PDN...Facebook friend??

talaxandra · Oct 19, 2011

I've twice had friend requests from patients, once in person and once online from a patient who'd gone to rehab, was a nurse at another hospital, and was friends with one of my colleagues prior to admission.

In neither case was I tempted. I think there's a massive potential for bad outcomes and very litle to gain.

However, I was talking about the ethics of this at uni with my superviser (who's co-founder of a paediatric bioethics unit) and a paediatrician. The former was talking about the murkiness of blurring boundaries; the latter said he's getting an increasing number of requests from adolescents, and refusing friending could get in the way of the therapeutic relationship. So he had two FB accounts - one for friends and family, and one for patients and (to a lesser degree) colleagues.

Reading this back I'm not sure I've actually helped - sorry!

caliotter3 · Oct 19, 2011

The clients are capable of doing enough damage simply by using the telephone. Not necessary to add a social network site scenario as another avenue to hold something over the head of the nurses. Don't think for one minute that the family is not aware that this is inappropriate and unprofessional on the part of the nurses. Whenever there is fallout over nurses crossing professional boundaries, it is the nurse who ends up without work and the family just goes on with the agency and new nurses. They get wise to this.

CrunchRN, ADN, RN · Oct 19, 2011

Just tell them it is 'against company policy" no matter how things may be now this is a very slippery slope.....

KateRN1 · Oct 19, 2011

Patients/families shouldn't be your friends. Your friends shouldn't be your patients/families. There is no blurring or greying of the lines. It really is very simple.

MsRN247 · Oct 20, 2011

I'm totally against it!

I think keeping the professional/personal social life boundary is important. Could it possibly lead to be a HIPAA violation?

ventmommy · Oct 20, 2011

I am friends with one former nurse that we adored. She stayed with us through her pregnancy and her baby was born with serious health issues. She decided to not return to nursing. She sent us a friend request and I accepted.

I think 2 other nurses have sent requests and I just told them that I'd rather not friend them because I belong to lots of mom groups on FB and need a place to complain. Also, I wouldn't want any hurt feelings when my status is something like "Nurse so-and-so is such a great nurse. I wish she could show up on time!"

systoly · Oct 20, 2011

What is to be gained from friending someone? (I don't do facebook)

It seems to me that interacting with a pt. or pt's family on a social network is indeed socializing/hanging out. Bad idea.

Kyasi · Oct 21, 2011

I posted a question about this a month or so ago to get everyone's opinion. I have found out that lots of my HHA's have friended their patients on F.B. (most of them don't have privacy settings on their accounts) We have a Code of Ethics that states that a caregiver will not share personal information, religious/political views, personal problems etc with their patient. All this is shared on F.B. and more (sexual preference?) Our Code of Ethics was written before F.B. was popular so doesn't expressly refer to that. My feeling is that it is crossing professional boundaries in every way.

Ventmommy, the nurse you friended is no longer working for you, so I don't think that is a problem.

I did PD nursing for 20 yrs and I understand the relationship that develops w/the families. It's difficult to keep that line from being blurred but you really have to. Every time you allow that line to move back, the professional relationship is compromised and eventually someone, the patient or caregiver, gets uncomfortable with it. I see this all the time. There were things that I knew other nurses would do on one case I was on. (ex: transporting the patient from a grandparents house to her house (while the mother was gone) I just wouldn't break policy no matter how close of a relationship I had with the parent... no way, no how. Always error on the side of caution.

Kyasi

Ms_Bee · Oct 22, 2011

I agree with you all. I do not think its the best idea to become friends on facebook with your patients. There was a unique circumstance that happened to my one of my nursing school friends where she went to school with her patients moms sister (they were acquaintances). They hadnt seen each other in years and then met again through the pt and are now "friends" on facebook. Im kinda on the fence about that one??

"I did PD nursing for 20 yrs and I understand the relationship that develops w/the families. It's difficult to keep that line from being blurred but you really have to. Every time you allow that line to move back, the professional relationship is compromised and eventually someone, the patient or caregiver, gets uncomfortable with it. I see this all the time. There were things that I knew other nurses would do on one case I was on. (ex: transporting the patient from a grandparents house to her house (while the mother was gone) I just wouldn't break policy no matter how close of a relationship I had with the parent... no way, no how. Always error on the side of caution."

Kyasi- I know exactly what you mean as far as seeing other nurses do things that cross the line. I have heard of other nurses baptizing their patients, lending their patients parents their credit cards, purchasing furniture for them, working with their niece/nephew etc. And I do agree with you, at times its very difficult to keep that line from being crossed because you spend so much time with these families but its very important to keep it from being crossed. Im pretty new to pdn (

Kyasi · Oct 23, 2011

It's a fine line. I took care of one child from the time she was born until about age 8. That was the case I was referring to when I mentioned transporting the child. One nurse on that case often took the child for weekends at her own home and transported her. (12 hr shift paid for by the agency, 12 hr at night unpaid) Can you imagine the liability if something had happened to that child in transport or at her home off the clock?

The relationship I had w/ the mom was a friendship although we didn't hang out together. I was a support person to her when her marriage failed. One day I came to the home for my shift and found the mother w/ the divorce papers that had been served hours earlier, clutched in her hands, and she was crumbled on the floor in a catatonic state. Her daughter was crying and needed a diaper change. So I tended to my patient first, calmed her down, started a feeding and then put my arms around her mother and let her sob in my arms. I couldn't not help her in her time of need. Was it crossing the line? Maybe. I considered that in helping mom, I was indirectly helping my patient also. But despite how well we knew each other, she knew I'd never not follow the agencies policies in the care I provided for her daughter and she never asked me to. I don't work for the agency anymore and I'm still a friend of the mother. She is in a different town and we meet for dinner occasionally, and she is my Facebook friend. Someday, when I don't work full time or when I retire, I intend to care for her daughter, so mom and her husband (they worked it out and got back together) can go on their first ever vacation. But now I can do it without compromising my professional standards. As I said, it's a fine line and there are no easy answers.

PsychNurseWannaBe, BSN, RN · Oct 24, 2011

Its simple for me... it a nurse-patient relationship. It is therapeutic relationship. I am not your friend... I am your nurse. I can and will be friendly, but do not expect me to be your BFF. Once that happens.... objectivity can be lost.