The double standard struck again when radiology staff at another U.K. hospital posed nude for a charity fund-raising calendar: The Nursing Times reported that there were no complaints. And a London hospital knowingly rented out a ward to a company that shot a big-budget pornographic film inside.
Britons do seem to obsess over the topic. Lord Benjamin Mancroft, a Tory peer (similar to a senator), delivered a House of Lords speech in which he complained that nurses at the hospital to which he was admitted were “promiscuous.” (His evidence was that he overheard his nurses chatting about their social lives.) He made this announcement a couple of months after the Council for Healthcare Regulatory Excellence issued “sexual boundaries” guidelines to health professionals, whose failure to comply could result in loss of license. Among other stipulations, the ruling banned doctors and nurses from dating patients.
Nurse-patient sex
Nurse-patient relationships open a new can of controversies. Minnesota’s Mayo Clinic fired a male neurology nurse for “maltreatment of a vulnerable adult” because he had sex with a patient several times in her bathroom. But the Minnesota Health Department subsequently determined that the man had not violated state rules because the relationship was consensual.
One in six U.K. nurses know of a coworker who has had sex with a patient, and one in ten think it is acceptable for nurses to have relationships with patients, according to a Nursing Times survey. A British nurse received a one-year suspension for having a three-month affair with a cystic fibrosis patient after he was discharged from her hospital and despite his returning for a heart and lung transplant. Hardly discreet about it, she joked to coworkers that she had to increase his oxygen and give him a nebulizer inhaler before they had sex.
In the United States, between 1999 and 2009, state nursing boards disciplined 636 nurses for sexual misconduct. “The actual prevalence, however, is not known. Indeed, 38 to 52 percent of healthcare professionals report knowing of colleagues who have been sexually involved with patients,” the National Council of State Boards of Nursing (NCSBN) reported. The NCSBN defines sexual misconduct as “engaging in conduct with a patient that is sexual or may reasonably be interpreted by the patient as sexual; any verbal behavior that is seductive or sexually demeaning to a patient; or engaging in sexual exploitation of a patient or former patient,” according to the council’s Practical Guidelines for Boards of Nursing on Sexual Misconduct Cases. “Any and all sexual, sexually demeaning, or seductive behaviors, both physical and verbal, between a service provider (i.e., a nurse) and an individual who seeks or receives the service of that provider (i.e., client), is unethical and constitutes sexual misconduct.”
It’s arguable that healthcare employers can hold tighter reins on staff because their stakes are so high. The Oklahoma Nursing Board barred a hospice nurse from practicing for twenty years because she had a sexual relationship with a married patient who was terminally ill. While the nurse argued the relationship was consensual, the board’s lawyer told the judge, “It is the responsibility of the professional to say no to the vulnerable patient.” The 43-year-old Lou Gehrig’s Disease patient attempted suicide after the nurse broke up with him.
When officials try to micromanage nurses’ sex lives, the slope slides rather precipitously. In Australia, a 61-year-old nurse faced disciplinary action because of a sexual relationship with a patient who was an old childhood friend she had not seen in decades and whom she ultimately married after they reunited. The Nurse Board nevertheless argued that the nurse had behaved unprofessionally because: “Consent is not an excuse with issues of professional boundaries. The care of a patient needs to be in a safe and trusting ethical relationship.”
Headlines in the U.K. exploded in 2010 when the Nurse and Midwifery Council investigated a British nurse whose hospital fired her because of accusations of “inappropriate relationships” with patients’ widowers. The resulting headlines—“Cancer Nurse Bedded Three Victims’ Husbands”—implied that the nurse had affairs with the men while caring for their wives. In reality, the divorced mother of two said that she began a ten-year relationship with one widower more than a year after his wife died, and later fell in love with the second widower, with whom she was in a year-long relationship that began months after his wife passed away.
It’s hard to see how engaging in a serious relationship with a former patient’s widower compromises nursing care of other patients (not to mention the dead one). But some states, including Maine, Arizona, and Washington, officially ban nurses from dating patient family members. When you work near your home, you inevitably will encounter people in different contexts. If nurses who spend most of their days working long hours at the hospital can’t have a relationship with coworkers, patients, or patients’ relatives, then Lord help the small-town nurse who wants to date.
The NCBSN prohibits nurses from sexual activities with former patients, clients, or “key parties” (defined as immediate family, including the spouse, domestic partner, sibling, parent, child, guardian, and others “who would be reasonably expected to play a significant role in healthcare decisions”) for two years after the individual is no longer a patient. After two years, nurses still cannot engage in sexual activities with a former patient or a former patient’s “key party” if chances are high that the patient will need future treatment or if there is an “imbalance of power, influence, opportunity, and/or special knowledge of the professional relationship.”
If healthcare employers can dictate whom nurses date, can they also control whom they befriend? Three weeks after a psychiatric patient was discharged from a Canadian hospital, she saw her nurse at a greenhouse, where the women chatted and exchanged phone numbers. The women eventually decided to rent a place together. The hospital fired the nurse for becoming platonic friends with a former patient. When the nurse took the case to court, the judge sided with the hospital. According to the Hamilton Spectator, the judge argued that the nurse should have known better because of the high “return rate” of psychiatric patients to their hospitals as well as their vulnerability and emotional dependency within the nurse-patient relationship.
Certainly, hospital paramours are duty-bound to uphold their responsibilities and maintain professionalism even after the relationship ends. Healthcare workers cannot afford to have “bad blood” between them. But nurses in particular are stuck; they are glorified as sex objects, then punished when they have sex.
In Ontario, after nurse Lori Dupont tried to end a long, rocky relationship with married anesthesiologist Marc Daniel, the doctor, who had a history of inappropriate and unwanted contact with nurses, harassed her at work, according to the Windsor Star. When several nurses complained, their manager reprimanded them. The nurses took it upon themselves to protect Dupont, inserting themselves between Dupont and Daniel when they were in close proximity, or sneaking Dupont out of the room.
Administrators were aware of Daniel’s physical, verbal, and sexual harassment of nurses. Internal reports list that Daniel suggested he give a nurse a naked, oiled backrub; kissed a nurse who bent over to speak to him; and broke a nurse’s finger when grabbing a pillow from her. On a quiet weekend day, Daniel and Dupont were inexplicably both scheduled in the OR. Daniel stabbed her to death, then killed himself.
While the hospital board chairman called the murder-suicide “an unforeseen event,” Dupont’s family and coworkers said that Hôtel-Dieu Grace Hospital prioritized Daniel’s career over Dupont’s safety. “When a nurse behaves badly, I’m before a disciplinary hearing and the hospital reports it to the College of Nurses of Ontario. When a doctor behaves badly, nothing happens,” nursing union officer Colin Johnston told the Star.