How to set boundaries as a Nurse

On 14-06-2024 | Read time about 4 Minutes

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How to set boundaries as a Nurse

Professional boundaries are set by legal, ethical and organisational frameworks to maintain a safe working environment for both the patient, but also the nurse.Maintaining professional boundaries is always the nurse’s responsibility. This includes physical boundaries and emotional boundaries.

When nurses cross professional boundaries, it puts the nurses’ needs above those of the patient. Crossing professional boundaries may include:

• Sharing personal or intimate information
• Flirting or indiscriminate touching
• Keeping secrets with or for patients
• Acting as the “super nurse”- as if you are the only one who can care for or understand the patient
• Showing favoritism by spending more time with a patient than necessary, taking sides in disagreements among family members, or performing personal favors outside of your scope of work
• Complaining, joking, or speaking negatively about your employer or colleagues to patients or family
• Meeting with patients outside of work in areas where direct patient care is not being offered
• Posting about a patient on social media via photo or comment
• Encouraging a role reversal, such as creating a situation where patients or families feel the need to provide the nurse with emotional support during times of distress
• Taking part in an act of omission or commission, which refers to any instance where the nurse fails to act in a manner that benefits the patient or threatens their well-being.
• Communicating with the patients outside of their treatment including via text message and social media.

Steps to prevent crossing professional boundaries.

With improved prevention and education, research, and constant self-awareness, nurses can create a safe and therapeutic environment. Avoid crossing professional boundaries by:

• Being aware and conscious of your professional role and obligations when at work and your role and responsibilities when you socialise.
• Being clear with friends, family and acquaintances about when you are on duty and when you are not. Giving advise when at a wedding or out at a barbeque is not acceptable as it may often be incomplete as well as sometime misleading without full clinical history.
• Nurses should not have an intimate sexual relationship with the patient, particularly if likely to provide ongoing care for the patient in the future.
• Avoiding privacy breaches- only look at records of the people in your care and for the purpose of providing ongoing care. Making a comment via social media, even if done on a nurse’s own time and in their own home, regarding an incident or person in the scope of their employment, may be a breach of patient confidentiality or privacy, as well as a breach of boundary.
• Ensuring that your behaviour meets the needs and best interest of the patients.
  • Do not discuss intimate or personal issues with a patient
  • Do not Engage in behaviours that may be interpreted as flirting
  • Do not meet a patient in settings besides those used to provide direct patient care or when you are not at work
  • Do not engage in keeping secrets with a patient or for a patient
  • Do not spend more time than is necessary with a particular patient and/or show favouritism.
  • Discourage patients showing overinvolvement by asking questions about a particular nurse or seeking personal information.
  • Do not speak poorly about colleagues or your employment with the patient and/or family

• Ensuring that your care is objective and that it does not have the potential to be seen as favouritism or conflicted by an existing or prior relationship with the patient.
• Regularly reflecting on practice – discuss with colleagues/ manager in the appropriate forum.
• Discussing with your manager or educator any complex relationships or concerns over boundary violations.
• Accurately documenting any treatment and strategies in place to manage the professional and personal nature of a relationship with a patient/s.
• Uphold the codes of professional conduct and ethics and ensure behaviour is in line with these as well as within scope of practice and organisational policies.
• Ensuring competency for scope of practice and understand your accountability as a professional, as a nurse. Nurses should not provide patients with medications, if they not being authorised to do so.