Dating a former patient

[sarahg88]

Hello,

I am an LPN in Canada working at a mental health facility. I met a patient nearly a year ago whom I had a totally unexpected connection with. It isn't something I was seeking out and never in a million years did it occur to me that something like that would happen. I explained at the time that it was inappropriate and crossing an ethical boundary. The patient understood. Now, that former patient is doing very well and doesn't have a long standing illness and are well into their recovery. It was a short admission and I would have only been in the circle of care. We have been talking and spending time together (initiated by him) and it is obvious that after all this time we would like to be with each other and are meant to be, regardless of the circumstances of how we initially came into contact, so we are now officially in a relationship. He is in university with a bright future and such a wonderful and kind person who just had a little episode. He comes from a wonderful family. I'm afraid my co-workers will judge me if they find out I'm dating an ex "mental patient" and that I will be the topic of gossip in the work place. How do I deal with this situation in a professional manner? As far as I can tell, I am doing nothing wrong. A significant amount of time has passed and their is no element of vulnerability.

[ItsThatJenGirl, CNA]

I also have a mental health diagnosis. And I would hate for someone to be told that they can't associate with me because of it.

Stop putting words into people's mouths. Literally no one said that. It's about him being a former patient, and not his mental health diagnosis. You're not a victim here, so don't paint yourself to be one.

[macawake, MSN]

I also have a mental health diagnosis. And I would hate for someone to be told that they can't associate with me because of it.

Associate with?

No one is saying that indviduals with mental health diagnoses aren't permitted to be in romantic relationships or that nurses aren't allowed to date such an individual, and I think you know that. The point is that a nurse, physician or therapist shouldn't get personally/romantically involved with a person who they have or have previously had a healthcare professional-patient relationship with. It's that pre-existing relationship that is the problem, not the diagnosis.

Not lashing out, just upset at the fact that there is a lack of support.

What would you have us do? Lie in order to make you feel better about your choice? I personally think you made a poor choice, but I do acknowledge that it is your choice to make.

No authority can dictate my life.

Even though I like to think of myself as a free spirit the fact is that there are a myriad of mechanisms in place that "dictate" how I behave on a daily basis and that affects the choices I make. Upbringing, my own moral/ethical compass, legal statutes/criminal law, societal/cultural norms, employment contracts and professional ethical guidelines etc. etc. etc.

We all get to decide to what extent we let these factors guide us and influence our decisions, but all the choices and decisions we make have consequences. I hope this works out for you OP.

@BostonFNP

First, I disagree that in any way it is "right" for your coworkers to judge or gossip about you. That is just not professional. They may question your professionalism and you may lose some professional respect, but hat is not a blanket excuse for co-workers to gossip.

I wholeheartedly agree with this.

[Ruas61, BSN, RN]

The thing is some conditions put one in a more vulnerable category. A mental illness or psychiatric condition requiring inpatient care/intervention meets that criteria.

[pixierose, BSN, RN]

OP, you're either looking for drama ("oh, the stigma!) or for someone to justify what you already know, at least on some level, isn't right on an ethical level.

Either listen or don't to the good advice offered.

[TriciaJ, RN]

FORMER patient. I see no policies stating this is an issue. I also had a nursing instructor who married one of her patients! It upsets me that there is a blanket policy on all of this. No authority can dictate my life. As for my professionalism, I am a highly respected nurse in my field and work with great compassion and competency. The fact that all of you are so disgusted makes me question your stigma. If it was a patient arrived to the ER with a broken arm and the same situation transpired, I doubt you would all have the same take on this. Right now, I'm saddened to think I work with people such as all of you.

You're right. The broken arm patient is a different story. When I worked med-surg, a few of my coworkers had married former patients. When I worked psych, it was a big, fat NO. Not because of the stigma, just a whole set of other dynamics.

