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment, or
- Submission to or rejection of such conduct by an individual is used as a basis for employment decisions affecting such individual, or
- Such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment.”(University of Michigan, 2017)
Upon researching what sexual harassment is I found that there are different types, one in particular stood out for me. “Hostile environment: sexual harassment occurs when unwelcome conduct of a sexual nature creates an intimidating, threatening or abusive working or learning environment or is so severe, persistent or pervasive that it affects a person’s ability to participate in or benefit from a University program or activity.” (University of Michigan, 2017)
This then led me to try and find out what more I could do if I was ever in such a situation again and I looked into better ways to managed inappropriate behaviour.
A study done in July 2018, found that 84% of students experience inappropriate patient sexual behaviour (IPSB), and that, “Physical therapy clinicians were more likely to experience IPSB if they were female, treating mostly male patients, or newer to the profession.” (Health Times, 2017). I realized how often my situation occurs to others and during my research I found this poster (image) which helps you analyze the situation and guides you through a way of handling it.
Bibliography
American Physical Therapy Association. (2018, July). Study: Ignoring Inappropriate Patient Sexual Behavior Doesn’t Work, but Other Strategies Might. Retrieved from APTA: https://www.apta.org/PTinMotion/News/2018/07/02/IPSBResponsesPTJ/
Health Times. (2017, May). How to deal with inappropriate patients. Retrieved from Health Times: https://healthtimes.com.au/hub/workplace-conditions/60/practice/healthinsights/how-to-deal-with-inappropriate-patients/2228/
University of Michigan. (2017). Sexual Assault Prevention and Awareness Center. Retrieved from Student Life: https://sapac.umich.edu/article/63
World Health Organization. (2017, April). Ethics and Professional Conduct. Code of Ethics and Professional Conduct.
3 thoughts on “Boundaries”
Good evening Sonali
Thank you for your submission. I do apologize that you had to experience such a unpleasant situation. I thought the way you handled the situation was the best that you could have and I am glad that your clinician understood the severity of such a situation and no longer allowed you to work in that area.
I liked how you explained the steps you followed after the incident occurred. You mentioned that one of the things you also did was research how to manage inappropriate behaviour… so perhaps mention a few things that you discovered whilst doing this research.
With regards to the patient, perhaps explain in more detail the patient’s behaviours and emphasize whether the patient was cognitively stable. Not that it is an excuse for any person to behave in such a manner but with certain conditions the patient’s do not have appropriate judgement, therefore emphasize if he was cognitively sound and that this behaviour was thus deliberate and intended to cause some sort of reaction from you.
With regards to your spelling and grammar, I found a few spelling mistakes that need to be corrected such as “quiet” should be “quite” in paragraphs 1 and 3. I would also suggest altering some of your phrases to make them more academic and less conversational such as “quite flirty” to “the patient was flirtatious” and ” flash me” to “showed me his genitalia in a sexual manner to elicit a response from me”.
I suggest that you find more evidence to support your ethical dilemma. Perhaps research if there has been a study on why male patient’s behave this way… is it for attention or to elicit a reaction from young professionals etc. Also remember to include a full APA reference list and not just the URLs you used to find your information.
I hope these suggestions help you to complete your assignment!
Regards,
Halinka
Hi Sonali,
Thank you for allowing me to read your writing piece on boundaries. What an awful experience you had to encounter. I completely understand why you started to feel uncomfortable and unsafe to work in that environment. Your writing made my think of my own clinical practice and how a patient saw my name on my name badge and kept sending me inappropriate messages and photos on social media. How can one continue to work in such an environment? I am so glad your clinician understood and said you weren’t allowed to treat patients in that environment. Your writing piece made me think of how your rights were violated in this situation due to you not having a safe environment to work in. Therefore, your content resembles what we have discussed in class. Perhaps you could make your writing piece stronger by adding a reference in how your rights were violated and therefore you were placed in this ethical dilemma.
I like the argument that you made about how we as students must create a patient-student relationship and how this patient has crossed the boundaries. I also liked the fact that you did research on how to handle this situation. Perhaps you can make your argument stronger by adding some more of the research you found on how to handle this situation. Also try to investigate why patients behave in this manner and if there are any consequences they can face when violating your rights.
Please remember to reference the resources used from the URL pasted at the bottom of your writing piece.
A few grammar errors that I have noticed:
First paragraph:
Second sentence: – Change quiet to quite
Third paragraph:
First sentence: – Change patients to patient’s
First sentence: – Change quiet to quite
Second sentence: – Change quiet to quite
Third sentence: – Change has to have
Fourth paragraph
First sentence: – Repetition of the word one. Change first one to on.
Last sentence: – Add a , after occurred, “what had occurred and I was no…”
Last paragraph:
Last sentence: – Change lead to led
Overall, I enjoyed reading your writing piece. Your writing piece is well constructed, and it affected me emotionally. Which is brilliant. I hope that you will find my comments useful. Good luck with your final.
All the best
Megan
Hi Sonali
Thank you for your submission! I cannot find Ruve’s writing piece for term 2 and thought your piece was really intriguing so I hope it is okay to give you feedback!
I am truly sorry you that you had this experience during your clinical rotations but I agree with Halinka in that you handled it really well and I’m sure this is going to make you a stronger health professional in the future! Please see my comments regarding your feedback below.
Content:
I think the topic of harassment is relevant to our ethics module as it is an ongoing problem we as health professionals (and especially students) face on a regular basis. I think the text and the topic compliment each other well and it helps to create depth to the piece as a whole. I like how you were able to connect your emotions and clinical experiences to the piece. In addition, your description of your experience is strong and thought-provoking and helps to raise the serious issue of student harassment, especially in the work environment we are in. However, I agree with Halinka in that you should try to add more information re: the cognitive state of your patient. Furthermore, I think you could add more length to your writing piece as I felt it was slightly short. Have you considered adding visual pieces to your writing? I think the usage of images and/or poems, describing the feelings of an individual in a similar situation as yours, would help to create more depth to your piece. However, I think your paragraphs flowed really well and I think your description of your experience is strong intriguing!
Argument:
I think your argument is strong and clear to follow from the beginning of the piece. I like how you acknowledged that we have to learn to create the correct patient-carer relationship and how this could be challenging as a student. However, have you considered adding more literature re: what the ‘correct’ patient-carer relationship is and what the specific boundaries between health professionals and patients are? I think it will help the reader understand what should occur before explaining what should not, making your piece more thought-provoking.
References:
In addition to what Halinka has suggested, make sure your final submission includes a full APA list. Furthermore, I think finding more evidence to validate the statements made in your piece will help to back up your thoughts and experiences described. In addition, don’t forget to add in-text references.
Writing:
The text is easy to read and I think your paragraphs flowed really well. Below are some of the grammatical errors I found, in addition to what Halinka has commented.
In paragraph 3: the sentence “..however I still has other patients..” should be written as “..however I still had other patients..”
In paragraph 6: “Now ethically, what would have been a better way..” try to make the sentence end in a question mark to indicate that you are questioning if a better reaction to the experience could have resulted in a different outcome.
Furthermore, make sure you use academically appropriate phrases in your text, as Halinka suggested.
Besides the grammatical errors, I think it is a very well written piece with lots of intriguing statements.
Good luck for your final submission!
Raadiyah x