Doing a favor vs. being an RN

[anon456, BSN, RN]

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!

[JulieCVICURN, BSN, RN]

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. I would advise you to do only what makes you comfortable, because there is always a chance that something could happen that you wouldn't like. For example, what if she gets an infection and they decide to sue you because they blame you for it or because you didn't tell them that it looked funky? As a licensed RN, you could be held professionally responsible for that.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Longish answer for a frequent questtion, but I'll include the rationales

If your neighbor has written discharge instructions for the dressing change, at least you know what the doctor expected. 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.

When someone asks your opinion on an ailment, it's tougher. You don't have a complete medical history, medication list, allergies, vital signs, or clean area and instruments to do a physical exam.

Nurses are people who want to help other people and it's a hard urge to resist when someone asks, or worse yet calls on the phone and asks, for us to give them correct medical information from a sketchy evaluation, second hand evaluation, or without even seeing the patient. I always keep in mind with phone calls that if the caller were capable of doing and relaying an adequate H & P, then they probably wouldn't be on the phone in the first place.

MY ANSWER? I cautiously give minimal general answers and ALWAYS encourage people to see a doctor, remembering that it's impossible to tell through the phone if it's an emergency.

Hope this helps. Wishing you a long happy career as a nurse.

[MurrR]

I would probably say that as much as I care about them and am fond of them, that my time off from work is limited and I prefer not to do the things at home that I do at work.

[M. H. P. rnbsn]

years ago you would have been doing a favor and your neighbors would have been very greatful. today you must protect your r.n. license first. as a professional nurse you can still help by providing the couple with a list of home health agencies. the hospital discharge planner may have thought the wife demonstrated knowledge to provide the skill service of surgical wound care. home health has 24hr. on call staff that can obtain a doctor order to see the patient that day; or following morning.

look up your state b.o.n. rules & regulation; ask your current employer for an inservice on this topic. example: if you tx. the patient as friend and he aquires a wound infection that requires further acute care; you will be held accountable as an R.N. I promise you, the children that never visit the elderly couple will be the first to file law sued.:heartbeat

[anon456, BSN, RN]

Thank you! That was my first instinct. I will stick to providing meals and doing laundry for them. If they were to ask my opinion about if something looks infected (which someone once did also- don't you love it-- people start asking you stuff they should be asking the doctor) I just say to be safe and ask the doctor! :-)

On the other hand I did strongly encourage a friend, who had a HA for 4 days and was getting a strange rash, to see the doctor right away. She wanted to wait and see. Turns out she was getting shingles. She now thinks I'm a genius because I told them the rash needed to be looked at and a HA that long is not normal! ha ha!

[noahsmama]

I wouldn't ask a neighbor who happens to be a lawyer for free legal advice, or a hairdresser to cut my hair for free. Asking a neighbor who is an RN to do wound dressing changes for free is stepping over that same line. I would politely decline for that reason alone -- but I would also be concerned about liability if I did a dressing change and the wound happened to become infected, even if it wasn't as a result of anything I did.

[pielrn]

I would also decline to do so. You never know when someone is ready to sue and we have to work too hard to get our license in the first place. I agree with the previous poster about not asking favors of other professionals. It simply puts you in an a bad position. Emergency care is one thing, but a bandage change is something the wife should handle.

[carolmaccas66, BSN, RN]

I don't see the harm in helping out, but I have had nurse friends do things for neighbours and unfortunately, the neighbours never stopped coming over for advice, etc. It's nice to be needed but it can create problems. Also they need the get district nursing service to come in isntead, as wounds etc may need to be dressed a certain way. but general should be OK as long as you set boundaries with them, ie: I am only free for an hour, I can only do this and then you need to get the district nurse to do this.

[Picklefreak]

I would do it for a neighbor who was a good friend, but not just for anyone. Like someone else said, would you expect your neighbor who was a plumber to come over and fix your drains for free? I guess in theory they could sue you if something went wrong, but it seems like a pretty slim chance. Again, I would only do it for someone I knew really well.

As far as giving advice, I would definitely avoid that. I feel OK offering factual information, but I'm not giving someone my opinion of what that rash looks like.

[SweetLikeSugar]

I have a neighbor that asked me to do a dressing change for her after her spinal fusion a few years ago and honestly, it never occured to me to tell her no. But, it was just a 1 time thing.....she called and told me that her husband was out of town, she had a fever of about 102 and just generally felt like crap. I took over some gloves and 4x4's from a camping first-aid kit and removed her dressing. When I saw that there was a ton of purulent drainage from the wound, I just covered it with the dry dressing and told her son to take her to the ER. Turns out she had a staph infection and required about 3 months of IV antibiotics from a home care RN. She was so grateful, I can't even imagine telling her that wasn't in my scope of practice. Maybe I'm too naive or too trusting, but I really just saw this as doing a favor for a friend. And I would do it again.

Now when I lived in my apartment, one of my neighbors found out I was a nurse and kept knocking on my door or stopping me in the parking lot asking me questions or for medical advice.. I repeatedly told her to consult her own MD.

[APRN., DNP, RN, APRN, NP]

Unless they are close family/friends, I follow the example of what the MD's do "Why don't you stop by my office tomorrow and I'll see you then".