As you may know, the Standards of Practice set out the minimum standards in paramedic services. Each regulated member is required to understand and comply with these Standards, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
In an effort to help regulated members understand and apply the Standards to real life situations, we will be sharing scenarios that give context to the Standards and ideas on how to implement this into practice.
The following scenario will attempt to address sexual abuse and misconduct involving a patient.
2.7 Sexual Abuse and Misconduct Involving a Patient
The Standard (2.7) Sexual Abuse and Misconduct Involving a Patient can be referenced in the Standard of Practice document on page 11 to 14.
Scenario:
Dustin is a Primary Care Paramedic working in a mid-sized Alberta community. One evening, Dustin and his partner respond to a call involving a 27-year-old patient, Miranda, who experienced abdominal and chest pain while attending a community event. Dustin conducts an assessment, including obtaining a medical history and performing a physical examination as clinically indicated before transporting Miranda to hospital for further assessment.
During the interaction, Dustin, out of earshot of his partner, begins making comments about Miranda’s appearance that are unrelated to the provision of healthcare services. Dustin comments that Miranda “must work out a lot” and later remarks that she “has a great body.” While assisting Miranda onto the stretcher, Dustin also makes comments about her breasts and buttocks and jokes that “a lot of people would be jealous” of her appearance. Additionally, when Dustin is putting on the ECG leads, he begins to fondle her breasts, as part of his “cardiac assessment”. Miranda becomes visibly uncomfortable but feels vulnerable and unsure how to respond during the ambulance transport, so she doesn’t question him in the moment.
In the week following the interaction, Miranda continues to feel distressed and humiliated by the comments made as well as the physical assessment during the call. Miranda later contacts the Alberta College of Paramedics to file a complaint regarding Dustin’s behaviour, stating that the comments and fondling were inappropriate, sexual in nature and made her feel unsafe and disrespected while receiving care.
Upon review and investigation, it is determined that Dustin’s conduct constituted sexual abuse and misconduct toward a patient. The comments and physical fondling of the patient’s breasts were unrelated to patient care, sexualized in nature and caused offence, humiliation and negatively affected the patient’s well-being.
In this example, Dustin failed to maintain professional boundaries with a patient and engaged in behaviour that meets the definition of sexual abuse and misconduct under the Health Professions Act and the Standards of Practice. Sexualized comments about a patient’s body, including remarks about breasts, buttocks, clothing or physical appearance are never appropriate unless directly relevant to the provision of healthcare services. Additionally, the touching of the patient’s breasts in a sexual manner is strictly prohibited and constitutes sexual abuse.
This scenario relating to the Standard (2.7) Sexual Abuse and Sexual Misconduct Involving a Patient, highlights the importance of maintaining professionalism and preserving patient dignity during all patient interactions. Patients are often in vulnerable situations when receiving healthcare services, and regulated members are expected to ensure that their conduct supports a safe, respectful and professional care environment at all times.