Licensed Professionals and Sexual Relations with Clients, Customers, and Patients: Oh My!

This case was reported in the Ohio State Bar Association Report, its a member publication of the Ohio State Bar Association.

Its depicted as "sexy" in the movies of yesteryear and today however, its unethical for licensed attorneys to engage in intimate or sexual relationships with clients.

Any licensed healthcare professional is "gambling" with his or her license when engaging in an intimate or sexual relationship with a client or even a former client depending on the "cooling off" period imposed by the state practice act, board regulations, and/or professional literature. Check your State Nurse Practice Act and/or Board of Nursing regulations.

Yes, we all know of nurses, dentists, physicians, attorneys, etc. who have married patients, dated patients, etc. and nothing happened with his or her license. That doesn't make the actions of the licensed individual appropriate, legal, or ethical.

In this case involving an Ohio licensed attorney, see Butler County Bar Association vs. Williamson, 117 Ohio St.3d 399, 2008-Ohio-1196, an attorney had his law licensed indefinitely suspended for professional misconduct. The attorney became involved in a intimate relationship with a female client after she hired the attorney to represent her in a divorce proceeding and domestic violence action against her husband.

The attorney allowed the client and her two children to move in with the attorney during the course of representation. Later the client and her husband reconciled.

Can you guess who filed the grievances against the attorney? You guessed correctly, the husband and his wife. Can you say messy?

What is the morale of the story? I don't know you tell me.

1. Know what your State Nurse Practice Act and Board of Nursing regulations state regarding professional boundaries and professional sexual misconduct.

2. There is excellent information about professional boundaries on the National Council of State Boards of Nursing website at www.ncsbn.org. See also the ANA Code of Ethics with Interpretive Statements at www.nursingworld.org.

3. In your state are you responsible for establishing and maintaining boundaries with patients or clients? Clients can include the patient and others involved in the patient's plan of care. Clients can be an individual, group, or community.

4. Think about former patients and clients and a cooling off period. Termination of the professional relationship and "safe practice" is a slippery slope in professional boundaries cases.

Is it wise to think a patient can be terminated from your facility on a Monday and you can start legally and ethically dating the patient on a Wednesday. I've seen it happen and its perceived as okay because the patient has been "discharged." However tell me more about what happened during the course of the professional nurse-client or nurse-patient relationship and you will usually see a multitude of boundary violations and boundary crossings.

What is a reasonable cooling off period? Is a cooling off period imposed by your State Nurse Practice Act or Board of Nursing regulations? What is a reasonable cooling off period? 6 hours, 6 days, 6 months, 1 year, 2 years, or more time from the termination of the professional relationship to initiation of a personal, business, or sexual relationship. 

Professional boundaries are serious and I am seeing more boundaries cases in my law practice either through full scale legal representation or legal consultations. The Ohio Board of Nursing several years ago had professional boundaries as the focus of an emerging issues conference.

What are your thoughts about professional boundaries in nursing? Did you learn about professional boundaries in nursing school? Is it covered in general orientation in your facility?