Patient dilemna

[Tepidorchid]

I'm switching to a new job and wanted advice as to how to tell some of my homecare patient's I will be leaving. One in particular is emotional at times and appears to be attached as he states that the nursing visits lift up his mood and his chronic wounds have never looked better. He is a generally pleasant person but has also shown at times to have a temper. I am concerned for my safety and was going to see if another RN can come on this last visit. Any advice on how to approach this?

[nurseprnRN, BSN, RN]

While it might be a courtesy to say good bye and good luck, it doesn't sound like a very cordial relationship, and it's not like breaking up with a boyfriend. It's a job. You don't owe him a big scene.

Surely you are not this patient's only nurse. You have days off and vacation time and such. You can just ... never come back from your day off, if you're really and truly worried about your safety.

[Vespertinas]

Maybe send them all a postcard with a little something written on there. You thought of them kindly and kept your distance.

[HouTx, BSN, MSN, EdD]

I know it's much more difficult to maintain professional boundaries in Home Care, but GrnTea is correct. Keep your professional distance - let them know that this is your last visit and their care will be provided by someone else. For heaven's sake, don't send any personal cards - this would only reinforce the idea that you had a personal connection and 'abandoned' them.

[Morainey, BSN, RN]

I'm not totally familiar with homecare, but do you ever make visits together with another RN? If someone is taking over for you on this case maybe you could say "this is so-and-so, she's going to be taking over your care because I am leaving my position." That way there's someone else present, and maybe he won't cause so much of a scene. Like a hand-off of care type of thing.

[Vespertinas]

HouTx, in the brief time I did home care, I felt very close with some of my patients. I wouldn't see it as inappropriate to have sent a postcard. Much more personal acts of connecting with patients have been expressed by nurses- attending funerals comes to mind. Then again, I didn't question my safety or their mental stability.