What would you have done?

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Ok we had this patient the past 2 weeks. He's a professional athlete who had a of things go wrong during his admission. As charge nurse (and for the first week or so I knew nothing about him other than some people relayed to him as a PITA) I felt compelled to help smooth things over. So last week I went in to introduce myself and try to make his stay better. Everyone (administration included) were bending over backwards for this guy, so needless to say I payed extra attention to him to make sure his needs (physical, emotional, etc) need were met and he's really a nice guy and I enjoyed talking to him. He's very far from home and it's the holidays. He had a lot of people's cell phone numbers (mine included in case any issues arose when I was off - i'm the only 'official' night charge). On saturday he called me up (my day off) and asked if I could pick him up and take him to his hotel as his kids (early 20's) had gone to get airline tickets and he wasn't anticipating on the discharge. I was already out shopping and in the area and the hotel was about 1.5 miles away. I said yes. I picked him up, asked him how the last few days had gone and if he had felt better. He said he was and was glad to be going home.

Cut to Christmas Eve. My director calls me at home saying she wants to have an extensive meeting tomorrow morning. Do you guys think I was over the line? I felt like I was helping both my unit and the patient and avoiding issues all the way around. It was my day off, so it's not like I was on the clock. I'm so worried now about getting my tail chewed off that I haven't slept since Christmas eve and I'm having terrible GI distress.

In any case, there are major boundary issues here.

Yeah, however with me, I'd have to say that they'd be personal boundary issues (it's just something I'd never do). I don't think it would be wise for mgmt to take the slightest official notice, rather just take the nurse aside for helpful discussion and exploration.

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Yeah, however with me, I'd have to say that they'd be personal boundary issues (it's just something I'd never do). I don't think it would be wise for mgmt to take the slightest official notice, rather just take the nurse aside for helpful discussion and exploration.
I think it extends beyond both personal and professional boundaries, especially given her comment "in case any issues arose when I was off - i'm the only 'official' night charge" . That isn't in the job description of any night charge I've ever encountered, and takes it beyond the personal and gives the manager a reason to make it an official reprimand.
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Specializes in L&D, medsurg,hospice,sub-acute.

Working in a sub acute, I have several times brought forgotten items to patients that got transferred to the ER, a nurse recently took a patient and her son who she doesn't see often home to her house for several hours on Christmas, once I took a uncontrolled diabetic pregnant patient out to work in the garden--just to stop from being stir crazy---several people I know have given Christmas presents (anonymously) to folks stuck as inpatients for Christmas--and several of us have taken patients out to church and lunch....nursing is about more than pills, IV and lab results!!For some of us--this caring for the heart and the spirit is why we do the other parts of nursing....

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Specializes in Family Nurse Practitioner.

I'm a little uncomfortable with all the personal info listed here. You might want to consider editting some of it. I hope it works out ok for you because obviously you did it with pure intentions.

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Specializes in ER, NICU, NSY and some other stuff.

If your role is simply as charge nurse, I would have to say that you did overstep your boundries. It is not uncommon for Administration or Managment to give out cell phone numbers etc to VIP patients. It is not common for anyone below that level to do so for unit related reasons. If his kids were off buying airline tickets, then obviously his discharge was at least somewhat anticipated.

Plus for your own safety it is not wise to go around giving out your personal numbers. Even "special" people can be dangerous.

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Specializes in ICU, School Nurse, Med/Surg, Psych.

I think that we all at one time or another come accross a patient or situation and cross the strict line of boundaries. I have had outside relationships with people I met through hemodialysis and it can get sticky if you both don't understand who you are. but giving the guy a ride- good grief, that is just plain being nice.

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I think that we all at one time or another come accross a patient or situation and cross the strict line of boundaries. I have had outside relationships with people I met through hemodialysis and it can get sticky if you both don't understand who you are. but giving the guy a ride- good grief, that is just plain being nice.
Her justification for providing him her contact info was because she was the 'official charge nurse'. That certainly blurs the line between personal and professional behavior, and makes me wonder what her professional liability (and that of the hospital) would be in her transporting him at discharge. I don't know the answer, and would love to know risk management/hospital attorney's take on this.
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Specializes in Utilization Management.
I think that we all at one time or another come accross a patient or situation and cross the strict line of boundaries. I have had outside relationships with people I met through hemodialysis and it can get sticky if you both don't understand who you are. but giving the guy a ride- good grief, that is just plain being nice.

