Opinion: Dilemma

A patient, who will remain on your ward for at least a few weeks following a road accident, asks you if you will go on a date with them after they are discharged. You want to accept but are not sure it is professional.

It is the meat of TV soap serials that patients fall in love with nurses and vice versa. At what point does such a relationship cross the boundary into unprofessional conduct? What guidance is available to the nurse practitioner?

A patient, who will remain on your ward for at least a few weeks following a road accident, asks you if you will go on a date with them after they are discharged. You want to accept but are not sure it is professional.

It is the meat of TV soap serials that patients fall in love with nurses and vice versa. At what point does such a relationship cross the boundary into unprofessional conduct? What guidance is available to the nurse practitioner?

Paragraph 2.3 of the NMC Code of Professional Conduct states that: 'You must, at all times, maintain appropriate professional boundaries in the relationships you have with patients and clients. You must ensure all aspects of the relationship focus exclusively upon the needs of the patient or client.'

This could be interpreted as requiring a registered practitioner to have no personal or intimate relationship with a patient or client for whom she or he is caring.

There have been many cases where doctors have been struck off the register of the General Medical Council for having a sexual relationship with a patient.

The draft of a new code of conduct on professional standards, published by the NMC, is more explicit than the present code. It states that, under the duty to maintain professional boundaries: 'You must establish and actively maintain clear sexual boundaries at all times with people in your care, their families and carers.'

Referring to the draft provisions, the chief executive of the Council for Healthcare Regulatory Excellence, Harry Cayton, was reported as saying: 'It's a delicate area and I'm keen we're not seen to be attempting to regulate love.' (NT News, October 9, p4).

A registered practitioner must not only act professionally but also be seen to act professionally. This means that, in personal relationships with those who are their patients and clients, they should be above any suspicion of preferential treatment or intimate involvement.

The nurse must make it clear to the patient that, while a patient, she or he cannot make any such promise. However, once the patient leaves the hospital and ceases to be a patient, the situation is different.

Bridgit Dimond, MA, LLB, DASA, AHSA, is barrister-at-law and emeritus professor, University of Glamorgan, Pontypridd