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Terminated for declining Chemo Patient
Hello all,
I'm new to this forum but thought that I could get some unbiased points of view on the situation I am currently going through.
I was recently terminated from my job (a chain massage "clinic") because I refused to work on a client who is currently undergoing chemo therapy. This client did have a very generic doctor's note in is file stating "may recieve massage therapy", I do not know if it was from his oncologist or his general practitioner. I AM NOT TRAINED IN ANY SORT OF ONCOLOGY MASSAGE, having said that, I declined to work on the client. At the end of my shift that day I was suspended because I refused to work on this client and subsequently fired.
I am not sure that oncology certification is a requirement the way prenatal massage certification is required to work on a client that is pregnant. I'm appalled, I really feel that I made the ethically correct decision not just for me but for the well being of the client.
Any advice, opinions, points of view are greatly appreciated!
Thanks.
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Replies to This Discussion
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Permalink Reply by Bruce A Hopkins on
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Hi Vanessa,
I have worked with cancer patients exclusively for seven years in a hospital oncology department and in private practice. I am also the webmaster of the Society for Oncology Massage. Ethically, you are right on. Unskilled oncology massage can clearly be hazardous to the client. Further, many physicians are not aware of this.
Please contact me, webmaster at www.s4om.org. I don't expect that we can help you personally, but perhaps, for the good of other clients, we can help your ex-employer to find a better way of dealing with this complicated and vexing issue.
You did what was right. You are to be commended! -
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Bruce, Thank you so much for the support. I actually see an attorney tomorrow to see if there is anything I can do to fight this emloyer and their horrible business practices. It is so imparative to me that clients receive the best care that they possibly can, taylored to their specific needs. Thanks again!
Bruce A Hopkins said:Hi Vanessa,
I have worked with cancer patients exclusively for seven years in a hospital oncology department and in private practice. I am also the webmaster of the Society for Oncology Massage. Ethically, you are right on. Unskilled oncology massage can clearly be hazardous to the client. Further, many physicians are not aware of this.
Please contact me, webmaster at www.s4om.org. I don't expect that we can help you personally, but perhaps, for the good of other clients, we can help your ex-employer to find a better way of dealing with this complicated and vexing issue.
You did what was right. You are to be commended! -
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Permalink Reply by Stephen Jeffrey on
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Hi Vanessa, hopefully armed with a letter/information from Bruce, and time to think over your loss as a valued employee, your employer may even take you on again and you can put this to rest as an experience for all concerned.............before any lawyers have to intervene.
all the best steve
Vanessa Samaniego said:Bruce, Thank you so much for the support. I actually see an attorney tomorrow to see if there is anything I can do to fight this emloyer and their horrible business practices. It is so imparative to me that clients receive the best care that they possibly can, taylored to their specific needs. Thanks again!
Bruce A Hopkins said:Hi Vanessa,
I have worked with cancer patients exclusively for seven years in a hospital oncology department and in private practice. I am also the webmaster of the Society for Oncology Massage. Ethically, you are right on. Unskilled oncology massage can clearly be hazardous to the client. Further, many physicians are not aware of this.
Please contact me, webmaster at www.s4om.org. I don't expect that we can help you personally, but perhaps, for the good of other clients, we can help your ex-employer to find a better way of dealing with this complicated and vexing issue.
You did what was right. You are to be commended! -
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Permalink Reply by Susan G. Salvo on
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Keep in mind that ethical issues are not always legal issues (and vice versa).
And unless her termination was unlawful, I doubt if legal counsel will help (be sure to see Monica Reno’s perspective in the discussion on Right of Refusal – it’s very insightful).
If it is a breach of ethics, be sure to define which one and go from there.
Also remember that unless Vanessa is bound by a code of ethics (i.e, part of her state law, part of an organization for which she is a member [AMTA, NCBTMB]), there may not be an ethics violation. -
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Permalink Reply by Lisa on
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and in the same line of thought...if there is an ethics violation but not a legal one, I'd suggest Vanessa reports the franchise to the state ethics board. perhaps a little "heat" will wake up these franchises into recognizing that they need to remember that their business is not just a business but a massage practice. and as such they need to treat their MTs and clients with respect and follow the same codes of conduct as their employees have taken an oath to when becoming MTs.
