Ethical and professional boundaries in HH

  1. I recently worked as a private duty nurse providing homecare. I was troubled by the behavior of the so-called primary nurse, who seemed to be extremely enmeshed in the family and the fact she was 'the favorite' nurse. This troubled me some, but not so much as when she bragged to me she was in the family will. She will receive a house and trust funds in return for caring for the patient, when the parents die.

    Now this to me smacks of improper boundaries, unethical, unprofessional...the whole shebang. :stone

    Am I wrong? Is this acceptable behavior for a home health nurse? Don't most of our BNE's have rules against this type of thing? :uhoh21:
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  2. 10 Comments

  3. by   Nickle
    GASP. . . .

    Make a report to the BON ASAP.

    My heart absolutely sank when I read this.
  4. by   mattsmom81
    Thank you for replying Nickle... and I'm glad I'm not the only one concerned about this....
  5. by   jmgrn65
    I agree with the above poster, this is so unethical!!!!!
  6. by   mattsmom81
    Thanks for validating my concern! Part of me thought 'Mind your own business.. perhaps this was a deal between 2 private citizens..and who is it harming? ' Then I thought of professional ethics and conflict of interest and boundaries....then this just doesn't set right with me.
  7. by   NRSKarenRN
    Quote from mattsmom81
    This troubled me some, but not so much as when she bragged to me she was in the family will. She will receive a house and trust funds in return for caring for the patient, when the parents die.
    Did you report your concerns in writing to nursing administration at the agency?
    If not, I would suggest you do so TOMORROW as it is their responsibility to ensure an ethical employment relationship exists and provide supervision to the nurse.

    It just may be that the parents have decided in case of their deaths that this nurse become patients guardian due to this nurses "devotion" to their child.
    However, I'd be concerned re "undue influence" if another family member got wind of this and decided to contest arrangements. It is NOT the norm, but certainly not unheard of. Grey area in SBON mind as long as no improper care provided, will not get involved.

    Biggest issue: one nurses over-involvement with the family driving away other nurses from providing competent care------- agency doing nothing about it.
    If you get no satisfaction from administration, time to QUICKLY move to another agency. I caution that you may be seen as upsetting the apple cart as case probably bringing in $$$ agency income, especially if private pay status. Not all places are ethical.
  8. by   renerian
    I agree 100% with Karen

    Wow first for me.

    renerian
  9. by   mattsmom81
    I'm already upsetting the applecart at this place...when I informed the agency of my discomfort and my concerns, they asked if they could call me back, they wanted to hear more and and they were going to work on placing me in another home. I have not heard back.

    I have resigned, as I do have the feeling this is not a good agency.

    Interesting Karen that your experience is some SBON's won't get involved. It surprisies me, but then again this is a new setting for me and I don't know all the rules. Thanks for the input!
  10. by   renerian
    Sorry you had to leave the agency........mattsmom............

    renerian
  11. by   Traveler
    Out of gratitude for the care we provide, many patients want to give us gifts at every visit. This is a poor area, so it may be some corn, tomatoes, or okra from their garden or even another prized possession. Lots of the elderly lady patients crochet and knit and are always offering these out of gratitude to our services. Our agency policy is to accept nothing, but we all have at some time or another. If I see that it will mean a lot for the patient to give me something and they will be offended if I refuse it, I take it and lovingly use it. It brings great joy to the patients when I tell them how handy the dishcloth has been and how well it has been made. Things like this happen 3 or 4 times a year max. Often the family will make a gift basket at christmas to bring to the staff. We accept this too since they took great care and love in doing this and would be offended if we declined. We have a man who has been a patient of ours off and on for years. He grows beautiful flowers and every week he brings us a new bouquet. We enjoy them, and it makes him feel good and productive. So, there are limits and boundaries. Being in the inheritence I think does cross the line.

    Ann
  12. by   Nickle
    Ann, I agree. We've often been brought gifts of food to the hospital unit for the staff to share when a patient leaves. These are delightful, and the company policy allows us to accept them. But when a patient's husband insisted he treat my husband and I to a steak dinner for the nursing care I gave to his wife, I respectfully declined.

    I can't imagine being offered a spot in the will!

    Mattsmom, did you report the incident to the state? Best wishes for a difficult situation.

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