Having a relationship with a patient

In all fairness chances are he wouldn't have been involved in her personal care. I work in home care and NONE of our male carers get involved in the personal care of our female clients.

Reply 42

mrt23498

14

Original post by Subcutaneous

I found out yesterday a friend of mine has formed a relationship with a patient on his ward. They decided to see each other whilst she was a patient, and hes seen her alone since she was discharged 2 weeks ago.

Im rather unsure how to handle this. Personally alarm bells are ringing such as:
Unethical
Unprofessional
Crossing professional boundaries

Which is making me to lean towards reporting him to my uni, however some if my friends are saying it's not that big of a deal, nothing wrong with it and its not my buisness.

What would you do?

How was his actions towards the Patient generally. Did he treat (Medically) her as he would anyother patient?
Imagine this situation:
You're a bartender, and a lovely lady come to you, you start talking and you think it could go further. You ask her out to a few dates.
Is it necessarily wrong?

Or perhaps, since he started these discussions during the ward, it wasn't a good iea of his. The, if any, relationships should start outside the ward (once she has been discharged).

Reply 43

Original post by Subcutaneous

Senior Nurse just highlighted this too me..i'd expect if i was breaking the code to be reported also. I've not made a decision yet as speaking to tutor later, but im expecting to be told to report it really.

Well obviously you're going to be told to report it by a tutor. It'd be irresponsible of THEM to not tell you to report it, considering they're actually of vital importance in the regulation of these sorts of rules.

You are definitely full of a sense of self-importance here when really you need to keep your nose out. You came on here asking for opinions when really you were going to report it anyway. Discussing it with a tutor is cowardly and you know that- because you've discussed it with a tutor you'll feel more professionally obliged to report it for your own job safety, whereas if you didn't discuss with a tutor you'd be left to make your own decision with nos sense of obligation either way and, I imagine, you wouldn't report it. However you seem to want a pat on the back for following the rules and a sense of power and importance from getting someone reported. Like a child who knows gossip about someone who's been naughty and goes to tell the teacher.

I'd agree with you if it had impacted patient care, or he did it regularly. But the fact is you say he's 44, he's no longer a young, sex obsessed man who just wants to get laid and acts like Todd from scrubs. He's a human being and clearly he found someone he liked and who liked him back. It was unprofessional to act on it on the ward but she's no longer on his ward.

(edited 13 years ago)

Reply 44

Trigger

18

Original post by Jessaay!

Well obviously you're going to be told to report it by a tutor. It'd be irresponsible of THEM to not tell you to report it, considering they're actually of vital importance in the regulation of these sorts of rules.

You are definitely full of a sense of self-importance here when really you need to keep your nose out. You came on here asking for opinions when really you were going to report it anyway. Discussing it with a tutor is cowardly and you know that- because you've discussed it with a tutor you'll feel more professionally obliged to report it for your own job safety, whereas if you didn't discuss with a tutor you'd be left to make your own decision with nos sense of obligation either way and, I imagine, you wouldn't report it. However you seem to want a pat on the back for following the rules and a sense of power and importance from getting someone reported. Like a child who knows gossip about someone who's been naughty and goes to tell the teacher.

I'd agree with you if it had impacted patient care, or he did it regularly. But the fact is you say he's 44, he's no longer a young, sex obsessed man who just wants to get laid and acts like Todd from scrubs. He's a human being and clearly he found someone he liked and who liked him back. It was unprofessional to act on it on the ward but she's no longer on his ward.

How she can even call him a friend when she is prepared to ruin his life for the sake of nothing is beyond me.

Reply 45

puddlejumper

2

Original post by WelshBluebird

Oh for gods sake come on. This situation is NOTHING like what you are on about.
Why do you say that the patient was "willing to play along". Perhaps she actually liked him?
If she didn't like him, or had a boyfriend, she would have said so. You know, exactly like people do in everyday life.
And just because you fancy someone, doesn't mean you are "perving over" or "lusting after" them. You may just, you know, like them.

The only questionable bit is that they "decided" to start a relationship when she was still a patient. But even then, if she didn't like him then she didn't have to meet him once she was discharged.
As I said, the rules are not always right. I'll repeat the example I gave in my previous post.

So if a nurse bumps into a former patient on a night out, they end up talking and clearly like each other, they can't do anything else?
What if its a few years down the line?
What if its a person they used to have a personal relationship with?

