“It is not okay!”

Sexual harassment: when one utters these words the first thing that comes to mind is the physical, the assaulted aspect of sexual harassment. Sexual harassment comes in many forms may it be verbal, emotional or physically (Mathew & Bismark, 2015).  According to the Equal Employment Opportunity Commission (EEOC), there are two types of sexual harassment claims: “quid pro quo” and “hostile work environment”. Quid pro quo means “this for that”. In this context, it involves expressed or implied demands for a sexual favour in exchange for some benefits for example, a promotion at work or to avoid termination at the workplace. Quid pro quo harassment is committed by someone who is in a position of power or authority over another’s. Hostile work environment harassment arises when speech or conduct is so severe and prevalent; it creates an intimidating or demeaning environment or situation that negatively affects a person’s job performance (SHRM, 2018).

Physiotherapy is by a nature a career which entails the therapist to be up close and personal. Physiotherapists usually develop a close physical and emotional bond with their patients. Therefore, it is of a great importance for physiotherapists’ to be aware of the limits of professional boundaries as we might be at a higher risk of boundary violation then other health professionals (Cooper & Jenkins, 2008). Physiotherapists’ are health professionals and they have a responsibility over the patients’ healthcare (WCPT, 2011). If an incident of sexual harassment had to be reported between a therapist and a patient, one would automatically assume the person in charge was responsible for it, as it has been made a norm that the person in a higher position would take advantage of a person in a lower position (SHRM, 2018). However, this is sometimes not the case; the health professional could also be the victim to the patients’ behaviour (Viglianti, Oliverio, & Meeks, 2018). Sometimes patients misinterpret the healthcare professional’s intensions for being misleading, of a sexual nature or as a “chemistry moment” but the physician could have been kind and empathetic toward the patient.

While I was on my clinical block at Macassar CHC, I experienced an incident where the patient misunderstood my kindness for being something more. I saw a patient, in his early 30s; he came to physiotherapy for his lower back. The patient came with his sister; she was his transport to and from the appointment. On arrival, he smiled at me and I smiled back as I thought it was the polite thing to do. During the session, I asked him if it was okay for me to sit next to him on the plinth, as I like to sit down next to my patients because it creates a sense of conversation and not a professional asking a whole list of questions. My main goal is always to make my patients’ feel comfortable in my presence.  As I was asking the patient work related questions, the patient responded with a smile and great enthusiasm, he was comfortable and I was comfortable. The conversation was flowing, after I asked my questions to avoid silence, the patient started to ask me if I was from the area, if I knew the area, and all those little details you ask people when you want to get to know someone. However, I did not think anything of it at the time because it was casual conversation.

The objective assessment started and I assessed everything I needed to assess and I went into my treatment. During my treatment sessions, especially if I am applying a hot pack I sit in the cubicle and do my notes to monitor the patient to avoid burns. While the patient was lying there I just heard “So do you have a boyfriend?”, I avoided the question, but later replied, “How is that an appropriate question, or any of your business?’, he replied, “ No, he is just being curious and just wanted to know”. I did not respond. I treated him and later on he made another comment like, “Yoh, you have soft hands and I wonder what else your hands can do? ”, I laughed( if you know me, you know if I laugh I am either laughing because it’s funny or I am laughing because I am nervous or uncomfortable- in this case, very uncomfortable) but I continued to treat him. After the session, I gave him his home exercises and I made his follow up appointment. When I gave him his card, he asked me for my number and I told him in a very professional, stern tone of voice, “Sorry sir, but I am not allowed to give it to you”. He just smiled at me and walked away. This is not all the details of the session, just a brief overview, but I felt very uncomfortable during this session. Sometimes, your kindness and polite nature could be misunderstood by the patient and they might think the two of you have “chemistry”.

