Professional guidance 3 Flashcards
Maintaining clear sexual boundaries
Guidance
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’
Why it’s important to maintain clear sexual boundaries
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
power imbalance
‘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
So what is sexualised behaviour and sexual motive and breaches of sexual boundaries?
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
So how could you avoid breaches of sexual boundaries?
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
what is a chaperone?
A person (usually the same sex as the patient) who is present as a safeguard for the patient and healthcare professional (formal or informal)
what is formal chaperone and informal chaperones?
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
what should you do to check if patient needs chaperone?
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
what are the benefits of a chaperone?
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
what should be done if you require examinations or consultations?
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.
previous patients or carers
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
Examples of attitudes and behaviours expected when applying Standard 1 to this guidance:
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
Guidance on religion, personalvalues and beliefs – legal framework
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
When might religion, personal values and beliefs influence day-to-day practice?
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
what should be done if a pharmacy professional is unwilling to provide services due to beliefs
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