Of all professions, nurses most often indicate that they have to deal with transgressive behaviour, according to figures from Statistics Netherlands. Reason enough for Thomas Groen and Maaike van Sasse van IJsselt to put the subject on the agenda. “Nurses have trouble setting boundaries.”
Groen previously worked as a nurse and now as a coach. In addition to being a nurse, Van Sasse van IJsselt is also a teacher. Together they are making a podcast for nurses and carers in which they discuss sensitive topics in the hope of breaking the taboo.
Why did you decide to pay attention to transgressive behavior in the podcast?
“Many stories came in via social media from people who shared their experiences with transgressive behaviour,” says Groen. “About half of the nurses and student nurses have had to deal with this at some point. That number is probably much higher, if you consider that not everyone steps forward.”
Van Sasse van IJsselt: ,,I also think that you do not immediately realize that you are dealing with transgressive behaviour. It’s often small things and especially as a student you might see something as ‘normal’ sooner.”
Statistics from Statistics Netherlands show that nurses are more often confronted with transgressive behavior than other professional groups. What is that about, do you think?
,,I think that it is always difficult to indicate that you do not like a certain way of interacting with each other, but in healthcare it is even more difficult. You want to take care and reassure, touching like a hand on a shoulder is soon part of that. You also have to deal with vulnerable and sick people,” says Groen.
Nurses are still seen as a kind of sex symbol
“In addition, I think that nurses are not taken seriously,” Groen continues. “They are still seen as a kind of sex symbol, there are nurses who are called ‘little sister’.” Van Sasse van IJsselt: “And on Halloween everyone dresses up as a nurse, often in short skirts.”
The reason could also be sought in the nature of the work. Groen: ,,In healthcare you are always very focused on that other person, the person in need, so that you pay less attention to yourself.”
“Illness symptoms also play a role,” explains Van Sasse van IJsselt. “It may be that a patient in his or her situation cannot do otherwise than react in this way due to illness. You have to accept that, but it does mean that it can go beyond your limits for you as a person.”
Are you being taught to deal with that?
Groen: ,,In addition to a coach and a manager, there is also a confidential counselor you can go to to report incidents like this. But we’ve never done that either. The work already entails such a high administrative burden that you don’t have to think about making a report in your own time.”
For a small part, it concerns people who exhibit inappropriate behavior because of their illness
,,It often helps to talk about it with colleagues,’ adds Van Sasse van IJsselt. “A lot more needs to be reported to make the problem transparent.”
It will also play a role that there is a different working relationship in healthcare. It is not about an employer and employees, but about patients and carers.
“To a small extent, it concerns people who exhibit inappropriate behavior because of their illness,” says Groen. “It’s hard to talk to someone about that. One of the consequences is that you will quickly deny someone care that is needed.”
Van Sasse van IJsselt: ,,In most cases, these are people who understand perfectly well that certain manners must be observed. But they forget that once they lie in a room with a few other men and shout: ‘There are only beautiful women walking around here’. I don’t need to hear that when I’m working. It also plays a role as a nurse that you build a relationship with the patient. A person is usually not in the hospital for just one day. If you indicate that your boundaries have been exceeded, that relationship has been damaged.”
How can a safe working environment be created?
“In the current system where reports are stored about, for example, medication use, it is not possible to report cases of transgressive behavior,” says Van Sassevan IJsselt. “That has to be different.”
As with other cases of transgressive behaviour, the blame lies not with the person who has happened, but with the perpetrator
Groen: ,,That shows that there is no consciousness. It would be good if employees were given handles that can help them indicate their limits.” “And if no reports are made, you don’t know what you’re dealing with,” says Van Sasse van IJsselt. Groen adds: “That also makes it difficult to point out a culprit.”
Who’s up to change that?
Van Sasse van IJsselt: ,,Nurses should not be pointed with a finger. As with other cases of transgressive behaviour, the blame lies not with the person who has happened, but with the perpetrator. Nurses are committed to helping others, but are unable to stand up for themselves and neglect themselves. Let healthcare organizations stand up for us and provide tools to deal with this.”
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