In Sierra Leone – Sexual Harassment Of Nurses
Evidence On Implications On Health Service Delivery
BACKGROUND
Sexual harassment continues to be a widespread social phenomenon prevalent almost in every employment and educational settings. Sexual harassment is an important and widespread public health problem particularly in nursing and healthcare. This piece will concentrate on sexual harassment behaviours in healthcare organizations and its implications on the quality of health service delivery. It is however, expected that, the issues examined in this piece will provide insight into happenings in other sectors; and authorities in both employment and educational settings will pay attention to this public health menace in a bid to reduce and/or mitigate the social, health and economic consequences of sexual harassment to the victims and organizational performance. (Photo: Alhassan Fouard Kanu, author)
According to available evidence in a global context, nurses and other care workers are more likely to experience offensive behaviours at work than other job groups. About 1 in every 4 nurses worldwide report exposure to sexual harassment; and the prevalence differs considerably according to country and healthcare setting.
Sexual harassment by definition is any deliberate or repeated sexual behaviour unwelcome to the recipient and is typically hostile, offensive, or degrading. The practice occurs in different ways and the environment determines the occurrence and thriving of sexually harassing behaviours. A hostile environment involves unwelcome sexual behavior or actions at work that yield a hostile, intimidating, or offensive workplace.
It has been observed that harassers use threats or rewards of employment decisions to coerce sexual favours. Sexually harassing behaviours can be classified into the domains of gender harassment, unwanted sexual attention, and sexual coercion. In short, gender harassment is the most prevalent form of sexual harassment and has the purpose of creating an intimidating, offensive or hostile environment. This category of sexual harassment is composed of verbal and nonverbal acts, such as sexist jokes and display of pornographic material, which intends to insult and derogate women rather than being an expression of sexual attraction.
Sexual coercion refers to an individual’s attempts to exercise his or her social power over a subordinate in order to obtain sexual cooperation.
Unwanted sexual attention, by comparison, consists of verbal and non-verbal behaviors (e.g., sexual comments) that are perceived by the target as unwelcome, unreciprocated, and offensive acts of sexual interest.
WHO ARE THE SEXUAL HARASSERS IN HEALTHCARE SETTINGS
The perpetrator of sexual harassment can be the same or opposite sex as the victim. Most harassment in nursing emerges from coworkers and supervisors, although patients and families account for some harassment. It has been found that, in hospitals the largest group of harassers of nurses is the doctors whilst in peripheral health units (PHUs) is the “in-charges”. Other than the facility-based harassers, supervisors of nurses from the health sector and educational institutions have also been reported to involve in this act.
EFFECTS ON VICTMS
Sexual harassment is often associated with short- and long-term psychological, psychosocial, and occupational consequences for victims and their families. Evidence has it that, 1 out of 4 nurses will be harassed at work by degrading, frightening, and potentially violent behaviors from supervisors or peers. Researchers have found that sexually harassing behaviours may include sexual remarks, touching, pressure for dates, direct pressure for sexual cooperation, and repeated phone calls, letters, and notes. These behaviours lead to emotional distress and they also disrupt the nurses’ job performance leading to errors and ineffective patient care.
When nurses are sexually harassed, they experience frustration and mental health problems that may include depression, anxiety, and post-trauma stress and may prompt high levels of burnout, staff turnover, and inefficient care delivery.
IMPLICATIONS ON SERVICE DELIVERY
Sexual harassment at work disrupts the nurses’ concentration on safe and competent care delivery and negatively influences employee job performance and satisfaction, which for an organization are the hidden costs of sexual harassment. Sexual harassment may cause decreased work effectiveness, productivity, and morale and high absenteeism and staff turnover. This interferes with the quality and quantity of work produced.
Replacing the nurses who leave because of sexual harassment results in significant costs to the health sector in recruiting and training new staff members. Worries about an unsafe work environment also increase absenteeism and turnover. If sexual harassment distracts the nurse who is passing medication, drawing blood, or handling surgical instruments, errors can be dangerous and potentially deadly. This focus on avoiding personal harm from harassment may keep the nurse from effectively attending to their patients; and hence, undermining the quality of service provision and with dire consequences to the patients.
WAY FORWARD
As highlighted in this piece, sexual harassment at work disrupts the nurses’ ability to give safe and competent care. The health sector, including private healthcare organizations need to practically provide written guidelines, policies, and education programs designed to set standards for acceptable behaviour at work. In addition, policies and procedures should list the penalties for unacceptable behaviour; and administrators need to monitor the enforcement of these policies and investigate infractions.
Orientations of new and old staff through trainings on sexual harassment each year with a view to establish rules to guide workplace behaviour that is free from sexual and other harassment, and explain and describe behaviours that constitute sexual harassment will be immensely helpful in promoting a sexually harassed-free healthcare working environment.
Author: Alhassan Fouard Kanu (FRSPH), Public Health Scholar-Practitioner, Doctor of Public Health (DrPH) Candidate.
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