friendship with patient after discharge?

[silkysteph]

I am an RN at an ambulatory center for plastic surgery. One of my roles is to provide overnight care for post-op patients in the recovery suite. One of my patients and I got along very well during her overnight stay. After her discharge, she got my email address from our secretary and emailed me asking to keep in touch outside of my professional role. I would like to stay in contact with her, but I am not sure if this appropriate.

I looked up the NMC Code of Conduct and researched the guidelines regarding nurse and patient relationships. My relationship with this patient is platonic, but the guidelines are written for those in sexual relationships. They state that a sexual relationship with a current patient is never okay (that's a no-brainer). And in the case of former patients, sexual relationships are "often found to be unacceptable."

I feel like staying in contact with this previous patient is not inappropriate because she is a former patient, the relationship is non-sexual, and the fact that she had plastic surgery means that she is not ill, or by any means, vulnerable. The most that would come of this is a regular friendship between two women who happened to meet as nurse and patient.

What do you all think?

[jennycRN]

I tend to be overly cautious about these things, because even if your motives are good and you are not in violation of your code of conduct, it is important to avoid even the appearance of impropriety.

That being said--- it was she and not you who has taken the initiative to maintain contact, for platonic friendship and not dating, and she is a former patient. As you point out, you were her nurse during a single overnight stay, not (for example) an oncology nurse during chemotherapy.

As a rule I would never give out personal contact info to a patient. There were only two times in my nursing career when I broke this rule under what I thought were 'safe' circumstances and both times I later became uncomfortable with that decision when these former patients contacted me ostensibly out of friendship, but they actually had some unresolved issues regarding their medical care (which I wouldn't have predicted) that they brought up. No 'badness' came out of it, but neither did a friendship :-)

[Sam J.]

Why did the secretary give a patient a nurse's email address, is the bigger issue. In my opinion, also- the fact you felt compelled to look up your state's code of conduct seems to confirm that you have some doubts about your relationship with the former patient? Also in my opinion- if you had run into that patient after discharge in a cafe, on the street, or other place distanced from your place of work, I don't think you'd have the same misgivings, perhaps.

[poppycat, ADN, BSN]

I would be having a talk with the office manager about the fact that the secretary gave out personal information to a patient.

[Silverdragon102, BSN]

Moved to the UK forum

Personally I would take the secretary to task for giving out your email address unless it is a works email address and that the plan is to keep in touch purely as a nurse monitoring a patient. Otherwise I would stay clear from a casual relationship until a period of time has passed from when you nursed her.

[SickSister]

I dont know what the rules and guidelines are in other countries, but in Germany it is no problem being friends with your former patients. I even know nurses who are married to their ex-pts. Whats the big deal? You are two adult, who met in a porfessional setting, and hit it off and now meet also in other settings.

There are only guidlines for psychiatry. So actually I cant be friends with my patients, which I totally understand and accept, as closeness and distance is a particular problem in mental health care. But I dont see an issue in non-psychiatric care.

[elkpark]

This is not something I would ever be willing to do. The circumstances under which you met permanently influence any relationship going forward.

[SickSister]

This is not something I would ever be willing to do. The circumstances under which you met permanently influence any relationship going forward.

You are right about that. But meeting in hospital doesnt necessarily mean that the influence would be negative. Im personally not friends with any of my former non-psych patients, but that is just pure chance. I know collegues who are friends with former patients and they tell me that the main difference is that they know a lot about their medical history than of other friends.

I think it is just a matter of personal choice. If one would be uncomfortable in such friendship then it is better not to stay in touch at.

[XB9S, BSN, MSN, EdD, RN, APN]

There are lots of alarm bells ringing for me here.

She may have been an elective surgical patient but she is still vulnerable as your patient and you were required to maintain a professional boundary whist she was in your care.

I've dealt with a number of occasions where these boundaries have become blurred and it rarely ends well for the nurse.

Think carefully about how you are going to proceed, and talk to your boss about it too see how they would deal with this situation. Any non professional relationship with a patient that has been formed whilst you were providing direct care would get me asking questions about your practice and conduct in work during that shift and would make me question professional boundaries.

I'm not suggesting you have behaved inappropriately yet, but highlighting if you pursue this relationship, how it may be perceived by colleagues and managers.

[vianne]

I likesicksisters response, its a sad affair when someone reaches out and we cant respond because we're governed by principles, I always hesitated about giving pts any of my details, then had occasion to be free too. I still hid behind the trust email address and this meant that they knew others could read it and so ( I thought) would be more cautious with their responses. What was I thinking ?! They were normal people with normal concerns and care about me as I had cared for them and just wanted to tell me so. I know this isnt the same as a fully fledged friendship,but the point is, you can still place your own boundaries where you want them, people need to contact each other. I would take the secretary to task tho !