IN LOVE WITH A PATIENT?

You find yourself strongly attracted to a patient and, especially if the attraction seems to be mutual, you could be heading for a problem. We all know that it is unethical to enter into any type of romantic relationship with a patient and that such a relationship can lead to a charge of professional misconduct and even losing your job. While caring for our patients, we must at all times remain within the boundaries of a professional, therapeutic relationship.

The nurse-patient relationship in an unequal one. The nurse is in a position of power while the patient is in a dependent, vulnerable position. The nurse also has a lot of sensitive personal information about the patient while, in contrast, the patient knows very little about the nurse as a person. These are the main reasons why it is unethical for a nurse to enter into a romantic relationship with a patient. It could affect professional judgment; lead to exploitation and even cause emotional and physical harm to the patient.

However, there have been many nurses and patients that have found themselves to be soulmates and ended up being happily married for life. So what do you do when there is a spark between you and a patient? The advice is to be very cautious and to make sure that you don’t overstep professional boundaries while you are the person’s nurse.

When you find yourself in the position where a romantic attraction has developed between you and your patient, you need to take a step back and analyze the situation objectively. It may help to write everything down, or even to discuss your problem with trusted colleague or supervisor. As with any ethical dilemma, this analysis will help you to decide what your next steps should be.

The most important thing to ask yourself is whether the romantic emotions you are feeling are the real thing and not just part of the nurse-patient dynamic.

It is common for a patient to become emotionally attached to his or her nurse or other caregivers. The patient may have unfulfilled emotional needs. Along comes the nurse, compassionate and caring, who meets these needs and the patient falls for her.

You in turn also have emotional needs. You may be overworked, stressed out, with little time to form meaningful relationships outside of your working life. It is reported that when health care providers are burnt out, they are more likely to develop romantic feelings towards a patient. The patient reaches out to you by showing kindness and interest in you as a person, and you, in turn, fall for the patient. Maybe the patient is even just flirting, and you mistake this as interest in you personally.

Be completely honest in asking yourself whether you are already overstepping professional boundaries and going beyond a healthy therapeutic relationship while interacting with the patient. Ask yourself whether any of your actions are more about your own needs than those of your my patient?

Signs that the relationship has moved beyond a proper therapeutic relationship include:

You spend more time than strictly necessary with the particular patient. You arrange assignments and tasks so that you can be with him or her more.You visit the patient when you are off duty.You believe that you are the only nurse who can meet the person’s needs adequately.You answer questions about yourself and share personal information that goes beyond that shared for a therapeutic goal. You discuss personal issues, such as problems with your family or colleagues, with the patient.You use touch, such as a hand on the patient’s arm, more than you normally would.You address each other with nicknames or endearments such as “Hi sweety,” etc.You keep secrets with or for the patient which go beyond standard patient confidentiality.Bringing and receiving small gifts.

Where strong feelings develop between a nurse and a patient it is always the nurse’s responsibility to establish appropriate boundaries to stop the relationship from moving beyond a therapeutic one.

After having analyzed the situation carefully, you may decide that you can continue caring for the patient but to discontinue the behaviors you have identified as possibly moving beyond what is appropriate in a therapeutic relationship. The situation can be discussed with the patient, explaining that while you are nursing him or her, you have to maintain a purely professional relationship. Where the patient is in the hospital only for a short stay this course of action may be simpler than in a long-term care facility.

If there is a strong romantic attraction between a nurse and a patient it will probably be too difficult to return to a purely professional relationship. In this case, you can ask to be no longer assigned to the particular patient. Even then, you should not pursue the relationship while the patient is in the health care facility, for example, by visiting during breaks or after hours and doing special favors.

It might be unkind to the patient for you to just disappear off the scene. Depending on the situation you can offer an explanation such as “I like you too much to maintain a proper professional relationship and have asked rather be assigned to other patients.” If the patient asks whether he or she will still see you, you can reply with “Not while you are in the hospital. If you want to, maybe we can get together after you have been discharged.”

Your feelings and those of the patient may have merely been a crush, fed by the intimate nurse-patient interaction, and may fade away once there is no longer any contact, especially when the patient returns to his or her normal life.

On the other hand, the feelings may be the real thing, and this leaves the possibility of starting a personal relationship after the patient is discharged. Because of the nurse’s position of power in the health care setting, it should be left to the former patient to make the first move. From your own romantic pursuits, you know that if someone is really interested in you, they will find a way to make contact.

There are still important factors which you should consider carefully and, once again, it might be a good idea to discuss these issues with a trusted friend or colleague:

Has enough time passed since the patient was discharged for any emotional attachment to you purely as a caregiver to have resolved?If it was a long-term patient, is it possible that you are being approached because he or she is still vulnerable and in need of care (even subconsciously)?To what extent can your knowledge about the former patient affect any future relationship?Is there any risk to the former patient?

We are human, and there are no restrictions on when and where cupid decides to shoot his arrows. Maybe what starts as a spark between you and a patient develops into a lifetime romance. There is no clear-cut-one-size-fits-all solution to the problem of attraction between a nurse and a patient. If you find yourself in this situation, the important thing is to remain professional while you are caring for the patient and to put his or her interests first, both within the health care setting as well as before you agree to a date.

By Frieda Paton.RN

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