Ask a Lawyer: Ending the NP-Client relationship

Question: 

I am a nurse practitioner and I want to end my professional relationship with a client. What do I need to consider before doing so?

Answer:

Ending the nurse-client relationship is not simple, and you should seek legal advice from the CNPS before proceeding. If the relationship ends in unwarranted circumstances, it may be considered professional misconduct. As a result, discontinuing the professional relationship when the client still requires nursing services is generally a measure of last resort.

There are several issues you need to consider before ending a nurse-client relationship:

• Is the relationship ending based on a prohibited ground under legislation?
• Is the client vulnerable in terms of the ongoing care required?
• Is trust an issue, as trust is considered one of the foundational elements of a professional relationship?
• Have you entered into a discussion with the client about the issues that are impacting the relationship?
• Have you created a plan with the client to help resolve the issues that are impacting the relationship?
• Does the status of the relationship enable you to meet your professional obligations?
• Are there employer policies in place about ending the relationship?
• Can you identify an alternate care provider for the client or, if given a reasonable amount of notice, could the client identify an appropriate alternate care provider?
• Are there alternate primary-care providers and community-health resources available?
• If ending the relationship is recommended, have you determined the necessary services that you should provide in the interim while the client is locating a new care provider?
• How best to communicate and document the concerns about the nurse-client relationship, and, if ending the relationship is recommended, letting the client know about the reasons for the decision and actions taken?

This list of issues is not exhaustive and the specific circumstances regarding the client and the NP will need to be considered.

Ending the nurse-client relationship can result in client accusations of abandonment to your nursing regulator. Therefore, it is prudent to seek legal advice prior to making this decision which may result in a regulatory complaint and investigation.

CNPS beneficiaries can contact CNPS at 1-800-267-3390 to speak with a member of CNPS legal counsel. All calls are confidential.

Published September 2017

THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVICE FROM ANY LAWYER, CONTRIBUTOR OR THE CNPS. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.