Sexual misconduct: it’s worse if you’re a nurse

Sexual misconduct: it’s worse if you’re a nurse

In 2009 the Professional Standards Authority published guidance for patients and professionals with the aim of helping them to avoid becoming a victim or perpetrator of sexual misconduct. Regrettably instances of sexual misconduct have continued and the PSA therefore, commissioned Professor Rosalind Searle, a chartered psychologist at the University of Glasgow, to produce a report on “Sexual misconduct in health and social care: understanding types of abuse and perpetrators’ moral mindsets”. 

Using analysed records in 232 fitness to practise cases where sexual misconduct was found proven against registrants of the GMC, HCPC and NMC Professor Searle explores where, when and why sexual misconduct occurs in health/care settings so regulators can put in place measures to tackle it earlier.

Of the 232 analysed cases some statistics are particularly significant. Of note, in the case sample:

• 88% of perpetrators were male
• Patients were the dominant group targeted by perpetrators (59%), with vulnerable individuals a significant subcategory (49%) – vulnerability being identified as someone who is younger, infirm or with mental health issues. The next most frequent group to be targeted are colleagues which are found in 32% of the cases.
• 54% of cases occurred within a workplace

Although denial and minimisation was, perhaps unsurprisingly present in the analysed cases it is concerning that in 13% of cases the registrant sought to blame the target for the sexual misconduct. Patterns identified suggest that nurses try to displace responsibility onto authority figures and seek to distance themselves from their actions through the use of euphemistic terms; whereas doctors try to diffuse responsibility amongst peers and try to dehumanise their targets.

An important difference that was identified between the professions was the sanctions they received. Specifically, doctors were statistically more likely to receive a suspension compared to other groups (46% of cases compared to 18% for nurses). By contrast 62% of nurses found to have sexual misconduct charged were struck off while only 33% of doctors received this sanction. This is an important issue as such disparities can lead to a perception for some that these actions are less likely to be ‘punished’, and so create an ambiguity for perpetrators. 

The report makes a series of recommendations which include:

1. Training and awareness raising as a means of deterring perpetrators and improving understanding amongst bystanders;
2. Introducing/improving clear policies/guidelines about relationships and their appropriateness between professionals and patients in the workplace.
3. Identifying potential hot spots for misconduct and intervening before sexual abuse occurs eg toxic work place environments with long working hours, under-staffing, little supervision, bullying and hierarchical culture.
4. Further research into mental health roles and workplaces to understand better whether these workplaces attracted more perpetrators or whether they denude the moral compasses more quickly of those working with them (26% of all cases involved those working in mental health)
5. Obtaining more and better data to address the lack of detail and inconsistencies in the way regulators collect, collate and categorise fitness to practise so regulators can use this data to identify trends and share their knowledge with other agencies optimally placed to intervene.
6. Parity of sanctions across professions to create a clearer framework within which sanctions are applied

The full report has now been published and can be found here.