Ending Abusive Patient- and Family-Initiated Relationships in Alberta Nursing Practice: The Case for a Nurse-Specific Regulatory Standard.

Background/

Objectives

Patient- and family-initiated abuse of nurses is widely recognized as workplace violence, but it also raises a distinct professional-regulatory question: when may a nurse end or restrict an established therapeutic relationship without creating an allegation of abandonment or discriminatory denial of care? This perspective focuses on Alberta and examines whether the province's nursing regulator provides a comprehensive, nurse-specific, all-registrant standard comparable in clarity to Alberta's physician standard. The concern is not the absence of every form of protection but the absence of a clearly defined regulatory pathway for all Alberta RNs and NPs.

Methods

Publicly available legal, occupational health and safety, regulatory, legal-risk and scholarly materials were purposively selected where they addressed relationship termination, discontinuing or declining care, workplace violence, immediate safety risk, abandonment, documentation, continuity of care or patient safeguards.

Results

The College of Physicians and Surgeons of Alberta standard provides a clearly defined regulatory pathway, including immediate discharge where a patient poses a safety risk, is abusive or fails to respect professional boundaries. Alberta nursing materials contain important elements but do not yet constitute a dedicated Alberta RN/NP standard applicable across office-based, community, virtual, home care and independent nursing practice. Interprovincial nursing standards demonstrate feasibility, operational detail, emerging professional consensus and potential templates for policy transfer; however, they do not bind the CRNA or create an Alberta regulatory benchmark for complaint review.

Conclusions

Alberta should adopt a nurse-specific standard for ending or restricting abusive patient- and family-initiated relationships. Such a standard should include ordinary and urgent safety pathways, prohibited grounds, documentation requirements, continuity safeguards, employer integration and practical templates. Nurse protection and patient protection are mutually reinforcing regulatory objectives.