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September 16, 2013

When nurses become attached to their patients

Daily Briefing

    Although nurses are taught to maintain emotional distance from patients, the "line between a professional and personal relationship with a patient can become blurred," RN Sarah Horstmann wrote on the New York Times' "Well" blog last week.

    Horstmann—who works on an orthopedic surgery unit—describes two patients who "crossed the invisible boundary nurses set for themselves" and "touched me so deeply it was impossible to maintain a professional distance." Both patients were elderly men who reminded her of her grandfather, who had recently passed away.

    The first patient was admitted after a total hip replacement. "I found myself constantly peeking back into his room asking if he was O.K. and if he needed anything," she wrote.

    "I never told him that he reminded me of my grandfather, or how he tugged at my heartstrings, and I often wonder if I should have. But I worried that in showing this man a little extra attention, I had somehow breached the therapeutic relationship."

    Soon after that patient was discharged, a second man was admitted for "comfort care," meaning no lifesaving efforts would be made on his behalf. "Medically, he had a lot of issues, but when he came up to the floor, the only thing he wanted was a bowl of oatmeal," Horstmann wrote. So she found him oatmeal in the floor's kitchen. "Watching him eat that oatmeal reminded me of some of my last meals with Grand-Daddy," Horstmann wrote.

    When transporters arrived to take the patient to a nursing home, Horstmann became emotional. "Even though I knew he was going to a nice and comfortable facility, I didn't want him to go," she wrote.

    "I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it's better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond," Horstmann wrote.

    "Nurses and patients move in and out of each others' lives so quickly, but we are nonetheless changed by every encounter" (Horstmann, "Well," Times, 9/13).

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