huge moral problem - need help!

[shaken-stirred]

Hi all!

First thing - I'm sorry, but english isn't my native language.

I have big moral problem. I work as a male nurse for short time. Not in psychiatric. As a student I had short practic learning in psychiatric hospital. When one of the patiets were going out, asked me for my phone number, because we were good friendds at talk. Because I was shocked, and my habit was that my phone number isn't private thing, I don't know why - I gave it to her. I was just a student and couldn't think about cnsequences in this moment.

We even had one or two meets, and one or two when she was back on the ward. It was nice, calm meets. And our contact has stopped. I was even thinking, that this could be a mistake, to give my phone number and wondering if it will end like this. Good idea, thought.

But she remembered. She asked me to come, okay, I went thinking about next calm and easy meet. I came as a friend. It was nice, but she said to me, that she's attracted with me. Didn't know what to do, tried few asks, to be sure, that she's serious and it is not some symptom. And she was sure. She wasn't "mental hot for anyone in pants", nothing from these. And I don't know what to do. I like her, think that she's attractive, but not this is worrying me.

Is it good in moral sense for a nurse? I'm not from psychiatry, she never will be my patient. She said, that she would feel safe knowing, that by her side is a person, who is in it "from medical side". but I'll ask again: is it moral for a nurse? As a person I don't have any doubts, but I do have huge dilemma as a nurse.

Our relationship went from therapeutic (if we can name it like this for me as a student then) to private, but just friendly. I know, my bad, but what is done, that is done. I didn't know what was I doing and never spoke about that sort of things with any proffessional. But heard few stories about things like this from my nurse friends before I went on studies. Some of them ended good, some not. I don't know what to do.

I need help. Please, help. Thanks.

[jadelpn, LPN, EMT-B]

It is highly unethical to start a relationship with a former patient that you took care of, even as a student, no matter how brief.

Going forward, do not, under any circumstances, give your phone number out to patients.

As a nurse, you need to set the boundaries, as you are in the position to do so. I would simply tell the woman that you were wrong to use her time as patient to give your number and by doing so, suggested a relationship other than a professional one. Which was wrong. And hope that it doesn't come back to haunt you down the line. (That is all you need is when the woman has a hospital stay to say "my boyfriend, the RN who works in this hospital gave me his number the last time I was here, and look at us now, HE makes me so happy!!")

Patients who are unwell can and do use manipulation as part of many disease processes. I would ask myself how you can move forward in a more professional manner.

[Anonymous1257]

You're role in meeting her was professional and clinical, you were in a position of power over an institutionalized psychiatric patient. Parlaying that position into a sexual relationship is highly improper, ethically and legally, and I strongly advise against continuing this relationship.

If you have any future interactions with psychiatric patients as a nurse, keep it professional. You are there to help them overcome their illness and care for them, not be their friend. Friendship can develop over time, but can also interfere with the therapeutic relationship and should ALWAYS be secondary to your role as a professional.

[shaken-stirred]

I am open to all the persons who I meet (and got few kicks in ass from life for that, but never like that), patients and staff. Maby here is problem with me, i don't know.

To tell you all, what I think, I wasn't favourizing her on the practises. I has spend more time with another patient, who I had to report to my teacher at the end of it. But, as I texetd higher, I'm open to all and talked to her too, as to many other patients. It started few days after the end of practises. She called, I didn't have her number.

I don't work on psychiatric, and do not intend to. The only time, when she saw me in smock was that few days. On my ward I'm often talking to patients, as my collegues, and we often go to private topics. It's common, like I can see it. I personally know nurses, that still have contact with former patients. But like I said earlier, it didn't went to this type of relationship.

I like to speak with her, but this thing shocked me. I do want to hold this friendship on, but I don't know, if I can. I don't know if I can do any step further either.

Please, don't yell on me. I'm not trying to justify me, but to understand whole situation and make best choice, choose best steps. I'm not trying to find any absolution. I want someone to help me.

[Anonymous1257]

If you're asking what to do, explain to this patient that you aren't interested in a romantic relationship. If you haven't engaged in any sexual activity with her than you shouldn't have any issues, as long as she doesn't make any accusations.

As to your colleagues who have friendships with patients, are these psychiatric patients? I still have to say that I view this as generally inappropriate for all the reasons I listed in my previous post.

[MrChicagoRN, RN]

Professional boundaries are that you keep professional relationships professional, and separate from the personal.

if you have access to an EAP program at work, I suggest calling them. It's free, confidential, and you can discuss things more easily in a 1:1 setting.

