Scenario 11 - Colleague’s duty to report

A nurse, who also offers psychotherapy, often sees adolescents who are struggling with depression or anxiety. The patients are often shy and slow to open up. The nurse wants to ‘put them at ease’ and so makes a lot of sexualized jokes and comments.

A colleague expresses concern about this behaviour, but the nurse dismisses it: “I’m just trying to ‘connect’ with the teens and this is how they speak to each other.”

Questions for discussion

Is the nurse doing anything wrong? If so, what?
What might you have done differently in this situation?
What impact on the patients might this behaviour have?
What other methods could the nurse use to ‘put them at ease’?
Does the colleague have a duty to report?

Key concepts this scenario illustrates:

Professionalism and language use
When you have a duty to report, and when you don’t
Other ways peers can step in when they see a boundary crossing or violation

It is the nurse’s responsibility to maintain the professionalism in a patient encounter, and failure to do so is a form of boundary crossing. Regardless of this nurse’s intent, the use of sexualized jokes and comments is considered sexual abuse in the Regulated Health Professions Act, 1991 (RHPA). In this scenario, the nurse may have their certificate of registration with CNO revoked if they are found to have sexually abused a patient.

Accordingly, the colleague has a duty to report sexual abuse, and the use of sexualized comments and jokes in the scenario because, as defined by law, it is sexual abuse.

Instead of trying to connect to his young patients by using sexualized jokes, the nurse should focus his efforts to connect by really listening to his patients and being available to them as a health care resource. It’s important to remember that the nurse’s role is not to be a peer to his patients; the nurse’s role is to provide quality health care.