EXECUTIVE SUMMARY

For the past year, sexual harassment has made headlines, sometimes daily, as celebrities and politicians deal with accusations. Research shows that nurses and other healthcare workers also experience sexual harassment, abuse, and bullying on the job.

  • One in four nurses reports workplace sexual harassment.
  • Some recent lawsuits have found in favor of plaintiffs, leveling millions in punitive damages to healthcare providers.
  • Sexual harassment can range from the extreme of sexual assault to an unwanted request for a date.

One out of four nurses reports sexual harassment on the job — and that is only one part of the physical violence and verbal bullying some nurses experience, studies show.1

Recent publicity about sexual harassment from celebrities and politicians has broadened public discussion of this problem and caused some organizations to improve their education and policies about sexual harassment.

Still, it’s a big problem in healthcare, as recent lawsuits highlight. For example, one California woman filed 18 written complaints about sexual harassment by surgeons and medical staff when she worked as a cardiac surgery physician assistant at a hospital. She was fired a week after her last complaint. The woman reported being called a “stupid chick,” being subjected to trashy sex talk, and being bullied — including a surgeon sticking her with a needle. A federal jury awarded her $125 million in punitive damages, a verdict that is being appealed by the hospital. (Find more information at: http://abcn.ws/2APC8pD.)

Many case managers, whether they work in hospitals, primary care clinics, long-term care facilities, or other healthcare settings, may have seen or experienced sexual harassment, as well.

A first step in preventing the problem is to define it. (See story on preventing sexual harassment in this issue.)

“Sexual harassment ranges from extremes of sexual assault down to ‘Did you get asked out on a date from someone you didn’t want to go out with?’” says Paul Spector, PhD, distinguished professor in the department of psychology at the University of South Florida in Tampa.

“A lot of sexual banter goes on in the workplace, and sometimes it rises to the level of harassment,” he says.

Generally, sexual harassment is unwanted behavior, a pattern of repeated behavior, and it creates a hostile work environment, Spector says.

“It flares up in the media every so often, going through cycles,” he says. “We saw it with the Anita Hill hearing, but the behavior has been going on, and sexual harassment is part of a broader mistreatment pattern.”

Sexual harassment that is unlawful and is subject to oversight by the Equal Employment Opportunity Commission (EEOC) must meet the following criteria:

  • enduring the offensive conduct becomes a condition of continued employment;
  • the conduct is severe or pervasive enough to create a hostile work environment that a reasonable person would consider intimidating, hostile, or abusive.

(For more on the EEOC’s regulations on workplace harassment, visit: http://bit.ly/2By9Lh0.)

“The legal definition of sexual harassment is what we use in the workplace, although most people use layman terms, which are much broader and typically in the eye of the victim,” says M. Ann McFadyen, PhD, an associate professor at The University of Texas at Arlington. McFadyen was a co-author of a paper on occupational sexual harassment, published in July 2017.2

Firing the accused employee often is the only recourse an organization can make, which is why so many news and entertainment companies quickly fired or severed ties with the stars accused of sexual harassment last fall.

Letting sexual harassment cases drag out can tarnish an organization’s reputation, McFadyen says.

“Scientific evidence suggests that false claims are no more than 2% to 5%, so the vast majority of allegations have some degree of merit or substance to them,” says James Campbell Quick, PhD, FAPA, distinguished university professor at The University of Texas at Arlington. Quick co-authored the paper on sexual harassment.

“Ann and I focus on the fact that this is not a sexual problem, but a power dynamic [involving] abuse of power, and the sexual dimension is the weapon of choice,” Quick says.

“What our study shows is that one of the biggest indicators of sexual harassment occurring is when you’re in a male-dominated field,” McFadyen says.

Studies show that male nurses also report sexual harassment, forced intimate touch, and others’ attempts to have sex, Spector says.

A 2014 review of 136 articles about violence, bullying, and sexual harassment reported by nurses found that male nurses were affected, although the studies didn’t indicate whether the alleged perpetrators were primarily male or female.1

If sexual harassment is thought of in terms of a power abuse, it makes sense that male nurses also would experience it. “In some cases, a person will use abuse to exert power over somebody, and in that case, it has nothing to do with sex,” Spector says.

“I’m interested in the broader issue of mistreatment, and sexual harassment is a component of it,” he says. “It can be very stressful to go to work and deal with this.”

Bullying and sexual harassment also can contribute to medical errors, he adds.

Sexual harassment can lead to mental health problems in victims, says Elizabeth Armstrong, PhD, professor of sociology and organizational studies at the University of Michigan in Ann Arbor.

“Decades of research in psychology, sociology, and other fields indicate sexual harassment and sexual assault have really negative consequences in terms of depression, anxiety, and health issues,” Armstrong says.

Major status inequalities can lead to workplace sexual harassment, and this likely is why nurses are vulnerable to it, she notes.

“The power differences are huge, and physicians may feel they have a certain amount of entitlement,” Armstrong says. “One would think one of the reasons why nurses experience a lot of harassment is that in a feminized, lower status job in an organization that is very hierarchal, they are working directly with men who have a lot more power than they have in the organization.”

This power differential also can affect how a healthcare organization handles sexual harassment complaints.

“If someone is a superstar, a doctor or surgeon, it can be difficult to say anything, and even if people do report the harassment to the organization, the organization might feel very reticent about pursuing or following up on the report,” Armstrong says.

REFERENCES

  1. Spector PE, Zhou ZE, Che XX. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud. 2014;51:72-84.
  2. Quick JC, McFadyen MA. Sexual harassment: have we made any progress? J Occup Heal Psych. 2017;22(3):286-298.