Workplace Harassment and Professional Boundaries

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Questions and Answers

Which of the following is NOT a common example of boundary issues in professional practice?

Gift giving

Sexual harassment

Employment discrimination (correct)

Conflict of interest

What is required for an action to be considered sexual harassment in the workplace?

The action must be welcomed by the recipient.

The action must occur in public spaces.

The action must be related to employment decisions. (correct)

The action must involve physical contact.

In the context of healthcare, who can be victims of sexual harassment?

Only healthcare professionals

Only patients

Both healthcare professionals and patients (correct)

Only individuals with a formal complaint

Which form of harassment is characterized by exchanging sexual favors for benefits such as grades or employment?

Quid pro quo Signup and view all the answers

What is the legal standard for identifying unlawful harassment?

The action must be uninvited and based on the victim's protected status. Signup and view all the answers

Gender harassment is primarily defined by which of the following characteristics?

Verbal and nonverbal behaviors conveying hostility or exclusion Signup and view all the answers

Which type of harassment involves unwelcome sexual attention that can include physical or verbal misconduct?

Unwanted sexual harassment Signup and view all the answers

Which of the following actions would likely NOT contribute to a hostile or offensive working environment?

Professional discussions related to work Signup and view all the answers

What is required for conduct to be considered abusive in a workplace environment?

The conduct must be subjectively abusive and objectively severe. Signup and view all the answers

What must happen to the supervisory role if a personal/sexual relationship exists between a medical trainee and a supervisor?

The supervisory role must be eliminated for the relationship to proceed. Signup and view all the answers

Which percentage of respondents reported experiencing inappropriate patient sexual behavior during their clinical practice?

86% Signup and view all the answers

What constitutes a common informal response to inappropriate patient sexual behavior (IPSB)?

Altering treatment to minimize patient interaction. Signup and view all the answers

Which of the following is listed as an unsuccessful strategy in dealing with IPSB?

Avoidance of situations leading to confrontation. Signup and view all the answers

What type of behavior can escalate from inappropriate patient sexual behavior (IPSB)?

Grabbing and touching. Signup and view all the answers

Why are physical therapists (PTs) considered at risk for experiencing inappropriate patient sexual behavior?

They work closely and physically with patients during treatment. Signup and view all the answers

Which formal response is suggested for addressing inappropriate patient sexual behavior (IPSB)?

Documenting the behavior for proper record-keeping. Signup and view all the answers

Which of the following statements best summarizes the reported experiences of female physicians regarding harassment?

Around 50% have experienced at least one form of gender-based harassment. Signup and view all the answers

What percentage of nurses reported experiencing teasing sexual remarks from patients and their relatives?

78.8% Signup and view all the answers

In what ways can the harasser be characterized in the context of workplace harassment?

Anyone, including non-employees such as family members. Signup and view all the answers

What behaviors indicate the potential presence of a 'hostile' work environment?

Supervisors ignoring inappropriate conduct. Signup and view all the answers

Why is it inaccurate to assume that only the victim is affected by offensive conduct?

Anyone aware of the conduct can feel discomfort or distress. Signup and view all the answers

What percentage of male nurses reported experiencing sexual harassment?

37% Signup and view all the answers

Which of the following statements regarding workplace culture and behaviors is true?

Workplace culture may normalize inappropriate behaviors. Signup and view all the answers

What is one example of unlawful sexual harassment that may occur without economic injury to the victim?

Unwelcome sexual advances made during working hours. Signup and view all the answers

Which of the following is not considered sexual misconduct in the context of a physical therapist-patient relationship?

Making neutral comments about a patient’s clothing Signup and view all the answers

What constitutes sexual contact according to the Virginia Code regarding physical therapy?

Verbal conduct that is explicitly sexual in nature Signup and view all the answers

Which of the following actions is described as a clear example of sexual misconduct?

Intentionally viewing a disrobed patient for non-diagnostic purposes Signup and view all the answers

In what context is sexual behavior with a patient considered inappropriate?

During any type of professional evaluation or treatment Signup and view all the answers

Which of the following actions violates ethical practice standards for physical therapists?

Taking photographs of a patient for personal use Signup and view all the answers

What is an example of therapeutic misconduct that is specifically ethical violation?

Touching a patient inappropriately during a therapy session Signup and view all the answers

Which of these actions constitutes a violation of a physical therapist's ethical obligations?

