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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by dancinbillie on December 20, 2007, at 10:37:07
I was an outpatient in Inova Fairfax Hospital's psych partial hospitalization program from April 25, 2007 through July 20, 2007 and again from August 10, 2007 through September 14, 2007. The Psych RN with whom I worked most of the time, XXX (hereinafter "XX"), crossed/violated boundaries several times. The two of us formed an extremely strong attachment over the months I was in the program. She told me specifically and on multiple occasions, "I think you know I love you," "I wouldn't usually self-disclose so much but I'm crazy about you," "You're very beautiful to me," "You haven't been loved enough," "I'll always care about you," "We have a special connection;" she hugged me on more than one occasion and she lent me DVDs and books. She made it clear that she did not want her colleagues to know the extent of her feelings for me, and instructed me that when I asked for a one-on-one meeting with her that I must do it in front of other people so that no one would think the one-on-one meetings were meeting HER needs. When I asked, she admitted that having one-on-ones with me was meeting some needs of hers but wouldn't elaborate on what those needs were. I have dozens of pages of contemporaneous notes that I made during the time I was in the program - unfortunately, I was very vulnerable while I was in the program and thus was so flattered by all the wonderful things XX was saying and doing that I decided, after a while, to keep a record of many of our talks so that I could look back at the notes later and feel good all over again.
Around mid-to-end of August, other members of the treatment team decided that our relationship had gone too far, and "separated" us. A couple of weeks later, in cognitive group therapy, I spoke of intrusive, obsessive thoughts I was having about XX - maternal transference issues (no safety issues). XX immediately took this to mean that I was sexually attracted to her and she went to the program's medical director about it, stating this made her "uncomfortable." I tried to have a couple of meetings with her and various program "chiefs" to straighten out the misunderstanding - I thought all was well after one meeting, but could tell by the way XX treated me subsequently that there was clearly still a misunderstanding on her part. I scheduled another meeting about a week later, this time with the program director, the medical director, XX and myself, and XX walked out of the meeting almost immediately because she said she did not want to "rehash" anything. A week before I left program, the medical director told me that XX was still "creeped out" and thought I was sitting around fantasizing about her and masturbating, which was not at all the case. Because XX was basically ignoring me at this point, I asked the medical director to be sure and reiterate to XX that I was having a strong maternal transference with her, nothing sexual. Later that day, I had a sixty-second opportunity to speak to XX, who admitted that she had misunderstood previously and further told me, "We're okay, don't worry - you know, there's a kind of funny aspect to all this!" The weekend after I left the program, I wrote a grateful letter to XX and mailed it to her home - her address was noted on some of the items she lent to me, along with her home phone number and cell phone number. I was not aware at that time that such an action would be a problem. Because I was having extreme difficulties with the separation from XX, my husband left a message on her cell phone that week, asking if she would be willing to "collaborate" with him to help me through the situation. She didn't return the call. Two weeks later, however, she returned the letter I'd written her to my husband, unopened, via the security manager of the hospital and threatened police/legal action if either of us tried to contact her again.
Although the plan was that I was to return to the partial hospital program after a couple of weeks of ECT treatment, I was advised informally by the program's medical director (my medication management psychiatrist) that I would be denied re-admittance to the program even though she had strongly advocated on my behalf and my insurance company case manager expected that I would return to the program as well. The medical director stated that the hospital would cite a "safety" issue between me and XX, because of the letter I'd sent and the cell phone message my husband left, but that the real reason I would not be allowed back into the program was because XX felt "uncomfortable" and had demanded of the hospital decision-makers that I not be allowed back into the program. The medical director also told me that there was an investigation going on into this situation but that XX had "clammed up" and was refusing to talk about it. The medical director further stated that, partially as a result of this situation and also because of other similar situations, she (the medical director) had tendered her resignation from the hospital as of January 2008. She (the medical director) has been directed by the hospital not to discuss the situation any further with me.
Both my medical management psychiatrist (the medical director) and psychotherapist think I should go back to the partial hospital program briefly to work some more with XX on the attachment issues and work toward a successful separation. I'm an adoptee and have always had attachment/separation issues, which XX was well aware of. At the very least, they both agree that I should be granted a mediated meeting with XX and whatever other hospital staff would be required for XX to feel "safe" in order to discuss the situation and see if I can get some closure. I've written a few letters to the hospital since October 30, but have once been declined re-admittance to the program with no reason given, have never been afforded the courtesy of a response to my request for a mediated meeting, and otherwise ignored. I and my family believe I've been psychologically injured, first by XX's boundary violations and then by the hospital's refusal to re-admit me to the program or grant a mediated meeting to resolve the issues with the person with whom I have the issues. I'm in therapy three times per week and have not yet been released to work. I'm suffering frequent suicidal ideation (at least daily) and am in a major depressive phase of my bipolar disorder since these events.
