We developed a sexual misconduct standard for all nurses in Nova Scotia.
As part of this initiative, consultation occurred in two phases.
In the initial consultation phase (February 13 – March 8, 2020), we sought feedback from diverse voices through an online survey and in-person meetings with key stakeholders to help inform the direction and development of the sexual misconduct standard.
In the second consultation phase (April 9 – May 10, 2020), we sought feedback from stakeholders through an online survey on the draft sexual misconduct standard for nurses. The draft reflected current best practice, aligned with other jurisdictions and included the diverse perspectives from stakeholders captured in our initial consultation phase. In this phase, we also collected feedback on the NSCN sexual misconduct policy and by-law.
Consultation Participation and Response
Initial Consultation Phase (February 13 – March 8, 2020):
- Held an open consultation via an online public survey and in-person meetings with key stakeholders to collect feedback to help inform the direction and development of the sexual misconduct standard of practice.
- Survey: In total, 222 individuals participated in the public survey. Eighty-three percent (83%) of participants were registrants. Other participants included representation from the public, employers, unions, students, educational programs, service providers, professional regulators and retired nurses.
- In-Person Meetings: In total, 15 representatives for the in-person consultations. In-person consultations were held with employers, nursing unions, educators and subject matter experts (Avalon Sexual Assault Centre and Sexual Assault Nurse Examiners).
- Stakeholders overwhelmingly expressed support for the initiative. Overall, stakeholders suggested we consider the following in the development of the standard and policy:
- Social Media Use
- Trauma-informed Approach
- Interdisciplinary Misconduct
- Client to Nurse Misconduct
- Reporting and Duty to Report
- Expectations, Consequences and Duty of Care
- Consent, Capacity and Vulnerable Clients
- Therapeutic Nurse-Client Relationship
Second Consultation Phase (April 9 – May 10, 2020):
- Held an open 30-day consultation via an online public survey to collect specific feedback on the draft sexual misconduct standard, policy and by-law.
- In total, 84 individuals participated in the public survey. Seventy-three percent (73%) of participants were registrants. Other participants included representation from the public, professional regulator, union, educational programs, employers, retired registrants and subject matter experts.
- Stakeholders again expressed support for the draft standard, policy and by-law. Stakeholder suggestions were minor in nature; many of these suggestions were requests for future resources and support.
- Specific feedback for the standard included:
- Need for examples
- Focus on simple language
- Information on how to report
- Additional clarity on consent and reference to former vs current clients in the standard indicators
- Suggested change related to the expectations of nurses regarding engaging in sexual behaviour with a former clients
- Suggested new glossary terms or additional clarity on current terms: sexual orientation; gender identity; consent; conduct unbecoming
- Minor grammar revision to standard statement
- Suggestion to refer to other legislation (e.g. Protection of Persons in Care Act)
Impact on the Project
Thank you to stakeholders for participating in the consultation opportunities for the sexual misconduct standard. Below is further explanation about how we incorporated feedback into the standard.
Initial Phase of Consultation:
Two groups of stakeholders asked why we were only focusing on sexual misconduct and sexual abuse instead of other aspects of abuse such as physical, verbal or emotional. We acknowledge that there are other forms of abuse and any such reports to NSCN will be managed through established conduct processes. The rationale for focusing on sexual misconduct and sexual abuse is because the literature specifically points out that sexual misconduct can lead to great client harm and the ability to provide clear expectations for nurses is a way to address this issue.
We incorporated, where possible, each of the identified concepts into the development of the sexual misconduct standard and policy. Two concepts that were suggested were not included:
- Addressing sexual misconduct from a client-to-nurse perspective. This perspective was not incorporated because it is not within our mandate.
- Using a trauma-informed approach. This approach will be considered in future work related to our internal processes.
Second Phase of Consultation:
We incorporated, where possible, stakeholder feedback into the final sexual misconduct standard and policy. This includes:
- changes to the language to ensure it was clear and concise,
- Added clarity regarding reference to current, former or vulnerable former clients within the standard and key concepts
- Added terms to the glossary.
Some of the feedback was considered in the development of practice support tools to complement the launch of the sexual misconduct standard. This includes:
- Information on how to report
- Providing examples through case studies, practice scenarios and webinars.
Based on external legal advice feedback we also broadened so that the definition of sexual misconduct included misconduct between colleagues.
We did not incorporate suggested changes to the glossary terms that were already defined in the Nursing Act or code of ethics. We also did not include suggested terms or references to other legislation that were not found within the standard or were currently found in other practice support tools.
The Sexual Misconduct Standard of Practice for Nurses was released to the public, registrants and other stakeholders on June 24, 2020.
A phased awareness and education plan began at the same time to support the pubic, registrants and nurse managers in understanding the standard and the expectations for nurses in the nurse-client relationship and within the workplace.
This plan began with the release of two fact sheets and the registration for three live interactive webinars. The first webinar was held on July 9, 2020 and is now available on the website. An updated Professional Boundaries Guideline, case studies and more webinars and fact sheets will be released on a monthly basis until November 30, 2020.
If you have any questions, please contact a Practice Consultant at firstname.lastname@example.org