Relationships with client family

[Hshea]

I've been a home nurse for 3 years. I know you are supposed to maintain a professional relationship with your clients and their family, but I have definitely crossed that boundary. I have a peds client, and we live in the same town, so my boys are in scouts with him and do several social events together. Our families have became close, and my client has visited us at our home before. Of course his family is more than ok with this, but what are the possible repercussions of the agency finding out? Has anyone else had this experience?

[llg, PhD, RN]

I grew up in a small town where my father was the only physician. Of course he had patients who were also friends ... and he was the physician of most of my friends. The relationship can still remain within professional boundaries as long as you keep things separate. People in small towns do it all the time.

If you don't feel you have crossed the line too far, you might want to talk with your supervisor as to where he/she draws that line so that you can avoid being fired for it. If you feel you can't do that because it has already because your professionalism has already been shot ... then you need to get off that case.

[Libby1987]

I've been a small town home health nurse. I've worked and lived here for 28 years and most of my patients were only 1-2 degrees of separation.

The way I've maintained my boundaries is by respecting and holding my nursing role has higher and more valuable than the *civilian* relationship I might have or had with the patient and their families.

They have a lot of friends, but they only have one home health nurse. In the rural small area where I work and live, home health nurses aren't interchangeable, even covering me for vacation was tough let alone permanently replacing me on a case, which only happened in a few rare cases where I requested it ahead of time.

Because I respect what I do and know the true value in it, it's almost sacred and I wouldn't consider ruining it by crossing boundaries. Not even following discharge (I do intermittent home health) because I would eventually have them back and/or a family member.

Have more respect for your nursing role with these folks, right now you're jeopardizing it and will be replaced. You're no doubt not intentionally being unprofessional but you're truly behaving like an amateur. I'm sure it's in your company's policy as cause for write up if not immediate dismissal.

[JustBeachyNurse, LPN]

You have definitely crossed the professional boundary line. The parents are okay with it...until they are not.

Simply having a current client in your home can be grounds for termination and an ethics complaint with the BoN.

Contact your agency corporate compliance officer or your supervisor.

You Ms y get a warning and be removed from this case. You also need to be prepared for termination if zero tolerance for ethics violations as this can also affect payment from government sources. Nurses got warnings for giving expensive gifts to patients for birthdays and holidays when a "thankful" parent was uncomfortable enough to complain to management. I think each was shocked. We only know about it as the affected nurses told others.