Becoming friends with patients?

canesdukegirl, BSN, RN · Jan 13, 2011

Here is the lesson I learned the HARD way:

My first year of nursing. Patient is labeled as difficult, and had stayed on my unit for about 2 months. I was assigned to her and for some reason, she was actually fine when I was her nurse. So she started to ask for me. I got to know her and sympathized with her situation...homeless, abusive past, seemed well put together nevertheless, and I felt sorry for her (yep, you can pretty much guess the rest-can we say manipulation that I totally fell for?!?). So upon d/c she went to a homeless shelter. She said that she wanted for me to help her learn some skills so that she could get a job. I believed her, so I went to see her at the shelter, got her some nice clothes that she could wear for an interview and took her to lunch to teach her the basics of what an interview felt like (she was socially awkward and I wanted to bring her into a social situation to ease her fears a bit). I went to the bathroom and when I came back, my purse was gone and so was she. Turned out she had a long rap sheet and totally fooled me.

This is not to say that your situation is anything like the one I had, but I learned to keep my professional boundaries. There was no class in nursing school about this subject, and being a newbie, I thought I was doing a "good". Nope. I was just a sucker.

Now I understand the difference between being sympathetic and being empathetic. I will never take a patient into my personal life again, but I will do everything I can to give them the best care possible when they are my patient. When they are discharged, I send them out the door with good wishes and a smile.

elkpark · Jan 14, 2011

There was no class in nursing school about this subject, and being a newbie, I thought I was doing a "good". Nope. I was just a sucker.
Now I understand the difference between being sympathetic and being empathetic. I will never take a patient into my personal life again, but I will do everything I can to give them the best care possible when they are my patient. When they are discharged, I send them out the door with good wishes and a smile.

Is this another of those things they've quit teaching in nursing school????? What can be more basic, important, and necessary to understand than professional boundaries??? This was certainly impressed upon me, repeatedly and in detail :), in nursing school (back when you actually learned how to be a nurse in nursing school), and I've covered it in detail in fundamentals, therapeutic communication, and psych nursing courses I've taught over the years.

I'm sorry you had a bad experience -- thanks for sharing it with others who may be in the same boat you were, and may be able to learn from your experience.

Ackeem, BSN, MSN, RN, APRN · Jan 14, 2011

Friendships are bidirectional relationships though- you meet the needs of your friends and they meet your needs. As a nurse, you shouldn't be having your social needs met through patient interactions: that's a big boundary issue.
So I'm with GHGoonette on the distinction being an important one.

Nursing is my occupation, I do it because I love it and I earn a living, no strings attached. That being said, I don't go to work everyday to have my social needs met by pts I have plenty of time to do that out of work.

Nurses in general are friendly towards pts resulting in pts being friendly towards nurses (not in all cases) so most of the time yes a friendship is formed like it or not, especially if the pt is admitted to the hospital over a long period of time and interacts with a consistent nurse everyday. but not to the point where boundaries will be cross, its all apart of enabling to pt to be comfortable through out his/her stay and this method is Strictly professional ( no strings attached ).

Now I don't want anyone to misunderstand what is written above, there is a difference between work friendliness and social friendliness, so obviously in this case I don't expect the pt to meet any of my needs. But it does work to my advantage of making my work easier also, meaning the pt will be less hostile, snotty,rude, stubborn and etc.

So you mistaking my friendship towards a pt for social gratification is very IGNORANT, coming from a nurse your self.

Hypoxia · Jan 14, 2011

Is this another of those things they've quit teaching in nursing school????? What can be more basic, important, and necessary to understand than professional boundaries??? This was certainly impressed upon me, repeatedly and in detail :), in nursing school (back when you actually learned how to be a nurse in nursing school), and I've covered it in detail in fundamentals, therapeutic communication, and psych nursing courses I've taught over the years.
I'm sorry you had a bad experience -- thanks for sharing it with others who may be in the same boat you were, and may be able to learn from your experience.

I am in nursing school right now. We just learned about boundaries and laws. They also taught boundaries to me when I went through my CNA class. What do you mean by "back when you actually learned how to be a nurse in nursing school"

backatit2 · Jan 14, 2011

Here is the lesson I learned the HARD way:
My first year of nursing. Patient is labeled as difficult, and had stayed on my unit for about 2 months. I was assigned to her and for some reason, she was actually fine when I was her nurse. So she started to ask for me. I got to know her and sympathized with her situation...homeless, abusive past, seemed well put together nevertheless, and I felt sorry for her (yep, you can pretty much guess the rest-can we say manipulation that I totally fell for?!?). So upon d/c she went to a homeless shelter. She said that she wanted for me to help her learn some skills so that she could get a job. I believed her, so I went to see her at the shelter, got her some nice clothes that she could wear for an interview and took her to lunch to teach her the basics of what an interview felt like (she was socially awkward and I wanted to bring her into a social situation to ease her fears a bit). I went to the bathroom and when I came back, my purse was gone and so was she. Turned out she had a long rap sheet and totally fooled me.
This is not to say that your situation is anything like the one I had, but I learned to keep my professional boundaries. There was no class in nursing school about this subject, and being a newbie, I thought I was doing a "good". Nope. I was just a sucker.
Now I understand the difference between being sympathetic and being empathetic. I will never take a patient into my personal life again, but I will do everything I can to give them the best care possible when they are my patient. When they are discharged, I send them out the door with good wishes and a smile.

