"It was me against the world"

March 2006 -- Global online careers leader Monster has posted a short but good article by John Rossheim headlined "How Nurses Can Fight Sexual Harassment." The piece explores some of the reasons for the prevalence of the harassment nurses face, including media stereotypes, and discusses some potential solutions. It relies on recent research, including Debbie Dougherty's University of Missouri study, and several quotes from Truth executive director Sandy Summers. The piece might have briefly discussed the negative effects harassment can have on patient care, in addition to the hospital liability and nurse retention issues it raises. But on the whole we commend Mr. Rossheim and Monster for a useful and candid piece.

The Monster piece covers some of the same ground as other recent press pieces about sexual harassment of nurses. But it does so fairly and concisely, and it is frank about the roots and stubbornness of the problem. Rossheim makes clear that the harassment does not come solely from patients, but can even come from "a male hospital physician's systematic assaults on female employees," as apparently occurred in a case involving more than 50 women at a Brooklyn hospital that resulted in a $5.5 million settlement in 2003. The piece also does not shrink from noting that nurses are "likely" to face the "occupational hazard" of sexual harassment, citing communications professor Dougherty's recent study in which 21 of 29 nurses surveyed reported that patients had sexually harassed them. The piece also cites a 2001 NurseWeek study finding that 19% of nurses had been harassed in the previous year, and that nearly a third of male nurses said they had been sexually harassed by physicians.

The piece quickly but persuasively explores causes and exacerbating factors in the harassment. It points to observers who say stereotypes fuel the harassment, quoting Summers: "Naughty-nurse images in the media are really nonstop, so it's clear where men get the idea that nurses are there to provide sexual service to patients." The piece also says that "[v]iolent" media themes may be a factor, noting that Dougherty (right) was "surprised" at the aggression the nurses she studied had faced: "Patients threatened to attack nurses sexually and called them prostitutes." The piece goes on to discuss underreporting by nurses, who may overadapt to harassment, citing an American Nurses Association brief. Nurses may try to shrug off serious incidents, and only one nurse in Dougherty's study had ever withdrawn from caring for a patient, which many hospitals do allow, at least in theory.

Commendably, the even-handed piece discusses the role of employers in the persistence of the problem. It notes that employers "should be highly motivated" to crack down on harassment because of liability and retention concerns. And it includes a quote from lawyer John Doran (who presumably represents hospitals) noting that hospitals usually have "meaningful training" as part of "comprehensive" sexual harassment prevention programs. But the piece also suggests that there is an "apparent disconnect" between what hospitals say they provide and "what employees recall receiving." Dougherty reportedly notes that only a few nurses in her study recall having any training at all. And the piece quotes Summers, who was herself "groped twice by inebriated patients" in clinical settings, as noting that employers are not always receptive to nurses' reports of harassment: "The hospital management showed me zero support...It was me against the world, as if I were a renegade."

The piece also discusses solutions. Suggesting that "liability and retention" issues "may" spur employers to act, it quotes Summers: "If we want to keep nurses in the workforce, we're going to have to do a better job of supporting them." The piece might have noted that this is especially problematic because nursing is in the midst of a critical global shortage. The piece also states that Summers recommends that hospitals pursue assault cases with law enforcement on behalf of nurses and that they offer counseling to harassed nurses. This counseling might include critical incident stress debriefing.

The piece ends with helpful advice to harassed nurses drawn from the ANA website. This includes making sure the harasser knows the "attention is unwanted," documenting it promptly, reporting it to management and if necessary law enforcement, and seeking support from friends, relatives and colleagues, including state nurses associations. The piece might have added that union representatives can also be helpful in these situations.

The article might have briefly noted that harassed nurses may be less able to provide good care, which can lead to poor patient outcomes, as well as nursing burnout and potential liability. Here again, these problems add to the already critical nursing shortage. It's possible that this short piece did not explore all of these larger health and policy issues because Monster's focus is on "employer and employee" issues, but they are all related.

On a final note, the piece stated that the ANA, the American Association of Colleges of Nursing, and the American Hospital Association failed to respond to requests for comment for the article. We note that pieces on a career website like Monster about sexual harassment may not make nursing look attractive to potential recruits. But of course, the piece would likely have been published whether Summers spoke to the reporter or not. And as the piece itself quoted Summers as observing: "If we don't talk about these problems, we're never going to be able to fix them." The Center believes that one critical factor in the global nursing crisis is a reluctance to speak frankly about the profession's true nature, including its problems. We hope that open discussion of the sexual harassment nurses face will make it less likely that future studies like Professor Dougherty's will show such unacceptably high levels of harassment.

We thank Mr. Rossheim and Monster for this article.

Click here to see the article: How Nurses Can Fight Sexual Harassment" by John Rossheim, published in February/March 2006 on Monster.

See our previous analysis on an AP article featuring Dr. Dougherty's study.