Student nurse/patient relationship boundaries

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Hello all wonderful nurses! I'm Maria, and I'm a first year nursing student. I'm 38 (never too late for nursing school I guess haha). Well, I found this site some time back and have got lots of great information over the months. I find myself in a small unsure situation at the time, and I decided to go ahead and create an account and ask for advice.

I will provide minimum detail and try to keep things short and simple. Last week, I had a young patient very close to my age (41). It was surprising since I had been used to dealing with mainly older adults. He was admitted for a serious illness and due for surgery in a few days..days in which I wouldn't be in clinical and probably wouldn't have him assigned to me again anyways. But we connected well on both a personal and professional level, and I became a comfort for him throughout my shift since he was extremely fearful of his.upcoming surgery. When it was time for me to end my shift, I made sure he was comfortable and eased his worries about surgery. He seemed like he wanted to keep in touch with me and asked for my Facebook. I'm against Facebook, so I told him I was sorry I didn't have one. So I decided to give him my email so he could email me after surgery to let me know how he is doing. I didn't think nothing if this and keep in mind I'm a first year student. We've never had lectures on how to handle situations like these. I know I should have asked my professor, but she was called to a meeting. Now I'm scared sick that I might have done the wrong thing, but I didn't want to hurt my patient's feelings and I really would like to know if all pulls through. So I hope someone can message soon with advice. Did I mess up? How should I have handled this? What should I do? I hope someone can ease my mind. Thanks.

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Maria, as professional nurses it is our job to keep things professional and ethical in the workplace. Giving out personal information is a no-no because we're taking care of patients, and we're in a seat of "power."

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Specializes in Acute Care, Rehab, Palliative.

Giving him your e-mail was a mistake. You have to keep it professional between you and the patient. Giving him personal information is against the rules.

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Specializes in Primary Care, OR.

While its apparent you mean well the best thing to do in nursing is remain professional.

It is hard to learn the techniques but there is a certain point in your conversations with this patient where you seeped over the lines. The best thing you can do now is recognize where that point was and make revisions in your future conversations with patients to make sure you don't get personal. (Although I know that is difficult especially when you encounter patients your age etc).

when you cut ties with patients make sure to give them a smile and wish them well, thats good enough. Sometimes even a hug if your into that kinda stuff lol. (Not I)

Good luck with your journey!

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Oh no! I feel just terrible. Do you think I should tell my instructor. No one else knows but me. And I'm not too sure if the patient will ever email or not. If they do, I plan on just hearing about his outcome and leaving it at that. I don't plan on developing a friendship any further because of my boundaries. But I don't want to get in trouble in case somehow my instructor finds out and I didn't tell. What should I do about that? And I am sure the patient only wanted me to know about his outcome of surgery. Nothing more. He knew how concerned I was. Any further advice about that? And thanks to all who responded so quickly.

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Specializes in Complex pedi to LTC/SA & now a manager.

Your relationship ended at the end of the clinical day. Your first mistake was voicing your curiosity & concern as to the outcome of the surgery. This is a major privacy/boundary issue. While humans are by nature curious, you have no business or right to inquire as to his outcome. Implying that you want to know how he made out was just as bad as giving your email. You could have stopped it by saying you don't do Facebook and wish him well. Did he ask for your email or did you offer?

If you worked in the unit and weren't caring for him next shift yet looked up his condition in his chart you would risk termination as it would be a HIPAA issue as you were not directly involved in his care.

Just tell your instructor what happened and what you did it can become a teaching moment rather than a major privacy/boundary issue.

Honestly I'm shocked you didn't have a clinical orientation that covered privacy, HIPAA & professional boundaries before you first set foot in the patient care area. We were required to complete facility orientation, safety, and privacy/HIPAA/boundary training for each potential clinical site before our first patient contact.

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Specializes in Pediatrics, Emergency, Trauma.
Your relationship ended at the end of the clinical day. Your first mistake was voicing your curiosity & concern as to the outcome of the surgery. This is a major privacy/boundary issue. While humans are by nature curious, you have no business or right to inquire as to his outcome. Implying that you want to know how he made out was just as bad as giving your email. You could have stopped it by saying you don't do Facebook and wish him well. Did he ask for your email or did you offer?

If you worked in the unit and weren't caring for him next shift yet looked up his condition in his chart you would risk termination as it would be a HIPAA issue as you were not directly involved in his care.

Just tell your instructor what happened and what you did it can become a teaching moment rather than a major privacy/boundary issue.

Honestly I'm shocked you didn't have a clinical orientation that covered privacy, HIPAA & professional boundaries before you first set foot in the patient care area. We were required to complete facility orientation, safety, and privacy/HIPAA/boundary training for each potential clinical site before our first patient contact.

THIS.

Take it as a learning experience. :yes:

Looking ahead, become familiar with HIPAA, as well as the nurse-patient relationship; there are techniques that you can apply in terms of maintaining and terminating the relationship effectively.

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Specializes in Med/Surg/ICU/Stepdown.

I have been in this situation several times, and I kindly advise the patient to write to me care of the hospital to let me know how he/she is doing, if she so desires. Beyond that, I never ask to keep in touch with patients. I wish them well on their journey and tell them that I hope they stay in good health and spirits.

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Thanks. But I'm just deathly afraid to approach my instructor about this. She is one of those tough ones..not very understanding. And I feel like I have finally developed a positive relationship where she seems nicer to me. I don't want to ruin it. Maybe I'm just not cut out for being a nurse. I feel so upset and sick. We had a HIPAA lecture but nothing on that kind of stuff so I wasnt informed and didn't think much of it until after.... :( And to whoever asked..yes he asked and I offered my email. The reason he perceived me as concerned as I was, was because we were doing an assignment on communication skills so I had to do an in depth assignment on that so we were working on psych things as well. So the conversation was long and I put practice into place. So as I went to leave I normally said I hoped all would go well for him and wished him the best. That's when he asked for my info. But I guess it don't matter the details anymore cause I've messed up so bad. :(

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This appears to be a great possibility for a working nurse to do but I'm a student. I had no option or knew one other than that.

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But I guess it don't matter the details anymore cause I've messed up so bad. :(

Well, plenty of nursing students have done lots worse and survived. I wouldn't beat myself up too much, just, as others have said, use this as a learning experience.

In my experience, lots of nursing students struggle with the concept that a professional, therapeutic, "helping" relationship is a lot different from the other relationships you're used to having with people. It can take a while to get the hang of it.

I don't know your instructor or your relationship with her, but I would think the best thing to do is "'fess up" to her and discuss it with her, and what you have learned from this situation -- that would be better than her finding out about this later on and perceiving you as having purposely withheld the information.

Best wishes!

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Specializes in Complex pedi to LTC/SA & now a manager.

I would be more afraid that your instructor found out via other means. Such as patient commenting to staff nurse that he got your email and staff nurse alerting charge and/or your instructor.

Be truthful. This is what happened, I tried to deflect by not having Facebook but felt pressured when he asked for my email. I complied without thinking and now don't know what to do...

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