Patient abandonment/Professional Boundaries??

Nurses Professionalism

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Specializes in Nicu.

In our unit, there is a nurse that appears to be infatuated with a patient and the family-to the point that if that nurse does not have the patient, the nurse will not leave the room until cares are done and even afterwards you will find said nurse checking on the patient throughout the shift. Our unit has private rooms with a sliding glass door. A few weeks ago, several nurses witnessed the nurse close the patient room door and sit in the patient room for a large portion of the shift conversing with the family-mind you, the nurse was also assigned she had 2 other patients that she was responsible for as well. When the nurse was seen in the other patients rooms one could tell the nurse was just doing bare minimum of what had to be done and would scurry back to her ‘favorite’ patient’s room and shut the door-this went on until the family left. 

Am I just being overly sensitive or is this grounds for disciplinary action by the employer as well as the board of nursing? Is she not crossing all kinds of ethical and professional boundaries as well as abandoning/neglecting her other patients?

Any insight would be greatly appreciated!

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It doesn't sound, on the surface, like appropriate nursing behavior. But I have to say I find it curious when people observe a situation like that and mainly just want to know if someone can/should be disciplined for it. Mention of the BON is out-of-bounds in situations like these; that's my personal opinion and I have a variety of reasons for it. I am an advocate of expressing your concerns in a responsible manner, beginning with the nurse in question, if your conscience is weighing on you. If your actual conscience is not weighing on you then you have no reason to worry about it at all.

We all have our patients that need care. If you are concerned, talk to the nurse (preferably) or to your manager, then let it go so that your own work or your own ethics are not compromised.

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Specializes in Nicu.
22 minutes ago, JKL33 said:

It doesn't sound, on the surface, like appropriate nursing behavior. But I have to say I find it curious when people observe a situation like that and mainly just want to know if someone can/should be disciplined for it. Mention of the BON is out-of-bounds in situations like these; that's my personal opinion and I have a variety of reasons for it. I am an advocate of expressing your concerns in a responsible manner, beginning with the nurse in question, if your conscience is weighing on you. If your actual conscience is not weighing on you then you have no reason to worry about it at all.

We all have our patients that need care. If you are concerned, talk to the nurse (preferably) or to your manager, then let it go so that your own work or your own ethics are not compromised.

       I find it curious that you think a nurse obstructing care of a patient and being secretive in her care of one patient and interactions with a family member and neglectful in care of another patient should not face some kind of disciplinary action. Also, why would I take it up with her, is that not management’s job? ?

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13 minutes ago, RoseT21 said:

Also, why would I take it up with her

I would do it because I believe it is the professional way to comport myself. I feel this way because my personal belief is that there are many instances where people, because they are mere human beings, should be given a chance to respond to a wake-up call (such as a word of concern from a peer) before being thrown to the wolves.

I am a human being who is far from perfect. If for some reason my judgment had become compromised, I would appreciate being thought of as someone who might be interested in getting back on the right track ASAP rather than thought of as someone who mostly deserves to be punished.

That is all.

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Take up the issue with the manager if you don't want to interact with said nurse.  The manager may actually be oblivious at this point.  Sometimes we don't see what our eyes see right in front of us.

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Specializes in Mental health, substance abuse, geriatrics, PCU.

I agree with what JKL said. It sounds like this nurse is crossing boundaries, it happens, we all have patients that we either identify with or connect with and it can be easy to get swept up in that and not think and behave as clearly as we should. I think a friendly conversation and bringing to her attention that she has gotten too involved with this patient at least gives her the chance to self reflect and modify her behavior accordingly.

That being said, I have worked with people that would not take this kind of conversation well, in which case you should get your immediate manager to address the situation.

As far as the BON, unless her behavior has led to verified sexual or financial exchanges or her excessive attention to this patient has resulted in harm or death of one of her other patients, then this really is better managed by her employer versus the board.

You mentioned in one post she was doing the bare minimum for her other patients and in the other post that she was neglecting them. If she is truly neglecting them then your supervisor needs to be notified immediately so they can receive the care they need.

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On 2/25/2021 at 4:21 AM, TheMoonisMyLantern said:

That being said, I have worked with people that would not take this kind of conversation well, in which case you should get your immediate manager to address the situation.

Very true. I have met a few whom I would decline to approach; they've shown their colors in the past.

I am simply VERY against the idea of BONs being weaponized even more than they already (most evilly) are by employers. I think we should have nothing to do with this precedent of abusing the ability to report a licensed professional to their board. Every nurse should understand that participating in willy-nilly reporting for everything under the sun is done at their.own.peril.

When I read posts like the OP, I am curious just as I said before. If someone thinks there is abuse or neglect going on, and their first concern is something that isn't even going to help that situation or that patient, sorry but that is suspect; their motivations are suspect at that point. How about worrying about the actual patient even if there is no concern about treating the nurse in question like a human being? I will note/call out this attitude every time I see it. This person who posted here needs an attitude check. If they have a problem with their coworker, deal with it like a professional. If they have a concern about a patient's care, deal with it like a professional. Don't come here to find out if you can get someone in big-*** trouble for something.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I would not contact the BON unless under dire circumstances, like true patient neglect/abuse/abandonment or narcotic diversion. Even then, I would definitely let management know and let them handle it first and foremost if at all possible. It's up to them (management) to deal with the nurse and HR or BON as they see fit.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
On 2/21/2021 at 5:15 PM, RoseT21 said:

       I find it curious that you think a nurse obstructing care of a patient and being secretive in her care of one patient and interactions with a family member and neglectful in care of another patient should not face some kind of disciplinary action. Also, why would I take it up with her, is that not management’s job? ?

Yes it is. So let them do it! NOT the BON.

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Specializes in Psych, Addictions, SOL (Student of Life).

In the facility where I work if someone went to management about this situation they would be sent back to resolve the issue with the nurse in question. Once that has been unsuccessful the management will call a meeting between the two nurses to discuss accusations and allow the nurse accused of neglect to answer to the accusation. This is not a matter for the BON

When you say the nurse does the bare minimum for other patients do you mean they are not caring for the patient as required by facility policy. If they are in compliance with facility policy again this is not a matter for the BON. A nurse is not required to go above and beyond for a patient ( Agreed it would be nice if they did). If the minumum is being done this is not neglect and you would have a hard time proving it. The only time the BON would even be interested in this scenario is if the nurse in question was comitting fraud, fuduciary abuse or if the said neglect was the direct provable cause of a negative outcome for the patient.

Having been investigated by the BON, After I made the mistake of reporting myself for a mental health issue - I always think long and hard about reporting anything to the BON which might result in that nurse losing their license or ability to make a living. Also Karma can be a female canine and what goes around comes around!

Hppy

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