Ethics of Nurse/Patient Relationships

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I just finished reading the thread about dating a former patient. 11+ pages of strong opinion regarding the ethics of starting a relationship with someone you are caring for. I am not trying to restart whether or not people believe that particular poster was wrong or right in his decision, but instead in discussing the reasoning people use in deciding if it was ethical or not.

So for anyone interested in joining this discussion - do you believe that it is ethical to start a relationship with someone you cared for as a nurse?

Why?

From reading the prior thread many posters brought up vulnerabilty - that the power balance led to inequality between patient and nurse and hence it was morally wrong to exploit that inequality. If you do believe this, do you feel that all relationships that begin with one partner in a vulnerable state should not be pursued? Or any relationship that is unequal can not work?

Are all nurse patient relationship inherently unequal? Why? Does the patient not have the right to accept or refuse any treatment, to determine for themselves how their care will proceed, to even "fire" their nurse and demand another one? If the patient is A&O and at least semi-independent in ADL's where exactly is the inequality?

Many posters seemed to indicate that the ethics changed with time (many mentions of 6 months to 1 year). What exactly has changed in 6 months that didn't in 1 week? (and honestly, how many relationships survive 1 year of no contact?)

So have at it! Can the nurse patient relationship survive? Should it? Or are there perhaps other reasons we should strive to sever that possibility?

Thanks

Pat

PS: For those who think I might have an ulterior motive, I am happily married with my wife reading over my shoulder. She has let me know, in no uncertain terms, that violating that relationship will lead to a significant change from me being a nurse - to being the patient!:eek::no::no:

As a recent patient, I thought about pursuing a friendship with my nurse. Phrase such as " You're so sweet " and "You're so cute" are phrases that I wouldn't raise an eyebrow to if it was my mother or grandmother. However, a pleasant, attractive, nurse is a little different, at least to me. That said, a few phone calls to her were rather quickly met with the "heisman" - you know the football trophy showing the running back holding a football with one arm and the other arm clearly pushed outward to thwart any tacklers. She basically said it wouldn't be professional or appropriate.:sniff: Phone calls were placed after I had been discharged and I was not under any mental therapy/psychological eval.

So this scenario isn't ok, but the following is?

Same two people, except they have never met before except for the first time at the deli of the local grocery store. They exchange phone numbers and later get together, maybe become friends or date or even marry. Sorry, but I don't understand the " professional and inappropriate " part. Seems like decent people would never meet because of this " wall ".

BTW nurses, I have a lot more respect for and appreciate all that you do. Having seen some of the stuff you put up with and reading it here on these threads has been an eye opening experience.

Hats off to all of you!!!:yeah::bow:

It depends on a few things:

1) The patient must be of sound health and mind. A relationship should not be started while the patient is still acutely ill, or if the patient is mentally ill.

2) The nurse/patient relationship must be over.

3) The nurse/patient relationship should not be used to initiate the relationship--i.e. no looking up a phone number in the medical records.

If those are met, I have no issue with it.

Specializes in Hospice.
As a recent patient, I thought about pursuing a friendship with my nurse. Phrase such as " You're so sweet " and "You're so cute" are phrases that I wouldn't raise an eyebrow to if it was my mother or grandmother. However, a pleasant, attractive, nurse is a little different, at least to me. That said, a few phone calls to her were rather quickly met with the "heisman" - you know the football trophy showing the running back holding a football with one arm and the other arm clearly pushed outward to thwart any tacklers. She basically said it wouldn't be professional or appropriate.:sniff: Phone calls were placed after I had been discharged and I was not under any mental therapy/psychological eval.

So this scenario isn't ok, but the following is?

Same two people, except they have never met before except for the first time at the deli of the local grocery store. They exchange phone numbers and later get together, maybe become friends or date or even marry. Sorry, but I don't understand the " professional and inappropriate " part. Seems like decent people would never meet because of this " wall ".

BTW nurses, I have a lot more respect for and appreciate all that you do. Having seen some of the stuff you put up with and reading it here on these threads has been an eye opening experience.

