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Nurse-Patient Interaction Opens Hospitals to Liability

February 15, 2006
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Few settings present as great a challenge for protecting workers against sexual harassment as hospitals. Each day, nurses come into close physical contact with dozens of virtual strangers--their patients--who aren’t employees of the hospital and who haven’t gone through a vetting process. It is difficult to predict how patients are going to treat nurses, and it is impossible for hospitals to enforce anything like an employer’s code of conduct on them.

This lack of control, however, doesn’t immunize hospitals against the actions of a nonemployee, says Jim Hall, partner at Barlow, Kobata & Denis, an employment law firm based in Los Angeles. The law is clear: An organization is liable for the behavior of a third party if it knows--or should know based on experience--of improper conduct and fails to take immediate corrective action.

This legal precedent has been reinforced time and again. Most recently, the 7th Circuit Court of Appeals in Chicago found a hospital liable for the sexual harassment of a nurse by a doctor who was not a hos­pital employee.

One way for hospitals to protect themselves is by educating and coaching employees. Hospitals may not be able to control how patients interact with nurses, but they can try to manage how nurses react in the face of sexual aggravation, says Debbie S. Dougherty, assistant professor of organizational communications at the University of Missouri, Columbia.

Dougherty is a proponent of what she calls "coffee chat training." It entails having experienced nurses sit with no­vices in a casual environment to talk about their experiences with sexual harassment in the workplace. Coffee chat training could prove to be very effective in hospitals because it meshes well with the professional culture of nurses, which often involves trading stories, Dougherty says.

Employee training is particularly crucial in a profession like nursing, where frequent bodily contact could lead to tricky situations. In their role as caregivers, nurses must determine the balance between closeness and distance with their patients. Discussing this delicate equilibrium among peers is important, Dougherty says. She explores this topic in a forthcoming research paper with a slightly intimidating title: "Paradoxing the Dialectic: The Impact of Patients’ Sexual Harassment in the Discursive Construction of Nurses’ Caregiving Roles." In it, nurses discuss how they handle sexual harassment.

In addition to training employees, hospitals should have a policy for coping with third-party sexual harassment firmly in place and enforce it vigilantly, Hall says. They also should provide an avenue through which nurses can file complaints. The process should include reassurance that job security won’t be compromised if they complain.

The key is to be proactive and not wait until something bad happens, Hall says. "The worst thing that a hospital can do is sit on its hands and do nothing."

Gina Ruiz

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