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

Farawyn · Apr 14, 2016

I can think of two . . . a rural setting and hospice. I live and work in both.
Many times I know my patients prior to them becoming my patients.
Two weeks ago a young woman came up to me at a grocery store and thanked me for being her nurse during delivery of her baby. I honestly did not remember her but didn't let on.
I completely understand and agree with not trying to maintain a friendship with someone you met when you were their nurse. But it is harder in a small town.
Also as hospice, we do go to funerals. Technically, we go as "hospice" and put it on our timecard but to tell the truth, I go as "hospice" but usually don't put it on my timecard.

Another. SN in your own school district.

Its hard. Nothing like showing up at Book Club and hearing THE NURSE is here.

Good lord.

Kitiger, RN · Apr 14, 2016

I've worked private duty pediatrics for years, and I've gone to a lot of funerals. The families have always come up and thanked me for coming. I've even had a couple funerals where the mom asked us ahead of time to wear bright colors and to share a memory.

There were some families who were more private; I did not go to those funerals. You get to know your families ...

On the other side, My Mom & I were greatly helped by a nurse who came to Dad's visitation. We thought Dad had died alone, but this nurse told us about his last shift with Dad (he painted a normal, comforting picture of his interactions with Dad the night before) and he told us that Dad had coded in front of the nurses' station, with people nearby. Understand that this nurse knew that Mom & I were both nurses, and that we would do better knowing exactly what happened.

I never saw this nurse again, but I'm so glad he came to the visitation.

nurseinthezoo · Apr 14, 2016

Once they've left my unit it's "goodbye" or "till we meet again," speaking of the frequent flyers, of course.

TiffyRN, BSN, PhD · Apr 14, 2016

The March of Dimes is a charitable organization, not a professional organization. I, personally, would never take direction on a question of professional ethics or behavior from a nonprofessional charitable organization, however well-meaning.
There was a thread here a while ago started by a home health RN who found herself in a situation in which she was providing home care but the family had contacted the previous NICU nurse, who was taking it upon herself to advise the parents and get involved in the home care, and it created a v. difficult situation.

I'm not arguing, just clarifying. I didn't know this about March of Dimes before my NICU years. They may not all be professionals, but they have a significant number of highly trained professionals that work with healthcare staff and parents. Our unit pays the salary for a MOD coordinator (minimum education: Master's). She is responsible for a plethora of family support services. Counseling, teaching, providing a sense of community.

I critically evaluate all education offered my way, including theirs. Their advice was conservative and well thought out.

Though the hospitals do regularly provide us with education on professional boundaries and HIPAA yadda yadda yadda. . . These families are with us for many months. We can be closer than their families at least for that time period.

I worked in the adult world (step down & telemetry) for about half my career and I agree that there, no contact is the norm.

The landscape is different in NICU, especially the kids we have for more than 2 months or so. I feel like you would hear similar stories from nurses in other long-term specialties, like oncology, hospice, bone marrow transplant. . . Just throwing out some ideas.

And there is no excuse for nurses to provide nursing/medical advice after the professional relationship is over. I have a few ongoing relationships. I make it very clear I don't hand out medical advice. If they don't respect that, I stop the contact.

bell1962 · Apr 14, 2016

This ! When I worked in a clinic in my small town, my patients often were my friends and family!

I can think of two . . . a rural setting and hospice. I live and work in both.
Many times I know my patients prior to them becoming my patients.
Two weeks ago a young woman came up to me at a grocery store and thanked me for being her nurse during delivery of her baby. I honestly did not remember her but didn't let on.
I completely understand and agree with not trying to maintain a friendship with someone you met when you were their nurse. But it is harder in a small town.
Also as hospice, we do go to funerals. Technically, we go as "hospice" and put it on our timecard but to tell the truth, I go as "hospice" but usually don't put it on my timecard.

KatieMI, BSN, MSN, RN · Apr 14, 2016

When my little one eventually went home after 3.5 months in NICU, quite a few nurses and neonatal NPs gave me their phones with permission to call whenever we need it, as well as to give those phones to other care team members if necessary. I do not know what I would have to do without these people - at the very least, it would definitely be WAY more drives through the night to the ER. We still exchange Christmas cards with some of them, and we showed off our not-so-little-one more than once when we happened to be near.

emmjayy, BSN, RN · Apr 14, 2016

Am I allowed to post in here? I'm not a nurse but I do have thoughts on this topic because I've been a paralegal for over 6 years.

When I started working as a paralegal, I really was curious for my first year or so what happened to former clients I worked with (the feeling went away once I got jaded and used to seeing really scandalous cases). However, it would have been neither professional nor appropriate for me to reach out to them for an update once the case was closed. If they called me and gave me an update, that's one thing but it would have been wrong for me to initiate that contact. Part of that is for my own protection - I really don't want some strange relationship with someone when I'm ethically bound to keep my mouth shut about how I know them or things that happen in their lives. I also don't want former clients asking me for legal advice off the clock "because we're friends now", which would be illegal for me to give to them and would put me in a really awkward position. Plus, I don't want them calling me or contacting me outside of work for work-related issues. It's also important for people coping with hard situations to have the people who helped them stay in their "boxes" I think. I don't think it's helpful to a former client (or, in this case, patient) to be approached by someone who had a confidential relationship with them. Just by coming up to them, you could really violate their privacy - perhaps the people they're with don't know about their stay in the hospital or their need to hire an attorney, and you talking to them puts them in a position where they need to explain themselves (or lie). Best to keep the relationship very strictly professional :)

brownbook · Apr 14, 2016

My aunt was cared for for years by three different unlicensed care givers, so not covered by any legal constraints or HIPAA.

I do think about them once in a while. I sometimes wonder if perhaps they think...."well...now that auntie died we're no longer of any importance to the family?" I wouldn't mind if we just exchanged Christmas cards or followed each other on FB.

If they were licensed aides or RN's I'd probably think more that they were "just doing their job" and maybe not feel the same way?

Editorial Team / Admin · Apr 14, 2016

I've been on both sides- the family of a hospice patient (my grandmother) who invited the nurses who cared for her to the memorial service. And I've been the nurse who's cared for my own neighbors, who would give me a quick update when we meet at the community mailbox. I've never initiated the contact, nor would I. Have I wondered about patients? Absolutely, especially the baby of the mother who died in the trauma bay as we were doing an emergency c-section with no time to get to the OR. But I've never gone in search of information because that would be crossing boundaries.

chacha82, ADN, BSN · Apr 14, 2016

NOPE. It will never look good to HR, no matter how innocent.

I have said this before in a previous post. We spend several shifts with a patient or family, and we think we know them. We really don't know them at all. You have no idea how they are going to interpret something like that.

Conqueror+, BSN, RN · Apr 14, 2016

Just know that if anything EVER goes wrong you will be at fault and penalized. There is no policy and procedure to hide behind once you are off the clock and away from your facility. It will never be worth it once the patient accuses you of something.....yeah but no one ever thinks that their extra special fuzzy patient will do that.

allnurses Guide · Apr 14, 2016

I've been on both sides- the family of a hospice patient (my grandmother) who invited the nurses who cared for her to the memorial service. And I've been the nurse who's cared for my own neighbors, who would give me a quick update when we meet at the community mailbox. I've never initiated the contact, nor would I. Have I wondered about patients? Absolutely, especially the baby of the mother who died in the trauma bay as we were doing an emergency c-section with no time to get to the OR. But I've never gone in search of information because that would be crossing boundaries.

It is part of hospice to go to funerals or memorial services.