Nurse-client Relationship Boundaries

  1. I am a nursing student and had an elderly female patient during clinical who I really connected with. She was my only patient for the day, so I got to know her pretty well. She had to go through a procedure and told me that she was very nervous about it. I spent most of the day caring for her and I went with her to do the procedure. At the end of my shift, she thanked me for caring for her, and told me that she could not have done the procedure without me. This patient asked for my email because she wants to hear what happens to my career and see how i am doing. I thought it was sweet of her, but I would never give out my personal email, so I gave her my school email. Did I still cross professional boundaries?
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  2. Poll: Did I cross boundaries?

    • Yes

      90.91% 30
    • No

      9.09% 3
    33 Votes
  3. 12 Comments

  4. by   elkpark
    In my opinion, yes. The relationship is professional and limited to the context of her receiving, and you providing, healthcare services. If you happened to run into her out in public at some point in the future and ended up having a conversation with her, that would be one thing. But providing her with any info about how to contact you outside of that clinical setting is out of bounds.

    You're going to find yourself in this kind of situation as you continue with your studies and enter nursing practice. Now is the time to start working on how to gracefully dodge this kind of request. Did you happen to ask your clinical instructor for guidance before handing out personal contact info to a client? You should have. I would hope that your instructor would have told you not to do it.
    Last edit by elkpark on Sep 28
  5. by   katyq82
    Yes, absolutely this crossed a professional boundary. I can see that you did it to be kind, but it still crosses the line. This is to protect both the patient and YOU. This patient sounds like she was a nice person and truly wanted to know how you do in the future. Other people may seem kind and caring but may be manipulative or have their own agenda. Either way it isn't appropriate.

    Over time you will learn how to handle this and other sticky situations where you want to be kind but have to say no. I would just say that you appreciate her good wishes but the policy of your school/health care facility does not allow students/staff to give out personal information or to contact patients outside of work/clinical. I would then thank her again for helping you learn and for her kindness and say that you wish her well.

    I would not share this with any other students at your school or any instructors as you may have violated your student handbook. I hope you can look at this as a learning experience that fortunately did not cost you anything in terms of academic probation or other consequences.
  6. by   PixieRN1
    Yes, I think it crossed a boundary because what happens if she blows up your email, becomes burdensome to you, turns on you, whatever...and she decides to change her opinion about you and suddenly you are in a nasty position if she decides to go up the chain of command about how she perceives you...especially since she now has your school email and knows what school to call if she wants to report you.

    Live and learn and I encourage you never to do that again.

    Best wishes.
  7. by   BBpeds18
    Quote from elkpark
    In my opinion, yes. The relationship is professional and limited to the context of her receiving, and you providing, healthcare services. If you happened to run into her out in public at some point in the future and ended up having a conversation with her, that would be one thing. But providing her with any info about how to contact you outside of that clinical setting is out of bounds.


    You're going to find yourself in this kind of situation as you continue with your studies and enter nursing practice. Now is the time to start working on how to gracefully dodge this kind of request. Did you happen to ask your clinical instructor for guidance before handing out personal contact info to a client? You should have. I would hope that your instructor would have told you not to do it.

    Thank you! I understand and accept my mistake now. I was rushing and ready leave the unit, and I clearly was not thinking properly when I did what I did
    Last edit by BBpeds18 on Sep 28 : Reason: wrong comment
  8. by   BBpeds18
    Quote from katyq82
    Yes, absolutely this crossed a professional boundary. I can see that you did it to be kind, but it still crosses the line. This is to protect both the patient and YOU. This patient sounds like she was a nice person and truly wanted to know how you do in the future. Other people may seem kind and caring but may be manipulative or have their own agenda. Either way it isn't appropriate.

    Over time you will learn how to handle this and other sticky situations where you want to be kind but have to say no. I would just say that you appreciate her good wishes but the policy of your school/health care facility does not allow students/staff to give out personal information or to contact patients outside of work/clinical. I would then thank her again for helping you learn and for her kindness and say that you wish her well.

    I would not share this with any other students at your school or any instructors as you may have violated your student handbook. I hope you can look at this as a learning experience that fortunately did not cost you anything in terms of academic probation or other consequences.
    Thank you for taking the time to reply and I really appreciate your advice. You are correct when you said that I did it to be nice, but looking back, I should have said no about giving her my school email even if she was a very nice person. I will definitely use your advice next time I encounter something like this in the future.
  9. by   elkpark
    Quote from BBnurse21
    Thank you for taking the time to reply and I really appreciate your advice. You are correct when you said that I did it to be nice, but looking back, I should have said no about giving her my school email even if she was a very nice person. I will definitely use your advice next time I encounter something like this in the future.
    Also, whenever you encounter a situation like this that is outside the customary clinical activities with which you're already familiar, be sure to ask your clinical instructor before you take action. I have taught clinical for a few different schools over the years, and I would certainly expect a student of mine to clear something like this with me, and not make an independent decision about how best to proceed. Best wishes!
  10. by   elkpark
    So, what I want to know now is, who's the one person (so far) who thinks giving out the email address is okay??
  11. by   elkpark
    Can any of the three people who voted "no" please explain your reasoning as to why this isn't a significant professional boundary violation? I'm sincerely curious.
  12. by   cjcsoon2bnp
    I'm a clinical nursing instructor and I would tell my student that this is a matter of professional boundaries. I agree that it was a mistake and a momentary lapse in judgement but I understand how a student could have done it with the very beat of intentions. I know that if this was my student I would have a honest but supportive conversation with them so that they understood the error and would not make a similar decision in the future but I would not crucify them for this type of mistake (especially if it was a one time issue versus a pattern of behavior with poor decision-making/professional boundaries).

    As a student if this kind of situation ever came up again I would use the fact that you are a student to "break it gently" to the patient and just say that you would "get in a lot of trouble if you gave out any personal info or contacted a patient outside of the facility/hospital". If you ever are not sure about this kind of thing then you should also follow up with your instructor before acting so that they can help you.

    I also agree with the other users that that at this time I would NOT tell anyone at your school about this because you may be subject to some sort of disaplinary action. Just keep this advice in mind and if the patient contacts you via email then I would not respond to it.

    !Chris
  13. by   wannabeny
    Yes. you should never give out this information to a patient. So far, it seems like she is a nice person who had genuine intentions, but remember that there are many different people who enter hospitals, and not all of them have the best intentions when asking for personal information. For next time, always er on the side of caution and ask your clinical instructor before doing anything like that. A kind "I appreciate it, but xyz says that I cannot give out personal information."
  14. by   BBpeds18
    Thank you so much for everyone's word of advice! I definitely learned from my mistake and will be very careful next time.
  15. by   amoLucia
    elkpark - this inquiring mind would like to know also.

    I would venture a guess that they are NOT seasoned, experienced licensed practitioners who protect the privacy boundaries. And they understand the potential for unsavory responses.
    Last edit by amoLucia on Oct 10 : Reason: eta

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