Crossing a line?

springchick1, ADN, RN · Nov 29, 2013

I think that since the family wants you to stay involved then it isn't a problem.

elkpark · Nov 29, 2013

Welcome to allnurses!

I think your best bet is to talk to your nurse manager about this. Families want us to do all kinds of things that aren't professionally or ethically appropriate, so that fact that the family wants it really has no bearing, IMO, on the question. Your statement that you "feel like we've bonded (or at least, I have.)" is a red flag for me -- would your continued involvement be about meeting the infant's needs, or your needs/wants?

For what it's worth, I would not be willing to do this and don't think it would be a good idea for anyone else to. As a friend of mine likes to say, "clear, healthy boundaries are the key to a happy life." :) The best thing for this infant is to start bonding (exclusively) with the adoptive family, and your ongoing involvement and presence would just complicate and confuse that process.

JustBeachyNurse, LPN · Nov 29, 2013

Welcome to allnurses! I think your best bet is to talk to your nurse manager about this. Families want us to do all kinds of things that aren't professionally or ethically appropriate so that fact that the family wants it really has no bearing, IMO, on the question. Your statement that you "feel like we've bonded (or at least, I have.)" is a red flag for me -- would your continued involvement be about meeting the infant's needs, or your needs/wants? For what it's worth, I would not be willing to do this and don't think it would be a good idea for anyone else to. As a friend of mine likes to say, "clear, healthy boundaries are the key to a happy life." :) The best thing for this infant is to start bonding (exclusively) with the adoptive family, and your ongoing involvement and presence would just complicate and confuse that process.[/quote']
I agree here. The adoptive family needs to develop a bond with the baby especially under these difficult circumstances.
Also checking with your clinical manager it facility ethics committee for guidance could be enlightening.

krisiepoo · Nov 29, 2013

Another thing to keep in mind, the family may see how much you've bonded with this baby and in an effort to not hurt your feelings (HOW did it come up for you to continue involvement in the first place?) they say "of course we'd love to have you continue to be involved" but not really mean it because they don't want to hurt your feelings or they're caught up in the tragedy, etc

I'm not a nurse yet, but I have been a case manager for many years and clearly defined boundaries is a hard yet necessary value to have and I would not continue to have contact.

amoLucia · Nov 30, 2013

You're too close and you need to make some distance. Work is work and that's why there's boundaries. As others have mentioned, ethics committees think the same.

I know over the many years of my practice, I'd become close to pts and families. And I wonder how they're making out. But that's just general wishing. I'd have to rent out Madison Square Garden if I ever reunited with all those interests over the years. Who knows? Maybe you'll run into them at the library or local Farmers' Market or Sunday morning at the WaWA for newspapers? (Just know that I HAVE met past contacts at those places.)

I think back to grammar school and high school when all my friends & I vowed 'to stay in touch forever'. Never happened. Just caught up in the emotionality of life at the time.

You can only wish that all turns out well. And smile with the positive. But leave work at work.

jadelpn, LPN, EMT-B · Dec 1, 2013

I think your ethics committee can give you some direction. But as a general rule, there are usually policies regarding this, and generally not indicated for a relationship outside of work.

I am sure it is very, very difficult (and bless you for what you do) NOT to get attached to a baby that you took care of at a time when the baby had no one else. But getting that attached will only prove heartbreak for you. The only thing you can do is wish the family well, be so proud of the fact that you gave this baby a chance in life, a few snuggles, you saved a life.

Sometimes the hardest thing to do is let go. But in this instance, I think that you need to.

jadelpn, LPN, EMT-B · Dec 1, 2013

And as a post note, you may think about speaking to someone about this to de-brief and put things into perspective. It takes a special kind of a nurse like you to take care of really sick babies and come out intact, but under these special circumstances you made need to have an impartial third party to help you cope with the loss.

KelRN215, BSN, RN · Dec 1, 2013

How do they want you to remain involved? In what capacity?

nurse4littles · Dec 2, 2013

The conversation has always been very much driven by the family. The aunt came in and saw me cuddling with the baby (not a rare occurrence, with any of the babies in my care, as long as they're able to tolerate it and I've got some free time.) and she saw how the baby reacted to me...having taken care of her for a long time, I knew how to calm her right down...and when she was awake I would talk to her and she would smile and smile. :)

We ended up talking for a long time that day and she brought up that she would love for me to keep in touch and that she would send me updates. We exchanged phone numbers and when the baby went home, she did send me updates with her weight and how well she was doing, it was nice.

Then she invited me to her christening ceremony, which is what prompted my initial post. In the few days since then, I've spent time talking about the situation with my coworkers and managers and no one seems to have a problem with me staying involved...there are a few other nurses who routinely get lunch with former patients and families and have even babysat on occasion.

What I've gathered is that my management has the attitude that people are going to bond in such a traumatic experience (especially this one) and as long as the feeling is mutual, there is no problem.

I appreciate the feedback I received on here, and I will be careful not to overstep, but I also feel like I didn't relay the situation as accurately as I could have. One of those things where if you weren't involved, it's hard to really get it. I'm not going into to details about how she lost her parents, but it was an event that brought my entire unit together and we became very protective of this little girl...I'm honored to remain a small part of her life. :)

NicuGal, MSN, RN · Dec 2, 2013

Honestly, look at your hospital policy. It is hard to break that bond, believe me, 27 years have taught me that, but just make sure you give no advice, babysit, things like that. In the court's eyes you are held to a different standard as you were a caregiver. We have to step back as caregivers and let the family be a family...and understand that we are not a member of that family. I would keep in casual touch and keep it at that.

elkpark · Dec 2, 2013

I also feel like I didn't relay the situation as accurately as I could have. One of those things where if you weren't involved, it's hard to really get it.

I would say exactly the opposite; the fact that you are personally and emotionally involved in the situation means that you aren't able to be objective about it the way posters here are. Nothing you could tell me about the situation would convince me that this is a good idea. But, as you state above, you have already made a decision and acted on it. As far as I'm concerned, you've already "overstepped," but different people have different opinions about this kind of thing. Best wishes.