Hats off to all of you!!!:yeah::bow:

No, the scenario you described is not ok. As the patient in the scenario, you're certainly allowed to do what you want, within the bounds of the law ... but the nurse would be skirting some ethical boundaries by going out with you so soon after being your caregiver. She obviously thought so, too.

Yes, it's a shame that some connections won't ever happen unless other events intervene AFTER the professional relationship is over, ie an accidental meeting in a laundromat, or being introduced by mutual friendsl or something like that. But, I've said before, the universe does not owe us relationships ... ya just gotta let some things go.

What would be the defintion of, " AFTER the professional relationship is over," legal or otherwise? To me ,it's when I'm discharged ,off hospital property. I know some other threads say 6 months to a year. In my situation, I had already been discharged. Seems crazy to me. Thanks in advance.

Specializes in Medical.

While there may be some potential relationships that never get off the ground because of this principle, the alternative is a greater risk to vulnerable patients.

We all know that there are unscrupulous (as well as short-sighted and/or stupid) nurses out there, just as in the general population. If relationships between health care providers and patients were given an all-clear then those who are least able to protect themselves could more easily be harmed.

AnytownUSA describes a situation where he (I assume) did not feel a power imbalance, and where he as the patient initiated further contact. His is not the position of many patients - being sick, particularly if it's with a serious, prolonged or distressing condition, can impair peoples' decision making ability and sense of self.

We know patients and family members can be wary of making complaints out of fear that the patient's care will be altered as a result. I don't think it's that much of a stretch to imagine patients fearing reprisals in the event of relationship rejection or refusal.

The cautions about patient/practitioner relationships are primarily there to protect patients, in the same way that student/teacher relationships (even when the student is of age) are frowned upon. It's not an equal relationship, there is too much potential for coercion, and even if the relationship is fully embraced by both parties there's too much scope for the impression of impropriety. This also protects the person deemed to have more power (int his case the practitioner) - in the event that a relationship is initiated and then ends badly, it would be diffifult for the nurse to prove s/he didn't take adbvantage of a vulnerable person to whom s/he had a duty of care.

When a student graduates, relationships between a teacher and former student are perfectly acceptable.

Specializes in Med Surg, Ortho.

I'm just curious on a person's thoughts such as this. It's just a thought, please no hostility. I read so many hostile comments on this board, so really, I'm not trying to offend.

Bartenders for instance. I'm in no way comparing bartenders to nurses. I'm a nurse now and was a bartender for close to 10 yrs. But.....is it okay for a bartender to date his/her clients? I met/marrried my husband who was a client first.

Bartenders are not in a therapeutic relationship with their customers, they are not 'caring' for vulnerable within the health care system, with its myriad of ethics-- BIG difference.

I was a waitress for a long time, and to me the food and beverage industry is more entertainment.

Specializes in Med Surg, Ortho.
Bartenders are not in a therapeutic relationship with their customers, they are not 'caring' for vulnerable within the health care system, with its myriad of ethics-- BIG difference.

I was a waitress for a long time, and to me the food and beverage industry is more entertainment.

I don't know. I know it's not a bartenders job to be therapuetic, but I remember having to listen to a lot of therapuetic like crap....all the time. :rolleyes:

Well, you wanted your tip, right?:wink2:

Specializes in Med Surg, Ortho.
Well, you wanted your tip, right?:wink2:

:yeahthat:

Specializes in psych. rehab nursing, float pool.

Professional boundaries are in place for a reason. First for the protection of the patient, second for the protection of yourself.

With that said. There are enough men/woman in the world that one does not need to be seen as so desperate to troll our patients for potential dates/partners.

You happen to meet in the future. Up to you.

Do things happen in the real world? Of course. Doctors who have been attracted to their nurses, or doctors who were attracted to their patients. Lawyers who date their newly divorced clients. It happens. Ever heard the horror stories of these things when they end? Or have you ever heard the jokes. Ever perused the Media section of videos where woman/girls dressed up as nurses are the star of the video.

If you want to open yourself up, hey up to you I guess.

PS. when I worked psych, and newly divorced we use to joke between ourselves at least our jobs gave us the knowledge of who not to date on the street. Joke or was it having the inside knowledge of patient through prior professional contact. You be the judge.

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