The sexual misconduct cases of prominent men like Harvey Weinstein, Bill Cosby, and Matt Laurer, and the #MeToo movement, which encourages men and women to speak up about sexual harassment and assault, have pushed the issue of sexual harassment into the spotlight.
Now, findings from last month's Medscape report Sexual Harassment of Nurses and PAs Report 2018, by Leslie Kane and Sandra Levy, show that these clinicians are not immune to this pervasive issue. And some reported sexual harassment has interfered with their ability to do their job.
Rates of Sexual Harassment
More than 6,200 clinicians across the U.S. were surveyed on the topic of sexual harassment in the healthcare workplace. The surveyors limited their scope to just the past three years of practice, and they outlined what constituted sexual misconduct for the purposes of the survey:
- Unwanted sexual text messages/emails
- Comments about anatomy/body parts
- Propositions to engage in sexual activity
- Being asked repeatedly for a date
- Offer of a promotion in exchange for a sexual favor
- Threats of punishment for refusal of a sexual behavior
- Deliberately infringing on body space
- Unwanted groping/hugging/physical contact
- Deliberate fondling of self
- Grabbing body parts
Based on this criteria, 11% of nurses, NPs, and PAs reported personally experiencing sexual misconduct in the workplace, and 14% reported witnessing sexual misconduct in the workplace.
Just 1% of those surveyed reported being accused of sexual misconduct, and 79% answered none of the above. That leaves about 20% of the participants having experienced sexual misconduct, witnessed sexual misconduct, or both.
The most common behaviors reported were sexual comments or leering at body parts, deliberately infringing on personal space, and unwanted physical contact, such as groping or hugging. Unwanted advances, such as being asked repeatedly for a date, explicit or implicit propositions to engage in sexual activity, and receiving unwanted sexual texts or emails, were also a common complaint.
The Effects of Emotional Distress
In addition to measuring sexual misconduct quantitatively, the report also asked questions about how sexual misconduct affected the victim’s professional life. When asked to measure how upsetting the incident, almost 90% reported that incident was moderately to very upsetting, with one third report of respondents reporting that the incident was very upsetting. Emotional distress is often a major factor in determining job performance and quality of care, and 73% of respondents said that these incidents interfered with their ability to do their job, with 15% reporting that the event interfered significantly.
The incidents of sexual misconduct changed how the surveyed clinicians approached their work in a variety of ways. 36% said that they avoided working with specific colleagues when possible and 23% reported that they engaged less with colleagues. Other effects included difficulty concentrating, increased absenteeism, and 3% reported an increase in medical errors or mistakes. Significantly, 30% of victims said that sexual misconduct led to thoughts about quitting their job, and 16% ended up quitting their job because of the incidents.
The results of this study exemplify the inherent benefits of having a strong sexual harassment policy and incentivizes healthcare leaders to combat sexual harassment.
Here are some other takeaways from the Medscape report:
- Gender dynamics: Predictably, more female nurses, NPs, and PAs experienced harassment than their male counterparts, and a majority (94%) of the perpetrators were male. However, almost twice as many male participants reported witnessing sexual abuse, harassment, or misconduct in the workplace. 4% of participants reported being accused of sexual misconduct, all of which were male.
- Age is not a factor: The survey found that harassment was spread relatively evenly across age lines. The largest age group that experienced harassment were nurses, NPs, and PAs aged 35-39, who composed 16% of victims surveyed; the second largest group were aged 50-54 at 15%. There were reports of harassment from participants of almost every age.
- Power dynamics: When asked about the perpetrators, nurses and NPs reported that 33% of harassers were physicians, and 48% reported “others.” “Others” included administrators, healthcare personnel, and patients. Interestingly, almost three-quarters of the respondents reported that the perpetrator were of an equal or subordinate position.
- Incidence reporting: A majority of the respondents (61%) did not report their perpetrator. Of those that did, 20% reported to their direct supervisor or department head, and only 8% reported the incident with human resources. Only 26% of reports led to an internal investigation, and many of them led to negative consequences for the victim; 28% said the perpetrator’s behavior was trivialized, 13% were retaliated against by management, and 12% were retaliated against by the perpetrator. Only 14% of reports led to the perpetrator being reprimanded, 9% of perpetrators were fired from the organization and practice, and 2% led to legal action against the perpetrator.