Discussing unnecessary intimate details during the session Signup and view all the answers

According to ethical guidelines, what is considered sexual harassment in a therapy environment?

Inappropriate remarks made to staff or students Signup and view all the answers

What is the primary criterion for determining if a person is considered a patient under § 54.1-3483 (10) of the Code of Virginia?

The nature and context of the professional relationship. Signup and view all the answers

Which statement accurately describes the impact of a patient's consent to sexual behavior with a practitioner?

It does not negate the statutory prohibition against sexual conduct. Signup and view all the answers

Under what circumstances may sexual contact between a practitioner and a former patient still be considered unprofessional conduct?

If it results from the exploitation of trust from the prior relationship. Signup and view all the answers

What is classified as a key third party in the context of unethical conduct involving a patient?

A spouse, parent, or legal representative of the patient. Signup and view all the answers

What defines unprofessional conduct in the case of a supervisor and a trainee?

Sexual contact resulting from the exploitation of trust from their professional relationship. Signup and view all the answers

Which action is recommended for managing incidents of harassment?

Document the incidents with dates and details. Signup and view all the answers

Which resource should employees consult for assistance with harassment issues?

The human resources director, if available. Signup and view all the answers

What condition would likely classify sexual contact as unprofessional conduct between a practitioner and any patient?

The contact has an adverse effect on patient care. Signup and view all the answers

Which of the following behaviors is considered an appropriate use of digital media for professionals?

Connecting with other professionals via platforms dedicated to networking Signup and view all the answers

What is a potential consequence of inappropriate digital media use in a healthcare setting?

Creating unrealistic expectations for patients Signup and view all the answers

Which of the following falls under the responsibilities of digital professionalism?

Monitoring your online identity for professionalism Signup and view all the answers

What should professionals avoid to ensure they do not violate HIPAA regulations?

Sharing patient information publicly without consent Signup and view all the answers

Which statement best describes the concept of digital professionalism?

Engaging in professional online interactions and communications Signup and view all the answers

Which action could be classified as inappropriate digital communication?

Publicly criticizing a colleague’s work on social media Signup and view all the answers

When utilizing social media, what is an important consideration for healthcare professionals?

Understanding and following facility policies Signup and view all the answers

What is one major landmine that healthcare professionals should avoid on digital platforms?

Posting patient information without consent Signup and view all the answers

Study Notes

Professional Boundaries in PT Practice

PT 8351, Professional Issues I
Boundary issues are a major concern for PTs, encompassing various issues like sexual harassment, gift-giving, and conflicts of interest.

Boundary Issues

Common examples include:
- Sexual harassment
- Gift giving
- Conflict of interest

Objectives

Recognize harassment by other healthcare professionals or patients.
Utilize appropriate professional resources when identifying possible signs of harassment or domestic violence.
Manage and prevent boundary issues in the workplace.

Harassment in Healthcare

True or False Questions:
- Only healthcare providers, not patients, can be victims of sexual harassment. (False)
- Men cannot be victims of sexual harassment. (False)
- Patients consent to being touched during a medical appointment. (False)
- Harassment does not have to be sexual in nature. (True)

Sexual Harassment

Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature.
It exists when:
- Submission to such conduct is made a term or condition of employment.
- Submission to or rejection of the conduct is used as a basis for employment decisions.
- It has the purpose or effect of unreasonably interfering with work performance or creating an intimidating, hostile, or offensive work environment.
Applies to employers with more than 15 employees (Title VII).

APTA House of Delegates

Sexual harassment is unacceptable in physical therapist environments.
Members have a responsibility to prevent and report such harassment.

Types of Harassment

Unwanted sexual physical or verbal attention (e.g., touching, inappropriate proximity, flirting)
Quid pro quo: Sexual coercion in exchange for something (e.g., money, grades, professional advancement)
Gender harassment: Verbal and nonverbal behaviors conveying hostility, objectification, exclusion, or second-class status targeting one gender.
Visual: (e.g., screen savers, inappropriate internet use, posters)

Is it Unlawful?

Harassment must be unwelcome and based on a protected status.
The conduct must be:
- Subjectively abusive to the person affected.
- Objectively severe and pervasive enough to create a hostile or abusive work environment for a reasonable person.

Personal/Sexual Relationships

If a personal/sexual relationship exists between a medical trainee and a supervisor with professional responsibility for the trainee, the supervisory role must be eliminated if they wish to pursue the relationship.