Is the hospital allowed to keep me out of the partial hospitalization program because one of the staff feels "uncomfortable?" Did the psych RN simply misstep or malpractice? I'm a paying client of this hospital and feel I'm being treated unfairly. Thanks.
Posted by lovelorn on December 20, 2007, at 11:24:02
In reply to Banned from partial hospitalization program =(, posted by dancinbillie on December 20, 2007, at 10:37:07
Well, you got your case well documented. Keep this record you've written.
I an no expert here. I imagine though that all such facilities have documented adminstration, operating and in-patient admittance guidelines which would outline the rules and procedures of admittance and outline when patients are not to be admitted.
You could always call them up for that information.
This sounds like you will need a legal opinion of whether any malpractice took place.
Posted by Deputy Racer on December 20, 2007, at 15:02:46
In reply to Banned from partial hospitalization program =(, posted by dancinbillie on December 20, 2007, at 10:37:07
I've removed all personal information regarding the non-poster identified in this post. Please don't post identifying information about third parties without their knowledge and consent.
Deputy Racer
Posted by Racer on December 20, 2007, at 15:36:34
In reply to Re: Banned from partial hospitalization program =( » dancinbillie, posted by lovelorn on December 20, 2007, at 11:24:02
Another option is to file a complaint with the licensing board. Include any documentation you might have -- especially anything in writing from the partial hospital program regarding their refusal to readmit you -- and send it off to the licensing board.
The bad news is that my own experience suggests that nothing will be done, but the process itself was helpful to me. What's more, if they get any other complaints in the next couple of years, they'll look at your complaint again, too. It's possible that you'll be part of preventing this sort of thing from happening to others, even if you don't get direct satisfaction from your complaint.
Sad, huh? But filing a complaint is a lot cheaper than hiring an attorney.
I'm very sorry this happened to you. I had a very bad experience some years back with my own treatment, and made complaints to various licensing boards as a result. As I mentioned, the process was helpful for me, although there were no actions taken. (At least, as far as I know.) It's hard to get over this sort of thing, but working towards your own healing -- regardless of what happens or doesn't happen to the other people involved -- is probably your best bet. The sad reality is that it's hard to prove malpractice, and it usually requires something so unequivocally outrageous that no one could dispute the problem. (I'm talking more along the lines of sexual exploitation, physical assault, amputating the wrong limb, etc. The sorts of psychological damage that we're discussing here may not reach that level, although it's still worth trying.)
Good luck.
Posted by dancinbillie on December 20, 2007, at 16:09:23
In reply to Personal Information Removed » dancinbillie, posted by Deputy Racer on December 20, 2007, at 15:02:46
Oh, I'm really sorry - thanks for looking out for me.
Thanks for your other reply too. I did fax a report to the VA Department of Health Professions yesterday, and I'll have to see if there are any other entities specific to nurses. I also made a report to the hospital's "conduct compliance" hotline a few days ago.
This has been so incredibly hard for me. I hate to be a baby and I hate to complain, but it's like I fell in love with XX. She was functioning as my "good-enough mother" for months, and she encouraged these feelings of mine, and was very well aware how very important she/our relationship was to me. Then, bam, no contact and a threat of police/legal action if I or my husband make any attempt to contact her again.
One minute I love her and the next minute I hate her. But I would NEVER do anything to injure her as she seems to fear. I don't understand how she could even think that! I'm so mixed up and depressed and suicidal over this.
> I've removed all personal information regarding the non-poster identified in this post. Please don't post identifying information about third parties without their knowledge and consent.
>
> Deputy Racer
Posted by rskontos on December 20, 2007, at 16:20:36
In reply to Re: Personal Information Removed, posted by dancinbillie on December 20, 2007, at 16:09:23
dancinbillie, I can offer no legal help only to say I am so sorry this happened to you and how confusing for you as well. It also makes me want to try and protect myself in my therapy as I move forward.
I wonder if there is a way to protect ourselves. You admit you only had the most innocent feelings and yet you got hurt. It makes me wonder if not she was the one that crossed the line in her mind and made you the scapegoat. it is scary to think that. And now to make you feel like you feel. well I think she should be sanctioned and have a professional injuction that at least says she needs to take a refresher course or go into therapy herself for a while. Because after all she is the professional the one that should know when a patient has crossed the line(and when they are just confused) and I think for her to put her "I am uncomfortable feelings" in the forefront before the wellbeing of a patient well then the hospital should have sessions with another therapist present with you and her until you are well enough to go it alone or transition to another therapist. But that is just my humble opinion of which they didn't ask for.Again I am sorry and it really sounds so wrong. I do think you will have fall out from this too to deal with and that is sad. I feel for you. I hope you find another therapist soon that can help.
good luck. rsk
Posted by dancinbillie on December 20, 2007, at 17:03:52
In reply to Re: Personal Information Removed » dancinbillie, posted by rskontos on December 20, 2007, at 16:20:36
Thanks so much for your reply. I feel like if I don't have an opportunity to discuss this situation with XX and try to work toward some closure with her, it's going to mess me up for a looooooooong time to come. I miss her so much, yet I want to ask her, "How could you do this to me???" I try to keep this whole thing off my mind as much as possible, but it's very difficult, seeing as how I'm an obsessive-type personality, among other things.
