Sexual Abuse

Scenario 13 - Determining if a nurse-patient relationship exists

Leo is a nurse practitioner (NP) working in a rural community health clinic. He heads to the local bar for a drink and sees Kayla. Kayla was a patient of Leo’s the previous year. Leo is interested in dating her and asks her out for dinner

Questions for discussion

  1. Was it okay for Leo to ask Kayla out?
  2. Has Leo violated a professional boundary?

Key concepts this scenario illustrates:

  • Practicing in a small rural town
  • Determining the nurse-patient relationship

The question of whether an individual continues to be a patient is a complicated one determined by the case’s circumstances. The law says that the nurse-patient relationship continues to exist for a minimum of one year after the date when the individual stopped being the nurse’s patient. If the nurse touches or speaks with the individual in a sexual way or engages in a sexual relationship with the individual at any time within the year after the relationship ends, it is sexual abuse.

Leo should think critically on his professional relationship with Kayla to determine if the nurse-patient relationship ended in keeping with CNO standards, and if a minimum of one year has passed from the time she stopped being his patient before approaching her for a personal relationship.

There may be some instances where it may never acceptable to engage in sexual relations with a former patient. For example, the treating relationship was very intimate or involved clinical methods that led to lasting power differentials such as psychotherapy and associated methods.

In determining if it is right to engage in a sexual relation with a former patient, a number of factors are considered, including:

  • the length and intensity of the former professional relationship
  • the nature of the patient’s clinical problem
  • the type of clinical care the nurse provided 
  • the extent the patient confided personal or private information to the nurse
  • the patient’s vulnerability in the nurse-patient relationship

If Leo approached you as a peer looking for advice, you could advise him to review the Therapeutic Nurse-Client Relationship practice standard.




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Page last reviewed May 05, 2020