Susan G. Salvo said:Keep in mind that ethical issues are not always legal issues (and vice versa).
And unless her termination was unlawful, I doubt if legal counsel will help (be sure to see Monica Reno’s perspective in the discussion on Right of Refusal – it’s very insightful).
If it is a breach of ethics, be sure to define which one and go from there.
Also remember that unless Vanessa is bound by a code of ethics (i.e, part of her state law, part of an organization for which she is a member [AMTA, NCBTMB]), there may not be an ethics violation. -
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Sorry everybody for my recent redundant posts as I learned how the system works.. I have had some instruction from the ABMP staff and I hope to do better in the future.
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I am currently studying (sson to be licensed in NYS) and have a few things we've learned:
1. IN NYS, our LMT license is on the line if we work outside our scope, which this massage may have entailed.
2. We are taught that Dr's notes are lovely to have, but if you, the therapist, is uncomfortable with the level of detail in the dr's clearance, contact the dr. before providing massage (or a specific modality) to any client you are concerned with exacerbating an existing condition.
3. Wee are alos taught that cancer and chemo/rad patients have some very unique concerns, and to proceed with extreme caution, if at all. This includes avoiding lymphedema and the tumor area itself.
4. This client should have been referred to a facility designed to treat clients with these conditions, someone in the category of high-riosk or medical massage is not a good candidate for a "chain" Massage studio with an unknown therapist, and you certainly had the right to refuse and likely should have.
That all being said, it is possible to offer some very gentle holds, perhaps some reiki or energy work, maybe some craniosacral work for this client in the meantime to perhaps offer some palliative relief, just a thought if the situation arises again for you.
in the end, we are taught that you should never use a technique for any client when you are not comfortable with the appropriateness based on the client's health or your training level.
You go girl and godd for you for sticking up for what were the client's real rights here....
Lisa said:I have two thoughts on this...
yes there needs to be some focus on the client, considering our practice facilitates nuturing and healing. and it is a shame that the client had to suffer because of this. i go back to Emma's comment (as Stephen also mentioned):
If I was going through chemo,I would want someone who knew what they were doing working on me and I would be happy if you told me you have never worked on someone going through chemo and you were not comfortable working with me.I would think you cared to not cause me any harm.
i would say the greatest show of concern we have for our clients is when we actually refuse one.
but i still have to go back to the franchise. there should be more accountability with THEM. They are the business owner. They are responsible for the client's well being. They are the ones that should be hiring professionals, facilitating/managing client/therapist relationships, and overseeing all aspects of the business. They did some of that at the TAIL end of the situation by firing her, yet not so much at the beginning in facilitating the relationship. They dictate ridiculous times for client/therapist consultations and just expect that everyone is there to get the cookie-cutter session. when the reality is that every client/therapist relationship is unique. it is the very foundation of what we do. and NOT every therapist is the perfect fit for every client. if we as therapists look past that, we WILL end up doing harm both to our clients as well as our profession.
Susan G. Salvo said:If we continue to address Vanessa’s topic, there needs to be some mention or focus on the client.
It was also her (the client’s) massage, her desire to feel better, and her time too.
Has anyone put themselves into the client’s shoes?
Jenifer moved into that direction, but it got lost in our “therapist rights” agenda.
My understanding is that the therapeutic relationship serves the client.
Am I missing something??? -
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Permalink Reply by Emma Torsey on
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I think it would behoove the massage chains to look up a few words, OBLIGATION- DUTY- RESPONSIBILITY-VOW-OATH.
It is a huge law suit waiting to happen.Someone is going to be forced to work on a client outside of that MT's scope of practice,a client will suffer and a lawyers going to be able to pay off his or hers home in the Bahamas. Mark my words it will happen if the chains don't start thinking of the client as a real,living feeling being rather then 50 bucks.
Peace,Emma -
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Very good point Emma ! it will be interesting to hear a lawyers veiw on this.
Do we have any lawyers on MBP ?..............surely some have seen the error of their ways and joined a better profession :) :)
Emma Torsey said:I think it would behoove the massage chains to look up a few words, OBLIGATION- DUTY- RESPONSIBILITY-VOW-OATH.
