Boundaries question

Remove patient from the context, and it's not illegal (criminal or civil) to speak to someone you know.

OK, thanks. Is it even unethical?

OK, thanks. Is it even unethical?

What's "ethics?" LOL jk. Probably yeah. Questions of laws and ethics depends on reasonableness and totality of the circumstances. It'd weird to give them the cold shoulder, but you should probably give more than the cursory head nod and "wut up?"

Thanks again, but can you tell me why probably? Probably unwise, lol. But, I'm new at psych, but at times love it.

Premature post above, thanks again, ITG.

The above is good advice. If the former patient approaches you then it is fine. I would say if the person is alone it is probably okay too. It is when they are with a friend/family member that things would cross the line (eg. they would have to explain where they know you from,etc).

I go by whatever the former patient does. If he or she speaks, I respond. I keep any conversation on neutral topics unless he or she talks about the time when we knew each other. I never initiate conversation, since the former patient might not want to talk to me, even if no one else is around.

As for the patient calling to the hospital, surely, if I have time, I'll talk to him or her, and again, keep the conversation neutral unless he or she doesn't. I'll also keep the conversation as short as is logical, since I am at work and have things that need to be done. However, if a patient is in crisis, I'm not going to just say goodbye. I'm going to do my best to get the patient to find appropriate help.

It's not illegal to talk to a former patient outside work. It is against most facilities' rules to initiate contact, such as calls to them, or visits, at least for a specified time-frame, such as 6 months. This also depends on where you work. Hospice nurses often keep in touch with their former patients' families. It has to be considered case-by-case.

Thanks for all the responses. I remain unsure why this nurse said this to me. She is pursuing a doctorate and I question if she knows something about this topic that I don't. (I'm sure she knows much more, lol).

the long and short of it is that once the patient is discharged you are no longer in a caregiver role. as such it is inappropriate to continue to act as though you are. if you bump into a former patient on the street and they want to talk shop you need to politely inform them that you are in the "wrong setting" to discuss such matters, but are glad to hear that they are recovered, or are willing to assist in their care should they seek such again. "my isn't the weather nice lately" is fair game.

if any other person is in earshot you may not disclose or make reference to the nature of your past relationship in any manner or detail. this would be a huge hippa violation.

it is considered inappropriate to be "friends" with or "date" or otherwise socialise with any former patient for a significant period of time, depending on your particular role as a caregiver (different for psych nurse than for psych social worker or psychiatrist). this generally extends to any patient of which you may be privy to the details of their condition and care. this would be a "dual relationship" in which there is a disparity of power, whether perceived or actual.

some psych caregivers wisely choose to refrain from relationships with former patients indefinitely. even if you follow the guidelines for your specific profession, a dual relationship can bite you in the ass right hard.

in small towns this can get confusing. 10 years ago an lcswc lived with me while in her clinical program. she moved out when her demons multiplied (3 immediate family members manifested already), but i have been aware of where she is and what she is doing thru common acquaintances. the other day i saw her in the grocery for the first time in 10 years, but it wasn't her, just a woman who looked damned like her.

when i spoke to her she told me she was not the person in question, but that she did know her. foolishly i asked how they were acquainted. as you guessed, it was in a patient/client relationship. i refrained from asking who was treating who.

best shag i ever had, but nuttier than a snickers bar.

I think the "why not" is best summed up as "dual relationship." Someone below said "remove the patient from the context and it's not illegal or unethical..." but you simply can't. Once they are your pt. they are always your pt., partly because they could become your pt. again. If you saw her at the mall and she approached you, it is difficult for you to anticipate how she would feel if you asked her how she was doing; you were around for a very difficult time and she may not wish to get into all that, or even be reminded of it - even if you were important to her, too. I think this is the best reason to hold very strong boundaries; we simply don't know how the pt. feels about us, about their time in the hospital, or about how their seeing us and talking with us could affect them.

I have talked with people about this in nursing and in mental health and my philosophy is that we can always hold a special pt. in our hearts and memories. But we have to hold them very, very loosely. Remember them, wish the best for them, but not pursue or attempt contact at all. They will be okay without us and can live their life without knowing how much they affected us.

I completely understand your feelings but I do think really firm boundaries are important.