The Unwritten Rules Of Dating As A Nurse

[Nurse Beth]

I'm just curious if it is against any rules to date a former patient of mine at the inpatient ward?????? please let me know he's such a sweet man and we totally connected a few months after he was in!

---

Dear Wants to Date Former Patient,

Nurses are the most trusted profession and as such follow a code of ethical behaviors. There are no legal rules around dating a patient, but we are bound to a code of ethics. The ANA Code of Ethics tells us when there's a conflict between personal values and professional values, the conflict must always be addressed in a way that puts our patients' safety and concerns first.

The intimate nature of nursing can lead to a risk of boundary violations and it's up to the nurse to establish the boundaries.

According to the National Council of State Boards of Nursing (NCSBN) there are questions to help determine the appropriateness of dating a patient and guide professional boundaries.

• How long ago was the nurse patient relationship? If it's a current relationship, dating is prohibited.
• Was the care provided extensive? A one day stay in the hospital is different than a two week stay.
• Is there a chance he'll be your patient in the future?

In your case, he was not your patient, and you did not enter into a nurse-patient relationship. You connected after he was hospitalized. You are not violating any professional boundaries, and I wish you and your sweet man well.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

This article is featured in the Fall 2018 issue of our allnurses Magazine...

Download allnurses Magazine

[carrienoka]

That is what I am saying, I am saying it is unnecessary for all of the negative things that have been said about being seen for mental health issues, that the only thing that was appropriate was the fact that someone said it can be a vulnerable population. Let me point out what I am talking about : " Is this real?

You want to date a guy you met as a patient in a mental hospital?

Hey good luck but when he starts displaying all the reasons that got him placed in mental health treatment you sure as heck can't say you weren't warned " or "It's not so much that he's a patient, but that you met him in a psych hospital. Nothing against mental illness, however, this isnt the case where you met a guy, and then discovered he had a mental illness.

I work in a psych facility and the patients there are really nice people of course that is until you read their chart and then it's apparent why they are getting treatment in the first place.

You will ultimately do what you want but please try to get to know this person first. "

THAT IS WHAT I AM HAVING AN ISSUE WITH

and despite that not being what the question is about I find it terrible that medical professionals are saying this about those with mental health issues....no matter the forum it just perpetuates the stigma, so I felt the need to point it out.

[carrienoka]

Disgusting coming from a mental health professional to talk about people in this manner.

as a psych nurse of over 20 years i can only offer this sound piece of advice. No!! No!! No!! That is unless you plan on never working in the psych world again and know it is true what neo soldier said... What got the guy there in the first place? I can't stress enough no!!

[carrienoka]

Disgusting coming from a mental health professional to talk about people in this manner.

it's not so much that he's a patient, but that you met him in a psych hospital. Nothing against mental illness, however, this isnt the case where you met a guy, and then discovered he had a mental illness.

I work in a psych facility and the patients there are really nice people of course that is until you read their chart and then it's apparent why they are getting treatment in the first place.

You will ultimately do what you want but please try to get to know this person first.

[carrienoka]

Disgusting coming from a mental health professional to talk about people in this manner.

is this real?

You want to date a guy you met as a patient in a mental hospital?

Hey good luck but when he starts displaying all the reasons that got him placed in mental health treatment you sure as heck can't say you weren't warned

[Neo Soldier, BSN, RN]

Disgusting coming from a mental health professional to talk about people in this manner.

I have a right to my opinion, madame. I have worked enough years to know that dating patients that you found at your job in a psych hospital is not the way to go.

[carrienoka]

I am not discussing the fact that you said don't date a patient from a ward, my issue is with you talking about humans like this. Sorry, I feel sorry that you work in this field and that is the way that you feel about your patients that you would talk about them in this way. You should be helping to end the stigma, not perpetuating it.

I have a right to my opinion, madame. I have worked enough years to know that dating patients that you found at your job in a psych hospital is not the way to go.

[carrienoka]

You specifically say nothing against mental illness and then go on to specifically say something about mental illness.

I have a right to my opinion, madame. I have worked enough years to know that dating patients that you found at your job in a psych hospital is not the way to go.

[Neo Soldier, BSN, RN]

I am not discussing the fact that you said don't date a patient from a ward, my issue is with you talking about humans like this...you should be helping to end the stigma, not perpetuating it.

Just because someone is human doesn't mean the person is appropriate to date.

I'm not perpetuating the stigma of mental illness. People date mentally ill people and thats ok, but when a nurse is talking about dating her patient who happens to be mentally ill, I find it ridiculous.

[carrienoka]

You absolutely are perpetuating the stigma. Many, many people seek help at one point in their life and you could go through their charts and see that they had a major stressor and no supports in place and needed to seek treatment and how about after you look in their chart they are also the exact same person, a nice person. I am in no way saying that people should be dating former patients, in fact that was already addressed in the original post, but I am saying that you are perpetuating the stigma that people with mental health issues are lesser than others and not as desirable as others. Sorry, but you are. If you were talking about a cancer patient and saying this people would be up in arms if you said once you look through their chart you see what landed them there in the first place.

