HELP! Social question-over the line?

tipsplease · Jan 19, 2011

I have been a nurse for a very long time; over the years I have found it necessary to detach myself from my patients (all of them). I am an emotional, touchy feely type of person; years ago I had a patient stalk me after i held his hand on the way to the cath lab. I thought nothing of it; I was young and pretty and bubbly and thought it was ok to do this; after that I realized that I am only there in a professional capacity, just as are docs. If the patient has unmet emotional needs, there are professionals to handle this. Think about it this way: it is inappropriate for counselors and other mental health professionals to form friendships after therapy; why should it be different for us?

silmas RN · Jan 19, 2011

Four of my closest friends are the parents of children who were my patients when they were infants. Those "babies" are now 35 and 37 years old. Our relationships have been strictly personal. Once the kids were discharged, they never treated me like a nurse. They never asked for medical advice and never expected me to continue caring for their children. I moved out of state when the kids were still young. When I visit, I stay with them. When they come here, they stay with me. They kids have not been an issue in over 30 years.

sallyspring · Jan 19, 2011

The only problem I see with this is how easy it is to give advi ce. Will you be able to reply to all related question with something like " I think this is something you need to discuss with the Dr./Nurse? "or I am afraid that i am not able to etc........

If they are friends indeed, the mom should be able to accept that you are not/will not become involed in the child's care. If an incident occurs while in your home, will you be expected ( by mom and the state/nursing body) to intervene?

lzerby · Jan 19, 2011

If you have to ask the question "Will this cause me to lose my license?" I would tend to think that even you have doubts as to the appropriateness of this action.

You formed a close social relationship with this client during a professional relationship. This would suggest that you should keep your distance already.

A common rule is that you should have no social contact with former patients for at least a year following the termination of the professional relationship. This prevents the inappropriate social relationships forming in the first place if you know you won't be able to interact on a social level for at least a year. This is a bigger problem in small communities than in bigger communities. You may run into someone by accident, and it probably is not inappropriate to stop and chat, or even sit down over a cup of coffee...but if your relationship was entirely professional, what would you really have to talk about? If the client wants to talk about their experience, then you are no longer having a social visit, they are consulting a nurse, sharing their feelings and experiences about their illness. If they want to talk socially, you need to evaluate yourself and how you feel about it (is it really social? would you do the same for this person if they had not been your patient? how does having seen them in their situation (ill, injured, recovering, etc.) impact how you feel about them and what you can talk about with others around?...).

Bottom line, I'd stay away, both socially and professionally to prevent any confusion or possibility of compromising the license. It's OK to be friendly, but keep your distance to protect the client and yourself.

turkoisernemt · Jan 19, 2011

I agree with the majority of the writers here. WHAT do you really know about this woman other than what she has shared with you? I mean really know!!!

Be nice, but absolutely do NOT put your vocation/avocation/ your home/family/ your new baby in jeopardy. You may have gotten on the lucky side the first time, but odds are against you for any long term good. Your name could and will be used by this "well-meaning" person in seemingly innocent conversation with someone who CAN skew the outcome.

Err on the side of caution, give her the name of affordable B&B's in the area. Ronald McDonald facilities, church groups, your hospital social resources. Get this burden off off you. She is using your good and sympathetic, altruistic nature for her benefit. If she was never at your facility, you would never know her and be asking these questions. And you will get burned. Be nice, be gentle, but tell her No not at this time, due to my pregnancy, whatever. She will get over her hurt feelings and displace them onto some one else. Don't let it be you. Protect your license, you worked too hard for it! TurkoiseRN

Trauma Columnist · Jan 19, 2011

And Elkpark and llg are the wise ones here - don't do it.

traumarus - a very old, cynical nurse

djmRN · Jan 19, 2011

my very first response was "sure, why not?" -- not only because as nurses, we want to help everyone, but because i've been in a very similar situation. early in my nursing career, i cared for and became attatched to one of my nicu babies and her family. when she was discharged home, the parents asked if i would be willing to come to their house and care for her on my days off. i took a few days off and obliged their request. i was young and very flattered that they asked me to care for this baby in their home, but, twenty-four years later, i cringe at what could have happened. if something had gone wrong with the baby while i was providing in-home care, i very well could have lost my license. :smackingf

i think helping with arrangements for "neutral" accomodations and offering to provide transportation or meals is ideal. this mom will completely understand if you explain this to her.

one last word of wisdom: if you have to ask the question 'is this ok?', then it probably isn't!

