Have you ever encountered a patient in one setting, only to meet the same patient again in another setting? Sometimes it was only after a few months. Other times, it was after a good several years. Do you take the knowledge, the experience and the history from your previous clinical setting and transfer them into the new setting when establishing a new relationship?

I have had several examples of such experience. These patients have complex chronic conditions. One example is a new born with short gut syndrome requiring surgery and then an indefinite need for long term TPN (total parenteral nutrition). I encountered him both in hospital and later in home care setting. Another example is a pediatric patient who has developed advanced stage of renal failure requiring dialysis and therefore he has been  encountered in the dialysis unit in a pediatric hospital and later in the adult nephrology unit. Another case  is a patient with severe neurological disorder rendering total care that has been transferred between long term care facilities.

You thought your relationship was over when you left your previous job but you realize these patients somehow become your patients again in a different setting.  You start all over again.

Should your relationship begin as a clean slate?

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