Title quote: Gabrielle Roth.
Maintaining Professional Boundaries in Nursing
Part III: Is what I am saying or doing promoting the patient’s ability to care for themselves?
Intorduction: Nurses are responsible to maintain healthy professional boundaries to protect the vulnerable healthcare services seeker.
The National Council of State Boards of Nursing defines professional boundaries as “spaces between the nurse’s power and the patient’s vulnerability. The power of the nurse comes from the nurse’s professional position and access to sensitive personal information.”
Autonomy- “self-law”. Ensure that what you are saying or doing helps the patient maintain or make steps toward autonomy. Autonomy is an ethical concept which reflects the patient’s right to control their life. Autonomy, competence and relatedness are considered the basis for the human need of self-determination. Providing too much care, or doing for a patient what the patient is capable of doing can unknowingly undermine the patient’s self-concept, and ultimately, blunt the patient’s inherent motivation to be independent. How can you care AND promote self-determination?
Ask yourself: What can I do to help the patient help themselves? Can the patient make that phone call to arrange a service? Does the patient need to have you attend all appointments with providers? Can the patient safely ambulate to the toilet rather than using the bedpan? Can the patient express what their care goals are?
Danger signs that professional boundaries have been crossed:
- The nurse or the patient believes that they are the only one that can care for the patient
- The nurse flirts with the patient
- The nurse is doing something for the patient that the patient could do for his or herself
- The nurse shares intimate or personal details
- Speaking poorly about co-workers or the place of care
“This is what it means to have autonomy — you may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.” Atul Gawande
For more information about how to maintain nursing professional boundaries:
Professional Boundaries and the Nurse-client relationship: Keeping it safe and therapeutic, a publication by the College of Registered Nurses of Nova Scotia
A Nurses Guide to Professional Boundaries published by the National Council of State Boards of Nursing
Guidelines: Professional Boundaries by the Nursing Council of New Zealand