that's horrible. was she able to do much financial damage with the contents of your purse?

really, not to be mean, but i don't think not leaving your purse behind in a public place (especially with a destitute person guarding it) is something that needs to be taught in nursing school. it's one of those basic things that most people learn as children if their mothers taught them well by example. i've seen people leave their purses in the classroom during breaks at school, etc., and there they are - "coach" purses with blackberries and wallets lying open for everyone to see. it's sad that you can't do that, but it's better to be safe than sorry.

canesdukegirl, BSN, RN · Jan 14, 2011

that's horrible. was she able to do much financial damage with the contents of your purse?
really, not to be mean, but i don't think not leaving your purse behind in a public place (especially with a destitute person guarding it) is something that needs to be taught in nursing school. it's one of those basic things that most people learn as children if their mothers taught them well by example. i've seen people leave their purses in the classroom during breaks at school, etc., and there they are - "coach" purses with blackberries and wallets lying open for everyone to see. it's sad that you can't do that, but it's better to be safe than sorry.

I immediately canceled my debit cards, so she was not able to do much damage with the large amount of cash I carried that day...10 bucks.

And you are right. I should not have left my purse under the table in a public place while I went to the restroom. My mother did teach me this common sense rule. As I stated in my previous post, I had developed a friendship with this patient and did trust that she would not take off with my belongings. Again, I was a sucker and it was a harsh lesson to learn, but a good one. The basis of my sharing this embarrassing story is that I crossed a professional boundary that I shouldn't have, and that is something that they didn't teach us at my school.

hiddencatRN, BSN, RN · Jan 14, 2011

So you mistaking my friendship towards a pt for social gratification is very IGNORANT, coming from a nurse your self.

Being friendly and a friendship aren't the same thing. I'm sorry you don't understand the difference, because then maybe you'd understand that we're not being "ignorant" in "mistaking" your point but that we're pointing out an important distinction between two concepts that you are conflating.

No one is saying the alternative to becoming friends with your patients is to be rude and cold to them.

Ackeem, BSN, MSN, RN, APRN · Jan 14, 2011

Being friendly and a friendship aren't the same thing. I'm sorry you don't understand the difference, because then maybe you'd understand that we're not being "ignorant" in "mistaking" your point but that we're pointing out an important distinction between two concepts that you are conflating.
No one is saying the alternative to becoming friends with your patients is to be rude and cold to them.

Well obviously I know they are not the same, we're way past that, what I'm trying to put out is that, the friendliness can ultimately lead to a friendship ( not the friendship that I'm going to tell the pt my whole life story or anything personal ) if the pt is there over a long period of time, without any boundaries being past. again this friendship NOT social ( professional ) you would know if your actually a nurse.

GHGoonette, BSN, RN · Jan 14, 2011

Well obviously I know they are not the same, we're way past that, what I'm trying to put out is that, the friendliness can ultimately lead to a friendship ( not the friendship that I'm going to tell the pt my whole life story or anything personal ) if the pt is there over a long period of time, without any boundaries being past. again this friendship NOT social ( professional ) you would know if your actually a nurse.

Ackeem, you mustn't take it personally. The original post carried some indication that the OP is not a nurse, and it was more to point out the distinction for the OP's benefit that I emphasized it. I'm quite sure most of us understand what you are saying; hiddencat was just agreeing that the distinction must be made, not attacking you....

Ackeem, BSN, MSN, RN, APRN · Jan 14, 2011

Ackeem, you mustn't take it personally. The original post carried some indication that the OP is not a nurse, and it was more to point out the distinction for the OP's benefit that I emphasized it. I'm quite sure most of us understand what you are saying; hiddencat was just agreeing that the distinction must be made, not attacking you....

yeah she was quick to point out the distinction, as if i didn't know them, that's fair enough, BUT was also quick to point out or suggest i had my social needs met by pt interactions, that was out of line.

linearthinker, DNP, RN · Jan 14, 2011

I'd say it depends. Should you become codependent to some psych pt? Uh, no. Some well balanced/adjusted person who has her gallbladder out, seems ok.

hiddencatRN, BSN, RN · Jan 14, 2011

yeah she was quick to point out the distinction, as if i didn't know them, that's fair enough, BUT was also quick to point out or suggest i had my social needs met by pt interactions, that was out of line.

You were equally quick to call me ignorant and suggest that I'm not really a nurse, so let's call it even and move on.