I need some opinions. The other night I was helping out in PACU. (I am usually in ER or Preop, but occasionally go to PACU when needed) I was asked by another nurse to transport her patient upstairs. The patient was early 30's female, very nice, always saying thanks when people helped her. We talked as I took her to her room. She had surgery for a cancer recurrence, so we talked about the surgery, her young kids, her family, etc. It was shift change, so I ended up having to wait with her for quite a while to see her nurse, the PACU nurse has to have face to face time with the receiving floor nurse. During this time we chatted some more. Then I left when her nurse got there.
The next day I was off. I was thinking about this patient and how nice she was. I called her room to check on her. I just let her know I had been thinking about her, and asked how she was doing...get well soon, etc. She seemed very appreciative.
A few days later I told her PACU nurse that I had spoken with her. This nurse was very offended with me and said I had broken HIPPAA (sp?) laws by calling the patient to check on her. Is this true? I just thought I was being nice. When I had my daughter, the L&D nurse called the next day to check on me. I know hospitals can be lonely places and thought one might like to hear a friendly voice and know someone was thinking of them.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
With all due respect, I disagree. We develop a rapport for the sole purpose of providing nursing care and not to satisfy our personal need for socialization, or quench our curiosity ( if we were right about a hunch or diagnosis) .
If the patient wants to or feels a need to maintain the contact, and the nurse agrees, let it come from the patient.
BTW, it is the facilities right to set policy on this.
Just my professional opinion.
Fixated- attached to someone or something in a neurotic and pathological manner
Fixated- obsession and an unhealthy compulsive pre-occupation with something or someone, arrested development
In my world, the definition matters. When you broaden the meaning of a word and use it inappropriately, in my mind you diminish it. English has a staggering amount of vocabulary, plenty enough to find one that describes what the OP did, which was not fixating.
In fact, I don't disagree with you about the reasoning behind the call- but OP was quite open in her reasoning for the call. She told us she was concerned. I am not going to dig for a dark motive.
I don't think it was appropriate, but I also don't think it was a hippa violation. I bet management would frown upon it though. A few posts have talked about how after bonding with patient's after caring for them, you run into them and ask how they are. I see this as a very different situation, she called the patient from home on her day off. Also, she wasn't her nurse. She didn't care for her, and build this "relationship" with her. She merely transported her from one floor to another. Really, how much bonding could have really taken place.
Specializes in accident and emergency nursing, general.
The next day I was off. I was thinking about this patient and how nice she was. I called her room to check on her. I just let her know I had been thinking about her, and asked how she was doing...get well soon, etc. She seemed very appreciative.
i see nothing bad in asking after a patient when you are not on duty ,
the most important thing is not to disclose the patients' privacy to other collegues
no i dont think you were inappropriate you were just being nice nowadays you dont see any real good patient care or any real form of communication between nurses and their patients keep up your caring attitude your patients and their families will appreciate it:yeah::yeah:
I disagree with using the rapport that was developed for the sake of direct patient care on a specific shift, and extending it for a caring-phone-call-from-home-follow-up-chat-calling to ask how are you and if my hunch about your care panned out. I disagree with the nurse initiating contact outside the parameters of her job responsibilities, and I still consider it a fixation which is unhealthy. If they were to run into each other at the market, in the hall or similar, it would be appropriate to ask how are you? but nothing more.
It is not for me or you or anyone to say if the chatty phone call was beneficial to the patient or not- only the patient knows that. I can't say what the patient felt about the phone call and if the OP described it as positive I still dont know as the patient might have been polite or still under the impression that the nurse represents the hospital for which the patient is still obliged to. The OP can not know if the phone call was welcomed or not and that is not the point. Bottom line, it is unprofessional unless the facility demands it as part of their follow up care. Some nurses described here situations where follow up was part of the care, in which case it is expected and professional.
My advice to the OP is that if she wants to continue a relationship with the patient after her shift is over, and if her boss (the facility) approves, she could give the patient her personal phone number or email address or a business card with this information and tell the patient, "I really enjoyed being your nurse today, if you want to call me on a personal basis for anything, feel free- here is my card".
The OP wasn't calling to "check their hunch" the OP transported the patient to the floor....I doubt it took a lot of "hunches" to get her there. They had a chance to chat while waiting to hand off to the floor nurse....that was the extent of their in-hospital relationship.
I didn't say that we knew that the patient said it was a positive, I said, we didn't know that it was negative....so projecting that it was negative was fiction. Lack of support of a hypothesis does not support the null hypothesis. I said by the OP's report it was positive. While it is not evidence of the patient enjoying the experience, we have no reason to disbelieve the OP.
I think, starting with the woman who have the OP a hard time, that this has been blown wildly out proportion (nearly 900 posts!!).
Specializes in LTC, CPR instructor, First aid instructor..
I remember when I was with a poor, elderly man who was in for a colonoscopy. I listened to him tell me about his pickup truck that needed repair, and his concerns about what the doctor was going to find. I was with him during his entire pre procedure, and listened to him tell me his history of bowel problems. I couldn't help feel sorry for him. The doctor did find intestinal cancer, but when the man asked me for the results, I just told him the doctor would tell him about that. Then when the doctor told him he needed to see an Oncologist, I saw the hopeful expression on his face fade away, and then he told the doctor he was grateful for me staying by his side and allowing him to talk, because it helped him cope.