You're right - XX is the professional and I believe she acted unprofessionally/unethically with me, and I think she could use some more therapy herself. I think it would be terrific to attend some therapy sessions together with her, seems like that could be very helpful to both of us. But I haven't had any contact with her since 9/14/07 and as much as I'd like to show up at the partial hospitalization program, or her home, and talk to her, I know that's completely inappropriate and would likely get me into some serious trouble, which I don't need. So I won't be doing either of those things.
Don't know what to do. Taking a hundred or so Seroquel tablets seems like a lovely solution, but I keep not doing that. I don't even know why.
> dancinbillie, I can offer no legal help only to say I am so sorry this happened to you and how confusing for you as well. It also makes me want to try and protect myself in my therapy as I move forward.
>
>
> I wonder if there is a way to protect ourselves. You admit you only had the most innocent feelings and yet you got hurt. It makes me wonder if not she was the one that crossed the line in her mind and made you the scapegoat. it is scary to think that. And now to make you feel like you feel. well I think she should be sanctioned and have a professional injuction that at least says she needs to take a refresher course or go into therapy herself for a while. Because after all she is the professional the one that should know when a patient has crossed the line(and when they are just confused) and I think for her to put her "I am uncomfortable feelings" in the forefront before the wellbeing of a patient well then the hospital should have sessions with another therapist present with you and her until you are well enough to go it alone or transition to another therapist. But that is just my humble opinion of which they didn't ask for.
>
> Again I am sorry and it really sounds so wrong. I do think you will have fall out from this too to deal with and that is sad. I feel for you. I hope you find another therapist soon that can help.
>
> good luck. rsk
Posted by Phillipa on December 20, 2007, at 20:45:45
In reply to Re: Banned from PHP » rskontos, posted by dancinbillie on December 20, 2007, at 17:03:52
Virginia? My license is good in VA too as well as NC and they are expanding the states so only one license is needed. I worked in a private hospital in VA near the beach. And yes it is unethical behavior. I did a lot of malpractice in Virginia before moving here. Dont know the location in VA but know the top attorneys in Hampton Roads. Phillipa
Posted by ClearSkies on December 21, 2007, at 7:20:26
In reply to Re: Banned from PHP » rskontos, posted by dancinbillie on December 20, 2007, at 17:03:52
I think you can't plan on getting any closure from the XX person who behaved so poorly with you at such a vulnerable time in your life. It's going to be up to you to be able to go forward without getting any admission of inappropriate behaviour from her. Sad, but probably true.
Racer had some great advice as to what to expect if you decide to file a grievance about what happened. I think it's an important step in making a record of what transpired, for others' sakes who might have interactions with the same person; and it's also a chance for you to fully process the events and start to put them behind you.
I also agree that you shouldn't expect to get any directly positive results from making such a report, based on Racer's experiences.
ClearSkies
Posted by Phillipa on December 21, 2007, at 19:07:05
In reply to Re: Banned from PHP » dancinbillie, posted by ClearSkies on December 21, 2007, at 7:20:26
I've seen nurses get fired for praying over a patient as they did not want it it was considered unethical and her own peers reported her. So I would follow -up with it. Just ask to speak to the Director of Nursing at the hospital and she will throughly investigate it happens all the time. Phillipa
Posted by dancinbillie on December 21, 2007, at 21:37:20
In reply to Re: Banned from PHP » ClearSkies, posted by Phillipa on December 21, 2007, at 19:07:05
Hi, thanks for your post. I've tried to get in touch with XX's boss since October 22, to no avail. She does not return phone calls and she had one of her flunkies respond to one of my letters in which I was told that I could not return to the program. XX, who has been employed at the hospital for at least 10 years, seems to be unusually influential/powerful, at least within the partial hospitalization program, which makes this all the more difficult for me.
I see what you're saying about nurses being fired for doing something that a patient doesn't want, such as praying over them - I was perfectly happy, though, as long as XX was being overly nice and telling me she loved me and lending me dvds and stuff - I got upset when she basically "abandoned" me, turned on me when she became "uncomfortable" over the misunderstanding/confusion between the maternal transference and sexual attraction. The program director, who was in the meeting with XX and I after I brought up the obsessive/intrusive thoughts/maternal transference in group therapy, admitted later to me that she and XX jumped to the wrong (sexual) conclusion and that they should have questioned it further before making any decisions.
