Unethical?

[RebecaRN]

Is it unethical to date a recent patient? A coworker was the nurse for this patient and days after discharge she was "in a relationship" with this patient. We work psych and this seems unethical and a boundary issue to me. It makes me sick to my stomach thinking about it. I'm not sure if I feel that this is a bigger issue than it is or not.

[Davey Do]

https://allnurses.com/psychiatric-nursing/dating-a-former-959114.html

[calivianya, BSN, RN]

It's a little skeevy in any situation but it's extra skeevy in inpatient psych. If the nurse and the patient both are of sound mind and mentally stable when they're interacting, i.e. the patient is hospitalized for surgery, that's less gross, but developing a relationship that started while the patient was in with a psychiatric crisis is just messed up.

[RiskManager]

This situation gives the risk manager the vapors from an ethical standpoint.

[FolksBtrippin, BSN, RN]

A few days is not long enough for the nurse patient relationship to have terminated fully before the romantic one begins, so yeah I think that's unethical.

That having been said I think three years is too long and reflects mental illness stigma.

[VivaLasViejas, ASN, RN]

This is wrong on a number of levels. For one thing, a nurse is not supposed to have any interest in a patient but a clinical one, and that ends when the pt is discharged. It's worse in psych, if for no other reason than most psych pts are very vulnerable (and apt to return), and the relationship between nurse and pt must have strict boundaries in order to be therapeutic. There is no therapeutic relationship outside the treatment facility. I think this has been covered before but thought I'd throw in my two pence worth.

[elkpark]

A few days is not long enough for the nurse patient relationship to have terminated fully before the romantic one begins, so yeah I think that's unethical.

That having been said I think three years is too long and reflects mental illness stigma.

It has nothing to do with "mental illness stigma." I've been in psych for 30+ years, and I've never heard of a "3 year" time limit -- the time limit has always been "never." Within the mental health professions, we consider any romantic (or other, e.g., friendship) personal relationship with a former client to be unethical and unprofessional, regardless of the amount of time that has passed, and regardless of the professional setting in which you met the individual (i.e., no different in medical-surgical settings), not because of the nature of the client's illness, but because any personal relationship arising from a professional relationship is fatally flawed because of the origin of the relationship and inherent power imbalance in the original professional relationship. You can't go back and "undo" the previous professional relationship. Any personal relationship is inherently exploitive of the former client.

[dishes, BSN, RN]

It is very possible the colleague's behaviour will result in a complaint to the BON and disciplinary action.

[kbrn2002, ADN, RN]

Yikes, Holy lack of judgement Batman! Yes that is very unethical. Could and should be grounds for termination and is very possibly reportable to your state's BON. Dating any recently discharged patient is hugely questionable ethics wise, when that recently discharged patient happens to be inpatient psych it crosses boundaries into a potential vulnerable adult violation.

I hate to make a blanket judgment about somebody based on so little information but I would have to say if this co-worker allowed herself [or himself] to become so emotionally involved with a patient that dating seemed like a good option this co-worker really shouldn't be working psych any longer.

[dishes, BSN, RN]

@rebeca how did you become aware that your colleague is in a relationship with the patient? and how did you respond when you became aware?

[Mandychelle79, ASN, RN]

It has nothing to do with "mental illness stigma." I've been in psych for 30+ years, and I've never heard of a "3 year" time limit -- the time limit has always been "never." Within the mental health professions, we consider any romantic (or other, e.g., friendship) personal relationship with a former client to be unethical and unprofessional, regardless of the amount of time that has passed, and regardless of the professional setting in which you met the individual (i.e., no different in medical-surgical settings), not because of the nature of the client's illness, but because any personal relationship arising from a professional relationship is fatally flawed because of the origin of the relationship and inherent power imbalance in the original professional relationship. You can't go back and "undo" the previous professional relationship. Any personal relationship is inherently exploitive of the former client.

taken directly from the Pa BON website

Professional relationship—

(i) For a registered nurse not involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between a registered nurse and a patient and ending with the patient's discharge from or discontinuance of services by the nurse or by the nurse's employer. The administration of emergency medical treatment or transitory trauma care will not be deemed to establish a professional relationship.

(ii) For a registered nurse involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between the nurse and patient and ending 2 years after discharge from or discontinuance of services. For a patient who is a minor, a professional relationship shall be deemed to exist for 2 years or until 1 year after the age of majority, whichever is longer, after discharge from or discontinuance of services.

[RebecaRN]

I became aware via facebook posts of "in a relationship with" and other very obvious posts there was/ is in fact a relationship. I'm saddened to say that several other coworkers knew before I (via facebook) and told me that I would "get over it in a few days". I went home and slept on it and discussed it with a trusted person in my life. I did contact my manager because in fact I can't "get over it".

[Pangea Reunited, ASN, RN]

taken directly from the Pa BON website

Professional relationship—

(i) For a registered nurse not involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between a registered nurse and a patient and ending with the patient's discharge from or discontinuance of services by the nurse or by the nurse's employer. The administration of emergency medical treatment or transitory trauma care will not be deemed to establish a professional relationship.

(ii) For a registered nurse involved in providing mental health services, the relationship which shall be deemed to exist for a period of time beginning with the first professional contact or consultation between the nurse and patient and ending 2 years after discharge from or discontinuance of services. For a patient who is a minor, a professional relationship shall be deemed to exist for 2 years or until 1 year after the age of majority, whichever is longer, after discharge from or discontinuance of services.

Is the OP in PA?