Professional Boundaries
Recently I read an article about a nurse who was the beneficiary of a deceased couple’s estate. I may not be recalling the facts exactly but the lesson of my message is what’s important.
The nurse provided for an elderly husband and wife for years up to the point where the home care could no longer provide for their needs. Even when the couple then went to a nursing home, the nurse continued to be active in their lives. She would visit them at the nursing home at least once a week. Providing for them hadn’t been just a job, she was genuinely quite fond of the pair.
As all time eventually leads, one of them passed away followed soon thereafter by the other. It was some time later that the nurse was surprised and shocked to learn that she was the beneficiary of their estate, as they had left no family. She had no idea about the estate, which primarily consisted of a house valued at a little less than $200,000.
Ethical questions arose about whether the nurse had been asked to be placed in the wills. If I understand correctly, an investigation is now pending.
What a difficult situation for this nurse. She loses two people that she cared for very much as friends as well as patients, feels like she won the lottery by inheriting the estate only to then to become the subject of an investigation.
Let’s take a close look at this matter. Should a nurse continue a relationship with a patient after the nurse-patient relationship ends? As nurses, especially those working home care where numerous hours and days are focused on giving care to the patient, the nurse sometimes becomes like a family member. She’s there providing care when other family visits which can make her seem all the more like a part of the clan.
However, even if you’re invited by the patient or relatives to participate in family functions … you are NOT family! Of course, you want to be pleasant and professional but there are boundaries. You are there to provide service, to provide care; not to be a social member of the family. How much are you sharing of your personal life?
The next ethical question that arises is should the nurse continue to see the family after the professional services end? Let’s look at it this way, do you know of any physician who continues to visit patients after the physician-patient relationship has ended? How many physicians give their personal cell phone number to a former patient?
There is a fine line between professionalism and friendship. Therefore, we need to err on the side of professionalism. If that means telling the patient, “I wish you the best in the nursing home but our professional relationship is now done,” that would be an appropriate way to end things.
Visiting weekly raises red flags.
Regarding the inheritance, this nurse had no idea that the couple would make her the estate’s beneficiary. I truly believe that she had no intention when she visited the couple weekly that she would end up being named in the will. Regardless, the fact that she was the only person close to this couple and was named in their wills means that it may have been more than just a professional relationship.
You know, I’m not here to judge and there is a fine line but as nurses we have to respect our boundaries and keep the relationship professional. Nurses are confronted with professional boundaries all the time and I suggest that you get continuing education on this topic to be clear on where your professional boundaries are. Here is a resource from the National Council of State Boards of Nursing. https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf
Our role in coming into their lives is for the reason of providing care, and that’s it. As much as we would love our patients and want to be friends with them, we cannot.
