Professional guidance 3 Flashcards

1
Q

Maintaining clear sexual boundaries
Guidance

A

Guidance regarding sexual boundaries based on the Council for Healthcare Regulatory Excellence (CHRE) document ‘Clear sexual boundaries between healthcare professionals and patients: responsibilities of healthcare professionals’

‘you must maintain proper professional boundaries in your relationships with patients and others you come into contact with during the course of your professional practice and take special care when dealing with vulnerable people’

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2
Q

Why it’s important to maintain clear sexual boundaries

A

Can damage public trust and confidence in pharmacy and other healthcare professions

May cause lasting harm to patients

If you are sexually, or inappropriately, involved with a patient, your professional judgement can be affected

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3
Q

power imbalance

A

‘an imbalance of power is often a feature in the healthcare professional/patient relationship, although this may not be explicit’ CHRE

Patients often vulnerable when they need healthcare
Often a power imbalance because personal information is shared or you have resources (eg. medicines) that the patient needs
Patient may not know what is appropriate professional behaviour and you must be aware of this

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4
Q

So what is sexualised behaviour and sexual motive and breaches of sexual boundaries?

A

Sexual behaviour = ‘acts, words or behaviour designed to arouse or gratify sexual impulses or desires’ Professional Standards Authority (PSA)

‘Sexual motive’ means that the conduct was done either in pursuit of sexual gratification or in pursuit of a future sexual relationship

Breaching a sexual boundary is not limited to criminal acts but can also include carrying out an unnecessary physical examination, or asking for details of sexual orientation when it is not necessary or relevant

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5
Q

So how could you avoid breaches of sexual boundaries?

A

Be aware of signs that show sexualised behaviour towards patients or carers ( gifts, money, visiting homes, asking q unrelated to patients health)

If you find yourself in a situation where you are attracted to a patient, you must not act on these feelings

If your professional judgement is affected or you think you are abusing your professional position and can’t be objective, you should find other care for the patient

Make sure the patient does not feel that they are in the wrong as a result of your actions

If a patient or their carer is attracted to you try to re-establish a professional relationship, and if not possible then transfer their care to another pharmacy professional

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6
Q

what is a chaperone?

A

A person (usually the same sex as the patient) who is present as a safeguard for the patient and healthcare professional (formal or informal)

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7
Q

what is formal chaperone and informal chaperones?

A

formal:

individuals who undergo appropriate training and may include a medicine counter assistant…

  • know the rights of patients
    -understand what chaperones are and -why they are needed
    understand the term intimate examination
    -understand the policy for raising concerns
    -be aware of their specific roles in the consultation which must be clear to both chaperone and to patients

Informal chaperone :

family members or friends of the patient

  • the presence of a familiar person may provide comfort or reassurance to patients and any requests such as chaperones should be accepted
    -they cannot take part in any procedures
    -Children can be chaperones if they provide comfort - but could be unreliable witness
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8
Q

what should you do to check if patient needs chaperone?

A

You should ask the patient if they would like a chaperone to be with them in the consultation room, and for any examination that they might consider intimate

If no chaperone is available, then offer to delay and re-arrange the consultation or examination until one is available, unless a delay is not in the patient’s best interests

Record any discussion that you have with patients about chaperones, including when they don’t want to have one present

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9
Q

what are the benefits of a chaperone?

A

A chaperone is present as a safeguard for all parties (patient and practitioners) and is a witness to continuing consent of the procedure

Provides emotional comfort and reassurance to patients

Can assist in the examination, for example carrying out blood pressure checks or blood tests (formal chaperone only)

Can act as an interpreter

Can provide protection to healthcare professionals against unfounded allegations of improper behaviour, or in aggressive incidents

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10
Q

what should be done if you require examinations or consultations?

A

If you need to undertake an examination:
If necessary (such as to expose an upper arm for a vaccination), the patient should be allowed to undress alone in a private undisturbed area and should be asked whether they would prefer that their chaperone is present for this

If clothing needs to be removed, the procedure should take place without delay to maintain the patient’s dignity and reduce feelings of vulnerability

Offer reassurance, be courteous

Keep discussion relevant and avoid unnecessary personal comments

Encourage questions and discussion
Once the examination or procedure is complete, the findings should be communicated to the patient.

