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Nurse-Patient Relationships: What is Too Close?

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By Kristen Smith, R.N.

Sometimes, there is a patient that stands out to us. A patient that, for some reason, is able to get down deep into our hardened, fragile hearts. When that happens, we tend to go even more above and beyond our duties to make sure that patient has everything he or she could ever want or need. We use our badges to buy them a Coke in the cafeteria, bring them a sprinkled donut from the staff break room, or add a little flavor to their ice chips, since that’s all they can have. I’ve done it countless times, and I’m sure many of you have, too. But what is too far? When is that line between nurse and friend crossed?

I once had a patient that pulled at my heartstrings more than most. For some reason, he and I just clicked. I was his favorite nurse, and he was my favorite patient. He was admitted to the hospital for an intractable headache and found out that he had Stage 4 brain cancer. I was there for him and his wife before they were aware of this diagnosis, but I knew. I was there to pick up the pieces and hold his crying wife when the doctors informed them of his diagnosis. And I was there to keep him as comfortable as possible until he went home under hospice care.

When that patient left, I often wondered how he was and if he had passed. I skimmed the obituaries in the newspapers more often than I care to admit. Months later, I was told he had passed about a month after he was discharged from the hospital. I still think about him, and I hope he did not suffer. I struggle with the guilt of not staying in contact with the family, but I felt it would be unprofessional. Leave work at work and home at home, right?

I know nurses who add their patients on Facebook, or go to visit them at home after discharge. As nurses, we are to remain strictly professional, but friendly. Most of the time that is easy enough to do. But every once in a while, we stumble a bit. Does it make us better nurses? Maybe we are being biased, since we are to treat every patient the same. Maybe we are just being compassionate towards those who need it most. A divine intervention allowed us to care for certain patients for a reason. Maybe we need that certain someone to remind us why we go to work every day.

What do you consider to be “too close” in a nurse-patient relationship? Are the official guidelines too strict, or not strict enough? How do you handle a situation where the line is crossed?

I am a full-time registered nurse, wife and new mom. I've recently started writing part-time and I love it! My family is my life. I enjoy spending time with them in my free time.

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