Look at it this way: a person with a broken arm can still trust his judgement. He has no emotional vulnerability to his caregivers. An x-ray can tell you definitively if his arm is healed. A mental health patient is very vulnerable to his caregivers. There is no definitive test that tells you he will be fine from now on. That creates a whole grey area that makes a personal relationship a very iffy proposition.

The med-surg nurses who married their patients? Solid long-term marriages. The psych nurses who did it? All blew up in their faces. No exceptions. When reading BON disciplinary actions one time, I saw a former colleague had her license REVOKED. She was a psych nurse whom I had high regard for. Her transgression: "Inappropriate relationship with patient." I was shocked and saddened for her.

Maybe this will never be you. Maybe this is the real deal. But if it was me, I would steer clear. Good luck.

[BSN16]

how did you even stay in contact with him??

[dirtyhippiegirl, BSN, RN]

You're right. The broken arm patient is a different story. When I worked med-surg, a few of my coworkers had married former patients. When I worked psych, it was a big, fat NO. Not because of the stigma, just a whole set of other dynamics.

Look at it this way: a person with a broken arm can still trust his judgement. He has no emotional vulnerability to his caregivers. An x-ray can tell you definitively if his arm is healed. A mental health patient is very vulnerable to his caregivers. There is no definitive test that tells you he will be fine from now on. That creates a whole grey area that makes a personal relationship a very iffy proposition.

The med-surg nurses who married their patients? Solid long-term marriages. The psych nurses who did it? All blew up in their faces. No exceptions. When reading BON disciplinary actions one time, I saw a former colleague had her license REVOKED. She was a psych nurse whom I had high regard for. Her transgression: "Inappropriate relationship with patient." I was shocked and saddened for her.

Maybe this will never be you. Maybe this is the real deal. But if it was me, I would steer clear. Good luck.

I am also a patient with an extensive mental health history and several hospitalizations. And a nurse.

This IS the stigma. Calling it "different dynamics" doesn't make the rest of what you just typed any less stigmatizing. It's like starting off a racist rant with "But I have a black friend."

The us versus them, all mental health patients are somehow more vulnerable or less competent than medical patients. That we (as mental health patients) are not capable of healing, that we will always be some sort of ticking time bomb that can go off at any moment. You'd get called out if you were making broad, sweeping characterizations about blacks or gays or immigrants -- and rightfully so -- and it should be the same for the mental health population, which is equally diverse and full of individuals who are not more or less competent or vulnerable simply because they've been hospitalized for mental illness.

[matcha-cat]

I am also a patient with an extensive mental health history and several hospitalizations. And a nurse.

This IS the stigma. Calling it "different dynamics" doesn't make the rest of what you just typed any less stigmatizing. It's like starting off a racist rant with "But I have a black friend."

The us versus them, all mental health patients are somehow more vulnerable or less competent than medical patients. That we (as mental health patients) are not capable of healing, that we will always be some sort of ticking time bomb that can go off at any moment. You'd get called out if you were making broad, sweeping characterizations about blacks or gays or immigrants -- and rightfully so -- and it should be the same for the mental health population, which is equally diverse and full of individuals who are not more or less competent or vulnerable simply because they've been hospitalized for mental illness.

I agree with what you said. My husband and I have both been diagnosed with mental illnesses. I am not a ticking time bomb, and neither is he. In fact, being able to talk about our mental illnesses was one of the reasons why we grew very close. Almost everybody I know has some sort of mental illness (whether it be alcoholism, anxiety, social anxiety, OCD, depression, etc.) I can understand why this would be hugely problematic with a nurse and her psych patient, of course, but I don't think the users here on AN can rightfully say they know what the situation is like and how it should be handled. They can warn the OP, of course, and give their advice, but they really DON'T know the situation.

Somebody else on here said that her believing that her and her love interest were "meant to be" was like her having a mental illness... They should be ashamed of themselves. What an immature and snotty comment to make. That's like... I don't know? Religion? Believing that your prayers will magically heal someone? Believing in good luck charms? Believing in rituals? Believing that in the end, the situation will always work out?

