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Need advice on nursing/pt relationship post discharge

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by NurseJackie87 NurseJackie87 (New) New

Specializes in Psychiatry.

dirtyhippiegirl, BSN, RN

Specializes in PDN; Burn; Phone triage. Has 8 years experience.

That's such a ****** thing to say. People with mental illness are people. Grow up.

Dude, I spent ten days on a psych ward last year. (Plus 45 days in rehab.) Spent most of my adolescence and early twenties in and out of psych wards -- maybe 30+ hospitalizations since I was 13. If AN handed out awards for professional crazies, I would win something. I'm sure.

It is generally advised that patients who "meet" on a psych ward (or rehab or residential facility or partial hospitalization) NOT become romantically involved for a reason. I think the same should extend to staff who meet patients on a psych ward.

Whispera, MSN, RN

Specializes in psych, addictions, hospice, education.

I don't think anyone else has mentioned this possibility, but it's worth consideration. What if he is hospitalized again, after you've established an out-of-the-hospital relationship. What would you do then?

There are so many negative things that could happen if you establish the relationship. Didn't we have a long thread about this awhile back? I can't find it, but maybe someone else can post the link to it?

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

Are you old enough to remember Nancy Reagan? She was famous for "just say NO". At the time it was meant for kids in reference to drugs. But I think it's transferrable to this scenario.

Just say no. Lather, rinse, repeat.

cooplist

Has 14 years experience.

Feb 5 by dirtyhippiegirl, BSN, RN

Do you really want to date someone you met on a psych ward?

Most people on psych wards are just like other people, even nurses, but are just going through a hard time in their life. I find it shocking that a nurse would have such a reply. By the way, I have been both a nurse, and a patient on a psych ward.

That being said, I don't think ANY nurse should date ANY patient of theirs at least until a good amount of time has passed.

Edited by cooplist
I wanted to include what I was replying to and explain more.

While working on my mental health unit I came into contact with a man who I had a connection with. While he was a patient he would flirt with me but I maintained the appropriate patient/nurse relationship. Now that he has been discharged I'm wondering about the ethical standards that might say that a personal relationship could be initiated? My own ethics has kept me from having any contact with him since discharge but I'd really like to get to know this guy outside our previous professional relationship. As background info I only work part time and he was only ever my patient a handful of times while he was in hospital.

I don't see why you wouldn't be able to remain in contact and friendly with the guy outside of work. You do still have YOUR OWN HUMAN RIGHTS!

NurseJackie87

Specializes in Psychiatry.

Ya but the point is as someone already stated. The only way we could be in contact is either he asked for my number before he was discharged which would be unethical for me to give or I look him up using his name which I only know from being his nurse which is a confidentiality issue

SummitRN, BSN, RN

Specializes in ICU + Infection Prevention. Has 9 years experience.

I respect the OP for acting on her doubts and asking here, then maturely reflecting on the responses and realizing the right course.

NurseJackie87

Specializes in Psychiatry.

It's been my dream to be a nurse. I needed to be reminded that actions have consequences and I love nursing. It wouldn't be worth losing it in the end.

I will tell you what. I did not read the responses as this struck a chord with me. Any number of mentally ill people generally speaking are manipulative. That is part of some disease processes. It is a symptom the result of which has worked for them in the past--and seemingly, worked with you.

You really, really need to think about your ethical practices. And what need this is filling in your own head. And to follow up with some counseling regarding this if you believe yourself unable to separate the 2.

And flirting???? You have got to be joking--that is wrong. On a number of levels. You can, and SHOULD in fact, separate your personal from professional. They are 2 different things. I do not mean to sound harsh, and perhaps you are unclear on boundary setting. But you do not, under any circumstances flirt with, engage in questionable behavior, or follow up with patients. Period. This is how one gets in a heap of hot water. The least of which is that patients deserve privacy. And if you are following up with information that you got only from the hospital, this is wrong, and a huge violation.

That this is even a question is disheartening and scary. I really almost hope this is either a homework question, or a trolling situation.

Do NOT get personally caught up in any circumstance. Especially with patients whose disease process is as complex and multi-layered as a mentally ill person. Manipulation, acting out, blaming and accusing you of taking advantage--these are all real, live things that you do NOT want carried into your personal life. (and I am not mentally ill bashing, there's LOTS of other disease processes that involve the same type of behavioral symptoms and issues, not exclusive to mentally ill people).

