Public Citizen Sheds Light on Sexual Misconduct Among Nurses

By Rhoda Feng

In January, Nathan Sutherland, a nurse at Hacienda HealthCare at Phoenix, Ariz., was arrested based on DNA evidence for the sexual assault of an incapacitated adult female patient at the long-term care facility. Sutherland had worked at Hacienda since 2012 and cared for the woman in 2018 when he allegedly assaulted her. The assault led to a pregnancy; the woman gave birth to a boy in late December to the surprise of her caregivers who were not aware of her pregnancy. As of press time, police are still trying to find out whether Sutherland assaulted other patients at the health center.

Sutherland’s alleged crime underscores the potential severity of sexual abuse of patients by nurses – made possible in part because of the significant power imbalance between nurses and their patients. Nurses also spend long hours with patients, often providing care that involves close proximity to patients.

Yet nurse sexual misconduct has not received the attention it deserves from the health care community, professional organizations and regulators, who are reluctant to recognize it as a national public health problem. Public Citizen undertook to shine a light on this problem, releasing a groundbreaking study last December showing that state nursing boards and health care organizations are failing to protect patients from nurses who engage in sexual misconduct.

“The findings of the study and the Arizona case unequivocally show that it is time for state regulatory boards (including boards of nursing) and the health care community to take a zero tolerance stance against all forms of abuse of patients by nurses or any other health care professionals,” said Azza AbuDagga, health services researcher for Public Citizen’s Health Research Group and lead author of the study.

Only 882 U.S. registered and licensed practical or vocational nurses have been reported to the National Practitioner Data Bank (NPDB) over nearly 14 years (from 2003 through 2016) because of sexual misconduct, according to the study – the first to analyze this national flagging system for sexual misconduct by nurses. While male nurses account for approximately 10 percent of U.S. nurses, they accounted for 63 percent of the nurses reported to the NPDB due to sexual misconduct.

Sexual misconduct by nurses is reported to the NPDB only if it results in an adverse disciplinary action by state nursing boards (or, less commonly, certain entities such as hospitals) or malpractice payments. The low number of nurses reported to the NPDB because of this misconduct—despite the fact that millions of nurses worked in the profession over the study period—suggests that many nurses who commit sexual misconduct go unpunished, AbuDagga said.

“Our findings, along with other published evidence, suggest that many nurses in the U.S. who exploit their patients are not being held to account,” said AbuDagga. “State nursing boards have full access to the NPDB data. They need to discipline nurses with malpractice payments for sexual misconduct to protect the public. Without such licensing action these nurses would simply be able to abuse more patients.”

According to the study, of the 882 nurses who faced consequences for sexual misconduct that resulted in NPDB reports, 866 were reported by state nursing boards. Nursing boards administered harsh punishments in most of these cases: 91 percent of such reports involved serious actions—including revocation, suspension or voluntary surrender of the nursing license. In contrast, state nursing boards took serious actions in only 75 percent of the nurse reports for other types of offenses.

However, nearly half of the nurses who engaged in sexual misconduct with patients that led to NPDB malpractice payment reports—16 out of 33—were not disciplined by state nursing boards for their misconduct, the study found.

The findings for nurses are consistent with those from a 2016 study by Public Citizen that showed that 70 percent of U.S. physicians—177 out of 253—who engaged in sexual misconduct that led to sanctions by hospitals or other health care organizations or malpractice payments were not disciplined by state medical boards for their unethical behavior.

The nurses with sexual misconduct-related reports identified in the new study accounted for just a small fraction (0.6 percent) of all nurses with NPDB reports that met the study criteria. Similarly, Public Citizen’s 2016 study showed that physicians with reports related to sexual misconduct accounted for approximately 1 percent of the total physicians with NPDB reports that met the study criteria.