I said 'in this case'. Do you imagine that the only time a patient is propositioned it is by someone that they like? After all, in many cases girls are approached by lads they wouldn't be seen dead with. But they have the freedom to say 'no thanks' and move on. She was a patient on a ward. If she didn't want his advances what action could she take? After all, we all know what happens to patients who 'rock the boat'.

What if the patient was unhappy about being approached in this manner by someone who she trusted to act professionally and who shouldn't be seeing her as a potential girlfriend? It was a hospital ward not a social centre, after all.

Obviously only an idiot would object to them having a relationship after she was no longer under his care and provided that he had made no approach to her while she was his patient. But that is not the case in this situation. He propositioned her while she was his patient and that is breaking the rules for professional behaviour.

I can't believe that there are so many people on a Health forum who believe it is acceptable to behave in this manner when you are in a position of trust. You clearly have a lot to learn about professional responsiblities and how to behave professionally.

And I also am astounded that people are comparing this with tittle-tattle in the classroom. Sub, whatever her faults, and God knows she has many, has a professional duty to report this incident. It doesn't matter whether it is her friend or a complete stranger. The responsibility is to report it.

Reply 46

puddlejumper

2

Original post by Trigger

How she can even call him a friend when she is prepared to ruin his life for the sake of nothing is beyond me.

Why is he prepared to ruin his own life by getting off with patients? It's his responsiblity. He knows the rules and he should abide by them. End of.

Reply 47

OP

Original post by Jessaay!

.

Im going to brush off the comment about self importance, as i don't think you've had much experience with practically acting on your duty of care as you're very early on in training, but its tough, and a very difficult thing to deal with. I really would suggest reading NMC hearings. However it was a very misguided comment, and i had not made a decision and recognised that my gut feeling was to report, but that i needed more opinions, to sleep on it and gain views from colleagues more senior to me. I also want to point out this is a healthcare and nursing forum, i was after experience from healthcare students who have more PRACTICAL experience of acting within a professional body, many students responding here don't have that. And as much as i know medical students also have the GMC, i know many junior students wont have the practical experience- and as students we're all LEARNING to be professionals.

To sum up the discussion with my tutor:
- it is a grey area
- NMC is very clear cut on this however
- As i mentioned previously we're learning to be professional, and as a senior student i did the right thing through highlighting the issue to the student and educating
- However if furthur events were to happen and i became to question furthur his conduct, lack of boundaries and awareness of the professional code then i'd be even more bound to report (and putting my own career at risk potentially). I agree with this and i feel more comfortable taking action on this. Plus it would be silly of me to report on from just what hes said!

HOWEVER
Turns out the ward sister has reported him already, from what i gathered from ward staff he was spending lots if time talking to her and not getting on with duties, and an another student saw him kiss her outside the hospital when going home and told the ward. He went and announced on fb an hour ago he'd been suspended from placement. SO i didn't have to do anything, and clearly there was more to it than he let on!

So lesson learned and if faced with a similar problem again i'd handle it better now more informed!

I think the majority of responses are rather mature, but i'd like to plint out to you all being a student nurse we have codes which affect not only how we are as profesdionals but also our personal lives. Particuarly when 50% of our degrees is spent directly with patients, and in senior years a degree of responsibility and management of patient care, learning to make decisions and become accountable practitioners. Its very hard to be a student and remember to be professional. Its very difficult and not easy, i'd rather you all bare this in mind when responding to threads like this questioning, as its so hard to feel in the middle and being duty bound...aswell as a friend & colleague.

Reply 48

OP

Original post by Converse

Wow, if that's how you are to friends, I'd hate to be your enemy. You're seriously considering altering the course of his whole life because of he decided to see someone. One person. Seriously?

If it happens regularly, then yeah, by all means report him. But once? No. It's not as if he's a teacher abusing his position with a student. Or preying on her vulnerability. I don't think it's unethical tbh. We can't stop having these feelings, just because our job says that we must.

Well it was wrong to say friend, he's a colleague, and an aquaintance outside of work.

Reply 49

WelshBluebird

16

Original post by puddlejumper

I said 'in this case'. Do you imagine that the only time a patient is propositioned it is by someone that they like? After all, in many cases girls are approached by lads they wouldn't be seen dead with. But they have the freedom to say 'no thanks' and move on. She was a patient on a ward. If she didn't want his advances what action could she take? After all, we all know what happens to patients who 'rock the boat'.

What if the patient was unhappy about being approached in this manner by someone who she trusted to act professionally and who shouldn't be seeing her as a potential girlfriend? It was a hospital ward not a social centre, after all.

