It was the strangest thing to happen in my career to that point.
Something just felt off, right from the introduction to a new patient. I couldn’t explain it, it just felt off.
The patient came in and was very demanding. Telling me over and over again, “deep pressure is the only thing that works for me, it HAS to be deep pressure.”
Fair enough, I weigh around 215lbs, I should be able to put enough pressure into this.
After they got on the table, I went to work. As I pushed in with more pressure, I would continually check in to make sure they were satisfied with the pressure.
Then about 15 minutes into the treatment the patient abruptly said: “this isn’t working for me, I want to stop!”
I quickly asked if I had done something wrong?
“No, I just want this to stop now, it’s not working for me.”
I ended the treatment and said I would meet them outside when they were ready. As the patient exited the room, their hand reached out with a credit card in it. I said there would be no charge as it was only a 15-minute treatment (they were booked in for 45) and were also dissatisfied with it. But they refused and paid for the treatment.
I sat there even more confused (although happy I would have the next 1/2 hour to figure out what just happened).
As they walked out the door, the patient turned back and said: “thanks a lot for making me feel safe.”
Now, I was even more confused (and convinced the person had been sent in as a test or something), but even in the confusion, there was something that I was concerned with even more.
What about MY safety?
Right Of Refusal
This is where things can get a bit tricky.
When I look at our provincial bylaws (I’m just going to assume most other places are about the same) under the code of ethics there is a wide range of topic and wording that apply to us in practice. And that wording can be read a couple of different ways, depending on your interpretation.
To highlight a few that are applicable to the point of this post:
- Massage therapists must set and maintain appropriate professional boundaries with a patient.
- Despite section 23(iii), a massage therapist may immediately terminate the therapeutic relationship with any patient that:
- sexualizes or attempts to sexualize the treatment or environment, or
- threatens the massage therapist or otherwise endangers the massage therapist.
- Massage therapists must protect and maintain personal and professional integrity.
- Massage therapists must maintain a safe and healthy treatment environment.
Now granted, the colleges responsibility is to protect the public and most of these are probably in place with that thought in mind, as opposed to protection of a therapist.
The reason I bring all of this up is because of the story I mentioned in the beginning but also because, most of the time when I hear of someone who has been falsely accused of something (these are just things I’ve heard in passing, not from anyone directly who has been accused), I also hear, they regret not ending the treatment themselves because something just felt “off.”
Since we are to maintain appropriate professional boundaries with a patient, the responsibility lies with us. If the patient is going beyond a boundary it is up to us to end and or alter the treatment.
As laid out, we can terminate a therapeutic relationship if a patient threatens or otherwise endangers us as a therapist. In this case, I’m sure the intent was if a patient was actually threatening or physically endangering us. But what about when they are doing something that could possibly endanger your career, your mental health, or your overall well being? If something during the treatment happens and our gut tells us something isn’t right, we should have the full right to end that treatment. It won’t be easy to do, but in the long run, it could save not only a career but also mental anguish. This is also a way we can protect and maintain our personal integrity.
Since we are also expected to maintain a safe and healthy work environment, have we taken the time to think how that affects us as opposed to our patients?
In my past career before becoming an RMT, I worked in an industrial setting dealing with health and safety. The one thing that always came up was our right as employees to have a safe work environment. Part of those rights was the ability to deny unsafe work. If you were told to do a job but considered it to be unsafe, you had the right to deny doing it.
While you had to give sound reasons for why you considered it unsafe, the company could not force you to do it until the safety concerns were rectified.
In this case, if a patient is doing something that is setting off some red flags for you, it is your right to demand a safe workplace environment and in turn should be able to deny treatment to a patient if you think your safety is at risk.
This is another one of those areas that is often overlooked because we are either self-employed or work as contractors.
There was an article being circulated a month or so ago, which highlighted a massage therapist getting killed on the job as she was doing mobile, home care work (I think it later came out that she was working under less scrupulous employment) with no one else around.
If someone was working as a mobile therapist by themselves, or even working alone in a clinic, there are certain safety guidelines set out through WorkSafe or department of labour that stipulate conditions that are to be met to protect someone in this case.
Some of the guidelines that are set out in order to protect someone working alone or in isolation are as follows:
- Develop and implement a written procedure for checking the well-being of a worker assigned to work alone or in isolation.
- Procedure for checking a worker’s well-being must include the time interval between checks and the procedure to follow in case the worker cannot be contacted, including provisions for emergency rescue.
- A person must be designated to establish contact with the worker at predetermined intervals and the results must be recorded by the person.
- Time intervals for checking a worker’s well-being must be developed in consultation with the worker assigned to work alone or in isolation.
So, if you are a clinic owner, think of how this applies to some of the people working in your clinics. Are there times in the day when they are at the clinic alone? Is anyone calling in to check on them? Are there emergency procedures in place if something were to happen to one of them?
How about for those of you who do mobile massage on your own? Do you have a check in system before and after your treatments? Does someone know your schedule for the day and the addresses you’ll be working at? Do you have a contact in case of emergencies?
This doesn’t have to be an expensive complicated endeavour, even if it is regular contact throughout the day to a loved one or co-worker, who can regularly check in with you, as long as there is constant contact with someone.
However, there are companies out there who offer this kind of check in service. When I used to work alone I would have to call in to a company every two hours. If they didn’t hear from me, they would try to make contact. If contact failed they would dispatch emergency help to come and check on me (fortunately this never happened). There are now even some phone apps available like this one to handle these types of scenarios. The whole point of this post was not intended to scare anyone, but as self-employed people, we rarely take the time to think about possible safety issues within our work. We are trained to constantly think about what is safe and appropriate for our patients, when in reality isn’t our safety just as, if not more important?