If a nurse has an intimate, consensual relationship with a patient, it is deemed unacceptable to the profession. But what if the relationship is with a patient’s spouse? A recent hearing examined such a case.
CB was an enrolled nurse at a rehabilitation centre. One of his patients, JX, had become a paraplegic due to an accident in September 2009 and had been admitted to the centre in November 2009. Throughout the admission, CB cared for JX. During this period, JX’s wife, HX, lived with their two children in the matrimonial home and visited the rehabilitation centre. JX was discharged in January 2011.
At the hearing, CB agreed he had engaged in an improper sexual relationship with JX’s spouse while employed to provide inpatient nursing services at the rehabilitation centre.
CB admitted that on or about 17 December 2010, he and HX engaged in intimate communication by text messages and Facebook, and that HX texted him provocatively posed photographs of herself. This led to an intimate sexual encounter in a pre-booked hotel room on 29 January 2011.
CB admitted that his sexual relationship continued without the knowledge of JX until March 2012, when HX left her matrimonial home and moved in with CB. This living arrangement continued up to and beyond the time of the hearing.
Noteworthy are sections of JX’s complaint to AHPRA:
“My wife … has been greatly affected by my accident and the damage it has done to my body, and sex was never going to be the same again, so all of this has been on her mind.
“I had feelings that a relationship was forming between the nurse and my wife, and I asked the nurse some questions, and any relationship was denied.
“In March 2012 my wife left myself and her two children to live in a two bedroom unit ... I didn’t realise at the time that there was a relationship with the nurse, and simply assumed she just needed to get away from myself, as I considered I ought to be no longer considered as a suitable husband.
“I looked up her mobile phone record on the internet and discovered a mobile phone number which was called quite often. I rang the number and tried to get the person to determine if I knew the voice. I immediately identified the nurse ... and then I hung up.
“This has hit myself harder than the tree. I feel useless, weak, defeated, hopeless. I was very angry too.
“The behaviour of this one particular nurse [CB] makes myself feel disgusted. He broke my trust, he lied to myself, deceived myself, he stole from myself, he had sex with my wife, he took my wife away from myself and my children, and he posed as a good person helping my family.”
Patient JX’s wife sought to contextualise the relationship. In a letter to the tribunal, she stated:
“[CB] was good to my husband during his stay at [the rehabilitation centre] and was nothing but kind and professional towards me.
“After my husband’s release … [CB] was kind enough to come over a few times to help me out around the house, fixing our lawn mower, servicing our car and helping with a clean-out in the garage. I do not believe that [CB] has done anything wrong. He never pursued or harassed me in any way while my husband was in [the rehabilitation centre]. We did not become close friends until at least a year after my husband’s discharge.”
An expert psychiatric witness told the tribunal that nurses have a responsibility to maintain a professional boundary between themselves, patients and others, such as a patient’s partner and family.
The witness added that CB had access to HX only because of JX’s hospitalisation, and that it would be irrelevant to suggest that any responsibility to maintain professional boundaries in relation to JX and his family disappeared at the point of discharge.
After all, regardless of when CB and HX had their first act of intimacy, the relationship was already an established sexual relationship involving explicit, sexualised communications from as early as December 2010, at a time when JX was still hospitalised. Such communications were considered inconsistent with the maintenance of professional boundaries. The tribunal found that the nature of these communications demonstrated a breach of professional boundaries.
The tribunal unanimously viewed CB’s behaviour as professional misconduct. It reprimanded CB in the strongest possible terms, cancelling his registration and disqualifying him from reapplying for two years.
Scott Trueman is a lecturer in the School of Nursing, Midwifery and Nutrition at James Cook University.Do you have an idea for a story?
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