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Should I report a co-worker, who works in psychiatric nursing and is dating a woman who became a patient at our facility?

Question:

Dear Nancy,

I work with an APN who specializes in psychiatric nursing and adult nursing. He has prescriptive authority. Recently, he took a female client as a date to a co-worker’s wedding. Even though he is not this patient’s counselor, is it a boundary violation to knowingly date a client of a co-worker in a psychiatric setting? If he is writing this patient’s prescriptions, does that automatically qualify her as his patient? What if they were dating before she came to the clinic, and how does that affect the prescription-writing aspect of this scenario?

I am afraid to confront him with this as he is a clinic director and co-owner of two of the six sites. He was sued by another patient a few years back and settled out of court. The past lawsuit involved a sexual relationship with a patient. I know he is involved in a divorce right now due to this current relationship. I would like to know where I stand before I talk to his superior because I am sure it will mean my job.

Rose

Dear Nancy replies:

Dear Rose,

The APN you work with who is conducting himself in this manner has a serious problem with professional boundary issues. Although there may be more to the current relationship between this patient and the APN, such as dating before she became a patient at the clinic, his conduct is
not acceptable.

Resources that may be helpful to you in evaluating how to handle this situation are: the National Council of State Boards of Nursing’s publication “Professional Boundaries: A Nurse’s Guide To The Importance Of Appropriate Professional Boundaries” available on the Council’s website at www.ncsbn.org (click on “NCSBN” then “Brochures” in the drop-down menu) and the American Nurses Association’s “Code of Ethics For Nurses With Interpretive Statements” available on the association’s website: www.nursingworld.org (click on “Ethics” for the drop-down menu that includes the Code and other resources).

If you are concerned about speaking with the APN’s superior, you might want to try another route. Sharing your concerns confidentially with your immediate superior and/or the CNO should be a safer way to express your misgivings. They most likely would be able to handle the matter without getting you directly involved. Either or both can then speak to the APN’s superior after they investigate and evaluate the full range of the APN’s behavior.

It would be hoped that after obtaining the facts concerning this person’s conduct, they would take appropriate action, such as counseling him, terminating him and/or reporting him to the board
of nursing.

You also could report the APN to the board of nursing for its review, but you need to be certain that you do so with only the facts concerning his behavior. Such reports are usually handled in a confidential manner by the board. The board can take over the investigation and determine how it will handle this APN’s conduct once its investigation is complete.

Cordially,
Nancy

By | 2013-09-09T00:00:00-04:00 September 9th, 2013|Categories: Blogs, Nursing careers and jobs|1 Comment

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    Tess January 5, 2018 at 9:30 am - Reply

    I came across this post, and I felt a need to comment. I was married to a psychiatric CNP that also had issues with ethical practices and boundary violations.
    The violations included inappropriate personal relationships with multiple patients and family members of patients to include sexual encounters, unprofessional communications, prescriptive violations, patients that inflicted self harm under his care during inappropriate relations, exchanging “professional” services outside the clinic setting for cash, and the list goes on.
    I contacted the board of nursing with this information to include emails handwritten notes between himself and patients to prove elicit behaviors and photos he took of himself in various sexual acts with one of his patients.
    He has been fired from two jobs and currently is still working in the psychiatric community taking care of vulnerable patients.
    I must say to the poster, at least in the State of Ohio, boundary violations do not appear to have high priority when it comes to reporting complaints to the BON.
    This particular CNP has been reported with photogenic documentation and 8 years later is still practicing with no restrictions or discipline
    My question is, if a particular practitioner is toxic and causing harm to a patient population and the BON does not act on this information what other sources are available to protect these types of patients?

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