Maintain healthy boundaries: Considerations when caring for patients.
Part 1 of 3.
People who seek healthcare services are inherently vulnerable. Nurses have access to sensitive patient information and are gatekeepers to knowledge and services vital to patients. While public opinion polls have repeatedly rated nursing as the most trustworthy profession, it’s important that nurses are aware of and attend to the power differential created between the nurse and patient. 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.”
Does what I am saying or doing keep the patient at the center of my care?
To whose needs am I attending? Mine or the patients?
Attending to the patient needs is an essential feature of the ethical principal “fidelity”. According to Advocate Web, Fidelity refers to whether the service promised is delivered. In the case of nursing care, is the nurse providing care exemplified by national standards? Questions a nurse might ask include: Is what I am saying or doing supporting nursing assessment? Patient care planning? Patient education? Evaluation of effectiveness of services?
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