My question is, I work as a community mental health nurse and have formed a therapeutic relationship with a client who didn't engage for many years, it has taken weeks, now helping him make massive changes in his life and he is a pleasure to work with, he will only engage with me.
I travel miles however for my job and was offered a similar job in the same trust but different borough near my house to start in a week which would be wonderful for me but I feel I cannot abandon this case.
Can I continue working with this chap though the borough will be different? I don't want to abandon him and still have appointments to attend etc. He has no NOK etc and only me right now.
The new job have said at the start they will be flexible with days so I can spend some time then.
I am working as a nurse combined with carer duties at the moment so may be able to work some days as his carer via social services, right now I provide support in all areas as he does not trust anybody else.
This is a very unusual case with a complex chap...he has now settled for the first time in years.
Well I changed my mind and decided to stay as at this point I don't want to let him down it feels wrong
I will try to break the unhealthy dependency / dynamic
Thank you all ?
In what way do you plan to try to break this unhealthy dependency / dynamic? You need a well thought out plan, one which includes your peers and your supervisor.
Specializes in Psych (25 years), Medical (15 years).
2 hours ago, Ms Blue Sky said:
Well I changed my mind and decided to stay as at this point I don't want to let him down it feels wrong
Interesting...
On one side of the 45 is ELO's Mr. Blue Sky and the flip side is Carl Perkin's Honey Don't.
"Mr. Blue Sky, you did it right, but soon comes Mr. Night."
"A little honey don't. A-say you will when you won't, uh-uh honey don't."
Specializes in Critical Care, Capacity/Bed Management.
On 5/22/2022 at 8:16 AM, Hoosier_RN said:
I understand your good intention, but also think of this: being "the only person that he will engage with" isn't therapeutic as well. What if you have a long term illness, etc? The patient will need to learn to receive care from others. Part of your therapeutic journey with this patient should include this
I agree with Hoosier, I believe that continuing to work with this patient outside of your new position requirements breaks the nurse-patient therapeutic relationship.
I think as nurses we often want to fix everything, but part of fixing everything is empowering patients to take control of their health and healthcare decisions and allowing patients the ability to act independently.
Thank you Okami, I'm thinking straighter now and seeing how ridiculous the idea of working with him in a new job would be
The truth is though (cannot write much here because of confidentiality) but people with his diagnosis most easily recover when they have a therapeutic relationship with one caregiver ( then will slowly bond with others ) and this has been proven and researched
The good news is, he is having another visitor from an older peoples charity shortly whom I'm hoping he could form a bond with fingers crossed so as not to encourage the dependency too much ?
Not sure I mentioned he is an older chap with cognitive impairment so naturally due to his age is more dependent for me to help with appointments etc
Specializes in Med nurse in med-surg., float, HH, and PDN.
What about you working toward training a new carer with the patient, so that gradually he/she will find the trust in having another person, who knows how to do things as you do.
Hey No Stars In My Eyes that's just what I was planning
Just has to be the right person once I have found someone I will feel free to move on
I will be happy to find someone as I can then take a more local job but feel I cannot just leave as I need to bring them in and slowly do the handover training them, telling them how he likes things done, likes, triggers etc but yes that is the plan ☺️
This man is so extremely hard to engage with if one does not persist due to trust issues then when he trusts he is lovely, he has fallen between the cracks and lost access to so many services in the past as everybody gave up, I'd hate for him to go back to that, the sad thing is he ended up feeling abandoned
That's what I'd like to prevent, he's extremely in need
I worked per diem HH for two different agencies and stopped working with one. I had a patient who wanted to continue services and belonged to the agency I stopped working for, so the patient's family merely discontinued services with one and started services with the other.
No big deal, except the agency that lost the case squawked a bit but had to acquiesce.
She can’t do that if she signed a non-compete agreement. The only way she can do it is by remaining PRN with the other agency if they allow.
Ms Blue Sky
28 Posts
Thank you, yes I do
I will leave and still present the case at panel for him luckily that is coming up soon ☺️
I will say goodbye and explain I am leaving as this job is right near my house, I pray it'll go fine