The same could be said about the nurse who is fixated on a patient and continues the interest and contact with said patient even after her work with that patient has been completed.
Professional nurses give their all during their shift Including caring and professional nursing care and when the patient is no longer under their care, move on to the next one. Only in the movies should nurses continue a personal contact.
the same could be said about the nurse who is fixated on a patient and continues the interest and contact with said patient even after her work with that patient has been completed.
i haven't seen anything in this longer than necessary discourse, about the nurse entering the information in the nursing care plan about what the situation between the patient and her family was, that needed intervention. once that occurs, no case is completed without addressing that problem.
professional nurses give their all during their shift including caring and professional nursing care and when the patient is no longer under their care, move on to the next one. only in the movies should (?) nurses continue a personal contact.
the denial that family members exhibited, that precipitated their negative response to a nurse who addressed the patient's need for correct information about her condition, wasn't normal or appropriate. action needed to be taken to ameliorate that imposition of guarded communication. referral to a social worker needed to be made to resolve the need that the patient and her family exposed, when an attempt to counter the misinformation the family wanted to continue, met outrage and threats to a nurse's job.
if the referral to msws couldn't be fulfilled that day, or the next one, it was entirely within the nurse's role to check on the patient the following day.
Specializes in Medsurg/ICU, Mental Health, Home Health.
I'm not even going to TOUCH the HIPAA issue here.
I really really really want to tell Rachelita that what she did was a-okay. I do.
But...
I don't think it was.
There's something about calling a patient on one's day off that isn't sitting right with me. If I were on the receiving end of that call, I would wonder why on Earth this nurse (who was never even in charge of my care, just assisted in a transport) took time out of her day...her NON-WORK day to check up on me. I think it would weird me out a bit. I know, I know...it's the thought that counts. Yeah, well...intent follows the bullet, too.
(Sorry if I'm making no sense. I'm sunburned, on Robitussin and Kyle Busch won the race. It means good ol' Camaro here is in a weird mood...)
"We talked as I took her to her room. She had surgery for a cancer recurrence, so we talked about the surgery, her young kids, her family, etc. It was shift change, so I ended up having to wait with her for quite a while to see her nurse, the PACU nurse has to have face to face time with the receiving floor nurse. During this time we chatted some more. Then I left when her nurse got there."
It seemed to me that they bonded, probably spent more quality time communicating, than most nurses spend with patients to whom they're assigned.
The next day when OP reported - on this site, that she called the patient)
"I called her room to check on her. I just let her know I had been thinking about her, and asked how she was doing...get well soon, etc. She seemed very appreciative."
Then she caught flack several days later for what I consider meanness on the part of the PACU nurse:
"This nurse was very offended with me and said I had broken HIPPAA (sp?) laws by calling the patient to check on her. Is this true? I just thought I was being nice. When I had my daughter, the L&D nurse called the next day to check on me. I know hospitals can be lonely places and thought one might like to hear a friendly voice and know someone was thinking of them."
Some L&Ds had follow up calling programs, but I haven't heard of that recently since the crunch in staffing at most OB units happened.
The other PACU nurse was probably jealous because you got along better with her patient. You helped transfer her to another floor and called her directly the following day. So, you aren't violating her privacy to anyone else. Some people just don't like to see other people happy, so they have to bring them down.
Yes, and since most patients in PACU are marginally conscious, nurses who have worked there for a considerable amount of time, lose perspective in regard to human decency....
Specializes in Medsurg/ICU, Mental Health, Home Health.
It seemed to me that they bonded, probably spent more quality time communicating, than most nurses spend with patients to whom they're assigned
No argument here; however, I still don't think that makes it okay.
I believe that the patient needs to make the initiative, needs to welcome the furthering of any sort of relationship, because he or she is the vulnerable party here. Or the nurse needs to ask, "hey, would you mind if I check in on you tomorrow to see how you're doing?" and then get a feel for how the patient sees the situation. The patient might very well (especially in this case) reply, "oh, I would love that! Please do!"
I know that I was brought up to make conversation with people, that it's just a nice thing to do to talk to a person, especially a person who is helping you, but also that conversation is simply conversation. My parents are those kinds of people who will just start talking to the person in front of them in line at the DMV, and talk and talk and talk. But you know what? Even though on the outside my parents have "bonded" with these people, it was all a matter of being polite, being friendly, making hay while the sun was shining.
Basically, "bonding" to one person is "chitchat" to another. And being in a position to access a person's location and whatnot makes a patient vulnerable.
I'm sorry if I'm not making sense.
I really do not in the least bit think that Rachelita is a bad person or meant to do harm. I also think, from reading her post, that no harm was done. I do believe, however, harm could have been done, and since we, as nurses, are in charge of keeping patients safe and advocating for them, we should avoid situations like this that are iffy.
:yeah:
nursel56
7,122 Posts
Fixated- attached to someone or something in a neurotic and pathological manner
Fixated- obsession and an unhealthy compulsive pre-occupation with something or someone, arrested development
In my world, the definition matters. When you broaden the meaning of a word and use it inappropriately, in my mind you diminish it. English has a staggering amount of vocabulary, plenty enough to find one that describes what the OP did, which was not fixating.
In fact, I don't disagree with you about the reasoning behind the call- but OP was quite open in her reasoning for the call. She told us she was concerned. I am not going to dig for a dark motive.