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Sexual Abuse: Nurse Had No Probable Cause to Report M.D., Nurse Not Liable
Legal Eagle Eye Newsletter for the Nursing Profession
Quick Summary: A nurse with reasonable cause to believe another
healthcare professional is abusing a vulnerable person must report the abuse to proper
authorities. Reasonable cause means more than suspicion of abuse or
knowledge of the opportunity for abuse. Reasonable cause is the same as probable cause in the
criminal law. Probable cause means grounds for belief supported by
factual circumstances which would lead a cautious individual to conclude that abuse is
taking place.
The Court of Appeals of Minnesota faulted a psychiatric nurse for not reporting that her employer, a male psychiatrist in private practice with hospital privileges at a psychiatric hospital, was sexually abusing adult female patients, each suffering from a dissociative identity disorder. (Psych Nursing: Vulnerable Patient Can Sue Nurse For Failing To Report Abuse By Psychiatrist, Court Says. Legal Eagle Eye Newsletter for the Nursing Profession (5)11, Nov. ‘97, p. 5. (click here to view)
The Supreme Court of Minnesota recently overruled the Court of Appeals and exonerated the nurse from civil liability.
The Supreme Court upheld the general principle that a nurse who fails to report the abuse of a vulnerable person by another healthcare professional can be sued in civil court by the vulnerable person, if the nurse has actual knowledge or reasonable cause to believe that abuse is taking place.
The Supreme Court also upheld the general definition of abuse to include non-therapeutic conduct which produces or could be expected to produce pain, injury or mental or emotional distress, and, more specifically, any sexual contact between a caregiver and a vulnerable patient.
The Supreme Court explained that the nurse in question had no actual knowledge that the two patients who sued were being sexually abused. The nurse heard one of a third patient’s alternate personalities accuse the psychiatrist of abuse during a therapy session. However, according to the court, that did not mean there was probable cause to report abuse of other patients.
The nurse was aware of what the court called "boundary violations" by the psychiatrist with respect to the two patients who were abused, that is, the nurse knew the psychiatrist had gone out for ice cream with them. However, so-called boundary violations, standing alone, the court ruled, do not give rise to a duty to report that the patients whose boundaries are being violated are being sexually abused.
The Supreme Court expressly ruled that the nurse knowing the psychiatrist had an alcohol problem did not mean the nurse had probable cause for reporting the psychiatrist for sexually abusing his patients. There are rules for reporting substance abuse. But failure to report substance abuse is not a relevant factor in a lawsuit against a nurse for failure to report sexual abuse of patients, the court ruled.
A physician drinking in the office or drinking in front of patients is highly improper. However, the court ruled it does not give a nurse grounds to have to report the physician for sexually abusing patients.
When they left therapy sessions the patients who were abused were often crying and showing signs of being emotionally drained, but the court said that goes with the territory when clients are in therapy and does not have to be reported as a possible sign of sexual abuse.
The Supreme Court also said that a therapist hugging or touching a patient, in and of itself, does not mean there is probable cause requiring a report that the patient is being sexually abused. Wall v. Hospital, 584 N.W. 2d 395 (Minn., 1998).
More references from nursinglaw.com
http://www.nursinglaw.com/abuse-reporting-nurse.htm
http://www.nursinglaw.com/abuserpt.htm
http://www.nursinglaw.com/bad-faith-abuse-reporting.htm
http://www.nursinglaw.com/abuse-patient.htm