Sexual harassment is an uncomfortable topic but it is a common occurrence, where there is a difference in power. According to Ramsaroop & Brijball Parumasur (2007), sexual harassment victims hold lower positions in the occupational hierarchy. There may be also a greater incidence of harassment among working women than men in South Africa (Ramsaroop & Brijball Parumasur, 2007). Sexual harassment is an inappropriate sexual behaviour. It can be any verbal or physical act of an explicit, or perceived, sexual nature, which is unacceptable within the social context in which it is carried out (Boissonnault, Cambier, Hetzel & Plack, 2017).
When I read up the definition of sexual harassment, it sounded to me more extreme compared to the situation I experienced. Thus, during my third block, I was given a patient and in his doctor’s notes it stated that he possibly have psychotic problems. But he still had to be assessed by the psychologist. He was also a drug abuser and had symptoms of withdrawal. I thought nothing about it at first but then as I had more sessions with him, I noticed changes in his behaviour.
One day he would act “normal”, other days he would act aggressive and then other days he would act inappropriate. In the beginning, when I first had sessions with him, he would say inappropriate things but I would ignore him. As I had more sessions with him, in that moment, he started to do inappropriate things, for example, trying to wrap his foot around my waist or try to touch my buttock. I would tell him it is not appropriate to do that and not to do such things again. He would promise me he would not do it again and that he was sorry. However, the next time I would see him he would do the same thing and seem to forgotten the conversation we had about not doing these things. It would make me feel uncomfortable when he acted inappropriate. On the other hand, I would also actually feel sorry for him, because he would tell me he doesn’t know why he acts the way he does. It feels like to him he is going crazy.
According to Boissonnault, Cambier, Hetzel & Plack (2017), the workplace violence in the health care sector is a worldwide concern. The most frequent perpetrators are patients, their relatives, caregivers and visitors. There are some older studies in physical therapy that focused entirely on patients as perpetrators of sexual harassment and other inappropriate sexual behaviour. Inappropriate patient sexual behaviour is committed by a patient and directed at a clinician, staff or other patient in a health care setting. It encompasses a range of behaviours from leering and sexual remarks to deliberate touch, indecent exposure, and sexual assault (Boissonnault, Cambier, Hetzel & Plack, 2017).
However, it is known if anyone acts or say inappropriate things there will be consequences but what if it is a patient that has mental impairments that necessarily don’t have control over their behaviour. How or should one handle/ reprimand a patient with mental impairments that acts or say inappropriate things? When i would tell the nurses, they would encourage him by laughing at the inappropriate things he would say or do. They would say “leave him he is a mad man”. So how can something like this be taken seriously or there be consequences if a patient is “mad man”? Should those with mental impairments be treated the same way as those without mental impairments when it comes to reprimanding them for saying and doing inappropriate things.
A ccording to Gaebel & Zielasek (2015), psychosis is a clinical syndrome composed of several symptom and where delusions, hallucinations, and thought disorder may be regarded as core clinical features. Which could explain the patient’s behavoiur but not necessarily justify his behaviour. I understand now why something like this would occur especially in our profession. It is due to the close contact and creating relationships with our paients. According to Butow-Dutoit, Eksteen, De Waal & Owen (2006), physiotherapists might be vulnerable to sexual harassment by both patients and co-workers in their environment. Due to close contact during assessment and treatment sessions and developing close relationships with the patients (Butow-Dutoit, Eksteen, De Waal & Owen, 2006).
Moreover, I didn’t report this patient to my clinician because I only had four sessions with him before he was discharged. I told myself just to hold it out till then. Half of me wanted to report him to my clinician and the other half didn’t because I also felt sorry for him because of his mental impairments. I also didn’t think and feel my experience was that bad because whenever I would hear the word sexual harassment, my mind would immediately would think of sexual assault. Not necessarily what I went through with my patient. Hence, in that moment I didn’t see it was a “big thing” to report the patient to my clinician.