Obviously only an idiot would object to them having a relationship after she was no longer under his care and provided that he had made no approach to her while she was his patient. But that is not the case in this situation. He propositioned her while she was his patient and that is breaking the rules for professional behaviour.

1 - "In this case" it is clear that the patient was happy enough. Otherwise she wouldn't have agreed to see him after leaving hospital. And if she wasn't happy with it, then she could have just as easily said "no thanks". If she had felt strongly against it she could have complained about it.

2 - So? People have met potential partners at work, on public transport, at a hospital (being on the same ward etc). It doesn't have to be a "social centre" for you to strike up a relationship with someone.

3 - Well you are the one banging on about the rules. And according to the rules (which you posted) then it is wrong to have a relationship with a patient after treatment aswell as during.

I realise this is a grey area, and there is the potential for abuse to occur. However, considering that both are consenting adults, both are sane, neither is taking advantage of the other, I'd say it is fine.

Reply 50

OP

As much as this could potentially be an interesting debate if we're looking at the general concept. However if you're not a healthcare student can you refrain from posting. It'd be uninformed and if i was after outsiders opinions i'd have posted this elsewhere. Its a very unique position and involves a knowledge and experience of working to a professional body within healthcare, which you won't have.

Reply 51

Kreuzuerk

3

The regulations and guidelines you keep waffling on about are designed to prevent extreme situations of patients being taken advantage of. For completely innocuous relationships, which undoubtedly represent the majority, they're largely irrelevant because no harm will come of it. It's a relationship between two competent, consenting adults. But because mental people do exist, guideline have to be drawn up. Is your 'friend' mental? No? Well then stfu.

It's as if you've gone...'shipman was a medical practitioner with an outside relationship with his patients...maybe all medical practitioners with outside relationships with patients are as mental as shipman'.

(edited 13 years ago)

Reply 52

davey jones

1

I haven't yet read what the patient's condition was. See I know that in the rules it is not relevant but hear me out...

If the patient had a minor admission for something relatively innocuous, maybe re-setting a broken hand, laparoscopic hernia repair then MAYBE this could be a reasonable situation. I have met two female nurses who met their husbands in the line of their work, and nobody shopped them to the authorities. Their conduct remains professional and their relationships have evidently flourished. So surely this implies that it is possible to date a patient without having an inherent power imbalance that will lead only to misery for the patient. I would personally keep my mouth shut and pretend I don't know.

That said, if the patient was chronically ill, mentally ill or in some other way vulnerable, questions must be asked and Subcut did absolutely the right thing if this was the case. It is a very difficult situation to be in. As Subcut mentioned, NMC hearings are awash with mental health patients being shagged by male and female carers, whilst at their most vulnerable.

Of course the nurse's gender must be noted. Males are driven far more by sex than women generally and female colleagues opinions vary on this. I have known some suggest that all male nurses wish to shag their patients and others that recognise most are just the same as any other professionals (professional in their behaviour towards patients). However , as males are often viewed as the sexual 'aggressor', a male nurse having a illicit relationship with a female patient is far more likely to be questioned than a female doing the same thing, even in the absence of any obvious vulnerability from the patient. I have known no males admit to ever dating a patient of their relative. Although we males may well comment to each other about who we would and wouldn't; man chat style.

But in conclusion, the rules are clear and unambiguous (and there exclusively to protect the vulnerable). If the man was so stupid to get in this situation, I wouldn't lose any sleep about the consequences for him. Subcut, in the limited information you have provided I would say you did about the right thing.

(edited 13 years ago)

Reply 53

OP

Original post by davey jones

.

Thanks. It was a gastro medical ward, i think she was there for chrons or UC, one of them anyway!

I know i was right to feel uneasy and question his actions. I wouldnt have been in the wrong IF i had reported but unfair. Obviously his actions on the ward were certainly out of the grey area as i now know!

Reply 54

FXX

Original post by Subcutaneous

As much as this could potentially be an interesting debate if we're looking at the general concept. However if you're not a healthcare student can you refrain from posting. It'd be uninformed and if i was after outsiders opinions i'd have posted this elsewhere. Its a very unique position and involves a knowledge and experience of working to a professional body within healthcare, which you won't have.

