Do you ever get hit on at work? Throughout my years as a nurse practitioner it has happened to me a time or two. Typically, the gesture comes in the form of an inappropriate comment which I choose to ignore or express distaste at depending on the situation. Once, a patient even went so far as to deliver a note asking me on a date to the front desk of the walk-in clinic where I was working at the time. Awkward.
While I’ve never been on the receiving end of a romantic gesture from a patient I’ve been tempted to reciprocate, the situation does happen-more than you would think. Given the nature of the nurse practitioner-patient relationship, crossing professional boundaries can lead to some sticky interpersonal, not to mention legal, situations. Taking a relationship with a patient outside of the professional realm can be considered sexual misconduct and carry some serious consequences.
So, what’s allowed and what’s not when it comes to professional relationships turned personal for nurse practitioners and their patients? The following FAQ’s will help.
When is a romantic relationship with a patient allowed and when is it considered sexual misconduct?
There are several things to take into account in determining the appropriateness of taking a patient relationship beyond clinic or hospital walls. First and foremost, the question to ask is “Is this a former or current patient?”. Nurse practitioners should never date current patients. In some cases, however, a romantic relationship with a former patient may be permissible.
In what instances is a relationship with a former patient permissible?
The acceptability of a romantic relationship with a former patient depends on the situation. Here are a few things for nurse practitioners to consider in determining the appropriateness of a romantic relationship with a patient:
- How long has it been since the nurse practitioner was in a nurse-patient relationship with this patient?
- Was the professional relationship short-lived or long-term?
- What kinds of things does the nurse practitioner know about this patient based on their professional interactions?
- Does a relationship pose a risk to this patient?
If a significant amount of time has passed since interacting with a patient in a professional setting, a personal relationship becomes more appropriate. A good rule of thumb is to keep about a year’s time between any NP-patient interaction and the initiation of a more personal relationship.
The type of nurse practitioner-patient interaction also comes into play. Did the NP treat this patient in the emergency department once for a sprained ankle, or was the NP interacting with the patient weekly during a serious health crisis? Limited encounters such as a visit for a sprained ankle are less significant than patient interactions where personal information is shared, the professional relationship is long-term, or the patient is in a vulnerable state such as a life-threatening diagnosis.
Dating a patient who was seen by the nurse practitioner once in a walk-in clinic isn’t as significant of a concern as a romantic relationship where the NP-patient interaction occurred over a long period of time. In situations where a patient is vulnerable, such as treatment for a life-threatening disease, it’s advisable to keep the relationship professional.
What if a nurse practitioner develops a romantic interest in a current patient?
If an NP catches a current patient swooning and is interested in reciprocating the sentiment, a relationship is not impossible, but should be carefully navigated. First, this patient must continue their medical care with another provider. The provider may be another in the same practice, but records should clearly indicate this patient is no longer under this particular nurse practitioner’s care. Allowing some time to pass between the time the patient has been under the NP’s care and the time the relationship becomes romantic is also necessary.
The small town problem. What if the NP is the only healthcare provider available to their significant other?
For nurse practitioners living in small communities, the NP may be the only provider available to provide medical care to friends and family. If at all possible, another provider should treat those the NP is closest to, for example immediate family members and significant others. If this isn’t an option, the dual nature of the relationship should be openly acknowledged. The nurse practitioner must delineate when he/she is operating in a professional rather than personal capacity.
When is a romantic relationship with a patient absolutely prohibited?
Romantic relationships with patients in which the provider was involved in treating a psychiatric condition are absolutely prohibited. Patients with psychiatric problems may be vulnerable. They have also disclosed very personal information within professional boundaries so any resulting personal relationship is seen as “unfair” or manipulative in the eyes of the law.
In general, is is highly advisable to keep your personal and professional lives separate. A relationship that crosses professional boundaries can result in discipline from your employer or from your state’s board of nursing. In some cases a relationship with a patient may even be in violation of criminal law.
The National Council of State Boards of Nursing offers resources helping to explain how to navigate personal and professional boundaries in healthcare.
You Might Also Like: Can U.S. Certified Nurse Practitioners Practice in Canada?