HELP! Social question-over the line?

Penelope_Pitstop, BSN, RN · Jan 11, 2011

LOL, She's not even working as a nurse while her new friend is living with her. Ok, then, Let's say you have a diabetic roommate, they have a diabetic crises, you intervene b/c as a trained RN you recognize a problem and interveine(sp). You "may" have saved their life b/c of what would've happened if you were not there. NOW she is your patient, guess she's moving out next week. Too bad... (;D, a little tongue and cheek) so to speek....Good thoughts from all though, every situation is different. Just do the RIGHT thing. And it is prudent to think about your license...don't forget the humans!
The original poster simply wrote she "was a primary RN for a patient for about a year and then they got discharged and went back home out of state. I became friends with the mom and the little patient." and some people are saying you "shouldn't cross that line" by letting them crash at your place the night before they go in for a procedure....You can be a friend and a nurse, just don't be performing any medical procedures or giving medical advice to the little tyke, k? jmho It's just a place to sleep btw friends.
Oh yeah, Other's are right, it would be better if you are NOT her primary care provider as a nurse at work anymore, but I have real friends who come into the ER all the time, and I take care of them, and it is not discussed between us except on their terms, in private. Big deal. They are glad to see a friendly face :)

Some healthcare institutions have rules as to whether or not one can care for a family member or friend when he or she is a patient. This is because a personal relationship has already been established which could possibly smudge the line between personal and professional.

In the OP's case, there has already been a professional relationship established. For there to be no conflict of interest, that professional relationship should be over and done with before a personal one is begun. (I am not heartless or dumb, I, become attached to many of my patients and I could see myself becoming more attached if I were in pediatrics.)

Okay, so the OP is not working as a nurse right now. Well, maternity leave isn't that long compared to this patient's last admission. So, the OP may go back to work and because she was the previous primary, be asked to primary again. Suddenly the "just friends" idea is out of the window. It's a slippery slope...so it's best not to even try.

I don't mean to belittle you, paranrs. But taking care of someone in the ED is different than caring for him or her almost every day for a year. I'm glad you are able to help your friends out when they come in to your department. But if you worked, say, oncology, and took care of them for long stretches, it could get to be an issue. Or, if you had taken care of them for long stretches and then started hanging out (beyond dinner or coffee or whatever) with the thought that you could be a caregiver again...well, this is where the problem lies.

paranrs66 · Jan 11, 2011

It's all good, you're entitled to your perspective, I have worked on Oncology, I have not invited anyone to move in with me but..."Family isn't about whose blood you have, it's about who you care about" to quote an intraspective colleague....Best regards....:)

llg, PhD, RN · Jan 11, 2011

OMG. What if I had a roommate that was a diabetic? What if someone I know has a cardiac arrest in front of me? What if a former patient saw me at the mall, had lunch, and choked on a chicken bone...Oh Please....maybe I missed something, but geez, if your scared to lose your license b/c you might have to "act" as an licensed RN, LOL, how do you make it in the world...If you are friends, and you wish to help, then do so. If you don't, b/c of whatever, then don't. And if you want to do some of that, set your personal boundries and stick to them. I once met a family that had nothing, mother had to go to hospital for stomach problems, 13 yr. old brought his premade baloney sandwiches to the hospital b/c he knew he would not have food if he didn't. Later, I brought them some food and blankets of mine. SCAREY. I coulda been sued! I guess!....guess I'll keep taken my chances with my license...LOL AND your not even working? That negates EVERYTHING. Do what you want.

1. Having someone in your personal life outside of work who has health problems is VERY different from transforming a professional relationship into a personal one. That's like comparing "apples to oranges." And no one is suggesting that if you run into a former patient at a public place (e.g. mall) and they choke on lunch, that you would be blamed. That's a gross exageration of the argument being made here for the maintenance of appropriate professional relationships -- and doesn't help the young nurses here learn how to handle the more delicate situations that arise in practice.

2. When you encounter a needy family/individual in your professional life, there are almost alwys ways you can help them professionally while still remaining professional. The key is to maintain the professional relationship ... work with your colleagues to help the person ... hook them up with resources that can help them long term ... make sure your managers, etc. know what is going on ... etc. Most facilities have Social Service Depts., links to community agencies, etc. that can be brought in to help. No one is suggesting that you ignore people who need help ... only that you help them in ways that are professionally appropriate.

ZippyGBR, BSN, RN · Jan 11, 2011

You crossed the line of appropriateness a long time ago. You became over-involved on a personal basis with this family and are now finding out how messy these things can be. The messiness is why you shouldn't cross the line in the first place.

that is hyperbolic and alarmist at best ...

or perhaps you better come and sack every member of staff on the unit i work on that has an facebook account we'll all got at least one ex-patient as a face book friend and many of us have several ... we are also known to go out socialising with current and ex patients ...

and you'd better sack 2 of my colleagues for being on the committee of an organisation that runs for the benefit of patients past and present of our unit , the other committee members being ex patients ...

and 2 of our senior staff who are married to ex patients ...

and you better sack all of the staff including Doctors who willing accepted a bottle of very nice merlot from one of our old patients who had been readmitted before christmas ...

that said i'd still be wary of having a an ex patient to stay or staying with an ex patient

elkpark · Jan 11, 2011

that is hyperbolic and alarmist at best ...
or perhaps you better come and sack every member of staff on the unit i work on that has an facebook account we'll all got at least one ex-patient as a face book friend and many of us have several ... we are also known to go out socialising with current and ex patients ...
and you'd better sack 2 of my colleagues for being on the committee of an organisation that runs for the benefit of patients past and present of our unit , the other committee members being ex patients ...
and 2 of our senior staff who are married to ex patients ...
and you better sack all of the staff including Doctors who willing accepted a bottle of very nice merlot from one of our old patients who had been readmitted before christmas ...
that said i'd still be wary of having a an ex patient to stay or staying with an ex patient

Perhaps standards and expectations about professional boundaries are different in the UK than in US. I disagree that llg is being at all "hyperbolic and alarmist" and agree completely with her comments. I would never consider, myself, "go(ing) out socializing" with clients, past or present, and I certainly would not be "friends" with any clients, past or present, through the internet. I would suggest that there is a very large difference between accepting a bottle of wine or volunteering on the board of a charitable organization and having someone stay in your house.

