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Discussion

Am I in violation of code of ethics?

So I work at an adult day care and it's not really like a normal nursing job. I'm with the same ppl 8hrs a day 5 days a week so I've grown very close to my members. They're like family to me. I've taken some of my members to bingo outside of work, invited one of my members over for thanksgiving because he has no family and I've purchased clothes for some of my members with my own money bc they can't afford new clothes. A lot of the members are very low income and they Can't afford new clothes. One lady was even being beat up by her husband and he kicked her out...she had no where to go so I let her stay with me for the weekend til she figured it out. Am I in violation of something here? I know I probably am but that really bothers me because I'm in no way exploiting or taking advantage of any of the members I do all I can to help them. Could I get in trouble for any of this? I'm just really worried when state does their compliance check that they may find out about some of these things and I could get my licensed taken or suspended. Where so I go from here?

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I feel like you could be. When I worked in detox we couldn't even say hi if we saw a client at the grocery store, we could actually go to jail if we got caught talking to an old client. (The client could come up to us, say hi, we can ask how they're doing but we can't go up and be like "JOE! How are ya? Kick that meth habit finally?") we couldn't give out phone numbers, fb friend requests nothing.

I think buying cloths is okay but letting them stay with you and things I think is a no-no.

All of your actions have crossed ethical and professional boundaries. This is what social work /social services are for. Permitting clients to stay with you and inviting them to your home for holiday meals most definitely violated professional boundaries as this is a low income vulnerable population. This can easily get you in trouble with the board of nursing. If a member mentions ANY of these actions to a state agency (and it's highly likely when investigators interview clients in a routine inspection) your nursing license and the facility license are at risk for citation. It could be someone you helped or someone jealous that you did not help them. Those in adult day care are a vulnerable population. It can be considered exploitation of vulnerable members of society impaired by age or disability. You created a relationship where they are now dependent on you for basic needs (clothing, companionship, socialization)

For those without clothing seek a social services referral for clothing vouchers. The domestic violence victim should have been referred to a shelter. You put your and your clients safety at risk by taking her into your home. You violated professional and ethical boundaries by making these clients dependent on you for emotional, social and financial support.

You. Need. To. Stop. Right. Now. You are risking ethics charges should someone find out and elect to report your actions to the BoN. Contact your malpractice carrier for advice how to protect your license retroactively.

  • Guides

You would refer people to the appropriate agencies to get the help they need. All of this is so over the line I wonder how it's possible you could have done the things you said you did and just now realized there might be an issue.

Taking a battered woman into your home instead of to the people trained to assist her can probably open you to civil liability beyond what the BON might do.

Rules and regulations have nothing to do with your good intentions, but are to protect patients as there is no way to know ahead of time who is likely to exploit people.

It's really caring to go the extra mile, it's just the way you are channeling it that is inappropriate.

I feel like you could be. When I worked in detox we couldn't even say hi if we saw a client at the grocery store, we could actually go to jail if we got caught talking to an old client. (The client could come up to us, say hi, we can ask how they're doing but we can't go up and be like "JOE! How are ya? Kick that meth habit finally?") we couldn't give out phone numbers, fb friend requests nothing.

I think buying cloths is okay but letting them stay with you and things I think is a no-no.

No nurse.... ever, in any setting.... should exchange phone numbers or Facebook friend requests with patients. Not just detox nurses.

  • Experts
You would refer people to the appropriate agencies to get the help they need. All of this is so over the line I wonder how it's possible you could have done the things you said you did and just now realized there might be an issue.

Taking a battered woman into your home instead of to the people trained to assist her can probably open you to civil liability beyond what the BON might do.

