We are now in trouble. Have we hit rock bottom. This is a problem. Wsbtv.com reported that an African-American nurse came to work a little tipsy (BAL .16), pulled a patient out of group, and began to touch him inappropriately. Now, I have heard of allegations where the patient might have been sleep or in an physical examination, but never actually pulled out of a “process-group” therapy session. What was even worse, there were cameras in the hospital so when the patient went to administration, there was absolutely no denying. Anchor Hospital it is time to lawyer-up. The nurse did turn herself in and I guess she admitted her wrong-doing. It is my hope that she was drugged or something. I would hate for her to lose her license over something like this happening. her bond was set at $10,000.00 because she did turn herself in after the incident. What is interesting is that, I am sure there is help for those of us professionals having difficulty with substance abuse.
In psychiatric medicine it is very important to keep counter-transference in check. Let me back-up and give you a couple of definitions quickly.
1. Transference-This is defned as the feelings that are developed in the therapeutic relationship from the patient to the therapist. (Patients may lash out and say things like, “You are just like my mother!” “I hate you like I hate my father.”) This is to be understood and accepted in therapy.
2. Counter-Transference-This is defined as the feelings that the therapist/provider develops towards the patient. These feeling are what gets most psychiatrist in trouble for sleeping with their patients. It is very important for a provider to immediately deal with any inappropriate feelings, whether good or bad, towards a patient immediately. If a provider has any erotic counter-transference, they should immediately step out of the therapeutic relationship appropriately and transfer the patient to another provider. This patient could be scared for life. When you check out the video below you will understand why this is such an issue.
I would just like to share a couple of things that may help you maintain the appropriate therapeutic alliance with a patient that you are treating in a care setting.
1. Establish appropriate clinical boundaries (you are not friends and you should keep the relationship professional)
2. Don’t discuss your personal life or issues, (i.e. marital status, where you live, vacation spots, ect.)
3. Appropriate distance in the room that your are providing service.( You should not be able to reach and and touch the person or really smell their perfume/cologne.)
4. Set appropriate and time-limited appointment times. (15, 30, 45 and occasionally when needed 1 hour sessions) Sessions should not typically go over an hour.
5. Be careful to keep the right patient mix. (all females, all males , etc. might just be bad news)
6. Appropriate lighting. It should never be too dark and candles are never appropriate. It sends the wrong signal. Feng shui is alright, but hire a professional to help you with ambiance.
7. Don’t see patients when you are emotionally vulnerable no matter how bad you need the money. The license you save could be your very own.
Take a look at the video below and let me know what you think. Also don’t forget to go by and pick-up my book at www.askdro.com. It will surely be helpful.