The sexual harassment I experienced was a form of sexual harassment where the patient made comments that were not hurtful in anyway but there was an underlying sexual tone in his words. The patient was exploiting our therapist-patient relationship, and he was also challenging my professionalism when he was making these comments and asking for my phone number (Schneider & Phillips, 1997). Patient-initiated sexual harassment has no set guidelines on how it should be dealt with, because the physician’s only aim is to provide the basic right of health care (WHO, 2008) (Viglianti, Oliverio, & Meeks, 2018). Professionalism is defined as the behaviour, aims, skills and qualities that describes a professional worker (Porcupile , 2015). As I previously mentioned, I did not respond to his comment and I just laughed, personally I thought that was the best way for me to avoid the situation, evidence states that students would rather “turn a blind eye”, avoid the situation completely and they would personally ignore any comments made (Phillip, Webber, Imbeau, Quaif, & Hagan, 2019). Many of you might be asking yourselves, “did she report the incident to her clinician?’ and the answer is no I did not. Personally, I felt I did not want to report it, I did not want to write out an incidents report, I was just over it by the time the patient left and I was not up for all the drama. Evidence has stated that many individuals would rather avoid confrontation or report incidents, because the situation has either been too lengthy or the situation has been dismissed to avoid any legal implications for the placement (Mathew & Bismark, 2015) (Viglianti, Oliverio, & Meeks, 2018).

In the future, Sexual harassment should be reported to the appropriate leaderships (clinician, supervisor, clinical coordinator, and head of the department). Students should feel comfortable with reporting incidents of verbal or physical sexual harassment to the clinician or even to their university supervisors or coordinators (Viglianti, Oliverio, & Meeks, 2018). Therefore, it is of a great importance that students develop strong, solid bonds with their superiors, so that matters like these can be reported. Students should also be stern and vocal to the patient and tell the patient that what they are doing is inappropriate. Students should also vocalize that they are there for learning purposes. They should make it known to their patient’s that they are busy exploiting their learning opportunity by making comments. If the student is unsafe they should have the right to excuse themselves from the session. They should report it to a colleague or someone in charge. The patient still needs to receive his right to basic health care but it can be provided by another health care professional. This is also a critical part of being professional. The situation needs to be handled accordingly to avoid any bias behaviour (Viglianti, Oliverio, & Meeks, 2018). Education on different types of sexual harassment should also be incorporated and taught to the patient, sometimes patients are not aware of the types of sexual harassment because of their lack of education and understanding (Mathew & Bismark, 2015). Let us be the change and report incidences like these to make the health care profession better.

References

Cooper, I., & Jenkins, S. (2008). Australian Journal of Physiotherapy. Sexual boundaries between physiotherapists and patients are not perceived clearly: an observational study, 54, 275-279.

Mathew, B., & Bismark, M. (2015). Sexual harassment in the medical profession: legal and ethical responsibilites. The Medical Journal of Australia, 203(4), 189-192. doi:10.5694/mja15.00336

Phillip, S., Webber, J., Imbeau, S., Quaif, T., & Hagan, D. (2019). EClinicalMedicine. Sexual Harassment of Canadian Medical Students: A National Survey, 15-20.

Porcupile , D. (2015, September 9). What is PROFESSIONALISM? What does Professionalism mean to you? Retrieved June 7, 2019, from Linkin: https://www.linkedin.com/pulse/what-professionalism-does-mean-you-daniel-w-porcupile

Schneider , M., & Phillips, S. (1997). Social science and medicine. A QUALITATIVE STUDY OF SEXUAL HARASSMENT OF FEMALE DOCTORS BY PATIENTS, 669-676.

SHRM. (2018, January 12). Better Workplace, Better World. Retrieved from What are the different types of sexual harassment?: https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/typesofsexualharassment.aspx

Viglianti, E., Oliverio, A. L., & Meeks, L. M. (2018). Sexual harassment and abuse: when the patient is the perpetrator. The Lancet, 392, 368-370. doi:10.1016/S0140-6736(18)31502-2

WCPT. (2011, September 22). World Confederation of Physical Therapy. London, United Kingdom. Retrieved June 7, 2019, from Classifying Health Workers: Mapping occupations to the international standard classification: https://www.who.int/hrh/statistics/Health_workers_classification.pdf

WHO. (2008). The Right to Health. Geneva, Switzerland.

3 thoughts on ““It is not okay!”