I completely agree with the first statement (and JustBeachy's post above). Re: the second sentence, it's not just a matter of civil liability, it could put you in actualy physical danger. I used to belong to an organization that ran a battered women's shelter, and it was not uncommon for angry men to show up at the shelter (despite our best efforts to keep the location a secret) angry, demanding their wives/girlfriends come home with them NOW, and fully prepared to get into a physical alteraction with anyone who tried to stop them from coming inside and retrieving their wife/girlfriend by force. Sometimes they showed up with guns. Getting directly involved, as an "amateur," well-meaning member of the public, in a domestic violence situation can easily be genuinely, physically dangerous for you and other members of your household. There's a reason why cops all hate getting sent out on a domestic violence call ...

Please stop all of this now. At some point, it's going to turn out badly for you, one way or another. Best wishes.

  • Experts
Am I in violation of something here? I know I probably am but that really bothers me because I'm in no way exploiting or taking advantage of any of the members I do all I can to help them. Could I get in trouble for any of this?
Based on the info you provided, many of your actions have grossly crossed the boundary lines that define a nurse/patient relationship.

The clients are not your personal friends or family and should not be treated as such. Do not take them into your home. Do not purchase items for them. Do not develop personal friendships with them. Do not develop any type of relationship with these people outside the workplace.

In addition, professional help may or may not be in order. There's a reason you get inappropriately attached to the clientele, and perhaps a skilled psychotherapist or counselor can address the underlying issues with boundaries. Good luck to you.

No nurse.... ever, in any setting.... should exchange phone numbers or Facebook friend requests with patients. Not just detox nurses.

I know I know.. I was saying the company goes after the nurse legally if we did.

I know I know.. I was saying the company goes after the nurse legally if we did.

Buying clothes for clients is not okay. It crosses professional boundaries and creates an additional (financial) dependency of the client on a healthcare professional.

I can easily understand feeling sympathy for your patients. I can also understand wanting to help them, but you have to understand that your actions are crossing the line. You seem to have good intentions, but you simply cannot contiue this way. This very emotional bonds develop when you are with the same people day after day. I'm sure your employer has very set rules about buying and receiving gifts from your patients. I know you CANNNOT ever let another patient stay at your home. I wish you the best of luck. Perhaps seek some therapy for yourself. They should be able to help you understand professional boundaries.

OMG. I don't mean this in an insulting manner, but did you just recently graduate nursing school, and somehow missed the ethics class coverage of situations such as these? Or are you a veteran nurse who has (up until now) not been noticed for SEVERELY crossing the boundaries of professional ethics?

There is just no part of your story that is ok. Wanting to help, yep, sure....refer them or the family member responsible for them to the appropriate agencies.

You actually took a battered woman--a PATIENT in your professional care-- into your HOME? Yet you ask "could I get into trouble for any of this?" Honestly.....I'm amazed you haven't been brought up on charges before now.

Suppose one of the fellas you were driving to bingo had a medical issue....or you had an accident....think it'd be all A-ok? What about that woman you took home and let stay with you....any chance she'd have a complication from that beating and need medical assistance? Think you'd be covered for all that in your home, off work?

So, while I agree that what the OP described is all an ethics violation, I'm not sold on the question about the clothes. When I worked in a LTC we had a few residents that had no one and little money. A few had very old, tattered clothes. Social services could do nothing. We would pitch in and get the basics like socks or would go to the Goodwill and get clothes for them. If that is wrong, I don't want to be right.

So, while I agree that what the OP described is all an ethics violation, I'm not sold on the question about the clothes. When I worked in a LTC we had a few residents that had no one and little money. A few had very old, tattered clothes. Social services could do nothing. We would pitch in and get the basics like socks or would go to the Goodwill and get clothes for them. If that is wrong, I don't want to be right.
In a LTC setting, I'll agree with this. Some families provided zero clothing for these residents, and donations and social services are not always adequate.

I will say that the best policy would be for the facility itself to buy clothes as needed, as opposed to individual staff members buying them. Unfortunately, some facilities drop the ball in this area, too. So staff making Goodwill trips happens.

And, if staff is sometimes buying clothes for residents, one has to be very careful not to show favoritism.

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