Thank you to the College of Registered Nurses of British Columbia for permission to adapt their case study.
As she hangs up the phone, Ling realizes she has a decision to make. Her sister, Naomi, is being discharged after an unexpected hospitalization and will need nursing care at home for several weeks.
As a registered nurse, Ling is used to fielding requests for minor care and advice from family members and friends. This situation however, will be more difficult to navigate. She knows her family will want her to be involved in Naomi’s care, and if she’s honest with herself, she would like to be as well. But would it be the best approach for everyone involved? How will Ling keep separate her roles as nurse and sister?
Ling knows if a nurse must care for a family member or friend because there are no other options, overall responsibility for care is transferred to another health-care provider when it is possible. She also knows that if a nurse wants to care for a family member or friend, caution is required.
Professional Boundaries for Registered Nurses: Guidelines for the Nurse-Client Relationship outlines requirements for nurses related to boundaries and professional relationships.
If Ling chooses to provide nursing care to her sister, she understands she’ll be entering into a professional relationship with Naomi and acting in a dual role. She knows she'll need to be objective enough to have an effective professional relationship with her sister.
Ling knows that this situation requires thoughtful consideration, caution and discussion with her sister, family and the care team. She'll need to be able to separate her personal feelings, values, beliefs and family relationships from her professional and ethical obligations.
She’ll want to:
Ling decides she’d rather be a sister than a nurse—she knows she can help Naomi with her recovery but doesn’t want the responsibilities or implications that come with providing nursing care. She realizes her relationship with her sister is too familiar to allow her to separate her personal feelings from her professional obligations.
She’s also concerned that her sister and family may have unrealistic expectations about what she can or should do. She lets Naomi know that she’ll be there to support her, but not as her nurse.
After careful consideration and discussion with her sister, family and the care team, Ling decides she will provide some nursing care to help out over the weekends. It’s a time-limited commitment and she has a support system that will allow her to keep the situation professional and as agreed upon.
Ling is competent to provide the necessary nursing care in a home care setting and is clear about her role within the plan of care developed by the home care nurses. She believes family relationships and expectations will not interfere with her meeting her sister’s care needs but has a plan if issues arise.
Have you been asked to provide nursing care to a family member or close friend? How did you make a decision?