  1. Hi Saschia. Thank you for sharing your writing piece and explaining the incident that occurred to you, although it may have not been that easy.
    I also had a similar experience at block once and I can confirm that it is an uncomfortable and overwhelming feeling because you do not always know what to do in that moment or how to react. It can be difficult at times because sometimes coming off as professional can seem “rude” to the patient – especially when you do not answer their questions the way they want you to.

    I like how you started your writing piece explaining what sexual harassment is because it gives the reader an indication of what your piece is about and makes it easier to follow. Also sometimes people have different understandings and perspectives of what sexual harassment is and not many know that it does not just have to be physical. You also explained your own personal experience that you had with the patient and then referenced it with authors who may have agreed or disagreed to the situation which makes your piece stronger.

    To stronger your argument/ writing piece – you can look further into:
    – why patients /visitors/ workers exploit sexual harassment (can add it in paragraph 3/4 when you are explaining your experience)
    Here is one link to possibly add to your writing piece as well – https://www.mja.com.au/journal/2015/203/4/sexual-harassment-medical-profession-legal-and-ethical-responsibilities – can be added in paragraph 3
    You can then combine these different overviews to create some “stronger” argument on why patients sexually harass vs your rights as a professional health care worker

    Grammar:
    paragraph 2 line 5 – a*
    paragraph 3 line 4 – asked*
    paragraph 4 line 11- feel*

    Also tip: do not forget to add your references 🙂

    Other than that, well done and all the best for your final piece!
    Erin

  2. Content:
    Dear Saschia. This was a very interesting piece for me to read as I did not think this situation was that common in a professional environment. This reflects the content of our ethics module as you describe how this was challenging your professionalism. In paragraph 5 you mention that it is challenging your professionalism. Consider maybe adding what professionalism is and how a professional should handle a situation like this. It will make your writing piece even more stronger if you add this as well. Here is something I used previously in one of my writing assignments to discuss professionalism and I think you can maybe find this helpful ; https://www.linkedin.com/pulse/what-professionalism-does-mean-you-daniel-w-porcupile
    Clinical practice:
    You have incorporated a very specific example of your own clinical experience which makes it easy for the reader to put themselves in your shoes and experience your emotions. I have not been in a situation like this but sue to you describing the whole situation makes it easy for me to understand your feelings and emotions.
    Evidence:
    Your writing is supported by evidence which makes it a very strong argument but, consider adding a reference list with hyperlinks so that the reader can read-up further about the topics that you are discussing.
    Language:
    The piece starts with an introduction discussing the topic in a professional manner and it ends with a conclusion to your ethical dilemma. This make it easy for the readers to follow your argument and also they are provides with a conclusion if they are faced with the same situations.
    Grammar: Paragraph 2: sentence 2; “have s responsibilities”.
    Digital literacy:
    Good use of tags because, it is the 2 major thing you focus the writing on. If you add your reference list make use of hyperlinks as discussed above under evidence.
    Thank you for sharing
    Agatha

  3. Thank you Saschia for this piece. I know how you feel, as I was somewhat in a similar situation in my clinical block.
    Content: The content is good, as it has a flow to it. This is something that happens a lot in our profession, especially to the women. Yes I agree with you, when you hear the word sexual harassment, you think of the sexual part. However, not necessarily the verbal part, saying things that can make you feel uncomfortable. I also agree with how our kindness and asking questions about their home life. Can be seen as a gateway of also asking us some personal questions. Your piece uses one of the topics discussed in ethics. You were able to link the topic to a personal experience. Which gives it emotion and makes the person who reads an idea of what you went through and how you felt in that moment. I liked how you in the end gave a solution of what one should do, if in a situation like this. You could maybe add a reference or two to support what as a student physiotherapist should one do in a situation like that. I would of liked to know what you did in that situation did you tell your clinician or did you leave it.
    Writing style: Just remember first put the quotes at the end and than a full stop. You have a clear introduction and states what is about to follow in the piece. You also have a good conclusion that gives a solution for your experience.
    References: You have good references to back up your claims but remember to add them at the end.

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