The intent of this position statement is to condemn sexual harassment in the workplace and to inform nurses of their rights and responsibilities in relation to harassment complaints.
It is the position of the New York State Nurses Association that:
Sexual harassment is a major problem in healthcare; it is a pervasive, disparaging, social, legal and ethical problem. It is a form of sex discrimination that affects both sexes, although, the majority of sexual harassment is perpetuated by men against women, and few working women have not experienced sexual harassment. Only ten percent of the sexual harassment complaints are filed by men and researchers theorize that this may reflect that fewer women hold powerful positions or men may be embarrassed and fear humiliation if they file (Fiedler & Hamby, 2000). Additionally, same-sex harassment complaints are on the rise but are also underreported. Some authorities contend that the nursing profession has the highest rates of sexual harassment (Madison & Minichiello, 2001).
Surveys have shown that many employees do not know what constitutes sexual harassment. In the United States, sexual harassment is classified as a form of discrimination under Title VII of the Civil Rights Act of 1964. It is characterized by conduct of a sexual nature that is unwanted and unwelcome by the receiver. Conduct is considered unwelcome when it is neither invited nor solicited and the behavior is deemed offensive and undesirable. Sexual harassment in the workplace is an unlawful exercise of power. The harasser uses his or her authority, or power to belittle, humiliate, refuse to promote, or demote someone (Hamlin & Hoffman, 2002). Harassing behaviors include but are not limited to the following:
The Equal Employment Opportunity Commission (EEOC) issued guidelines in 1980 and defines sexual harassment in two ways:
Quid pro quo -- “something in exchange for something else” (Garner, 1999. p.178): Unwelcome sexual advances, request for sexual favors, and other verbal or physical conduct of a sexual nature constitute harassment when a submission to or rejection of such conduct is used as the basis for employment decisions (Gardner & Johnson, 2001).
Hostile work environment: Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature that has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment (Ibid).”
The enactment of the Civil Rights Act of 1991 further impacts sexual harassment cases. This law permits punitive and compensatory damages for sexual harassment victims. The current EEOC guidelines authorize courts to hold employers liable financially for their employees’ sexual misconduct (Fiedler & Hamby, 2000).
Despite the well documented nature of this public health problem and the laws to protect individuals, underreporting and detrimental costs to human dignity and organizations persist. In a study of 188 critical care nurses, 46% reported suffering from sexual harassment, which included offensive sexual remarks, unwanted physical contact, unwanted verbal attention, requests for unwanted dates, sexual propositions and one physical assault. Physicians represented the largest percentage of offenders, followed by co-workers, and supervisors. The majority of the incidents are unreported, perpetuating this public health problem (Sandberg, McNiel & Binder, 2002).
The detriment to the victim involves both short- and long-term psychological, psychosocial, and occupational consequences. Emotional distress may be manifested by anxiety, depression, post traumatic stress disorder (PTSD), and substance abuse. Many victims experience increased absenteeism, burnout, job change, interpersonal conflict, and/or impaired intimacy and sexual functioning. An unsafe work environment leads to compromises in patient care; for instance, when the harasser is a colleague, valuable patient care information may not be communicated. Also, a distressed individual may have difficulty concentrating, in turn, missing important patient information (Valente & Bullough, 2004). Organizations incur costs from lawsuits and claims, increased absenteeism and turnover as well as poor productivity. The Department of Labor reports that U.S. organizations lose roughly $1 billion annually related to absenteeism, lowered morale, and new employee training because of sexual harassment (Moore, Cangelosi & Gatlin-Watts, 1998).
According to Gardner and Johnson (2001), “Prevention is the first, last, and primary line of defense against sexual harassment; in fact, prevention is the cure. Simply for the sake of human dignity, employees in healthcare settings are entitled to safe, harassment-free workplaces” (p.9). Reliable procedures, education, follow-up and a “zero-tolerance” approach by an organization will curtail sexual harassment and prevent its consequences. Employers must have a strong policy that clearly indicates the position of the organization related to sexual harassment. The EEOC recommends that employers voice strong disapproval of sexual harassment and educate all employees.
