Is it ever okay to follow up with a patient you've cared for outside of work?

verene, MSN · Apr 14, 2016

I have never intentionally sought information about a patient or family once they've left my care. A few times I have received an update but it has always been at family/patient discretion - they been the one to initiate reaching out with the information. (e.g. a family member spoke with a chaplain and explicitly asked s/he convey an update to myself and other members of the care team who took care of the patient).

Once a patient leaves my care I'm not a part of their life anymore and they aren't a part of mine. Do I think about patients and families from time to time and wonder how they are doing? - of course I do, but once they leave my care I have no medical or personal reason to know about their health information or general life. I have very strong personal boundaries and one of those is that once people aren't my patients or families anymore I let them go.

allnurses Guide · Apr 14, 2016

I agree with Verene. It's a core tenet of the ANA Code of Ethics, and additionally HIPAA and social media have made employers almost in a state of perpetual paranoia regarding what may have been overlooked in previous decades, although the concepts were drilled into our heads then, they called it "confidentiality".

Now, is there ever, ever a situation in which there may be an exception? Yes, but it would be so rare I don't think it merits calling the ethical principle a maybe or a sometimes.

I'm curious, Momma1RN, what is the compelling argument on the side of a nurse independently following up after your patient is discharged?

TiffyRN, BSN, PhD · Apr 14, 2016

It's not uncommon at all for NICU nurses to stay in contact with a former "primary". I've been doing a course related study on it. March of Dimes gave a presentation on social media at the last National Neonatal nurses conference. That was one of the topics. They even gave suggestions on having an employer sanctioned FB page where families and nurses could "legally" leave pictures and messages.

jadelpn, LPN, EMT-B · Apr 14, 2016

In a common acute care situation, where patients are in and out and sometimes back in again, no it is not wise to establish a relationship of any sort that would then continue outside of work.

It is crossing a boundary if the goal is to keep work at work and not work at not work. If one is establishing that type of relationship with someone in their care, so much so that is continues outside of the facility, then one should reflect on why they are crossing that boundary to begin with.

Not all patients are demanding jerks. Some are funny and awesome and yes, you could envision yourself IN AN ALTERNATE SITUATION becoming friends.

Sometimes patients will come back to say hi, send cards, "check in"....but if that same former patient showed up at your house, then it would be a bit intrusive, and crosses a boundary.

I can see that babies/kids of course you would want to know how they are. And awesome to see that they are thriving. Especially those who were under your care for months. A facility setting up social media that parents can choose to participate in (or not) is a great idea.

TheCommuter, BSN, RN · Apr 14, 2016

The nurse/patient relationship is supposed to terminate once the patient is no longer under the nurse's care. Maintaining contact outside the nurse/patient relationship entails crossing a slippery boundary that would best remain uncrossed.

For my sanity, I'd prefer to forget about the vast majority of the patients to whom I've provided care over the years.

Sadala, ADN, RN · Apr 14, 2016

No no no no no! This can just lead to badness. You don't want badness, do you?

Fiona59 · Apr 14, 2016

No. I've had the odd one approach me in the mall to say Hi. But the look of confusion on my face usually makes them tell me how I know them.

There are a few I wonder about, but no way am I going looking for them

Farawyn · Apr 14, 2016

No no no no no! This can just lead to badness. You don't want badness, do you?

This made me laugh!

OP, what do YOU think?

There are enough interesting people in the world that I don't need to befriend my patients, no.

xoemmylouox, ASN, RN · Apr 14, 2016

In certain areas I can see how it is more common, but for most of the nursing roles out there.. no.

Maevish, ASN, RN · Apr 14, 2016

My brother is a CNA on an Oncology floor and they very frequently care for people (and their families) for multiple weeks/months in the year and I've worked in Onc as well with similar experiences. I've never kept in touch with pts after care, but my brother developed a real fondness for one pt and the family even asked him to go to the funeral when the pt passed. He was so blessed by the relationship and didn't seek it out himself. It was all the work of the pt and the family, who'd appreciated all the care (my brother really is amazing) given over the 2 years of near constant admissions.

I don't think there's anything wrong with it if the pt has initiated it. If OB/NICU/PEDS pts and their families can do it, then why not other pt populations and their families?

I think for me to do it it would have to be a very special situations. The most I've done is little extra things for them while in hospital (like letting them call a family member on my cell phone when the room phones aren't working or dialing out), but that's all.

xo

Libby1987 · Apr 14, 2016

I've had a few contact me to give an update and I run into them often at the local grocery store in our small town where there's a usually a warm exchange with an update volunteered but even as a home health nurse I don't reach out and contact any of my former patients and/or caregivers.

Unless it's part of customary follow up and we are the one assigned or the most appropriate to make the call, once they're discharged from our care, they remain in discharged status until they are readmitted. Anything else exceeds or alters the professional relationship.