Hospital Romance

In pop culture, nurses find love, marriage and passion at work. Here is the real story.

On the left, a photo of the characters from ER holding each other, the middle is on a couple getting married with a rose on top of the photo, and the third is a couple sitting in a hospital bed holding each other

SCENE: After resuscitating a car crash victim, handsome doctor Doug Ross (George Clooney) and attractive head nurse Carol Hathaway (Julianna Margulies) embrace — and soon find themselves sharing their first kiss.

“I shouldn’t have,” whispers Ross apologetically.

“Well, you didn’t do it alone,” Hathaway replies with a smile.

This scene is from the first season of “ER,” but if you’re a veteran television viewer, you can probably recall countless moments just like it. Hospital romances are the lifeblood of every medical series, whether reality show, daytime soap or nighttime drama. The life-and-death decisions come and go — it’s the romances that keep audiences tuning in.

But what about real life? Hospital romances do happen, but the drama and the consequences don’t always work out the way they do on TV.

The Heart Wants What it Wants

During the Civil War, Dorothea Dix, that great pioneer of U.S. Army nursing, took a dim view of romance within her ranks. Dix didn’t even want her nurses to be too young or too pretty, lest hostile Army doctors accuse the nurses of being more interested in finding husbands than in doing their duty.

Today, romances between nurses and patients are still frowned upon. The National Council for State Boards of Nursing (NCSBN) considers such relationships to be sexual misconduct, no matter who initiates them. “It is an abuse of the nurse-patient relationship that puts the nurse’s needs first,” declares the NCSBN pamphlet A Nurse’s Guide to Professional Boundaries.

Even so, sometimes the heart wants what it wants. In 2013, James Costello, one of the victims of the Boston Marathon bombing, fell in love with travel nurse Krista D’Agostino while undergoing treatment at Spaulding Rehabilitation Hospital, where D’Agostino worked. After a much-publicized whirlwind courtship, the two tied the knot in August 2014.

“She hates when I say this, but I’m actually glad I got blown up,” Costello told the hosts of “The Today Show” after he and D’Agostino announced their engagement. “I wish everyone else didn’t have to, but I don’t think I would have ever met her if I didn’t, so I’m pretty happy.”

Not all nurse-patient relationships end so well. Back in 1997, a nurse from Lawrence, Kan., wrote to advice columnist Ann Landers, lamenting that her husband, a former patient, was a hypochondriac who expected her to take care of him 24/7.

There have also been several cases of correctional facility nurses who fell in love with inmates and ended up aiding the prisoners’ escape attempts. Back in 2005, Jennifer Hyatte lost her job as a nurse at Tennessee’s Northwest Correctional Complex over her relationship with a prisoner whom she then married. She later killed a guard to help her husband escape. Both husband and wife are now serving life sentences without the possibility of parole.

Workplace Romance

A 2015 study in the International Journal of Management Reviews, by Scottish organizational behavior professor Fiona Wilson, Ph.D., estimates that most workers — as many as 70 percent — have workplace romances at some point in their careers, whether it’s a casual fling or a long-term relationship leading to marriage. Healthcare is no different.

In a high-stakes, high-pressure workplace, it’s natural for sparks to fly, and real-world nursing can be just as dramatic as anything you see on TV. Especially in the emergency department, intense drama and heart-wrenching tragedy may be part of every shift. Such intensity has a way of fostering romance, even if the protagonists aren’t always as ruggedly handsome as Nathan Riggs (Martin Henderson) of “Grey’s Anatomy.”

Nursing Education

The sparks definitely flew when Nancy Kessler, RN, met her future husband years ago. “He was working as an aide and an orderly at West Park Hospital in Cody, Wyo., in the med/surg unit. He had just gotten out of the Army,” Kessler recalls. “At first, I mistook his confidence for arrogance, so I had to get to know him until I figured it out!”

The Kesslers have now been married for 35 years and have two daughters and three grandchildren. He is a lab technologist, while she is an RN working on a women’s health unit. Nancy says, “We work different shifts, but coordinate our days off to spend them together.”

Ashley Schultz, RN, fell in love with a fellow nurse. “My husband Chris and I met working in the NICU at the children’s hospital,” she says. “We both had been working in the NICU for three years at the time. He was the only male nurse in the NICU.”

The Standard Plotline

Once upon a time, many people assumed most hospital romances were between doctors and nurses. Nurse-doctor romance has always been a popular plotline in medical fiction, especially back in the days when it was rare for women to become physicians and rarer still for men to become nurses.

Well into the 1980s, if a hospital show featured a prominent female nurse, there was a good chance she would become a romantic interest for some male doctor. You still hear that assumption from time to time, particularly from older patients or relatives.

A married nurse anesthetist on the Allnurse.com message board recalled the time one of her patients asked if she was married and then assumed that her husband must be a doctor. “I said, ‘Oh my god, no, it’s bad enough having to work with them, much less be married to one,’” the CRNA recalled. “Suddenly, there was a dead silence on the other side of the drape. After I took my foot out of my mouth, I peeked over and said to the surgeon (a relatively benign guy who had recently removed my gallbladder), ‘Present company excepted, of course!’”

