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December 2010, Volume 40 Number 12 , p 10 - 11


  • Susan A. Salladay PhD, RN


I'm a staff nurse at a small community hospital. Recently I cared for an acquaintance who's a local realtor. When I casually mentioned that our family was thinking about selling our home and purchasing a larger one, she offered to help me with the sale for a reduced commission. She even said she'd have a plan ready to go as soon as she's released from the hospital.I asked my manager about the wisdom of pursuing this arrangement. She advised that this could be seen as a "dual relationship" in which professional roles and responsibilities overlap with a personal relationship. But she told me not to worry as long as I maintain professional boundaries and confidentiality.I'm still doubtful. What do you think?-J.L., N.C.You were wise to seek a second opinion from your manager, but the advice you got isn't sound. State law and nursing ethics prohibit nurses from developing business, social, or sexual relationships with patients (or former patients).In business relationships, "I'll scratch your back if you scratch mine" is an approach that gets things done. But in healthcare, professional relationships are carefully limited and clearly structured to avoid conflicts of interest.The nurse-patient relationship is not a friendship or a business relationship, and its purpose isn't the mutual exchange of information or services. The situation you describe blurs the boundaries and gives the professional relationship a social dimension.Professional boundaries exist to protect both nurses and patients from overstepping expectations. In this relationship, the patient's willingness to reduce her commission could be viewed as a favor granted to guarantee a certain type or quality of care that you don't normally give to all patients. The patient could also be seen as meeting your needs, rather than the other way around.Review your hospital's policy and procedure on professional relationships and boundaries. Then thank your patient for her willingness to help, but decline her offer. Explain

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