Legal Nursing Question

Nurses General Nursing

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Specializes in Cardiac Telemetry, ED.

I am a nursing student, first semester, and during clinicals today I grew a huge heart for my patient!

She was a close-to 60 year old patient who has had a lot of previous medical conditions/procedures such as; CAD, CABG (2), MI (3), Stents (6). She was recently diagnosed with breast cancer, last September I believe.

She has no psychosocial support whatsoever! Her husband died 9 years ago, both parents are deceased, dog has passed away, brother is in Australia and maybe calls once a month, and a sister who lives fairly close to her, but yet since her diagnosis of cancer she has never came around to see her.

You can very much tell she is depressed, and for obvious reasons; no one to support her through this hard time, mastectomy, no hair, etc. And she seemed to use sarcasm as a coping mechanism for her depression..

After trying my hardest to get a social worker in to see her before her discharge, and before I left clinicals, I went in and just sat and talked to her that it would be very healthy for her to join some support group in the community, even going to church and joining a life/small group.

I have been around a few family friends that have been diagnosed with cancer, and a team of people would join together and create a support group for whomever and would do charitable stuff for them.

The question I had about legal issues is, am I able to find her phone number and/or address in the phone book and ask when or if I could bring her dinners some nights? Or just going over to clean the house, mow the lawn, etc..? And if this is possible, would I be able to just grab it off of our computer-based system?

My heart grew a lot for her and I feel so bad

Thank you so much!

(And please do not mention to me that I cannot let my heart get in the way of caring for patients, because if that day ever comes I will be retired or deceased! And also don't act like my parents and tell me that I cannot do this for every patient I grow a heart for. I put my heart and soul into my job now (PCT) and will continue to do the same as a nurse.) Thank you!

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No, Your nurse-patient relationship terminated when she was discharged. Let it go

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Specializes in psych, addictions, hospice, education.

You're coming from a good place in your heart to ask this. It's something many of us have wanted to do, to do whatever we could to help a patient.

However, you absolutely can NOT call her to arrange a time and way you can help her, and you can NOT grab her personal information off the computer system. Contact between staff and patients is seen by most employers as breaking a boundary that is set for a reason, even if you are not someone breaking it for you own selfish reasons (and I definitely see you wouldn't be doing that). Snagging the phone number off the hospital computer is a violation of confidentiality laws. Even if you just happened to remember it from having seen it and having a photographic memory...

In your career you're going to run into patient after patient you want to help in this way and in all sorts of other ways. It's heartbreaking that we can't do everything we'd like to do to help them, but it just isn't possible.

Warm hugs to you for your caring heart!

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You did what you could do within the context of your professional relationship with this woman. Going any further would be a serious violation of professional/ethical boundaries and could also get you into serious trouble at school.

Part of nursing school is learning about and internalizing the limits and boundaries of the nursing role. We have all had clients that we felt strongly about, who tugged at our hearts, but what you are suggesting is a really bad idea.

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Specializes in Cardiac Telemetry, ED.

sonoritygenius, whispera, elkpark

thank y'all! i appreciate it. i had a hunch that it was crossing boundries, but i didn't feel like looking through all 20 text books to find the answer!

thanks!

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I had a hunch that it was crossing boundries, but I didn't feel like looking through all 20 text books to find the answer!

For futurer situations, a general "rule of thumb" for boundary issues is that, if you have any questions/concerns about whether it's okay to do something, it's probably not okay. :)

Another useful RofT is to ask yourself whether you would do (whatever the thing is) in front of your boss (or, in the case of a student, your instructor(s)) -- if you wouldn't do it in front of your boss or instructors, you probably shouldn't do it at all ...

Best wishes! :balloons:

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Specializes in Cardiac Telemetry, ED.

Once again, thank you elkpark!

I believe that is some great advice that I will keep in mind as my career goes forth.

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Specializes in Med/Surg - Internal Medicine.

Your :redbeathe is in the right place, and please don't ever get down on yourself for putting your heart and soul into your work. But remember that you need to set boundaries...you could always do some research regarding local support groups for your patients depending on their diagnoses and provide those to your patients (or refer to the social worker to see if they have any ideas). I know there are a lot of different cancer support groups out there and some are free of charge and offer a variety of programs to uplift the spirit and promote a healthy psychosocial well-being.

Best wishes!!:nurse:

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Specializes in Cardiac Telemetry, ED.

sammijornbsn,

thanks for listing such great ideas! i will have to check into them.

thank you!

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Ever heard of HIPPA, you cannot access their information for personal use(calling them, visiting them). You seem like a good nurse but the law is the law, and breaking it has dire consequences.

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that's a tough situation - and it's been the hardest part of my job (and many other's i'm sure) to distance myself. just the other night a little old lady with dementia who had given the staff trouble all day long took a liking to me and was so cooperative. she kept asking if i would come back and check on her when i had time (which of course i would do anyway) but i did make an effort to go and sit with her and spend more time with her than i normally would with a patient. she started saying things like, "if it weren't for you, i don't know what i'd do. do you promise you'll look after me? let's make a promise to each other that we'll be there for each other" etc, etc, etc. i helped her make some phone calls to her family (something she'd wanted all day and nobody did) and they wanted to speak to me on the phone. they were being nice and making promises to her that they'd come and see her the next day, but i knew they weren't really going to - they seemed pretty "out of it."

i felt bad when i had to leave. i thought i should go in and tell her goodbye, but i knew it would just kill me because she'd start begging me to stay. the reality is (even though you said you don't want to hear it) i have my own family to take care of, and while i'd like to be a hero to everyone who "needs ME" i just can't do it.

i won't ever stop worrying about people and wishing there was something i could do, but i can only do what i CAN do. i can't save everyone, and i can't risk losing my job trying to save SOMEone which would only backfire because it would keep me from helping ANYone even just a little bit - and that would really be a shame for the world to lose a healthcare provider who really does care based on the fact that they cared too much.

it will get better - you'll learn to cope with these situations without becoming too attached. good luck.

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Pre-nursing student here. Regardless of whether or not it is recomended or even appropriate, if you were to ask the patient if you could have their contact info and thoroughly explain to them that it is not for anything professional, but strictly for personal reasons, to be used for personal contact outside of the facility and outside the realm of a nurse, could they give it to you and you be able to use it for her original intentions? Again, throw out for a moment if its recomended or not or in good taste or not, but if the information were acquired with the patient knowing WHY and consentingly gives it to you, would that be LEGAL (not recommended, but LEGAL)?

Obviously pulling it from their medical records would be a def violation of HIPPA, but since its their information, I would think that they would have the right to share it with whomever they want assuming they are fully informed as to why one would want it.......though I could be wrong!:)

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