Of course, as is obvious from just this thread, there is also a wide range of opinions on this question among US nurses.

bjaeram · Jan 11, 2011

I think I disagree with most of you. This lady has a friend who lives out of state. The friend will be in town and needs a place to stay. She is staying as a FRIEND not as a paient. Who cares how they met MONTHS ago. I work with nurse who met her husband because he was a patient. They didn't persue anything while he was a patient but now they are happily married. You can't always control where you meet your friends/spouse. It needs to stay professional at work and it might be a better idea to not directly care for this child at work. Outside of work in the nonprofessional world people are allowed to have friends.

llg, PhD, RN · Jan 11, 2011

I think I disagree with most of you. This lady has a friend who lives out of state. The friend will be in town and needs a place to stay. She is staying as a FRIEND not as a paient. Who cares how they met MONTHS ago. I work with nurse who met her husband because he was a patient. They didn't persue anything while he was a patient but now they are happily married. You can't always control where you meet your friends/spouse. It needs to stay professional at work and it might be a better idea to not directly care for this child at work. Outside of work in the nonprofessional world people are allowed to have friends.

I see your point ... but my point is that this "friendship" never should have developed in the first place. And the dynamics may be unhealthy because of the way it started. The patient/mother may feel dependent on the OP in some way, relying on her for support and advice becasue of her status as a nurse. It may not be a normal friendship between equals because it started as a professional/patient relationship and morphed into something else.

That sort of thing can work out OK on ocassion -- but it is risky -- and young nurses need to learn to avoid those types of situations by maintaining appropriate professional boundaries. Yes, sometimes it works -- but other times, it does not -- and the damage done when it doesn't work out can hurt both the patient and the nurse.

The potential for these relationships to hurt or exploit the patient is why people consider such relationships unethical. The potential for the nurse being hurt is why people consider such relationships foolish.

Guest27531 · Jan 11, 2011

You developed a new friendship and what you do with your friends is personal. I would have said this even if you were currently working, however, your maternity leave should help make this even clearer. Who you have stay in your home is your business. I know nurses who married patients, nurses who adopted patients, and nurses who took pediatric patients on vacations. The situations are endless and circumstances differ. Do not be confused by "conflict of interest" rules when it comes to real life. Sometimes it takes some real thought or help of a lawyer to sort out when a fine line may be crossed. In your situation it is a no-brainer. You are free and clear to socialize with whom you please and it's none of the hospital's business.

RNAV8R · Jan 19, 2011

You are on maternity leave. You have no pt/nurse relationship with the child at this time...as long as that does not change, there is no issue.You are not providing any care to the child.

ShannonFaas · Jan 19, 2011

I am up in the air on this one....what if this person was one of your best friends already...are they saying you would have to sever that relationship? If they are a previous friend, you could meet them anywhere after work, could have them over to spend the weekend. Developing friendships in our field (especially in long term patients) goes hand in hand. I would talk to your supervisor.....let them know that you are friends, have maintained contact, and ask if there is any consequences. I wouldn't hesitate to have a friend stay with me. And even though we have nursing licenses, if we help someone in need (find someone on the ground unresponsive and start CPR) we are protected by the good sumaritan law. Our licenses wouldn't be affected. Just because we are nurses doesn't mean we can't be friends.

btlrcthy · Jan 19, 2011

I have a different take on the subject than most of the responders. O.k. no one will know at what point you two became friends unless you tell them. In other words you could have been friends since childhood, or friends prior to your becoming a nurse... no one will know unless you tell them. We can't help who we become close to or who we find ourselves in need of their friendship. We are nurses with a license but before that we are human. I don't think this is unethical at all. Keep in mind nurses have gone as far as having intimate relationships with coworkers and patients, and yes even marry them, and guess what they still have their license. Now that's my take on it. I wish you well.

BluegrassRN · Jan 19, 2011

And the dynamics may be unhealthy because of the way it started. The patient/mother may feel dependent on the OP in some way, relying on her for support and advice becasue of her status as a nurse. It may not be a normal friendship between equals because it started as a professional/patient relationship and morphed into something else.
That sort of thing can work out OK on ocassion -- but it is risky -- and young nurses need to learn to avoid those types of situations by maintaining appropriate professional boundaries. Yes, sometimes it works -- but other times, it does not -- and the damage done when it doesn't work out can hurt both the patient and the nurse.
The potential for these relationships to hurt or exploit the patient is why people consider such relationships unethical. The potential for the nurse being hurt is why people consider such relationships foolish.

I'm up the creek without a paddle, then, because my three best friends in the world are women I met while providing care for them.

I understand the ideal of professional boundaries you are trying to convey. I just don't think it is as black and white as many of us make it out to be.

So, OP, what did you decide to do? Personally, if you are no longer this child's nurse, and you have maintained a friendship with the family after they moved, I see no problem with this. If you feel the mother wants to stay with you not out of friendship but because she feels more comfortable staying with a nurse, that to me is a problem. If for both of you it is simply that you are friends and you have room for them, I think it's nice, and I hope you have a good time catching up.