An organization must clearly indicate that a harassing environment is not authorized or condoned and implement consistent methods to be sure it is understood by all employees and the harassment policy is publicly displayed. This should enhance employee confidence in reporting incidents. The policy must have a clear and concise definition of sexual harassment including related behaviors that constitute it. In addition, the policy should be written to outline the process and contacts for reporting a complaint. Education programs are the best means of prevention and all employees must attend. Managers should be instructed on how to deal with harassment issues and become keenly aware of organizational and personal liability issues. It is of utmost importance that managers not be judgmental of the victim and understand that individual perception and interpretation is what determines sexual harassment (Valente & Bullough, 2004). Lastly, managers, supervisors and physicians need to set the example of appropriate behavior, as studies have shown that those individuals who occupy positions of power are more likely to be harassers (Gardner & Johnson, 2001).
Once an organization has a strong commitment to control sexual harassment, it will assist the registered professional nurses to protect themselves. According to the American Nurses Association (ANA), RNs have the right to a workplace free of sexual harassment. Registered nurses can combat sexual harassment by utilizing these four tactics: confront, report, document, and support. If an employee perceives and interprets an individual’s actions to be sexual harassment, they must clearly state to the harasser that the attention is unwanted. Next, the harassment should be reported as per agency policy by using the organization’s “chain of command.” Documentation is key; it should be completed while the incident is fresh in the victim’s mind and should include: what happened, where, when, how both parties responded and names of witnesses, if possible. Lastly, seek support from colleagues, friends, organized groups, and state nurses associations. As a last resort, and if an RN is unable to stop sexual harassment through the organization’s internal system, an employee has the private right to take legal action under Title VII, which can be completed with the assistance of an attorney.
The New York State Nurses Association recommends that:
*If you are covered by a collective bargaining agreement, sexual harassment complaints may be remedied through the grievance and arbitration procedure in that agreement. If such a situation exists, consult your NYSNA nursing representative for assistance.
Other NYSNA position statements addressing violence include:
Approved by Board of Directors 3/10/92
Reviewed and revised by the Expanded Council on Nursing Practice on April 1, 2005.
Approved by the Board of Directors on April 8, 2005.
American Nurses Association. (1993). Workplace issues: Workplace rights. Sexual harassment: It’s against the law. Retrieved February 5, 2005 from http://www.nursingworld.org/dlwa/wpr/wp3.htm.
Decker, P. (1997). Sexual harassment in health care: A major productivity problem, Health Care Supervisor, 16(November), 1-14.
Fiedler, A. & Hamby, E. (2000). Sexual harassment in the workplace. Nurses’ perceptions. JONA The Journal of Nursing Administration, 30(10), 497-503.
Gardner, S. & Johnson, P.R. (2001). Sexual harassment in healthcare: Strategies for employers. Hospital Topics, 79(4), 5-11.
Garner, B. A. (Ed.). (1999). A handbook of basic law terms. St. Paul, MN: WEST Group.
Hamlin, L. & Hoffman, A. (2002). Perioperative nurses and sexual harassment, AORN Journal, 76(5), 855-860.
Madison, J. & Minichicello V. (2001). Sexual harassment in healthcare-classification of harassers and rationalizations of sex-based harassment behavior, JONA The Journal of Nursing Administration, 31(11), 534-543.
Moore, H. L., Cangelosi, J. D. & Gatlin-Watts, R. W. (1998). Seven spoonfuls of preventive medicine for sexual harassment in health care, The Health Care Supervisor, 17(2), 1-9.
Sandberg, D. A., McNiel, D. E., & Binder, R. I. (2002). Stalking, threatening, and harassing behavior by psychiatric patients toward clinicians. Journal of the American Academy of Psychiatry Law, 30, 221-229.
Valente, S. M., Bullough, V. (2004). Sexual harassment of nurses in the workplace, Journal of Nursing Care Quality, 19(3), 234-241.
For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.