How much personal info do you share with pts?

[Bouncyball]

I am a second year RN student. I have had some really nosy, pushy patients the last couple of weeks and it has made me wonder where to draw the therapeutic communication / your asking me too many personal questions line. I know as nurses we are supposed to have a therapeutic relationship with our patients, but at the same time are not supposed to get too close, or share too much with the pt. It seems like in order to have a therapeutic relationship with your pt that you need to be somewhat open with them. Where do you draw the line?

My instructors say that we should easily be able to sit down with the patient and interview them for our care plan. This includes their relationship status, if they are happy in the relationship, if they have kids, job status/ financial status, personal stressors and so on... These questions seem pretty personal to me, but I understand why I am supposed to ask them.

Well, lately my patients have been starting to ask me personal questions.I am talkative and outgoing, but usually prefer to keep to stick to topics like movies, weather, pets, and just small talk. I have never been comfortable discussing things like my relationship, kids, or what neighborhood I live in with people I don't know. Am i just too sensitive? are these normal things people talk about with strangers?

I am sort of torn because I feel like if I flat out refuse to tell them anything that they may not want to keep talking to me, and that is not fostering a good nurse patient relationship. But on the other hand I feel like the pt probably does not see anything wrong with asking me stuff since I was just interviewing them. So, how much do you share with your patients?

On another side note, what is a nice way to tell a patient that you don't want to answer their question if giving a vague answer and changing the subject does not work. For example, a patient asked me where I live the other day. I said "oh, not too far from here. Where do you live."

Pt- "I live on x st and w st. Where exactly do you live again?"

Me- "sort of by the west side, can I get you anything before I go to lunch"

pt- "no I don't need anything. Where exactly do you live, like what streets?"

I just excused myself at that point without answering. What would have been a good way to handle this?

[tewdles, RN]

Good point, our personal lives are NOT the focus...the therapeutic relationship and the patient are the focus.

[itsnowornever, BSN, RN]

I have a whole different persona who has no husband and no kids and three dogs when a patient asks. It's none of their business. However, I have broken my rules on rare occasion. The little lonely sick lady who just wanted a connection, the scared woman who was worried about a c-section scar (I showed her mine, she was freaking out!), and my little old man that was trying to talk me into going home with him! LOL you will figure it out and learn, white lies about this stuff doesn't hurt. Just stick to a story.

[kookiepumpkin]

I just went through an encounter with a pt with a drug seeking, manipulative personality disorder. I am originally from Europe, my accent is subtle but noticeable. It frequently becomes a subject of conversation with patients. I don't mind telling where I'm from. Pts usually have sth to say about the country, language, culture etc. In this case though, the pt demanded to know where I'm from, insinuating that my education is inferior and I should go back to #*% (somewhere in eastern Europe, not my country). All that because I refused to give her more narcotics and sedatives at that time as she was frequently falling asleep during the conversation, slurring her speech, low O2 sat etc. My answer to her was that it doesn't matter where people are from, that we all adhere to the same standard of care and don't judge people by their race and country of origin, therefore I would not tell her. Then I offered to have the charge nurse come and explain it to her. Needless to say, the pt - nurse relationship ended there.

[Skwerl]

I came upon this thread after doing a Google search for advice on this sort of thing. I'm not a nurse....I'm an ultrasound tech working in a veteran's hospital. A lot of our patients aren't right in the head, and I can be alone in a dark, quiet room with a patient for up to an hour at a time. Some of them ask way too many questions. Many are just making conversation, but that doesn't mean I want to give them my information. Also, some of them are creepy or dirty old men. It was good to read the replies here. I was beginning to think I was being hypersensitive about discussing my personal life.

On a side note, my job takes a certain amount of concentration. Sometimes my patients want to tell me their life stories and it's disruptive to the exam. I am learning to be able to tell people that I need them to be quiet, but I can tell that some get in a snit over it. It's really hard after spending years in the service industry, where "the customer is always right" is the attitude, to learn to develop these types of boundaries.

[turnforthenurse, MSN, NP]

You decide where to draw the line. I don't work on a psych floor. Most of the time I have no problem telling a patient I am married and don't have kids if they ask. We have a lot of patients who are veterans or military spouses and they ask what my husband does (he is military) or if he is deployed...again, most of the time I have problem talking about that information. I don't tell them more personal information (like where I live, etc).

[Steveinn02]

Answering personal questions from pts is best avoided. If asked if I am married or what do you do in your spare time, I make it very clear that those questions are inappropriate. As a male nurse I once answered that I was not married when a female pt asked me. Suddenly i was bombarded with "why not?" "whats wrong?" "are you gay?". It was an awkward situation in a room with 3 other pts when she became offended when I told her it was not her business and her questions were inappropriate. That was years ago. Most pts understand its not a reciprocal relationship but if they don't as a nurse you may have to spell it out for them. And most pts will not persist with such questions if you don't answer and change the subject to the task at hand.