Doing a favor vs. being an RN

[anon456]

I am a brand new RN and not sure where the line is here--- if you have a neighbor who had just had surgery and can't reach the wound to do bid bandage changes, and his squeamish wife asks you if you wouldn't mind doing the bandage changes for her, would you be able to say yes? Or would that violate some nursing act? Same with this same neighbor asking you to hand him prescribed meds so he doesn't have to get out the chair to reach them?

I know that a non RN could legally do this as a favor to the person, but as an RN would I have some kind of liability risk or be practicing in the wrong way?

Another one I get a lot is friends asking me what I think of such and such med that they have been prescribed. I try to keep it general such as "this med belongs to this certain class, and I have learned that it's used for this or that purpose" but I tell them that I can't give personal advice about how they should take the med and their doctor needs to be the one to ask about that.

If you could clear this up for me I would really appreciate it!

[mystory, BSN, RN]

Are you extremely close to your neighbors? If not I think it is strange and boundary encroaching for them to expect or even ask you to do this. For loved ones I would be happy to but for neighbors not so much. I would wish the man a speedy recovery but make it clear that I am not trained or comfortable doing procedures outside of the hospital, where the environment is sterile and resources are abundant (ideally ).

[elkpark]

Personally I would do it, but I would make it clear to the neighbor that I am doing this as a neighbor, not as a health care provider, and that I am not acting in that capacity.

In any case I'd help teach the family how to do the dressing change, making it clear you're doing it as a favor and not as a nurse.

I'm not clear what you mean by these statements. If one is a licensed healthcare provider (of any variety), there's no such thing as "making it clear" to someone else that you're only acting as a neighbor, not in your capacity as a licensed healthcare provider. You can't "turn off" your nursing license -- if you're licensed as an RN, you're licensed 24/7/365, and you're legally responsible and accountable as an RN for anything healthcare-related you do, whether it's at work during working hours, or in a neighbor's home as a favor -- that's the point of being licensed.

[AggieNurse99, BSN, RN]

How I've phrased PICC line care to my sister in law: If, god forbid, it becomes infected and I've been taking care of it for you as a favor, your health insurance is unlikely to cover the cost of antibiotic treatment which, for a central line infection sepsis can cost up to $42k. [out of control diabetic].

[Kyrshamarks, BSN, RN]

I gotta ask, what ever happened to being neighborly? I have helped many neighbors over the last 25 years do things like dressing changes and setting up medication boxes and looking st their kids burns and scratches. That is what being a neighbor if about. Helping them when needed with the skills that you have. I have has a neighbor who installs air conditioning units come over when he heard from another neighbor that mine went out and I was going to wait three days for a repairman. He fixed it for free. I offered to psy but he said what kind of neighbor would he be if he did not help out another neighbor. A lawyer that lives across the street helped with some issues we had to get a later written for. He did it for free. Help your neighbor.

[MedSurgeMe]

I think the prior posts covered most issues well. However, you also have to be concerned about your medical mal practice insurance. If you don't not have your own med mal insurance, you are relying on your facility's insurance. However, if you're working outside the facility, their insurance will not cover you. Then, if you get sued, you'll have to pay for your own lawyers and all sorts of other craziness. This applies not only to advice you give to neighbors but also friends, the internet, etc. So be careful and weigh your options before you decide.

[ComeClarity]

It depends on how much you trust your neighbors not to sue you should the wound get infected or whatever. I wouldn't do it unless it was an immediate family member (parent, grandparent, spouse, child). It sucks that we have to live in fear of being sued as licensed nurses, but it's just the reality of our sue-happy world.

[psu_213, BSN, RN]

I gotta ask, what ever happened to being neighborly? I have helped many neighbors over the last 25 years do things like dressing changes and setting up medication boxes and looking st their kids burns and scratches. That is what being a neighbor if about. Helping them when needed with the skills that you have. I have has a neighbor who installs air conditioning units come over when he heard from another neighbor that mine went out and I was going to wait three days for a repairman. He fixed it for free. I offered to psy but he said what kind of neighbor would he be if he did not help out another neighbor. A lawyer that lives across the street helped with some issues we had to get a later written for. He did it for free. Help your neighbor.

That's very nice of you and your neighbors--but here is the problem. It may seem mean or unneighborly if you do not help them with a dressing change, and you may be worried this would cause bad feelings. Imagine, however, if something were to go wrong, even if it is out of your control. Say they develop a wound infection. Even it you did not cause it, the wife/pt may not realize that, and may blame you. This would cause a lot worse feelings that if you politely bowed out and did not perform the dressing changes.

[Five&Two Will Do]

Wow this is a tough subject. I think that I personally feel I am competent in my practice and confident in my assessment skills. Like a couple of others have said, I would be inclined to help my neighbor and certainly do some teaching. I would change their dressings provided they had the proper materials. Is it a sterile dressing change? If it looks bad you can always encourage them to call their PCP and make an appointment. I would do this because I know how and trust that I will do it properly. In North Carolina I am not going to be held liable if I act according to standards of practice and not outside my scope. Dressing changes including sterile dressings of wounds older than 48 hours are part of the CNA II scope of practice in this state. You should get used to being asked medical questions cause when people find out you are an RN they are gonna ask. I have a friend who is in his 60's and lives a poor lifestyle. He came over one night and complained of feeling really bad. I asked him several questions about his symptoms and came to believe that he had PVD pretty badly. I convinced his stubborn butt to go to the ER the next morning as his s/s had not subsided. He ended up with a fempop bypass later that day. Good thing I did not say I could not give hime any advice.

