Volume 7 • 2020 • Issue 2

Most provinces have legislation which directly or indirectly requires employers to have workplace harassment and workplace violence policies in place, to train all employees on the policies, and to investigate complaints of workplace violence and workplace harassment. These obligations of employers extend to protecting employees from other employees and from third parties, such as a patient. In Ontario, and in most other Canadian jurisdictions, employers are required to train employees on the workplace harassment and workplace violence policies that are in place. Even where training may not be required, it is highly recommended to train all employees on these policies, and to ensure that the training includes the steps that employees are expected to follow if they become aware of harassing, violent or threatening conduct at the workplace. I also typically recommend that employers provide re-training annually with an opportunity for employees to ask questions. Annual re- training sends the message to employees that the employer takes harassing, violent or threatening behaviour seriously, and invests time in curbing and addressing this type of behaviour. Q How is sexual harassment defined? IK: Most Canadian provinces have legislation that protects employees from sexual harassment and violence in the workplace. In Ontario, for example, the Occupational Health and Safety Act (OHSA) defines sexual harassment as harassment because of sex, sexual orientation, gender identity or gender expression, or a person in a position of power making sexual solicitation or advance toward a worker, where the solicitation or advance is unwelcome. The OHSA does not specifically address sexual violence, but rather protects a worker from the threat of, attempt to exercise, or the exercise of physical force against a worker that causes or could cause physical injury to the worker. This definition includes violence of a sexual nature. SR: Harassment is often repeated and ongoing but may not involve bodily violation—it can also be verbal. Once there is bodily contact, it begins to cross that boundary into assault when a patient is physically encroaching on or threatening someone. You must acknowledge sexual harassment, investigate it, put policies in place to prevent it, and train your staff and yourself about how to respond to it. Awareness of the problem is a good first step, but training is necessary. People need to know what to do and what to say. – Henrietta Van hulle H ow can a dentist, as the employer and practice leader, respond to this situation in a way that ensures the workplace remains a healthy and safe environment for the entire team? We asked 3 subject matter experts to weigh in on this scenario. Q What is the first thing that a dentist should do when a member of the team relates an experience like this? Henrietta Van hulle (HVh): First, offer support to the hygienist. There are several questions to ask: if they want to talk about what happened; if they want someone else present; if they want to call a family member for support; do they want to stay at work or do they need to go home for the day; do they need medical attention or counselling? Basically ask, “Are you ok and what do you need?” Then, if they are ready to talk, acknowledge the seriousness of what has happened. You should say that this is sexual harassment and it is unacceptable and, in most provinces, illegal.* Start writing an incident report, which will be the first part of the investigation. Document what you have been told. Provinces may have legislative requirements or guidelines for investigations. Tell the victim how you are going to get back to them with information. Later, use what you’ve learned from the process to put new prevention policies and practices into place. Sheela Raja (SR): As a behavioural scientist, I talk to people about how to become an “active bystander.” Be aware of what is happening in the clinic around you. Addressing situations such as sexual harassment require that everybody take some responsibility to help. Educate yourself about the legal and educational support options available if sexual harassment happens to a colleague. Learn how to intervene. In the moment when the harassment is occurring, you can share your concern. Take your colleague aside and say something like, “I noticed that person isn’t treating you right.” In this scenario, where a colleague tells you that they have been harassed, you can start by saying, “Thank you for trusting me enough to tell me that this happened.” Give your colleague an opportunity to leave the situation. The first order of business is helping your colleague feel safe. Then create documentation. Write down everything that happened. I tell people to act like a reporter. And you may need to figure out what to do about the patient. Do they need to be treated by someone else? What needs to be done about the patient? Longer term, an incident like this can be a catalyst for culture change on a broader scale. There needs to be a clear policy that shows patients that you and your staff treat them with respect, and in turn, they need to treat you and your staff with respect as well. Q What are the dentist’s legal obligations toward the hygienist, as her employer? Inna Koldorf (IK): The dentist has an obligation to maintain a safe work environment, free from harassment, violence and other threatening behaviour. SCENARIO A hygienist on your team tells you that she has been sexually harassed by a patient. How would you handle this situation? At the end of a cleaning appointment eight months ago, a patient told a hygienist that she had a “sexy figure” and asked her on a date. The hygienist told the patient that she was flattered, but she had a fiancé. “That’s a shame,” the patient said, and put his hand on her upper arm. She moved away from him and laughed. She didn’t mention the exchange to anyone at work but told one of her close friends on the phone. Today, the patient is back for an exam and the same hygienist works with him. She treats him with the same cheerful friendliness with which she treats all patients. Toward the end of the appointment, after you’ve seen him and he is alone with the hygienist, the patient asks her why she isn’t wearing her engagement ring. She tells him she didn’t wear it to work; it makes putting on gloves difficult. He grasps her hand, now gloveless, and places it against his chest and says, “You’re breaking my heart. Just one kiss?” She shakes her head no and pulls her hand away. “Well, you aren’t as easy as you look, I guess,” the patient says as he leaves. The hygienist tells you what happened as soon as thepatientleavesthedentaloffice.Sheisembarrassed and upset. She then tells you about the exchange eight months ago. Harassment can be harder to identify and address because it often isn’t as clear as sexual violence. If someone physically violates your body that is very clear. Harassment is often couched in name calling, jokes, or demeaning someone. You might think, “I should have a sense of humour about this.” Q What are a dentist’s legal responsibilities after an incident of sexual harassment is reported to the dentist? IK: Health and safety legislation in some provinces and the common law require employers to investigate when a complaint of workplace harassment is made by an employee. In most Canadian provinces the definition of workplace harassment includes workplace sexual harassment. As a result, once the dentist becomes aware of the incidents that the hygienist was experiencing, he or she has an obligation to investigate. It is important to note that the obligation to investigate exists whether the dentist hears about the incidents directly from the hygienist, or whether he or she becomes aware of the incident through other employees, rumours circulating in the office or even through an anonymous email or voicemail. Because there is a legal obligation to investigate, the dentist should keep an investigation file with all of the documentation that the investigation produces, including notes taken during meetings with the hygienist about the allegations, witness statements, and a report of the findings. If there is action taken by the dentist after the investigation is concluded, that action may be noted in the investigation file as well. HVh: You must acknowledge sexual harassment, investigate it, put policies in place to prevent it, and train your staff and yourself about how to respond to it. Awareness of the problem is a good first step, but training is necessary. People need to know what to do and what to say. • Healthy Workplace Series • • Healthy Workplace Series • 33 Issue 2 | 2020 | I ssues and P eople 32 | 2020 | Issue 2