However, it is said to report any form of sexual harassment as soon as you feel uncomfortable in a situation no matter the sitiuation. In the Employment Equity Act, 1998 (Act 55 of 66 (4): 1998), it states to report any form of sexual harassment as soon as possible. The way to go about reporting a perpetrator is to lodge a complaint either an informal and formal complaint to your employer. The informal complaint, involves where the complaint or employer explains to the perpetrator, that their actions are inappropriate and making the other person feel uncomfortable. While the formal complaint, involves lodging a complaint and the perpetrator goes through a disciplinary hearing ( Employment Equity Act, 1998 (Act 55 of 66 (4): 1998).
I feel, if I maybe told my clincian, and my clinician spoke to him. He would have maybe understood how serious his actions were and that he should stop what he is doing. On the one hand I feel I should have told my clinician about him but on the other I feel what I went through with my patient wasn’t something that serious that I needed to report him.
Therefore this experience taught me that, if I would to be in a similar situation like this I would rather report it to my clinician. I should have lodged an informal complaint. I should have told them the moment I felt uncomfortable because thinking back I noticed it felt like a nuisance every time I had to go and treat him. Not knowing what type of person I was going to interact with in that moment. Even though the patient might have mental problems, this shouldn’t stop one from reporting them. As this might show them how serious their actions are and hopefully show them not to do it again with anybody else.
References:
Butow-Dutoit,L., Eksteen,CA., De Waal, M. & Owen, JH. (2006). Sexual harassment of the physiotherapists of South Africa. SA Journal of Physiotherapy, 66(4): 9-12. Retrieved from https://doi.org/10.4102/sajp.v62i4.160 on 8 June 2019.
Boissonnault. J.S., Cambier. Z., Hetzel, S.J. & Plack, M.M. (2017). Prevalence and Risk of Inappropriate Sexual Behavior of Patients Toward Physical Therapist Clinicians and Students in the United States. Physical Therapy, 97(11), 1084–1093. Retrieved from https://doi.org/10.1093/ptj/pzx086 on 23 May 2019.
Gaebel. W & Zielasek. J. (2015). Focus on psychosis. Dialogues Clin Neurosci, 17(1), 9–18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421906/ on 22 May 2019.
Ramsaroop. A & Brijball Parumasur.S. (2007). The Prevalence And Nature Of Sexual Harassment In The Workplace: A Model For Early Identification And Effective Management Thereof. SA Journal of Industrial Psychology, 33 (2), 25-33. Retrieved from https://www.google.co.za/url?sa=t&rct=j&q=&esrc=s&source=web&cd=6&cad=rja&uact=8&ved=2ahUKEwiJt4LgkbLiAhXZTxUIHb4-CCYQFjAFegQIBhAC&url=https%3A%2F%2Fsajip.co.za%2Findex.php%2Fsajip%2Farticle%2Fdownload%2F374%2F367&usg=AOvVaw0adDjQw_ZAk4LpNKIOd4TX on 22 May 2019.
South Africa. (1998). Employment Equity Act (no. 55 of 1998). Pretoria: Government Printers.
4 thoughts on “Sexual Harrassment and patients with mental impairments”
Hi Jamie. Thank you for sharing your experience, although it may have been difficult.
I personally have not been in a similar situation so I cannot even imagine how you were feeling in that moment. I think it is a very tricky conversation but something that has to be brought up.
I like how your writing piece explains your own personal experience and is backed up by references which explains how prevalent sexual harassment is and can be in the working environment. I’m assuming it is overwhelming and you do not always know what to do in that moment, especially if it is a psychotic patient. You also stated what sexual harassment is which is beneficial to your writing piece because sometimes people do not always understand the meaning and concept of what it actually is. Your writing piece also made me aware of how psychotic patients present – which also raises concerns of what do you do in that situation, especially after you told the patient to stop.
I think for your piece, you can put your own personal experience in one of the top headings (after you explained what sexual harassment is) so it gives the reader an immediate idea of what you are speaking about and why you chose the writing piece – thereafter you can back up your writing with the references.