It is a huge law suit waiting to happen.Someone is going to be forced to work on a client outside of that MT's scope of practice,a client will suffer and a lawyers going to be able to pay off his or hers home in the Bahamas. Mark my words it will happen if the chains don't start thinking of the client as a real,living feeling being rather then 50 bucks. Peace,Emma -
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LOL!
Stephen Jeffrey said:Very good point Emma ! it will be interesting to hear a lawyers veiw on this.
Do we have any lawyers on MBP ?..............surely some have seen the error of their ways and joined a better profession :) :)
Emma Torsey said:I think it would behoove the massage chains to look up a few words, OBLIGATION- DUTY- RESPONSIBILITY-VOW-OATH.
It is a huge law suit waiting to happen.Someone is going to be forced to work on a client outside of that MT's scope of practice,a client will suffer and a lawyers going to be able to pay off his or hers home in the Bahamas. Mark my words it will happen if the chains don't start thinking of the client as a real,living feeling being rather then 50 bucks. Peace,Emma -
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Unfortunately, you are missing something. Vanessa's refusal was a focus on the client by not proceeding into an area with which she was unfamiliar and potentially creating harm. It wasn't because she was afraid of touching a cancer patient. She refused not to protect herself, but the client. Harming the client is not to the client's best interest, no matter how well intended.
We at the Society for Oncology Massage have written into our standards of practice the right of refusal. It is common for a cancer client to request some technique or application of massage that may not be good for them. It is our responsibility as professionals to recognize these conditions and keep the client's best interest at heart. It is also our responsibility to educate ourselves to be able to understand what these conditions are and if we are not certain that what we may do is safe, then to error on the side of caution and not do them. First do no harm. The client trust in you as a professional not to harm them. This does not mean we cannot benefit the client in other ways and still provide a positive and rewarding massage experience.
When a physician writes a referral vs. a prescription, he is depending on the professional referree to use their skilled judgement on determining the proper course of treatment for the patient including the right to decline treatment if it is potentially harmful to the patient. If an oncologist refers a patient to a surgeon for a procedure and the surgeon says it would be unsafe or cause harm, the oncologist accepts that.
d. Right of Refusal. The practitioner shall decline to use any massage
technique that the practitioner judges may be detrimental to either client or
practitioner.
In another response you mentioned that the intake form, history and physical, etc. should reveal any problems. That is correct. But, does the average therapist know how to deal with the special information that a cancer patient may reveal? I believe the answer is no. Consider the disparate standards for massage across the nation, as your own work with MTBOK is trying to address. In many schools students are taught to completely stay away from cancer patients and if this was Vanessa's case, having her work on a cancer patient was going against her training.
Though I have some personal feelings on the matter, the legal issues of her situation will be completely dependent on Vanessa's location, training, etc.
George Lee, VP Society for Oncology Massage
Susan G. Salvo said:If we continue to address Vanessa’s topic, there needs to be some mention or focus on the client.
It was also her (the client’s) massage, her desire to feel better, and her time too.
Has anyone put themselves into the client’s shoes?
Jenifer moved into that direction, but it got lost in our “therapist rights” agenda.
My understanding is that the therapeutic relationship serves the client.
Am I missing something??? -
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well and even in the best of circumstances, our intake form, history, assessment, etc is done most times at the time of the session. it's a lousy time to realize THEN that the massage is not in the client's best interest.
i try to do my intake before the day of the session. this way it not only gives me time to look over and "plan" the session but also gives me time to refer the client out should the need arise.
unfortunately spas and franchises don't incorporate such thought into their procedures...let alone even give ample time to go over it before the session.
George Lee, LMBT said:In another response you mentioned that the intake form, history and physical, etc. should reveal any problems. That is correct. But, does the average therapist know how to deal with the special information that a cancer patient may reveal? I believe the answer is no. Consider the disparate standards for massage across the nation, as your own work with MTBOK is trying to address. In many schools students are taught to completely stay away from cancer patients and if this was Vanessa's case, having her work on a cancer patient was going against her training.
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