My 2 Cents

Professional Boundaries Post Request for an Ohio Nurse and her Colleagues

I received the following email from a nurse yesterday:

Can you tell me about professional boundaries regarding RNs and behavioral health clients?  I am seeking direction in 'timelines' of appropriateness in establishing social relationships with prior clients. 

For example, is it 'ok' to have lunch with a former client?  (i.e. not a sexual boundary issue)  If so, what is considerate appropriate time-wise? 

As my peers & I discussed this, the next question was 'what about dating' a former client?  How much time needs to lapse for this kind of relationship to not be considered a boundary violation?

We've had no success in finding any real answers on the OBN website.  Maybe you have a blog about this -- if so, would you direct me where to find it. 

Thank you -- your website/blog is great!  If you don't have any current blogs on this topic, maybe you could take into consideration for future blogs. 

I appreciate any information you can share -- & I'll gladly share with my peers.

Thanks for your consideration!

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Thank you Ohio nurse for contacting me and suggesting a post for my blog. I smiled when I read your email because I love it when nurses research the Nurse Practice Act and Board regulations then analyze and discuss how it applies to daily nursing practice. Now that's what I am talking about!!!

I actually have an article appearing in the next Kentucky Nurse, the newsletter of the Kentucky Nurses Association about professional boundaries and professional sexual misconduct.

I have published several peer reviewed articles on professional boundaries in nursing and professional boundaries and professional sexual misconduct is one of my favorite presentation topics. As a home care nurse, I have also encountered a number of boundary issues.  

I will link the KNA article to this blog post when its published in September 2008. Although I cannot provide you with legal advice and counseling and answers to your specific questions on this blog, I think you will find the article very informative.

 

Update: My Nephew is Recovering

My nephew is doing well. Thank you for the emails and notes of prayer I received.

His surgery was successful. His ASD was closed and he is recovering.

My Nephew is Having Surgery Today

My 7 y/o nephew is having open heart surgery today at Cincinnati Children's Hospital to repair his Atrial Septal Defect. He also has pulmonary hypertension.

Please keep us in your prayers.

Why Do We Like to Play the Victim?

This has been a long week or it seems long anyway.

I spoke with a nurse this week who is having licensure issues with a nursing board. The nurse is upset because of the proposed discipline against her license offered by the state nursing board to resolve a pending complaint.

1. The nurse insisted that she was tricked by the State Nursing Board and never told she could retain an attorney during the investigation. She didn't know there were attorneys who represent nurses before the Nursing Board. She feels victimized and cheated.

Comment: Nurses are educated professionals. As a professional don't depend on anyone to inform you of what your rights are in a particular investigation whether its internally in the workplace, criminal, licensure, etc.

Its your license, do some initial research into your options. Trust your instincts; if your gut is saying "hey I am not comfortable" or "I need to speak with someone" get online, contact your state nurses association, or contact an attorney.

You worked hard for your education and license; work just as hard to keep it! We have to stop playing the victim role, meaning here that we blindly assume and trust that "everyone" whether its nursing management, human resources, law enforcement, regulatory agent, Board investigator, etc. has our "best interest" at heart. Its your job to have your own best interests at heart at all times. Then when things don't go as planned we can say "I didn't know" "no one told me" "how would I know".

Why do we as nurses like to play the victim role? 

Will I remain a member of the ANA and the Ohio Nurses Association?

I had someone email me yesterday asking this question. The ANA House of Delegates ended Friday. I was not able to the attend the ANA HOD (gosh darn!).

Therefore I need to review what was adopted, adopted as amended, and rejected before I make a decision.

Several Ohio Nurses Association members (who I respect and adore) commented to me that any decision made now will be in the heat of moment and I should give it at least one year.  

I need to "get the skinny" on what happened at the ANA House of Delegates. Its trickling in slowly.  

Will I remain a member of ANA and ONA? I will for a period of time. I am a delegate for the Center for American Nurses from the Ohio Nurses Association and I would lose this status if I terminated my membership with ANA/ONA.

Will I remain a member of the ANA Congress on Nursing Practice & Economics? No.

Will I remain a member of the Center for American Nurses? Yes

Baptist, Democrat, and Thirty-Six

A neighbor asked me my age. Before I could reply his wife told him you don't ask folks their age, religion, or political affiliation.

Do you agree?

I replied I was born July 2, 1971, I am a Baptist, and I am a Democrat.

Go OBAMA!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

What Do Physicians Really Want?

See this link and what's being proposed at the American Medical Association of House of Delegates.

AMA Resolutions Involving Other Health Professions

The American Medical Association's (AMA) resolutions for its upcoming House
of Delegates meeting (occurring June 14-18, 2008) have begun to be posted
online The following are links to two resolutions of particular interest
that will be considered at the meeting. Should you choose to submit
comments on these resolutions, the deadline and contact information are
posted at the end of this communication.