Patient Sexual Behaviors

86% of respondents reported some experience with sexual behaviors, with 63% indicating at least one experience as harassment.
84% of physical therapists experienced inappropriate patient sexual behavior (IPSB) during their career/training.
47% had experienced IPSB within the previous year.

IPSB Escalation

Escalation of IPSB can range from comments, romantic gifts, and sexual gestures to grabbing, touching, indecent exposure, and aggressive behaviors.

Why are PTs at Risk?

PTs ask patients to disrobe and touch various body parts.
Close proximity during transfers and lifting.
Work in private rooms.
Discuss personal matters.

PTs are Not Alone

50% of female physicians experienced gender-based harassment, and 37% reported sexual harassment.
60% of female nurses and 34% of male nurses have experienced harassment.

Nursing

91% of nurses reported experiencing sexual harassment in the workplace.
78.8% encountered teasing remarks.
55.2% were asked by patients to initiate romantic relationships.
48.5% experienced sexual jokes, 45.8% non-sexual touches, and 20.8% experienced sexual touches during nursing tasks.

Hostile Environment

Open discussions within earshot of others.
Promotion based on sexual favors.
Patients repeatedly asking therapists for dates.
Pornography in the workplace.
Supervisors/managers not addressing the behaviors.
Dirty jokes and sexual slang.

The Norm

Assess the workplace culture.
Identify behaviors that are tolerated.
Understand differing perceptions of sexual comments/gestures.

Severity of Allegations

The most common allegation is failure to adhere to policies and notify referring practitioners of adjusted treatment plans (11.1% and 18.5% respectively).
The highest percentage (70.4%) is physical, sexual, emotional abuse/misconduct.

Considerations

Victims and harassers can be anyone (e.g., supervisor, agent, co-worker, family member).
The victim doesn't have to be the person harassed.
Unlawful harassment can occur without a loss of income or job.
Harasser's conduct must be unwelcome.

Federation of State Boards of PT

Sexual misconduct includes engaging in or soliciting sexual relationships (consensual or not).
Engaging in or soliciting sexual relationships with patients, making sexual advances or engaging in other verbal conduct or physical contact.
Intentionally viewing a patient in the course of treatment without it being related to treatment.

Maryland Code of Ethics

PTs and assistants must not engage in sexual misconduct (includes various specific behaviors, such as with patients, during evaluations or treatment).

Virginia Code Regarding Sexual Contact

Defines sexual contact and includes examples of behaviors that may be considered sexual contact.
Explains when a person is considered a patient.
Outlines scenarios where sexual contact between a practitioner and a former patient or key third party may still constitute unprofessional conduct.

Legal Resources

US Equal Employment Opportunity Commission (EEOC) website for guidance on workplace harassment.
State licensure boards for relevant information.

How to Manage Boundary Issues

Contact GWU faculty for help.
Do not tolerate harassment.
Go to a supervisor if a policy exists and possible.
Keep a journal of dates, involved parties, and incidents.
Gather evidence if possible (e.g., emails, photos).
Clearly set boundaries (verbal, appearance, not accepting gifts).

Institutional Level Policies

Employers should conduct risk assessments, have policies protecting employees, and offer regular training.

Digital Professionalism

Analyze the correlation between in-person and digital professional behaviors.
Digital media guidelines include avoiding sharing patient information, understanding HIPAA implications, and adhering to workplace policies.

Appropriate Digital Media Use

How to connect and network with other professionals while maintaining an online professional identity.
How to present yourself and your business appropriately online.
How to use digital platforms for education, outreach, advocacy, and community engagement.

Inappropriate Digital Media Use

Avoid sharing patient information, ensuring HIPAA compliance.
Respect workplace policies regarding communicating online.

Digital Media Landmines

Identify digital media landmines, such as the potential for HIPAA violations, harassment, crossing professional boundaries, and unrealistic patient expectations.

Tips

Be careful with all photographs.
Do not compromise the professional relationship.
Do not comment on work online.
Use correct grammar.
Be judicious with shared links.
Follow the "mom" test.

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Description

This quiz explores key concepts related to workplace harassment, boundary issues, and professional conduct in healthcare settings. Test your understanding of the definitions, legal standards, and types of harassment that can occur in the workplace, as well as the implications of personal relationships in professional environments.