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 Invisible Borders: Sexual Misconduct in Nursing

Margaret Hughes, RN, BN, Dip Hlth System Man, MBS (Health Systems), PG Cert (Nursing), C.A.T., Senior Lecturer, Christchurch Polytechnic Institute of Technology

Tony Farrow, RN, BN, Dip Health (Mental Health Nursing), MHSc (Hons), Grad Cert Higher Ed., Senior Lecturer, Christchurch Polytechnic Institute of Technology


Hughes, M., & Farrow, T. (2004). Invisible borders: Sexual misconduct in nursing. Nursing Praxis in New Zealand, 21(2), 15-25.

Abstract
Sexual misconduct can occur when nurses practise in close physical or emotional proximity with patients. Nurses, however, have a professional responsibility to maintain professional boundaries to avoid the potential for sexual misconduct to occur. In New Zealand, there is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, we make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice.

Key Words: Sexual misconduct, sexual boundaries, professional boundaries, nursing guidelines.

Introduction
Nurses often work in close physical and emotional proximity with patients, meaning that they must be ever vigilant about maintaining professional boundaries, including those of a sexual nature. However, there is evidence from both international literature and Nursing Council of New Zealand (NCNZ) disciplinary hearings, that nurses have been involved in incidents where they cross sexual boundaries, leading to sexual misconduct. Despite this, there is a relative lack of critical discussion about sexual misconduct in the New Zealand nursing literature. The purpose of this article is therefore to analyse issues surrounding sexual misconduct in nursing and to recommend the development of guidelines to avoid such behaviours. Significantly, no suggestions are made for the content of these guidelines. Rather, we recognise that nursing practice is context specific, and therefore guidelines need to be produced that reflect sound ethical principles which can be applied in multiple settings.

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