Concerns and Sexual Boundaries Flashcards
Why is it important to maintain sexual boundaries?
if sexual boundaries are crossed:
it can damage public trust and confidence in pharmacy and other healthcare professions
it may cause lasting harm to patients
if you are sexually, or inappropriately, involved with a patient, your professional judgement can be affected
What are sexual boundaries and breaches of sexual boundaries?
sexual behaviour - acts, words or behaviour designed to arouse or gratify sexual impulses or desires
breaching a sexual boundary is not limited to criminal acts but can also include
- carrying out an unnecessary physical examination
- asking for details of sexual orientation when it is not necessary or relevant
How can you avoid sexual boundaries?
be aware of signs that show sexualised behaviour towards patients or carers
- avoid revealing intimate details about yourself
- establish a purely professional relationship
What are chaperones? When are they needed? What should be done if they are not available?
a person (usually the same sex as the patient) who is present as a safeguard for the patient and healthcare professional - can also act as a witness to the patient’s continuing consent for the procedure
should ask the patient if they would like a chaperone in the consultation room
record any discussion that you have with patients about chaperones, including when they don’t want to have one present
if no chaperone is available, then offer to delay and re-arrange the consultation or examination until one is available
How should EHC (emergency hormonal contraception) be dealt with in regards to under 16s?
is considered appropriate if:
- the young person can understand the advice
- the young person could not be persuaded to inform their parents or agree for the doctor to do this on their behalf
- the young person is likely to start or continue sexual behaviour whether contraceptive treatment is given or not
- the young persons mental or physical health is likely to suffer if contraceptive advice or treatment is not offered
- it is in the young persons best interest that parental consent is not obtained prior to offering contraceptive services
What are abuse and neglect? What are the different types?
abuse and neglect are forms of maltreatment.
- someone may be guilty of abuse or neglect by inflicting harm, or failing to act to prevent harm
types of abuse:
- physical, emotional, sexual, neglect
- financial/material, discriminatory, institutional, domestic
What are fabricated or induced illnesses?
fabricated or induced illness signs include:
- reported symptoms are not explained by any medical condition the child has
- new symptoms are reported on resolution of previous ones
- over time, the child is repeatedly presented by the parent or caregiver with a range of symptoms
- the child’s normal activities are being curtailed
What is emotional abuse? What are signs of it?
persistent emotional maltreatment
- affects emotional development
= feelings of worthlessness, being unloved, feeling inadequate or valued only if as they meet the needs of another person
signs:
- disturbed sleep, speech disorders, fear
What is sexual abuse? Who is at risk? What are signs of it?
may include:
- physical contact, penetrative or non-penetrative acts or acts of involving children in looking at, or production of sexual images, watching sexual activities
children and vulnerable adults are at risks
signs:
- STIs, pregnancy, genital bleeding or itching, self-harm, withdrawn, poor performance in school, knowledge of sexual activity inappropriate for age
What is neglect? Who is at risk? What are examples?
persistent failure to meet a child’s basis physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development
increased risk to children with carers or parents with alcohol or drug addiction
failing to:
- provide adequate food, clothing and shelter
- ensure adequate supervision
What are signs of neglect in vulnerable adults?
neglect of vulnerable adults includes:
- being left along and ignored by carers
- not being given sufficient food or drink
- risk of pressure sores if not given appropriate mattresses etc
- not helped to wash
- not assisted to get out and about
signs:
- poor hygiene, dental caries, inappropriate clothing for the weather, constantly hungry, recurrent infections, being non-demanding or apathetic, aggression, anxiety
Why is it important to raise concerns? What are types of concerns?
it is a professional responsibility
may include concerns about your colleagues, employers, trainees, other healthcare professionals, carers or care home staff
might be concerns about behaviour, competency, work environment or any actions that may compromise patient safety
What are laws relating to raising concerns?
Public Disclosure Act 1998 (PIDA) – protects employees who raise genuine concerns and expose ‘malpractice’ in the workplace from unfair treatment or victimisation from their employer
it sets out a step-by-step approach to raising and escalating your concerns.
How should you raise concerns?
you should normally raise your concern with your employer first, before taking it to a regulator or other organisation
- report without delay especially if you know risk of death or serious harm
- report to your immediate supervisor
- report to another suitable person in authority or an outside body
keep a record
maintain confidentiality and not disclose information without consent, where possible
What is drug driving? What is the medical defence for drug driving?
patients taking their medicines as prescribed or in accordance with product information
this may be raised at any point providing that the drug was:
- lawfully prescribed, supplied or purchased over-the-counter, for medical or dental purposes
- taken in accordance with advice given by the prescriber or supplier, and in accordance with any accompanying written instructions