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11
Q

previous patients or carers

A

The same principles apply to patients or carers that you have dealt with in the past and who are not your patients any more

It is your responsibility as a pharmacy professional to act appropriately and professionally, even if the relationship is agreed by everyone involved

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12
Q

Examples of attitudes and behaviours expected when applying Standard 1 to this guidance:

A

Listen to the other person and understand their needs and what matters to them

Give the person all relevant information in a way that they can understand, so that they can make informed decisions and choices

Respect and safeguard the person’s dignity

Recognise and value diversity, and respect cultural differences

Recognise your own values and beliefs but do not impose them on other people

Take responsibility for ensuring that person-centred care is not compromised because of personal values and beliefs

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13
Q

Guidance on religion, personalvalues and beliefs – legal framework

A

Pharmacy professionals must make sure that they keep up-to-date with and comply with the law, with any NHS or employment policies and contractual responsibilities of their employer

In context of this guidance, important to understand and keep to the relevant framework of equalities and human rights legislation

Employers must also keep to the relevant employment, human rights and equalities law and must not unlawfully discriminate against pharmacy professionals because of their stated or perceived religion, personal values or beliefs

Equality Act 2010 protects individuals from indirect and direct discrimination and harassment. Includes religion or belief. Protection applies in the workplace, the provision of services and other contexts
within equality law, religion means any religion, including a lack of religion
belief means any religious or philosophical belief, and includes a lack of belief

Human Rights Act 1998 – right to freedom of thought, conscience and religion. However, subject to qualification and cannot be used to support an action that disproportionately infringes the rights and freedoms of others

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14
Q

When might religion, personal values and beliefs influence day-to-day practice?

A

Contraception (routine or emergency)
Fertility medicines
Hormonal therapies
Mental health and wellbeing
Substance misuse
Sexual health

Remember pharmacy professionals have the right to practise in line with their values or beliefs as long as they act in accordance with equalities and human rights law and make sure that person-centred care is not compromised

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15
Q

what should be done if a pharmacy professional is unwilling to provide services due to beliefs

A

If a pharmacy professional is unwilling to provide a certain service, they should take steps to ensure the person asking for care is at the centre of their decision-making (use the consultation room if available)

Be honest and respectful in your discussions (not imply or express disapproval or judgement)

Work with the person asking for care so that they can come to an informed decision. Check their understanding.

Understand the needs of the person and any specific barriers they face

Discuss alternative options with the person, if necessary

Alternative options may include referral to another health professional, however need to judge whether referral is appropriate and so have to take into account the ability of the patient (and legal implications) to access alternative services

A referral may not be appropriate in every situation (e.g if the service is not accessible or readily available elsewhere, or if there is some obstruction to timely access to the service)

If alternative services are not really feasible (e.g. service not available) then expectation is that the pharmacist should provide the service

Keep a record of all your discussions and decisions made

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16
Q

what are factors to consider when working as a pharmacist?

A

Factors to consider when working as a pharmacist

Range of services you can provide, the roles you feel you can carry out, and how to handle requests for services sensitively

Suitability of the location, environment and working hours

Types of services the pharmacy is contracted to provide

Whether you will be working on your own

Being open and honest with your employers and colleagues i.e you should tell your employer, as soon as possible, if your religion, personal values or beliefs might prevent you from providing certain pharmacy services

17
Q

Questions for pharmacy professionals to ask themselves to help ensure and demonstrate that they have provided person-centred care in this context.

A
  • have i considered the range of services - i feel able to provide?
    -is the work location and environment suitable for me
  • have i made the care of the person my priority
  • have i considered the impact of my actions on the person
    -how do i hanfle the requests senstively, without embarassing the person
  • have i been open with my employer about the services i feel able to provide
    -are the right arrangements in place to make sure people come first
    -if a person has raised their religion, personal values or beliefs have i considered how it might relate to their care
    -have i made a record of any descions relating to referrak including discussions with the person asking for care
18
Q

what is female genital mutilation (FGM)

A

An estimated 137,000 women in the UK affected by FGM (underestimate)
FGM includes all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons - may also be referred to as circumcision, initiation, or being ‘cut’
Usually carried out on young girls (infancy to aged 15), most commonly before puberty starts
Carried out for cultural, religious and social reasons within families and communities
Procedure usually carried out by women with no medical training, without anaesthetic or antiseptics and using non-medical tools
There are no health benefits to FGM
Long term consequences include – chronic vaginal and pelvic infections, difficulty in passing urine and persistent urine infections, infertility, kidney problems, complications in pregnancy, psychological damage…

In England and Wales under the Female Genital Mutilation Act 2003, in Scotland under the Prohibition of Female Genital Mutilation (Scotland) Act 2005, both as amended by the Serious Crime Act 2015
FGM is considered a criminal act and is illegal in Great Britain
Also illegal to arrange for a child to be taken abroad for FGM. If caught, offenders face a large fine or up to 14 years in prison

All pharmacists and pharmacy technicians have a mandatory legal duty to report, orally or in writing, to the police if:
-they observe physical signs indicating that FGM may have occurred in a girl under the age of 18, e.g difficulty walking, sitting or standing, spending longer than normal in the toilet, depression, OR
-a child/young person tells them that they have had FGM

19
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A