Sexual Boundaries Flashcards
Why is it important to maintain clear sexual boundaries
Can damage public trust and confidence in pharmacy and other healthcare professions
May cause lasting harm in patients
If inappropriately involved with a patient, professional judgement can be affected, compromising the best care and interests for the patient
What is the power imbalance
Power imbalance is often a feature in the HCP/patient relationship, although it might not be explicit - pharmacist has power:
- Patients are often vulnerable when they need healthcare
- Personal info is shared and you have resources (e.g. meds) that a pt needs
- Pt may not know what is appropriate professional behaviour and you must be aware of this
What is sexualised behaviour 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 like SA, but can also include carrying out unnecessary physical examinations and asking for details of sexual orientation when unnecessary or irrelevant
How to avoid breaches of sexual boundaries
Be aware of signs that show sexualised behaviour towards pt or carers e.g.
- revealing intimate details about yourself
- when the reason behind the following actions is sexual e.g.
- giving or accepting social invites
- visiting pt home w/o appt
- meeting pt outside of normal practice e.g.
no staff around
- asking Qs unrelated to pt health
What to do if you find yourself in a situation when you are attracted to a patient
Do not act on these feelings
If professional judgement affected or you think you are abusing your professional position and can’t be objective, find other care for patient
Ensure pt doesn’t feel that they are in the wrong as a result of your actions - they probably aren’t aware of professional boundaries
What to do if a patient or carer is attracted to you
Try to re-establish a professional relationship, if not possible then transfer care to another pharmacy professional
Important notes to consider when undertaking examinations
Allow patient to undress alone in a private undisturbed area and ask if they prefer that their chaperone is present for this e.g. for vaccinations
If clothing needs to be removed, procedure should take place w/o delay to maintain the patients dignity and reduce feelings of vulnerability
Offer reassurance to be courteous
Keep discussion relevant, avoid unnecessary personal comments
Encourage Qs and discussion
Once examination is complete, findings should be communicated to patient
Vaccinations and clothing removal
Need to tell them if clothing needs to be removed, let them do this in private in an undisturbed private area
Ask if they want a chaperone
Need to ask consent to touch them
Perform with no delay to maintain dignity
What is a chaperone and when are they offered
A person, usually of the same sex as the pt, who is present as a safeguard for the pt and HCP
2 types: formal anf informal
Should generally always offer patients a chaperone during examinations, especially when the pt considers it to be intimate
Role of chaperone should be made clear to pt and the person who is undertaking the role
What is a formal chaperone
Someone who has undergone appropriate training
Includes medicines counter assistant, pre reg trainee or registered pharmacy technician
Need to be aware of their specific role in the consultation, which must be made clear to both the chaperone and pt
Need to know the rights of pt
Understand what is meant by chaperone and why one may be needed
Understand the term intimate examination
Understand policy for raising concerns
What is an informal chaperone
Most appropriate type of chaperone in the CP setting
Usually family member or friend of pt
Presence of familiar person may provide comfort or reassurance to a pt and any request for such a chaperone should be accepted
Unsuitable for an informal chaperone to undertake any part of consultation
May be acceptable for a child to be one if they are providing comfort to a pt, however may make an unreliable witness to the continuing consent of the pt to a procedure
What to do if there is no chaperone available
Offer to delay and rearrange consultation or examination until one is available, unless delay is not in pt best interest
Record keeping: examinations, chaperones
Record any discussion you have with pt about chaperones, including when they decline one
What to do if you are unhappy to undertake a consultation w/o chaperone
Make every effort for pt to see another appropriate HCP ASAP
Benefits of chaperone
Present as a safeguard for all parties (pt and practitioner) as is a witness to continuing consent of procedure
Provides emotional comfort and reassurance to pt
Formal chaperone: can assist in examination e.g. carrying out BP check
Can act as an interpreter
Can provide protection to HCPs against unfounded allegations of improper behaviour or in aggressive incidents
