How much personal info do you share with pts?

[Bouncyball]

I am a second year RN student. I have had some really nosy, pushy patients the last couple of weeks and it has made me wonder where to draw the therapeutic communication / your asking me too many personal questions line. I know as nurses we are supposed to have a therapeutic relationship with our patients, but at the same time are not supposed to get too close, or share too much with the pt. It seems like in order to have a therapeutic relationship with your pt that you need to be somewhat open with them. Where do you draw the line?

My instructors say that we should easily be able to sit down with the patient and interview them for our care plan. This includes their relationship status, if they are happy in the relationship, if they have kids, job status/ financial status, personal stressors and so on... These questions seem pretty personal to me, but I understand why I am supposed to ask them.

Well, lately my patients have been starting to ask me personal questions.I am talkative and outgoing, but usually prefer to keep to stick to topics like movies, weather, pets, and just small talk. I have never been comfortable discussing things like my relationship, kids, or what neighborhood I live in with people I don't know. Am i just too sensitive? are these normal things people talk about with strangers?

I am sort of torn because I feel like if I flat out refuse to tell them anything that they may not want to keep talking to me, and that is not fostering a good nurse patient relationship. But on the other hand I feel like the pt probably does not see anything wrong with asking me stuff since I was just interviewing them. So, how much do you share with your patients?

On another side note, what is a nice way to tell a patient that you don't want to answer their question if giving a vague answer and changing the subject does not work. For example, a patient asked me where I live the other day. I said "oh, not too far from here. Where do you live."

Pt- "I live on x st and w st. Where exactly do you live again?"

Me- "sort of by the west side, can I get you anything before I go to lunch"

pt- "no I don't need anything. Where exactly do you live, like what streets?"

I just excused myself at that point without answering. What would have been a good way to handle this?

[CheesePotato, BSN, RN]

Name. rank, and serial number. According to "Hogan's Heroes" that's all the Geneva Convention requires.

Indeed. But something tells me frantically yipping, "CheesePotato, Trauma Team Lead, 627717-13Z!" as an answer to everything would go over about as well as a lead brick.

Pt: Ma'am, I'm a little nervous.

Me: CheesePotato, Trauma Team Lead, 627717-13Z?

Pt: Well, it's my first surgery....is my surgeon good at what he does?

Me: CheesePotato. Trauma Team Lead? 627717-13Z. 13Z.

Pt: My husband is coming. Can you look for him afterwards?

Me: Cheese. Potato. Trauma......Team Lead 6277, 17-13Z.

Pt: Thank you.

Me: Potato.

[enchantmentdis, BSN, RN]

I will tell you from personal experience that patients and/or their visitors may innocently be trying to engage you in conversation, but beware. Never trust a patient or family members. Once you get into a conversation with them about any aspect of your life, or any of your political or religious beliefs, the discussion is now about you, not them. If they have to ponder about anything you said, and they disagree with you, or have to think about what you said too long, they get uncomfortable and start seeing you as the nurse who talks too much or gives out too much information. If they feel like they have to sympathize with your situation, they will feel like they have to take care of you somehow, or be too attentive; and you'd be surprised how many patients or family members report to management, "wow that nurse talked a lot about herself and was unprofessional because of that". The manager then has something to write you up about--unprofessional conduct.

When you are dealing with sick people and their families be prepared for them to be super-sensitive and ready to blame, or at least mention the nurse who is talkative and opinionated, because it's convenient to blame or talk about the nurse and bring her behaviors into question with management. I always tell them, "yes, it's been on tv all week, but i'd like to get your assessment done and treat your pain, because the doctor may be making rounds shortly". I also have said to other patient's, "we've been told by our supervisors to focus on the patient, and limit personal discussions so we can more adequately serve you".

You just have to find a creative ways to deflect these people. And yes i said "these people" because they exasperating as heck, because you never know when they are going to talk to management about you. Like i said, never trust patients or their visitors.

[enchantmentdis, BSN, RN]

It really depends on the patient and the rapport that we've built. Overall i don't mind sharing basic info like married v. single and talking about kids or favorite hockey teams, but i generally won't get terribly specific unless there is something strange that a patient and i can form a bond over - and then only if it's benificial and not going to be creepy.

Problem with this is even if you've spent days building a rapport, the patient may tell their family without your knowing it and, whammo, family not happy about personal conversations and reports it to management.

[enchantmentdis, BSN, RN]

I'd talk about our dogs and cats because that was always a good icebreaker. When you live in

a very rural area and have off-beat looking dogs, people do remember you. My husband walks

our two dogs all over town, and people remember them. Because I'm physically no longer able

to exercise them, people don't immediately connect me to the dogs.

[ATTACH=CONFIG]11899[/ATTACH] Mannie - age 3 months

Haha. Funny you mention this one. I had a family member report to management that i spent more time with the dog than with the patient.

[niko1999 RN BSN]

Most I have shared is I'm married ( I do wear my rings to work), I have no kids but I have a cat. Sometimes, depending on the patient, if we get on the subject, I will tell them about my eventual goal to go for anesthetist . And if they ask where I'm from, I will tell them the town I'm from, but nothing more. I think once I had a pt that had family in the same neighborhood as me, and I mentioned I lived in the nearby neighborhood.

[HippyDippyLPN]

I dont really share much besides little tid bits like I am married, have kids, etc. Hell I dont even tell my co workers personal things lol

[Pistachio]

Depends on the relationship with the patient. I've learned to let my affect and manner set the stage for not sharing much and people respect that. In primary care though we might see the same person repeatedly over a period of years and I feel comfortable sharing a little bit with them, but only as it really pertains to the conversation, and put it right back on them. It gets much easier over time. It just is kind of a double standard that we ask all these questions and then not share about ourselves.And just wait until the "who are you going to vote for!"

You just say "I'm planning to write myself in, you should to, I'll give you a great cabinet position." :-)

[tewdles, RN]

What you might share is going to depend dramatically on what type of nursing you practice.

In hospice nursing, for instance, we maintain very firm professional boundaries. We also seek to develop very trusting relationships with our patients and families.

To make those things work together it is important to remember that there are "public" elements to us as nurses...things people have mentioned before like marital status, children, common interests, etc. There are less public things like personal experience with death or disease that might be shared.

The bottom line really boils down to the intent and focus...

Our intent must always be to facilitate communication and the development of a therapeutic relationship in order to meet the patient needs. If the focus of the conversation EVER becomes about US then we have violated a boundary and must back up and re-direct.

It we are giving information that causes the patient or family to worry about us, console us or to feel a need to care for or protect us then our relationship is no longer therapeutic and must be changed ASAP.

There is no question that the care of people in their homes over weeks and months vs. care in the acute setting leads to slightly different communication patterns.

[wooh, BSN, RN]

Re: Who we're going to vote for:

You just say "I'm planning to write myself in, you should to, I'll give you a great cabinet position." :-)

Nice! Another little tidbit to put in my orificenal when smiling and nodding doesn't cut it. :)

[JerseyBSN]

I don't give any personal information. Period.

[tewdles, RN]

I don't give any personal information. Period.

Would it be fair to guess that you work in an acute care setting where you do not establish long term relationships with your patients?

[lykeen]

It's best not to focus on your personal life with patients. You are there to take care of them; keep the focus on them!