I suggest to stronger your argument/ writing piece – you can look further into:
– what are your human rights as a student physiotherapist and what to do when sexual harassment occurs
– why patients /visitors/ workers exploit sexual harassment
Here is one link to possibly add to your argument as well – https://www.mja.com.au/journal/2015/203/4/sexual-harassment-medical-profession-legal-and-ethical-responsibilities
Grammar:
In paragraph 4, you could rephrase the sentences and instead of using “then, and then so often, you can maybe say “at that time / in that moment / afterward”
In paragraph 4 – line 4: instead of “bum”, you can use the word “buttocks”
All the best for your final piece. Good job!
Erin
Hi Jamie. Thank you for sharing your experience, although it may have been difficult.
I personally have not been in a similar situation so I cannot even imagine how you were feeling in that moment. I think it is a very tricky conversation but something that has to be brought up.
I like how your writing piece explains your own personal experience and is backed up by references which explains how prevalent sexual harassment is and can be in the working environment. I’m assuming it is overwhelming and you do not always know what to do in that moment, especially if it is a psychotic patient. You also stated what sexual harassment is which is beneficial to your writing piece because sometimes people do not always understand the meaning and concept of what it actually is. Your writing piece also made me aware of how psychotic patients present – which also raises concerns of what do you do in that situation, especially after you told the patient to stop.
I think for your piece, you can put your own personal experience in one of the top paragraphs (after you explained what sexual harassment is) so it gives the reader an immediate idea of what you are speaking about and why you chose the writing piece – thereafter you can back up your writing with the references.
I suggest to stronger your argument/ writing piece – you can look further into:
– what are your human rights as a student physiotherapist and what to do when sexual harassment occurs
– why patients /visitors/ workers exploit sexual harassment
Here is one link to possibly add to your argument as well – https://www.mja.com.au/journal/2015/203/4/sexual-harassment-medical-profession-legal-and-ethical-responsibilities
Grammar:
In paragraph 4, you could rephrase the sentences and instead of using “then, and then” so often, you can maybe say “at that time / in that moment / afterward”
In paragraph 4 – line 4: instead of “bum”, you can use the word “buttocks”
All the best for your final piece. Good job!
Erin
Dear Jamie-Lee
Thanks for sharing. I had almost the same experience and I know how uncomfortable it is. Yes a patient is psychotic but that doesn’t justify his behavior! Such patients do learn from repetitive action or output, those patients should be told every time when they do something wrong. Give them a sign to say no don’t do that and the staff as well must do that so they patient registers that such is not acceptable. He’s a mad man but what else was tried to make him see that his behavior is not acceptable?
Anyway, your content is good, has your reflection on the topic and supporting statements. Started well with giving a background of sexual harassment and psych patients which made it easier for one to understand and follow your reflection. There is flow between your paragraphs and your referencing style is good. Just few grammatical errors that Erin highlighted already, work on that. It would be great if you could include an ethical dilemma that you found yourself in and it affected or will have an impact on your profession.
Otherwise your reflection is good and sorry that you had to experience that.
Good luck with your final submission!
Kat x
Hi Jamie!
Thank your sharing your story, it must have been difficult. I really like how you linked the content with a very personal experience, making this piece such a gripping piece. The content also links nicely with the topic at hand. You really allowed me to be in your shoes in that situation. It really made me think about how I would react and how it would make me feel. Would I report it, or let it slide because he is a “mad man”. It also really made me question the nursing staff and why sexual harassment is acceptable if the patient is a “mad man”? Any form of harassment should be unacceptable?
Your work has a nice logical flow with supporting each statement with evidence. Good job! Your grammar and spelling overall is good, some minor changer could however be made. For example, use the word “buttocks” instead of “bum”.
Have you considered mentioning what YOU think? Is it acceptable in certain cases? Do YOU think the nursing staff was handling the situation the right way? And if not, why? And what would you have done differently? Also try and mention how this experience changed your future approach to clinical practice and what you would do if a situation like this presents itself again.
I really enjoyed your piece, well done!
Ruve