Just because someone is human doesn't mean the person is appropriate to date.

I'm not perpetuating the stigma of mental illness. People date mentally ill people and thats ok, but when a nurse is talking about dating her patient who happens to be mentally ill, I find it ridiculous.

[5150rn2]

As a psych nurse this is an interesting question. Because there are multiple factors. It's easy to simply say no,never..but I don't agree with never and always..

My opinion is, if you provided direct care and then start a relationship with a patient no matter the diagnosis shortly after dc, it does bring up ethical questions and for myself, I wouldn't date them. There are organizations like the Army that don't allow drill sergeants or members of the cadre to have personal contact with a recruit or their family for 6 months. ( generally for the recruit that's a non issue). But part of the reason has to with appearances and fairness. You don't want a question of conflict of interest to be raised. So in that same light, it would be in a person's best interest to make sure that there is no misunderstanding over the nature and basis of the relationship, it's about maintaining your professional integrity. So at best put some time between contact and a change in the nature of the relationship. (For a caregiver with direct contact)

in this case, if the nurse was never a care giver and they just happened to meet on the unit and down the line met up again and started dating no big deal. ( assuming there was no chart snooping prior). I think as far as the mental health issue, that shouldn't be a deal breaker necessarily. If you met this person anywhere else would you date them? And just as kind of an aside.. you have no idea in general what a person may or may not have as mental health goes in the real world. so. At least you know in advance no? Informed decision.. ( yes I know, probably inappropriate humor).

Just my thoughts..

[Megan1977, MSN, EdD, RN]

I just keep thinking about the old saying- "Don't fish off of the company pier". In other words- do not enter into a relationship with a patient- past or present- the nurse needs to maintain strict boundaries and use common sense.

[Della_Psychic]

There are a lot of stigmatizing comments here & even within the governing boards regarding this issue.  There are worlds of difference between, say, a schizophrenic/antisocial PD or severely bipolar patient and someone seeking help for situational anxiety or depression.  How can evidence-based medical professionals claim to be against stigmatizing mental illness and hold these views?  

You can't.  You contribute to it directly by painting all "mentally ill" with the same brush.

I agree that dating current patients, those seeking inpatient care for acute mania, psychosis, "hard" drug addiction or other SEVERE or persistent mental illnesses involving violence and/or crime is a terrible idea & dangerous for med providers.  But putting all mentally ill patients in the same basket or implying that improvement is not a realistic outcome for most means treatment is a pointless sham & these people are somehow broken permanently or a danger to the holy gods/goddesses of medicine who sit atop our thrones administering treatment to them from on high.  The reality is much blurrier and I speak as a psych nursing student.  

Many in my field are former or CURRENT psych outpatients on medication themselves.  Just like many interventionists/addiction counselors are recovered/ing addicts and alcoholics.  There's a ton of overlap because being raised in dysfunctional families & living with these illnesses makes one naturally interested in treating them.  That includes personality disorders like NPD (Narcissistic PD) which is nearly universal among psychiatrists & many talk therapists as studies have confirmed for decades.  It's a scary scene with many, many breaches of boundaries--many of which are harmless for the most part.  But not all. 

That's why it's so important that the nursing boards & legal agencies spell out CLEAR & concise guidelines with easy to understand consequences for those who violate them.  In my experience, mentally ill patients are more likely to be overly naive & trusting with pure intentions while these boundary-stomping doctors/nurses behave more like s3xual predators with no intention of loving them long-term.  Terms like "counter-transference" imply that clients always initiate the unhealthy line-blurring behavior which is just laughable.  The whole system is set up to gaslight & victim-blame should things get out of hand.  And again, I speak as a psych nursing student.   (Referring only to those professionals who choose to step across that line in the 1st place, obviously.  There are some great ppl in this thankless line of work).  

Try as I might, I can not find a unified consensus on this question online.  Every website talks in terms of "should/shouldn't" and "terrible IDEA".  Lots of things are a terrible idea yet it doesn't stop people from doing it.  What's the worst that is likely to happen to a U.S.-based inpatient or outpatient psych nurse who consorts romantically with a consenting adult ex-psych patient he/she used to work with?   Are we talking professional or legal ramifications if the patient files a complaint & provides evidence?  An NP or APRN, not a psychiatrist or talk therapist.  

It's a common & important question, particularly in rural settings where even medical providers may not be too well-educated and there's tons of overlap between family, friends, classmates, coworkers, exes, potential partners & other social/professional circles.  Towns where the (married) police chief is sh@gging multiple women on the school board & abuse of power is the norm.  If you don't live in one of these places, consider yourself lucky.

TL;Dr - We all know you SHOULDN'T but we also know that people DO.  So what happens in terms of professional/legal repercussions should they be caught?  Sources greatly appreciated.   ??