[Gooselady, BSN, RN]

I think those of us who've been in nursing for a while forget that the OP's dilemma is not that uncommon, and some people really are just 'that' open to invitations of friendship and connection.

When you are a nurse or any kind of healthcare professional, it is always inappropriate to develop intimate relationships with a patient. This is ESPECIALLY true with psychiatric patients, who most often need ongoing hospitalization. If they are hospitalized once, it's likely they are sick enough to need ongoing hospitalizations, at least for a while. In general, a person sick enough to be hospitalized for psych reasons is going to REMAIN that sick for a time, and it's no stretch of the imagination to say they are quite vulnerable -- especially to a healthcare professional.

When it is their MIND that is 'sick', rather than their body, the issue of 'power' is even more disparate.

I did psych nursing for the first 17 years of my career, and those first couple of years were a real education in developing interpersonal boundaries with psych patients. We aren't BORN knowing we must have different boundaries with psych patients, you have to learn it, and that's what you are doing now OP; learning.

I think your attitude of regret is very appropriate, and you see how this went 'wrong', and you understand WHY it went wrong. The thing to do is block or delete her number so she cannot contact you, after you gently tell her that your position implies a friendship is not good for HER. I know you don't want to hurt her feelings, which are vulnerable too. She needs to learn a lesson too, that friendships are inappropriate with staff. This is stuff EVERY psych patient and EVERY psych worker need to understand, it's not personal, it's just the way things are :)

[shaken-stirred]

if you have access to an EAP program at work, I suggest calling them. It's free, confidential, and you can discuss things more easily in a 1:1 setting.

I don't trust our EAP to be proffesionalists. As I work in my workplace, I have reasoned, that many of my coworkers are people, who you can't trust, not only nurses and doctors.

I think your attitude of regret is very appropriate, and you see how this went 'wrong', and you understand WHY it went wrong.

Yeah, I think I am. It's why I have a problem.

The thing to do is block or delete her number so she cannot contact you, after you gently tell her that your position implies a friendship is not good for HER.

Can I leave it with "Yeah, we can talk. We can leave it friend, but with no romance"? It was an option, when she said it.

[JustBeachyNurse, LPN]

You know this is ethically and morally wrong. Your conscious tells you to end it now but you are trying to justify your emotional response. This can end badly. You made a mistake giving a patient your phone number (regardless if she was a psych patient or not). So what if she attempts suicide and ends up on your med-surg ward? Then what?

This can end badly reflecting not only on you but your school and also result in being brought before the BoN on ethics violations. Patient trust and safety is paramount and as such professional boundaries are necessary

You have been given sound advice. It's your choice to follow through with the professional, ethical choice and admit you should not have given a psych patient your personal number (you could have been expelled from school if caught!) & end this now OR follow your emotional choice and let the dust falls where it may,taking multiple risks.

[shaken-stirred]

I think that I know what should I do now. Thank you for helping me. It's time to end this play.

And lesson for the future, as you wrote: never give your phone number to anyone who's "under you". Keep things proffessional. Like you advised me. Thank you one more time.

[BuckyBadgerRN, ASN, RN]

Yeah. Stop that line of thinking. You're playing with fire and you WILL get burned if you don't figure out where to draw the line. Giving out your number? Ranks right up there in the top 3 of worst ideas ever. What do you suppose would happen if your clinical instructor or school found out about that? Pretty sure that I know.

Sorry, but "English isn't my first language" is not an excuse I buy here.

]I am open to all the persons who I meet (and got few kicks in ass from life for that but never like that), patients and staff[/b']. Maby here is problem with me, i don't know.

To tell you all, what I think, I wasn't favourizing her on the practises. I has spend more time with another patient, who I had to report to my teacher at the end of it. But, as I texetd higher, I'm open to all and talked to her too, as to many other patients. It started few days after the end of practises. She called, I didn't have her number.

I don't work on psychiatric, and do not intend to. The only time, when she saw me in smock was that few days. On my ward I'm often talking to patients, as my collegues, and we often go to private topics. It's common, like I can see it. I personally know nurses, that still have contact with former patients. But like I said earlier, it didn't went to this type of relationship.

I like to speak with her, but this thing shocked me. I do want to hold this friendship on, but I don't know, if I can. I don't know if I can do any step further either.

Please, don't yell on me. I'm not trying to justify me, but to understand whole situation and make best choice, choose best steps. I'm not trying to find any absolution. I want someone to help me.

[jadelpn, LPN, EMT-B]

You can be a professional, and still be nice, friendly, outgoing, caring and not continue any of it after you leave a facility. Your work life is your work life, your personal life is your personal life. Do not mix the 2.