Sexual abuse and sexual misconduct: What do I need to know?
Marie is a registered nurse who lives and works in a rural town in Alberta. Yesterday, she finished her set of five shifts and is looking forward to having a few days off. She decides to meet up with some friends at the local coffee shop. While there, Marie sees someone who she thinks she recognizes, but can’t seem to pinpoint where she knows him from. After a few seconds, it clicks and she remembers that he was one of the post-op patients she cared for around 10 months ago. Eric, a young man around the same age as Marie also recognizes her and they start talking. An hour and a half passes by quickly and Marie and Eric seem to be getting along quite well. Before leaving, Eric expresses his interest in Marie and asks her for her phone number. Marie gladly gives it to him.
The next day, Marie goes for brunch with her friend who is also a nurse. Although Marie and Eric are not dating and have not entered into a sexual relationship at this point, she’s excited about Eric’s interest in her and shares the details with her friend. Marie’s friend asks if she has recently received a letter in the mail from CARNA about the new Protection of Patients from Sexual Abuse and Sexual Misconduct Standards developed in response to amendments to the Health Professions Act (HPA). Marie responds and says, “I think so, but I didn’t really pay much attention to it.” Her friend responds and says, “Well, you should really read it. The consequence of engaging in a relationship with a patient or former patient that can be considered sexual in nature is significant. A finding of sexual abuse against a nurse will result in cancellation of their practice permit. You should call a CARNA Policy and Practice Consultant before seeing Eric again.”
After brunch, Marie decides to call a CARNA Policy and Practice Consultant to learn more about the new standards as she wants to clarify her professional responsibilities and accountabilities. The Policy and Practice consultant tells Marie that changes to the HPA have established mandatory penalties for sexual abuse and sexual misconduct by all regulated health professionals. She also learns that although she is no longer caring for Eric, CARNA’s standards state that an individual is considered to be a patient for one year after the date of the last clinical encounter where a health service was provided by the nurse.
Even after one year, there may be circumstances where it is still considered inappropriate for a nurse and patient to have a sexual relationship. The Policy and Practice Consultant explains that this is due to the power imbalance that exists between a nurse and a patient, and the vulnerability that exists in a patient. Marie also learns about other important changes including when an individual is considered a patient and a former patient, considerations for nurses providing episodic care, when a sexual relationship with a former patient is never considered appropriate, and the new standards and expectations of CARNA registrants. Marie is reminded that the obligation to maintain professional boundaries always lies with her, as a nurse, not Eric, the patient.
Specifically the standards include:
- Maintaining therapeutic professional boundaries in all interactions with the patient in the provision of professional services
- Self-reporting to the registrar of all relevant regulatory bodies a nurse is associated with, as soon as reasonably possible, any finding of professional conduct against the nurse
- Reporting the conduct of a member to the complaints director of the appropriate college if a nurse has reasonable grounds to believe that the conduct of any regulated member of any regulated profession constitutes sexual abuse or sexual misconduct
Upon learning about these new expectations, Marie decides to take steps to maintain professional boundaries with Eric.
Disclaimer: Our case studies are fictional educational resources. While we strive to make the scenarios as realistic as possible, any resemblance to actual people or events is coincidental.