resident/staff boundaries in LTC

Nurses Relations

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Specializes in adult psych, LTC/SNF, child psych.

I'm a friendly young looking 26 year old RN working a wing that is mostly long term, with some rehab residents sprinkled in for good measure. I smile, I treat all of my residents with care and consideration, and my work is well appreciated. I worry, however, that I let my A&Ox3 male residents say things that could be considered inappropriate and unacceptable by others or that it could cross the line between friendliness and harassment.

I tend to use terms of endearment (hon, love, etc.) casually with pretty much everyone in my life that I come across once I get to know them. I kinda consider my residents "family members" because I spend so much time with them and the terms of endearment come out. If someone were to say "don't say that to me", then I'd obviously be more formal with them, but my residents seem to like it and it puts them at ease. I like to think that I have a good rapport with all of my residents, regardless of the formalities of our interactions.

I was doing my morning walkabout before accepting shift report and while I was walking out of a room, a resident called my name. I stopped and called back, asking what I could do for him. To my surprise, he said "dolcebellaluna, I love you". He's a bed-bound young man and has never made any inappropriate gestures or comments. I responded as taken aback, saying, "Woah...that's a bit inappropriate. Maybe my coffee didn't kick in and I misheard you." He didn't say anything else and I went about my day without anything else.

I've had male residents ask to hold my hand or for a hug and I consider it harmless and innocent. I have no interest in any sexual misconduct with residents but I don't consider what they're doing harassment.

Am I paranoid because I came from psych, where boundaries were very clear cut? Am I just being too friendly?

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

Frankly I wouldn't know what to say but I would probably make a joke or tease back. I like having a laid back rapport w/ my residents but most are quite a bit older so there's not much concern about harassment.

Depends on how they say it. I usually just say back "aw thank you! We love having you here but we hope you can get better and go home."

Unless they are like "rip your scrubs off and make love to me" I wouldn't be too concerned.

Specializes in adult psych, LTC/SNF, child psych.
Depends on how they say it. I usually just say back "aw thank you! We love having you here but we hope you can get better and go home."

That's a smart idea! I try hard to make my response more about them than me, even if I might feel uncomfortable. I think I'm probably just over-thinking this, aren't I?

Specializes in Pediatrics, Emergency, Trauma.

That's a smart idea! I try hard to make my response more about them than me, even if I might feel uncomfortable. I think I'm probably just over-thinking this, aren't I?

No, you are not.

You still need boundaries, regardless of what specialty your are in.

Boundaries are good things. By the patient saying "I love you"---eh, depends on the context. May not have been intended as a romantic type of love statement.

"You are too sweet to say so!! I am glad that it shows that I enjoy spending my workday with y'all!!"

LTC is much like a family. Psych is entirely different, in that the mind of someone with mental illness is not always clear--so boundaries are very important to not muck up the works for increased function. LTC residents may have some sort of brain issues, but for the most part can figure out the intent of your communication with them.

Bottom line, it is all about intent. Terms of endearment, "you rock" sorts of communication are wildly different than sexual innuendos.

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