Of course, doctors and nurses do sometimes end up together. “I married a doctor 17 years ago,” said another Allnurse.com commenter. “We married because we were best friends and had a lot in common. It was the best decision I ever made.”

She added that after vision problems ended her husband’s practice, “We did the ol’ role reversal thing. He cooks, cleans, does the laundry and raises the kids while I go to work.” (There’s a twist you probably won’t see on your favorite nighttime hospital drama!)

Fools Rush In

The star-crossed lovers of TV’s hospital romances face all sorts of melodramatic obstacles: hostage standoffs, plane crashes, amnesia plots and even long-lost identical twins. Real-world consequences aren’t usually quite that exciting, but workplace romances can still have plenty of serious pitfalls. Close relationships between people in the same department or unit — even family relationships — can create problems of favoritism, coworker resentment and loss of objectivity.

Breakups can be even worse. Acute care settings are stressful enough without coworkers taking out their relationship squabbles on everyone else in the unit! Romantic overtures on the job also run the risk of sexual harassment complaints. We all know that a supervisor making a pass at one of their direct reports is a red flag, but a nurse passed over for a promotion in favor of a coworker who’s sleeping with the boss could also have a claim. So could coworkers bothered by a couple having steamy midday liaisons at work.

Hiring Now

Sexual harassment and hostile work environment claims can mean costly liability for hospitals, which has led hospital leaders to set strict rules about employee relationships. Some local hospitals require employees to inform human resources if they have any personal relationships with fellow employees. Many facilities prohibit workers in relationships from working in the same department or in any position where either supervises the other, even indirectly.

Never Tear Us Apart

Most hospitals now have policies like this, but they’re a relatively recent development. Thirty-five years ago, Nancy Kessler’s husband was able to work as her aide while she was a charge nurse. She says they worked well together and didn’t have any power issues that might have become disruptive to the unit. “I don’t remember anyone having a negative reaction to our relationship,” she says. “Coworkers gave us a wedding shower. We weren’t aware of any policy that stated we couldn’t date.”

Changing rules have created some headaches for long-term employees whose relationships predated the policy. Lesleigh Berg, RN, whose husband is a lab tech, says that when they first became involved, “There was no policy about dating coworkers that I was aware of. The administration didn’t say anything about us dating. It was when we became engaged and married that they started putting up boundaries.”

After their wedding, Berg and her husband were forbidden to work in the same unit. Hospital administrators, she says, “thought that others would complain or that I was giving him special treatment. I actually was harder on him than the other techs. Also, we were talked to in the office [and told] that home stayed at home and work was work.”

Hospital rules created even more drama for Ashley Schultz and her future husband, Chris. “We initially kept our relationship a secret until one day I went into work and the charge nurse and manager were talking at shift change about how they couldn’t get a hold of Chris,” Schultz recalls. “He was a no-show for his shift. They called his number (his mom’s house), but his mom hadn’t seen him in three days. They started to call the police. I had to fess up and tell them that he was at my house!”

After the couple came clean, Schultz says, “Some of our coworkers were shocked, but most of them were super-excited for us and loved seeing us together. We were the unit couple that everyone loved, although it was hard at times feeling like our relationship was on display in the NICU. We had many people from work at our wedding.” Ashley and Chris Schultz have worked together in the NICU for 10 years, she as a charge nurse, he as a staff RN.

Now, they alternate days off so one parent can be home with their three children. “We are deeply in love with each other and our kids,” Ashley reports. “We enjoy living on our five acres with about 30 chickens.” ­

A Thorny Ethical Dilemma

Back in January 2010, the AMA’s online ethics journal, Virtual Mentor (now called AMA Journal of Ethics), published a case study about a fictional hospital contemplating an even tougher policy on dating: a total, no-exceptions ban on relationships between coworkers.

This zero-tolerance policy was as hypothetical as the case study’s fictional “Healer Hospital. As the authors’ commentary illustrates, rules so strict would be almost unenforceable. Threatening to fire employees for dating would also create a whole new range of liability risks and morale problems for hospitals. The point of the case study was to highlight how complicated employee relationships can be from an ethical perspective.

Anyone who’s ever tried to dissuade lovers who are determined to be together has forgotten their Shakespeare — even the long-feuding Montague and Capulet families couldn’t keep Romeo and Juliet apart. And yes, in pop-culture fiction, Dr. Doug Ross and Carol Hathaway, RN, finally end up together in the Season 1 finale of “ER.” No matter what hospital policies are in place, the emotions of the heart are strong and will prevail in the end.

On the other hand, the desires of the lovers must be balanced against the interests of the staff, the hospital and above all the patients. So, if you become involved with a fellow nurse or member of the team, be discreet, be considerate of others, and definitely check in with human resources and your nursing manager to make sure you don’t violate protocol.

While the rules may be cold-blooded, they remind us of everything that’s at stake in real-world hospital romances. You will likely be restricted from working with your loved one —a sacrifice, yes, but what could be more romantic than that?­­

ERSILIA POMPILIO, RN, MSN, PNP, is a pediatric nurse practitioner, nurse media expert and the founder and CEO of Rogue Nurse Media.

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