[Five&Two Will Do]

I actually meant to say PAD:clpty:OOPS

[Ruby Vee, BSN]

i'm not clear what you mean by these statements. if one is a licensed healthcare provider (of any variety), there's no such thing as "making it clear" to someone else that you're only acting as a neighbor, not in your capacity as a licensed healthcare provider. you can't "turn off" your nursing license -- if you're licensed as an rn, you're licensed 24/7/365, and you're legally responsible and accountable as an rn for anything healthcare-related you do, whether it's at work during working hours, or in a neighbor's home as a favor -- that's the point of being licensed.

i gotta ask, what ever happened to being neighborly? i have helped many neighbors over the last 25 years do things like dressing changes and setting up medication boxes and looking st their kids burns and scratches. that is what being a neighbor if about. helping them when needed with the skills that you have. i have has a neighbor who installs air conditioning units come over when he heard from another neighbor that mine went out and i was going to wait three days for a repairman. he fixed it for free. i offered to psy but he said what kind of neighbor would he be if he did not help out another neighbor. a lawyer that lives across the street helped with some issues we had to get a later written for. he did it for free. help your neighbor.

what happened to being neighborly? in the small farming community where i grew up, the neighbor with the snowplow on the front of his tractor plows out your driveway for you in the winter, and you might let his cattle graze on your unused pasture. when dad died, they were all at the house with casseroles, and whenever i visit mom, they invite me to dinner. in the big city where i live now, not so much. i don't even know most of my neighbors to say hello to, and i certainly don't expect them to show up to help out when i need it. that's what friends are for.

even in the country, though, while the neighbors drive my mother to the hairdresser once a month, they drive her to the hairdresser's place of business in town and pay her for the service. the hairdresser, also a neighbor, drives my mother to church regularly -- that's the neighborly thing to do -- but she has to make a living and cutting hair is how she does it. so if i were back on the farm, i might drive my neighbor to the doctor's appointments or to church or bringing over casseroles, but i wouldn't be giving him his injections or changing his dressings. that's how i make my living.

[elkpark]

I gotta ask, what ever happened to being neighborly? I have helped many neighbors over the last 25 years do things like dressing changes and setting up medication boxes and looking st their kids burns and scratches. That is what being a neighbor if about. Helping them when needed with the skills that you have. I have has a neighbor who installs air conditioning units come over when he heard from another neighbor that mine went out and I was going to wait three days for a repairman. He fixed it for free. I offered to psy but he said what kind of neighbor would he be if he did not help out another neighbor. A lawyer that lives across the street helped with some issues we had to get a later written for. He did it for free. Help your neighbor.

I just want to clarify -- I wasn't suggesting at all that one shouldn't help out a neighbor, or that I, personally, wouldn't help out a neighbor or friend with healthcare related needs (I have, plenty, over the years :)). I was just responding to the comments that suggested that some people posting here see some meaningful difference between working as an RN and helping out someone with healthcare related needs as a favor. The earlier comments about "making it clear" to the neighbor that you're just doing this as a friend or a neighbor, not as a nurse, caught my eye, and I just wanted to clarify that one is just as responsible and accountable, legally, when one performs nursing functions outside of one's actual job as when one is at work. If you are a licensed nurse and you volunteer to help a friend or neighbor with healthcare-related needs, it's important to understand that you're taking on the same duty of care and legal responsibilities that you do when you go to work -- the fact that you're not getting paid doesn't change that, and neither does anything you might say to the friend or neighbor about "only" doing it as a favor -- and it seemed like some of the other posters didn't necessarily undertand that (or maybe I misunderstood what they were posting).

I didn't mean that we should never help out a neighbor or friend -- just that we should understand clearly the responsibility that we're taking on if we do help out.

[Music in My Heart]

I see a lot of responses like, "no, I wouldn't do it" because you wouldn't "ask your friend who was a plumber to fix your drain."

These, to me, are part of what's going so wrong in our country -- the refusal to simply help other people.

I run into my daughter's pediatrician at school and have, on occasion, received her advice... which has sometimes been, "you should come in to see me." My neighbor's daughter is a dermatologist and has freely offered advice. My friend who's a welder has come over and repaired a metal bed frame. A friend who does concrete work came over and provided advice and equipment to lay some concrete. A friend who's a cabinet maker did some gratis work when he had some time to fit it in. And on and on and on. For that matter, some of the docs at work will write 'scrips based on informal contacts in the hall.

There was a time in this country where everyone wasn't out to score a buck off of everybody else and it was a better time, IMO.

Would I do it for just anybody? Nope. Would I do it for a friend? Yep. How 'bout a neighbor who really needed the help? Yep. Is there a risk of being burned? Sure (IMO, very small as described in this situation). But then again, there's a risk of being burned even if you take no risk at all.

JMO.