I still stand by my original point (staying out of it if they're mentally stable and consensual). I understand that even as a student, you have a duty to maintain the integrity of your profession. I also understand that what this student has done breaches a number of statements in the code of conduct related to professionalism, confidentiality, trusting relationships, and so on. However, I think some common sense needs to be applied as well. My personal belief is that many of the codes of conduct are to cover both patients and healthcare professionals in the worst case scenarios, much like speed limits are imposed based on the worst possible weather conditions. If the patient is capable of making decisions about their life choices, they should be allowed to do so, even if it involves a person that is also acting as their healthcare provider. Acting out a patient-staff relationship in public in hospital grounds is not on, and if I had seen that I would be contemplating reporting that to my line manager. However, if it had been going on behind closed doors and not flaunted out in public, I would be willing to leave them to it and if ever called up to a hearing as a witness, would deny I had any knowledge of their relationship, as I genuinely wouldn't know the extent of it and have no personal interest in finding out. If I felt it wasn't detrimental to her care, or the care to any of the other patients on the ward at the time, I don't believe there is any justification for reporting him.

That's my view as a student radiographer anyway. I think we have very different relationships with patients though, and don't have very much experience working on wards, but I still have two sets of codes of conduct to follow (HPC and the Society of Radiographers) so I have very similar professional issues to contend with.

Reply 55

Original post by Subcutaneous

Im going to brush off the comment about self importance, as i don't think you've had much experience with practically acting on your duty of care as you're very early on in training,

That may be, that doesn't mean I'm clueless to it and how you're supposed to act, and also how conduct occurs in reality. We are taught about it by doctors who have been in such situations, and to an extent we have to act professional ourselves in a limited manner, when we're on placements etc. Medical students of different ages do also talk, believe it or not. I'm not as clueless as you probably think and I do think, in this case, it was a matter of self-importance just in the way you were acting. If you were REALLY bothered about it and it shocked you to your core to such an extent that it challenged your professional boundaries, you'd have gone to report it almost instantly I imagine. I realise you call him a "friend" (though in this case, that's debatable), but if I saw something a friend was doing that made me feel patient care was being sacrificed, I'd have gone to see someone straight away about it rather than posting a thread on TSR regarding the matter and umming and ahhing. It seems you were acutely aware nothing was REALLY going on between him and the patient that was harmful or sinister.

Reply 56

davey jones

1

I think in Subcut's defence, nursing students have a great deal more early patient contact and spend a lot more time learning about and fostering therapeutic relationships than medical students (who I acknowledge do have some focus on soft skills, but a great deal more focus on the hard science of medicine). This leaves nursing student's in a strange position sometimes, when they know something going on is wrong, but often they are the most vulnerable there. They are not protected by employment law and can easily be failed/hauled through the coals in a profession that is renowned for its bullying. Similarly, one would not want a reputation for complaining about any old thing, so opening a discussion on the matter seems reasonable. Although I am dubious as to what sort of advice one could possibly expect from TSR; the home of so much life experience, wisdom and reasoned discussion.

I think also if the ward sister felt duty bound to complain, it seems a little harsh to sling accusations at the student for being unsure of her role and expectations in a very difficult situation. I will also add that seeing a patient's safety or well-being compromised by a colleague through either concious misconduct or sheer incompetence is not an if, it is almost guaranteed in your choice of career. I wonder if you will be so sure that you will know what to do and be prepared to bite the bullet so effortlessly. But I don't blame you for your confidence in this debate, when I was younger I though I knew everything too, and low and behold I actually knew **** all.

Reply 57

Trigger

18

Original post by Subcutaneous

As much as this could potentially be an interesting debate if we're looking at the general concept. However if you're not a healthcare student can you refrain from posting. It'd be uninformed and if i was after outsiders opinions i'd have posted this elsewhere. Its a very unique position and involves a knowledge and experience of working to a professional body within healthcare, which you won't have.

The arrogance in this post is breath taking.

Reply 58

Original post by Subcutaneous

As much as this could potentially be an interesting debate if we're looking at the general concept. However if you're not a healthcare student can you refrain from posting. It'd be uninformed and if i was after outsiders opinions i'd have posted this elsewhere. Its a very unique position and involves a knowledge and experience of working to a professional body within healthcare, which you won't have.

That's a load of crap. Just because they don't work in healthcare doesn't mean they can't have an opinion, or that their opinion is uninformed.

It's not rocket science, people are generally aware of the rules. I don't have experience working within it yet, but I'm not exactly unaware or uninformed. In fact, we're tested on rules, laws and professional obligations incredible amounts. You're unbelievably arrogant.

Reply 59