The question of whether an individual continues to be a client is a complicated one determined by the case’s circumstances. The law says that the nurse-client relationship continues to exist for one year after the date when the individual stopped being the nurse’s client. If the nurse touches or speaks with the individual in a sexual way or engages in a sexual relationship with the individual at any time within the year after the relationship ends, it is sexual abuse.

Leo should think critically on his professional relationship with Kayla to determine if the nurse-client relationship ended in keeping with CNO standards, and if a one year has passed from the time she stopped being his patient before approaching her for a personal relationship.

There may be some instances where it may never acceptable to engage in sexual relations with a former client. For example, the treating relationship was very intimate or involved clinical methods that led to lasting power differentials such as psychotherapy and associated methods.

In determining if it is right to engage in a sexual relation with a former patientclient, a number of factors are considered, including:

• the length and intensity of the former professional relationship
• the nature of the client’s clinical problem
• the type of clinical care the nurse provided 
• the extent the client confided personal or private information to the nurse
• the client’s vulnerability in the nurse-client relationship

If Leo approached you as a peer looking for advice, you could advise him to review the Professional Boundaries and Nurse-Client Relationships practice standard.