"The clock has run out on sexual assault, harassment and inequality in the healthcare workplace. It's time to do something about it."
That's the slogan for Time's Up Healthcare, a campaign charged with unifying national efforts to bring safety, equity and dignity to healthcare work environments. The campaign's advisory board is made up of prominent physicians, nurses and others, including Pamela F. Cipriano, PhD, RN, past-president of the American Nurses Association, and Roberta E. Gebhard, DO, president of the American Medical Women's Association. The ANA and American College of Physicians are among the national organizations partnering with Time's Up.
The campaign is about focusing on what can be done to promote equity and end sexual harassment so nurses, physicians and others can work in healthier environments, according to Time's Up Healthcare Advisory Council member Eileen M. Sullivan-Marx, PhD, RN, professor of nursing and dean at New York University College of Nursing.
Nurses, according to Sullivan-Marx, are a big part of the campaign's focus. [caption id="attachment_55364" align="alignleft" width="199"]
Eileen M. Sullivan-Marx, PhD, RN[/caption] "Nurses are present everywhere and are such a critical part of environments," she said. "When nurses practice in healthy environments, outcomes are better." Harassment in the healthcare workplace needs to be part of the conversation, so men and women feel free to talk about and report the bad behaviors of others.
"This is everyone's issue, and when you have bad behavior and an unhealthy environment, there needs to be approaches that are built in to not only empower women to speak up but empower everyone to speak up when they see a situation or have a situation," Sullivan-Marx said.
Learn how to identify unhealthy behaviors
Time's Up is asking not only individual providers to join in the effort, but also institutions, organizations, universities and health systems to join and create solutions for healthier workplaces. Self-reflection, awareness about what others might find offensive and learning are part of the improvement process, according to Sullivan-Marx, who said she hasn't personally experienced workplace harassment. But she explained it doesn't have to be obvious harassment. Sometimes, it's subtly part of the culture in work environments, and most people can remember a time when they might have contributed to that culture.
"When I was early in my career as a staff nurse, there would be inappropriate flirtations or comments that just were embarrassing," she said. "Sometimes when I reflect back on those, it was like a breakdown of discipline. Things maybe got too casual or too chummy ... and maybe we all did that."
In other situations, harassment is overt. Sullivan-Marx said physicians and nurses can be caught in a workplace hierarchy, where providers feel they have to give in to the sexual harassment to get a promotion or even keep their jobs. Bullying also contributes to unhealthy work environments in healthcare. An RNnetwork survey suggests 45% of nurses have been verbally harassed or bullied by other nurses.
How to address sensitive issues
Time's Up can help providers start chapters in their communities in which they hold meetings to openly and safely talk about issues and work on solutions. But even that can be challenging. At one meeting a young physician who attended said young, female medical residents are often hesitant to say they're part of Time's Up for fear of retribution or bullying from colleagues, Sullivan-Marx said. One medical resident early in her residency said she didn't know whether she should tell her department chair that she was attending the meeting, Sullivan-Marx said. It's important to educate people who are coming into the profession and new nurses through nursing school, nursing orientation and nurse mentoring that inappropriate behaviors shouldn't be tolerated in the workplace. Healthcare administrators and leaders shouldn't see the effort as a threat, but rather one with the goal of providing better patient care through healthier work environments for everyone in healthcare.
"We need to speak up and say something," Sullivan-Marx said. "We can't have situations where we say, 'That doctor is just that kind of person,' or 'You just have to watch out for him,'" she said. "We should say, 'Of course this is inappropriate,' and we should be talking about it and not checking ourselves before we say something."
Time's Up is a platform for discussion and action, but it's still in its infancy. Sullivan-Marx said the campaign is focused on fundraising and growing its base of health professionals beyond nurses and physicians to gain momentum. "They are very interested in all healthcare workers, including direct healthcare workers who are often in the least powerful positions," she said. Sullivan-Marx said harassment often leads to nurses leaving jobs they might otherwise enjoy. Young medical residents and direct care workers might not have that option.
One approach to Time's Up Healthcare campaign
Sullivan-Marx has taken steps in NYU's College of Nursing to make sure communication lines are open. "In our organization, we have open town halls on a regular basis around equity, inclusivity, diversity and belonging, which is a theme here at NYU," she said. "We have a committee that sets standards for us and works with all the departments in the school to ensure that we have the latest training. Unconscious bias training is being done now among all our faculty members." NYU has open, anonymous reporting for every employee. The human resources department not only provides information but also has an open-door policy to make sure people can come forward.
"It's also making sure through training and conversation that we're constantly aware of how things might be read as offensive by other people," Sullivan-Marx said, who added sensitivity training is important.
"I just had an open forum with students," she said. "It was open to anyone who wanted to come. The students had a good dialogue with me and among themselves. It was prelicensure undergrads and also some graduate students in the room, and we had a real conversation about things. It's sort of like we're not accepting bad behavior. Time's up. Here's how we're moving forward and creating healthy work environments." Another step in the right direction, according to Sullivan-Marx, is pursuing Magnet designation, which helps to address healthy work environments for nurses and shared governance.
Inclusive and equitable teams work better
"In healthcare, we know that lives are saved by working together and improving collective intelligence through teams that are not only diverse, but are respectful, inclusive and equitable," according to the Time's Up website. "Time's Up is an organization that insists on safe, fair and dignified work for women of all kinds. "We want women from the factory floor to the floor of the Stock Exchange, from child care centers to C-suites, from farm fields to the tech field, to be united by a shared sense of safety, fairness and dignity as they work and as we all shift the paradigm of workplace culture." "Powered by women," the site continues, "our Time's Up programming addresses the systemic inequality and injustice in the workplace that have kept underrepresented groups from reaching their full potential. "We partner with leading advocates for equality and safety to improve laws and corporate policies; help change the face of corporate boardrooms and the C-suite; and enable more women and men to access our legal system to hold wrongdoers accountable.
"No more silence. No more waiting. No more tolerance for discrimination, harassment or abuse. Time's Up."
Take these courses about equity and harassment:
- Sexual Harassment: Illinois Licensed Professionals (1.0 contact hr) The goal of this educational program is to provide licensed professionals with the required content regarding sexual harassment for the State of Illinois.
- Sexual Harassment: Mandatory Training-Connecticut (2.0 contact hrs) The goal of this educational program is to provide all employees with knowledge of sexual harassment and how to respond.
- Domestic Violence Awareness for Healthcare Personnel (2.0 contact hrs) The goal of this course is to enhance the ability of nurses in various settings to identify and treat people who are victims of domestic violence and abuse.
- Nursing Ethics: Ethical Decision-Making and Dilemmas (1.5 contact hrs) The principle of well-being, or beneficence, doing good and preventing harm, obliges the nurse to promote the health and safety of patients in decisions made by and for them. The principle of equity, or justice, requires that patients be treated fairly and equally in the decision-making process. This module will further explore these principles and discuss methods of determining decision-making ability in borderline cases.