Resolution 303 Protection of the Titles "Doctor," "Resident" and
"Residency"


http://www.ama-assn.org/ama1/pub/upload/mm/471/303.doc


The "Resolved" clauses in Resolution 303 state that:


"RESOLVED, That our American Medical Association adopt that the title
“Doctor,” in a medical setting, apply only to physicians licensed to
practice medicine in all its branches, dentists and podiatrists (New HOD
Policy); and be it further


RESOLVED, That our AMA adopt policy that the title “Resident” apply only to
individuals enrolled in physician, dentist or podiatrist training programs
(New HOD Policy); and be it further


RESOLVED, That our AMA adopt policy that the title “Residency” apply only
to physician, dentist or podiatrist training programs (New HOD Policy); and
be it further


RESOLVED, That our AMA serve to protect, through legislation, the titles
“Doctor,” “Resident” and “Residency.” (Directive to Take Action)"


Resolution 214 Doctor of Nursing Practice


http://www.ama-assn.org/ama1/pub/upload/mm/471/214.doc


The "Resolved" clauses in Resolution 214 state that:


"RESOLVED, That our American Medical Association oppose the National Board
of Medical Examiners participating in any credentialing procedures for
Doctors of Nursing Practitioners (DrNP) and refrain from producing test
questions to certify these DrNP candidates (New HOD Policy); and be it
further


RESOLVED, That our AMA make it a legislative priority to urge Congress to
increase funding for residency slots, particularly primary care physicians
(Directive to Take Action); and be it further


RESOLVED, That our AMA adopt a policy that those nurses who are Doctors of
Nursing Practice must only be able to practice under the supervision of a
physician and as part of a medical team with the final authority and
responsibility for the patient under the supervision of a licensed
physician. (New HOD Policy)"


Comments on these resolutions for consideration by the AMA reference
committee must be submitted by June11, 2008 to roger.brown@ama-assn.org.

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What do you think?

What is Your Impression of Attorneys?

I spoke with two nurses this week who both mentioned how badly they were treated by attorneys.

One nurse who allegedly diverted narcotics is seeking representation before the Nursing Board. She contacted two different attorneys. One attorney told her "what she did was stupid" but he would represent her. The nurse said she got the impression that the attorney didn't want to be bothered with her or her case because he was so condescending.

Another nurse is being investigated by the Nursing Board and is seeking attorney representation. She contacted at least 5 different attorneys. Two of the attorneys rushed her off the phone after quoting her a price for representation, one attorney was very crude and rude, and another attorney told her "I know some people on the Board and who work for the Board" and this may help her case.

What has been your experience with attorneys and law firms? What is your impression of attorneys and the services provided by attorneys?

Be honest, I can take it.

I enjoy practicing law. I am happy and I enjoy what I do for a living. Don't get me wrong, of course I have bad days like everyone else, but I am happy. 

I don't consider my law practice "a job" or "a position"; its my life, my livelihood, and its who I am. Its me from my bright business cards to my colorful letterhead. I am a RN and an attorney and I represent nurses.

I have worked in positions as an attorney just for the experience or the money and I wasn't miserable (okay actually I was in one position) but I always yearned for more. I was working in the position but planning and plotting my escape. Are you planning your escape? Have you recently escaped?

Nurses and Attorneys are service providers. Personally, I think how you feel about yourself and if you enjoy what you do for a living impacts how you treat, manage, and interact with clients, patients, or customers as a service professional. What do you think?

South Charleston, West Virginia

I am meeting with several clients who live in the Ashland, Kentucky and Ironton, Ohio area on Sunday, April 20th in South Charleston, West Virginia. We are driving in on Sunday afternoon and departing Monday afternoon.

Any suggestion for activities and sight seeing in Charleston, West Virginia?

My Pretty Yellow Truck and My Boyfriend Barry

This is a nightmare. My boyfriend Barry had an accident in my 2000 Nissan Frontier last month.

My insurance carrier paid for the repairs. I find out today that between the autobody shop and a Nissan dealer (these folks were replacing the airbags) my truck started having engine problems.

Well guess what? I need a new engine. My truck was leaking oil (closed containment system) and it wasn't caught until the truck started knocking.

Its not covered by the insurance company because its unrelated to the wreck and of course the autobody shop and the Nissan dealer are pointing the finger at each other. No accountability. It would be nice if these folks had a license issued by the state; I would file a complaint!

I am in the same position that I was a month ago when my boyfriend Barry wrecked my truck. I have a truck I can't use. I am disgusted; but I am not upset.

I am an attorney but I don't feel like suing anyone. Why? I will obtain more pleasure tormenting my boyfriend Barry about my pretty yellow truck for the duration of our relationship. Also I am going to parlay this truck situation into all expenses paid Las Vegas vacation for my birthday in July from my boyfriend Barry.

It will cost $4,500 for the rebuilt engine and labor.

My boyfriend Barry is buying me a new car. I want a crossover vehicle, convertible sports car, or a four door jeep. What do you think?

He also wants to eat home-cooked soul food meals again; so he is planning to fix my pretty yellow truck at the end of the summer. I haven't cooked since my boyfriend Barry wrecked my pretty yellow truck.