tipsplease · Jan 19, 2011

Don't know if this helps any, but maybe sharing my experience with an attorney friend will help you make up your mind. I was in an awful car wreck a year ago; car was totaled, I was injured (hit by a drunk going the wrong way on the interstate)....I had just started a new job and had no PTO built up; was out of work for a month and broke as a joke. My daughter's friend's mother is an attorney who supposedly had lots of experience in this area, so I hired her to represent me. Long story short, this was the nightmare from hell....it was very evident that the woman either didn't care or didn't know what she was doing or both.....but, after it was all over with, she was satisfied with her performance. This ended a friendship between us. I have since talked to other attorneys who told me she absolutely did not do justice to my case.

So, guess this message is, never mix social with business.

Mars · Jan 19, 2011

Yes. This is something you could get in trouble for because your relationship is based on your meeting them as a nurse, then becoming friends. There is a film, I believe called somthing about a thin line. It came from the national association of boards of nursing I think. It speaks to the fact that you can't establish friendships with patients.

The challenge is even harder for those of us who live in rural areas because we are already friends with our patients.

The problem is largely related to the earlier post that said they will expect you to act as a nurse even though you are not currently serving as their nurse. There is at least one court case I have read about where it was almost the exact situation here. And the nurse lost.

Spirit2L1 · Jan 19, 2011

Well, that's a tough one as you could end up in a bad spot at some point. I have been a RN 26 years, and have seen quite a few people befriend patients. If heaven forbid, something happens to the patient, where there is a question of hospital liability, then the mom may expect you to provide info to her regarding what may have happened or not have happened. Plus, if for some reason this had to go to court, it could be seen by the hospital that you were somehow involved inappropriately, causing you to be discharged. I would rethink having them stay with you. Especially if you work for the hospital. Often we do like people we take care of over the years, but there is a fine line there. There is an article on this site about the nurse who had a relationship off duty hours with a terminal patient, but her license was revoked by the board of nursing who saw that as inappropriate. Certainly that is a great deal different than what your relationship is, but, nonetheless, a nursing board can construe things otherwise. I myself, have felt that there were many wonderful patients and families out there, but, I have not gotten involved over the years as you can never be sure what their expectations of you are in the long run. Even with families and friends who become ill, I am very hesitant to provide advice other than to say "Ask your doctor" as people often to not give you reliable information regarding the status of the patient. It saves you from looking bad or incompetent to that person. Good luck to you, hope you make the right decision.

Lastly, it is one thing to have been friends prior to caring for the child, it is another after the fact because if you were personal friends in the first place, then you shouldn't have taken care of the patient for a year. If you are unclear, get free legal advice from someone. Also, the hospital where I work when a family or patient needs help after or during the hospital stay, they put out a request to the entire hospital to respond to a need, not just to an individual which makes it a personal basis.

sophie_bob_kids · Jan 20, 2011

Are you out of your mind?! which school did u go to?!
NO that is unethical and unprofessional!
Did you ever think if the mom was readmitted to your hospital she could potentially say to your colleagues whom she's staying with?
Either way if ANYTHING at all happens to her or patient in YOUR home you are liable to the MAX as RN not a friend.

Chill out! She came her for advise. Not to be attacked.

quetepye · Jan 20, 2011

Wow, this is a tough one. I'm a student nurse and have seen a few issues like this come up already. They puzzle me since there are so many sides, plus there is no unanimous standard. They don't touch things like this in school.

That said, I am also a patient and had liver disease from age 5 until I got a transplant last year. Some of the relationships I've formed with certain doctors, nurses, etc. are SO special to me and even though I'm out of peds, I still am in contact with many of them. If one of them friends me on Facebook, I gladly accept. In fact, I'm friends with a couple members of my transplant team on Facebook. Of course, I'm still (and always will have to be) a patient of theirs.

Still speaking as a patient, I would never even ask one of my previous nurses to take me into their home EVER (I would never want to put them on the spot like that) But if the situation arose, I really don't think I'd object. Unless you know what it's like to have a close relationship with a nurse for YEARS, I'm not sure if anyone, or whoever may potentially be the one to attack your license, has a right to question it. It's definitely an interesting dynamic and intentions can definitely be confused.

Ultimately, I would never offer to even meet up with a patient outside of work for fear of losing my license. I might want to, but fear would hold me back. As a student, I wish stuff like this was more "cut and dry" but every day, I realize more and more that nursing laws/policies/licenses are a very cloudy area.