Why I said it was probably OK: the OP was in the area and the ride was less than 2 miles.

Translation: 4 minutes from door to door that enhanced the patient's perception of "good customer service."

Yes, technically it should not have been done, but believe me, the OP would've spent more time getting the right person for the job than actually doing it herself.

Remember, rules are made not to be broken, but used with a healthy dose of common sense. JMO.

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Specializes in Emergency & Trauma/Adult ICU.

I see several problems here. Definitely, boundary lines were obliterated when you gave this patient your personal cell phone number. I note that in your 2nd post you state that other members of your hospital's administration had given their office phone numbers to the patient, and that is at their discretion (although probably foolish as well) but that is a world away from giving a patient your personal number. You do not work for the patient -- you work for the hospital.

Which brings up the next point. Even if you need to be available at night because you are the only "official night charge" there still must be some procedure/policy/practice in place where a charge nurse of an individual unit or, more preferably, the house supervisor who is actually in house at the time can contact you or other administration if needed. Not a patient. If a patient has issues, the patient and/or family can take it up the chain of command appropriately.

Driving a patient somewhere? Never in a million years would I do such a thing unless I knew the patient outside of the hospital before he/she was a patient. This has less to do with fear of something happening while we are driving a short distance than it relates to boundaries.

For your sake and the sake of all your coworkers (nurses, physicians, administrators, everyone) I hope you have not been as matter-of-fact in your conversations with this patient re: the cause & effect of certain complications he encountered while in your facility as you have presented them here. I'm stating my honest opinion here: if you've had conversations with this patient using this same language ... I hope you are either contacting your insurance carrier or are scouting out attorneys.

I suspect your meeting with your director will be about boundaries, policies, liability and damage control.

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Specializes in Orthopedics/Med-Surg, LDRP.

OK, some clarifications. I was not the ONLY person who gave out their personal cell numbers. Other clinical coordinators and our director also gave out their numbers to the pt.

I was reprimanded this morning and I'm quite upset about it. I was following the lead of what everyone else was doing and didn't do anything more than anyone else did. I didn't neglect any other patients or situations and the day he was discharged, the one poster was right - It was less than 2 miles away to his hotel and the hospital would have had to get him a travel voucher, by the time a cab arrived (I've seen them take upwards of an hour) and whatnot, I could have easily done it myself. I was trying to end his stay on an 'up'note and not the difficulties that the stay started with.

If I could have done it all over again, I would have done it different. It just seemed like a nice thing to do at the time, but evidently nice is wrong in nursing.

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Specializes in Emergency & Trauma/Adult ICU.

I certainly don't doubt that you're a nice person.

But if you've been given the responsibilities of charge nurse, it's time to think in management terms.

Boundaries, hon.

Good luck to you. Your facility & your staff may have a rough road ahead.

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You do not work for the patient -- you work for the hospital.

Driving a patient somewhere? Never in a million years would I do such a thing unless I knew the patient outside of the hospital before he/she was a patient. This has less to do with fear of something happening while we are driving a short distance than it relates to boundaries.

For your sake and the sake of all your coworkers (nurses, physicians, administrators, everyone) I hope you have not been as matter-of-fact in your conversations with this patient re: the cause & effect of certain complications he encountered while in your facility as you have presented them here. Here, you've presented them as fact: patient contracted a MRSA infection while in your ER ... PICC line was ordered to be inserted (or possibly actually inserted) into an extremity where the patient had one or more DVTs ... patient's chest tube site became "horribly" infected ... Wow. I'm stating my honest opinion here: if you've had conversations with this patient using this same language ... I hope you are either contacting your insurance carrier or are scouting out attorneys.

I suspect your meeting with your director will be about boundaries, policies, liability and damage control.

I think you need to do some serious thinking about your actions here, no matter what the meeting with your supervisor is about. You gave enough info in your post to possibly identify the patient. How do you know who else in your hospital is a member of this site? Anyone can recognize this situation and report you. There have been reported instances of people getting in serious trouble and even fired over their activities related to this site. Even though you didn't give out the name of the person, he can be identified from your post. And you made comments about his medical condition. I think you need a few days off sans pay to reconsider your behavior. Please consider your own safety if you don't consider discretion. We don't want to hear about you being found dead somewhere because you got too friendly with the wrong patient. Another question. Do you give your personal number and offer taxi service to all of your patients? If you do not, then your good intentions are a little tainted.

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