Interested in my nurse practitioner

Dear Alice,

I am a graduate student and have been using Health Services for a number of years. On recent visits, I couldn't help but notice a certain nurse practitioner on whom I now have a big crush (pardon the school-kid terminology). On my last visit through walk-in, luck would have it that I got this person to treat me (a random happening--I didn't choose it in any way). I felt somewhat awkward during the visit, yet happy to see this person. Nonetheless, I realize that this is not an ideal state of affairs, but I don't know how to handle it. I am due to return to this same N.P. for follow-up.

Should I tell this person that I feel awkward receiving medical treatment from someone I would rather be dating, or should I just make an appointment with another person? Would it be possible to seek medical attention from this person after letting them know how I feel? If I do end my medical relationship with this person, how would I begin a different one? There don't seem to be many occasions when students and the Health Service staff interact outside a medical setting. I would hate to pass up the possibility of meeting that someone special due to professional constraints that would not hold had we met under different circumstances.

— Confused but hopeful

Dear Confused but hopeful,

To crush or not to crush on, that is the question. Many people have at least one experience in their life where they have crushed on their teacher, physician, nurse, therapist, veterinarian, or other professional healer or helper. Even more so, many people have fantasized or role-played scenarios that involve hooking up with their doctor, older neighbor, babysitter, or any other person with whom there could be an unequal power dynamic. Many people find the power imbalance to be erotic, possibly due to the forbidden nature of crossing these kinds of boundaries. This isn't to say that the power differential between you two is the sole cause of your crush, but it could be one contributing factor. However, acting on these feelings in real life is where things get tricky. When it comes to providing care, health care professionals have ethical guidelines that they need to follow. If they're adhering to their professional ethics, they would be unable to provide care to you after you express your feelings and would be required to transfer your care to another provider. This can all get a bit complicated so if you're ready, read on to learn more!

Many institutions have policies that prohibit relationships between those in positions of authority and those who aren't. Usually, if there is an established professional relationship or has been one in the past, meaning that the individual had supervised, evaluated, advised, mentored or had involvement in any employment actions with the other person in question, then they're prohibited from engaging in a romantic relationship. Most of the time, only the human resources department of the institution in question is authorized to make exceptions to this policy. Beyond human resources policies, most medical organizations, such as the American Medical Association and the National Council of State Boards in Nursing, prohibit providers from entering relationships with patients as it's a violation of their code of ethics. In some places, it can even be illegal.

Furthermore, telling your NP about your attraction could place them in a bit of a predicament. If they reciprocate your feelings, they will still be obligated to maintain professional boundaries based on a professional code of ethics and the rules of their office or supervisor. In many instances, even if someone is a former patient, there may be a certain amount of time they have to wait before they can enter a romantic relationship with that person. Even if you both agree to terminate your medical relationship, your NP's job or credibility could be on the line if you to were to engage in a romantic relationship.

It may be worth exploring the potential pros and cons of disclosing your feelings. What do you see as possible pros of disclosure? What may be potential cons? Making a list of both the pros and cons may help you figure whether or not telling your NP about your crush is worth it or not. Additionally, it may be beneficial to take a moment and anticipate what possible outcomes could occur from telling this person how you feel. When considering this, be sure to think through the outcomes not just for yourself, but for the outcomes that the NP would also be working through as well. 

Note that in any possible scenario that includes telling your NP, they'd be obligated to transfer your care to another provider. Once you've had some time to think about these scenarios, ask yourself how you feel about each case. What outcomes can you live with? Do any scenarios feel particularly difficult to handle? Does it feel worth the risk of whatever you view as the worst possible outcome to disclose your feelings? How urgent is the desire to make your attraction known? Will you feel regret if you do not? Will you feel regret if you do, and it doesn't go as hoped? Getting familiar with your thoughts and feelings about certain outcomes, the positives and the drawbacks of each outcome, as well as the potential consequences for the NP, will help you find the best course of action when navigating your situation.

If you choose not to tell your NP how you feel, you have a few options. You may continue to seek care from her if you won't feel uncomfortable or make the NP feel uncomfortable. You may also decide to make an appointment with another NP. People change providers all of the time for any number of reasons, so you can switch providers without having to let people know why you want to make a change. Whatever choice you make, here's hoping this helps you find a little more clarity!

Good luck!

Last updated Apr 01, 2022
Originally published May 01, 1994