I was looking at rules and regulations for VA nurses, and under "unprofessional conduct" for which nurses can be disciplined is "abusing, neglecting or abandoning a patient." I'm wondering if what I perceived as "abandonment" by XX is the type of "abandonment" covered by that clause . . .
I was thinking tonight that I wish I could get XX to come to some of my therapy sessions with me, that would be so helpful. I'm sure she would not do that, though - would that be an "abandonment" since she was a clinician of mine who removed herself from my case before any resolution took place regarding problems she caused/encouraged?
Are XX's boundary violations "abusive" or "neglectful?"
Take care, thanks for all your posts =)
> I've seen nurses get fired for praying over a patient as they did not want it it was considered unethical and her own peers reported her. So I would follow -up with it. Just ask to speak to the Director of Nursing at the hospital and she will throughly investigate it happens all the time. Phillipa
Posted by Phillipa on December 21, 2007, at 22:31:07
In reply to Re: Banned from PHP, posted by dancinbillie on December 21, 2007, at 21:37:20
Abandonment means walking off the job and leaving your patients without a nurse so no that doesn't apply. So what you're really saying is that you (please don't take this wrong hard to word) attached yourself to her and wanted her as a sexual figure or mother one of the two. She leant you things that you appreciated. I used to do this too and it's okay as long as the material is approved for the patients. And then she and her boss decided you were forming an unhealthy attachment. Please correct any misconceptions I have. I think maybe a meeting with her, a collegue who was there and saw what was going on and the Director of the Hospital might help to clear things up. Do you think so? Phillipa
Posted by dancinbillie on December 22, 2007, at 13:14:30
In reply to Re: Banned from PHP » dancinbillie, posted by Phillipa on December 21, 2007, at 22:31:07
Hi, yes, you're right, I did attach myself to her - and she also attached herself to me. Please see my prior posts for details.
With the encouragement of the soon-to-be former medical director of the program (who is my medical management psychiatrist here on the outside) and my psychotherapist, I've been trying to set up a meeting since October 22, but I can't get any answer. Since XX communicated through hospital security not to try to contact her, I'm not trying to do that. I'm trying to go through the proper channels at the hospital, but they're ignoring the letters I've written except one, to which they responded that I can't come back to the program.
Thanks again for your responses =)
> Abandonment means walking off the job and leaving your patients without a nurse so no that doesn't apply. So what you're really saying is that you (please don't take this wrong hard to word) attached yourself to her and wanted her as a sexual figure or mother one of the two. She leant you things that you appreciated. I used to do this too and it's okay as long as the material is approved for the patients. And then she and her boss decided you were forming an unhealthy attachment. Please correct any misconceptions I have. I think maybe a meeting with her, a collegue who was there and saw what was going on and the Director of the Hospital might help to clear things up. Do you think so? Phillipa
Posted by Racer on December 29, 2007, at 1:44:35
In reply to Re: Banned from PHP » Phillipa, posted by dancinbillie on December 22, 2007, at 13:14:30
What about having someone on your treatment team contact the hospital about it? If they think having someone from the program -- or even XX herself -- attend one or more of your sessions to try to help process what happened, maybe if they approached the hospital program management, they could get somewhere with it.
Here's what I've learned, for myself, about this: it has taken a number of years to get over what happened to me, and I still have trouble related to it at times. Working with a good therapist -- that is, a therapist who fits my needs at this time -- has helped a lot, mostly processing the trauma, and exploring how it recreated earlier experiences from my life. As a result of that work, I'm getting through a lot of childhood trauma as well as the psychological trauma induced by the agency in question. It's hard, and I hate that I'm not over it yet. In fact, it's hard not to blame myself -- still -- both for what happened and for not getting over it sooner. I'm also left with a good deal of residual distrust of doctors in general, which is particuarly difficult to deal with.
My advice, based on my own experience, is to focus on your own recovery -- and not on working anything out with the people involved with the PHP. Most likely, they won't agree to engage in your treatment. That's unfortunate, since it might help speed your recovery, but it's also true. For one thing, if they agree to be part of your treatment, they risk a level of liability which I'm sure they'd like to avoid. More to the point, though, thanks to liability issues, NO ONE can say what you need to hear right now -- "I'm sorry." Even if they did show up, you'd be much more likely to hear something more like, "Gee, it's unfortunate that you crossed a line," and hearing that won't do you much good. I know that I heard something similar, which made me feel even more impotent in my hurt and rage. That's not going to do much for your healing, and your healing is what this is about now.
I'm sorry if this is only half coherent. Today has been rough for me, and I just can't seem to express myself very well.
Good luck.
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