Now, I am a huge advocate of the rights of the mentally ill. It is a disease process and not a character issue. However, mentally ill people who are hospitalized for poor symptom management are not in a position to make choices based on rationalization. And yes, you "flirting back" (and I am not sure, but if there was chemistry, there was some "flirting back" and you may not have recognized it as such) is unethical behavior on your part. And any mentally ill advocate would and could go for the nth degree in making sure that your ethics were questioned if this came to life. That is the reality. And with better symptom control, this former patient could turn this around to a huge ethical breach on your part. Back away and disappear from this situation today.

In order to succeed as a nurse, you need to be sure that you are aware of ethical and professional boundaries that are to be put into practice in order to build your own character and reputation as a nurse. There are nurses who are unaware of the magnitude of such breaches. If you need professional guidance, get it.

I wish you nothing but the best in your future successes, but please take a moment and re-work your boundary setting and ethical behavior standards.

Edited by jadelpn

I don't see why you wouldn't be able to remain in contact and friendly with the guy outside of work. You do still have YOUR OWN HUMAN RIGHTS!

We have "our own human rights," but we also have professional responsibilities. Entering into a personal relationship with a former client is considered a huge boundary and ethical violation in psychiatric nursing (for v. good reasons). It is a bad idea for both individuals personally, and is likely to have serious negative repercussions for both individuals.

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

She said he flirted with her, not that she was flirting. She also said that she did maintain an appropriate relationship.

It's been my dream to be a nurse. I needed to be reminded that actions have consequences and I love nursing. It wouldn't be worth losing it in the end.

You can stay strong in your belief that actions have consequences, by reading the disciplinary hearing results on your provincial regulatory body website, also read the relevant educational resources... a little fear can go a long way to prevent complaints against a nurse's license.

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

I don't think anyone else has mentioned this possibility, but it's worth consideration. What if he is hospitalized again, after you've established an out-of-the-hospital relationship. What would you do then?

There are so many negative things that could happen if you establish the relationship. Didn't we have a long thread about this awhile back? I can't find it, but maybe someone else can post the link to it?

Found it: https://allnurses.com/psychiatric-nursing/dating-a-former-959114.html

NurseJackie87

Specializes in Psychiatry.

Exactly he flirted with me I maintained my professional boundary the entire time.

dirtyhippiegirl, BSN, RN

Specializes in PDN; Burn; Phone triage. Has 8 years experience.

Most people on psych wards are just like other people, even nurses, but are just going through a hard time in their life. I find it shocking that a nurse would have such a reply. By the way, I have been both a nurse, and a patient on a psych ward.

Never been a psych nurse but have 30+ psychiatric hospitalizations, myself. My advice comes with the heart and experience of a professional psychiatric patient, which I was for most of my adolescence and early twenties.

I'm not a psych nurse or patient, but a family member of several people who have been institutionalized for psych reasons. From that perspective, a relationship with a former patient is very worrying. It smacks of power imbalance, codependency, and an anti-therapeutic relationship at the minimum.

Just think what you would feel like if you found out that your very vulnerable father/brother/uncle/cousin fell for the charms of his nurse and brought her home to meet the family. The ick factor is pretty high.

I am glad you came here to ask before you continued, and I am really glad, for your mental health and his, that you changed your mind.

I hope you find a more appropriate source for the needs you have and are able to move on without too much damage.

Exactly he flirted with me I maintained my professional boundary the entire time.

But that you describe your nurse/patient relationship as having a "connection" and that you did not (or perhaps you did) redirect inappropriate behaviors ie: flirting, then further on describe his psych d/o as "low on the scale" these are BIG RED FLAGS that need to be addressed by you to prevent this from happening in the future.

Bottom line--doesn't matter the reason that this patient was admitted. You were his nurse. Which makes it an ethical issue to date this former patient.

Please seek outside support if the situation at home is also creeping into your work life and clouding your judgment, even to a partly cloudy with a chance of rain. I am so sorry for your situation at home. It totally sucks, and can be quite devastating. I get this. Sucks out loud. However, do not ever get yourself into a situation where you need to find some self esteem at work from patients. That will not end well.