I believe my husband and I are "meant to be" but not because of some magically intertwined destiny. I've NEVER connected with another person the way I have with him. He's not some person I decided I liked enough to make a lover. He's my best friend, and even though I'm not religious, he helps me feel "whole" in a spiritual way and it's the first time I've ever felt like I could truly relate to someone. I still struggle with anxiety and depression, and I'm so thankful to have him help me through the rough times.

I can't give the OP advice on what to do with her job or how she should handle the situation. Of course, it's apparent that she needs to proceed with caution, and ultimately she's the one who knows most about the situation and will have to tackle it with how she sees fit.

[blondenurse12, MSN, NP]

I'm going to play devil's advocate here based on what I've read. It kind of seems like pretty much every responder, save the one before me is basically saying the former patient has no self determination because they have in fact reduced him to his mental episode/illness, not as an actual human being. I certainly think this situation can get sticky but mostly due to the fact that it seems like the OP lives in a very small community.

I have an immediate family member who is a healthcare provider in a small community and he cannot go anywhere without meeting patients/patients' family members. If it is a rural community, there also is probably a small dating pool so it is conceivable that the OP and the former patient would eventually orbit. We also don't know what he was admitted for and it sounds like it was for something short and temporary. Maybe suicidal ideation due to a horrible life event? We don't know but it sounds like this isn't some chronic condition that would potentially need re-admittance. My concern would be the staff gossiping but in that case, maybe find a new job?

[TriciaJ, RN]

Not saying the people with history of mental illness can't make good and stable partners, or that there's any "us" vs "them". There usually are, however, rules about engaging in relationships with those we have recently cared for. The relationships I've seen between psych nurses and their former patients have not gone well. The powers-that-be usually have rules against this, for a whole host of reasons which can make this a career-killer.

Success is more likely with a measured, thoughtful approach and a time lapse of a few years. No, they're not "ticking time bombs" (any more than the rest of us), but a young person who is still in college and was hospitalized less than a year ago might not be out of the woods yet.

There are many red flags in OP's post. We should not be going to work to meet our own social and relationship needs; it makes us less effective as providers. The OP needs to be very sure she is not chronically blurring professional boundaries.

[dirtyhippiegirl, BSN, RN]

The relationships I've seen between psych nurses and their former patients have not gone well. The powers-that-be usually have rules against this, for a whole host of reasons which can make this a career-killer.

You keep repeating this like your ancedotal evidence somehow carries weight. I once cared for a paraplegic who liked to marry his nurses. He went through three in seven years. I also know a burn nurse who married a burn victim and they divorced pretty quickly. So what?

There ARE official rules and unofficial good ideas that enforce boundaries on extra-circular nurse-patient relationships, yes. But the basis should be the same for medical and psychiatric patients. Not all psychiatric patients are inherently more vulnerable than all medical/surgical patients by virtue of their illness. That is the stigmatizing belief.

Success is more likely with a measured, thoughtful approach and a time lapse of a few years. No, they're not "ticking time bombs" (any more than the rest of us), but a young person who is still in college and was hospitalized less than a year ago might not be out of the woods yet.

If he's not a ticking time bomb in your mind, than why talk about how he's "not out of the woods yet" ?

There are many red flags in OP's post. We should not be going to work to meet our own social and relationship needs; it makes us less effective as providers. The OP needs to be very sure she is not chronically blurring professional boundaries.

Well, I personally enjoy having other nurse-friends in my workplace. It makes my job much more enjoyable and I certainly don't need you to tell me that it makes me a less effective provider.

I do agree that a nurse who constantly blurs the nurse/patient boundary with multiple patients has some issues, but that doesn't seem to be the case here. You haven't specifically mentioned any other red flags pertinent to the OP.

[Ruas61, BSN, RN]

Being a provider places you in a different role. It is not an equal footing. There is a dynamic there that can be tough to overcome in the reality of life.