Neal Howard, the host of Health Professional Radio, interviewed Kate Fenner, Ph.D., RN, Managing Director of Compass Clinical Consulting, about sexual harassment in the  healthcare setting. This is part 1 of a two-part interview. You can also listen to the complete interview on audio, “Sexual Harassment in the Healthcare Setting.”

Types of Sexual Harassment

Neal Howard: How is sexual harassment defined in a healthcare setting, and is it any different in the healthcare setting from what we hear in the mainstream media?

Kate Fenner: From a legal perspective, it certainly isn’t different. I should be clear that I’m not a lawyer. My background is accreditation and regulatory affairs, but from the legal definition, it is no different in a hospital except that it also extends of course to patients as well as employees and visitors in a hospital setting, otherwise the definition of harassment is very much the same: any unwelcome advances, any creating of a hostile work environment, any requests for sexual favors and implications that a person in power can adversely affect an individual if they don’t cooperate, those all fall within and happen in hospital environments just as they do in every other environment.

The U.S. Supreme Court has ruled that there are two types of sexual harassment covered by the Civil Rights Act, which recognizes sexual harassment as an infringement on employee’s civil rights.

Quid pro quo: “Job security, advancement, or benefits are tied to sexual favors. This type includes unwelcome sexual advances, requests for sexual favors, or physical or verbal conduct of a sexual nature that are tied directly or implicitly to employment.”

This type of harassment is fairly straightforward (come to my hotel room and we’ll talk about your promotion). It also applies to retribution/punishment for rejecting a person’s advances (since you won’t go out with me, I’m demoting you).

Hostile work environment: “Inappropriate behavior is so pervasive and severe that it permeates the workplace and interferes with the individual’s ability to carry out the duties of the job.”

This type is more subjective and covers a variety of bad behaviors; unwelcome jokes, graphic images, insults, threats, gestures, touching of a sexual nature. Typically, most quid pro quo cases also include hostile work environments.

Neal Howard: Now, I would think that it’s a little bit more complicated being as you suggested that it trickles down to the patients, the visitors of those patients, support staff, not just the people who are involved in taking care of the patients. How can you prevent sexual harassment in the healthcare setting in the first place, but then how do you address it going to your customers, not just the people that work there, but your clients, patients, and patients’ family?


Kate Fenner: Excellent question. The prevention side is step one, of course, and it’s a very strong policy, but more importantly than very strong policy, zero-tolerance policy is communication and education of policy, so that as staff join an organization, they have as part of their required orientation, the zero-tolerance policy, and education about their rights and responsibilities. Every right usually has an attendant responsibility. The prevention part is making sure that managers and medical staff leaders all are aware and have a similar zero-tolerance policy.

Harassment Free Work Environment 

It’s also making sure that people understand their rights to a harassment-free environment, whether its staff members or actually as patients enter hospitals, there’s a requirement that hospitals inform them of their rights, and their right is to safe and competent care essentially. I think the whole issue of sexual harassment as being part of a larger ethical piece about why hospitals and healthcare facilities exist, and we’re here to serve people when they’re needing us, and that service includes making certain we observe their rights to dignity and self-protection.

Neal Howard: Now, we’re talking about the rights and dignity of the patient as someone seeking care, we don’t often hear about someone, for example, coming into the insurance agency to buy insurance and sexually harassing the agent or coming into the bakery and harassing the chef. Is it possible that these sexual harassment issues emanate from a patient who’s being at the hospital for an extended period of time or for different types of mental or physical issues; how do we address those types of issues?

Kate Fenner: Oh, you are spot on with the problem in healthcare, because there are some fairly illustrative court cases where employees have been harassed by patients and hospitals have not taken preventative measures, have not intervened, and the employee has been found to induce myriad of compensation because of it. Particularly with patients who may have an altered mental status, think about patients with Alzheimer’s, patients with mental health issues in general. But patients tend to, particularly if they’re in for a while, they can become disoriented, and also their world alters a little bit.

So, it’s very important that we take steps when that happens, when a patient harasses a staff member, to intervene and explain to the patient that this is not acceptable, and if need be, to reassign the staff member so that they’re not exposed.

End part 1.

Read more from Kate in part 2: Sexual Harassment: Taking on the Imbalance of Power in the Healthcare Setting.

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Kate Fenner, RN, PhD Managing Director As Managing Director of Compass, Kate uses her problem-solving and communication skills to help clients meet their clinical and cultural goals, focusing on organizational optimization, performance improvement, and regulatory compliance. Kate has led and participated in dozens of mock surveys to help healthcare organizations meet the standards and expectations of regulatory bodies such as the Joint Commission, the Centers for Medicare and Medicaid Services, and State Departments of Health, and guides hospitals and health systems through accreditation and regulatory compliance response and recovery efforts.

A regular keynote speaker throughout the country, she authored a leading college text on law and ethics in healthcare, co-authored other texts on a variety of healthcare issues, and currently serves on the editorial board of the Journal for Nursing in the 21st Century.

Contact Us

Compass can help your organization identify opportunities to improve your culture of safety. To ensure that your organization doesn’t receive unwanted scrutiny for failure to create a work environment conducive to patient safety, contact Kate Fenner, RN, PhD, Managing Director at (513) 241.0142, or via the contact form below for a confidential discussion of your concerns and to schedule an assessment of safe work practices in your organization.

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