Crossing professional boundary.

Nurses General Nursing

Published

These questions are for any nurses who would like to respond.

Do you know of any situations in your nursing history regarding a nurse crossing professional boundaries?

How do we maintain professional relationships? What are some warning signs that the professional relationship the becoming unprofessional? Is there anything wrong with becoming personally involved with a client?

Nursing Student (SLU)

Helen

I worked in an independent birthing center, and part of the appeal (for both the clients and the staff) is that there is none of the "it is unprofessional to become involved with your patients" kind of thing. Many of my closest friends are people whose birth I attended, or whose childbirth classes I taught. Of course, I didn't become best friends with everyone. And we all remained professional in terms of our roles while in the clinical setting. There are still professional boundaries, and for example, I do not give my phone number out to my clients--I do give my email, though, so that they can ask questions about classes. At the hosptial I do not develop these relationships with my patients. The setting is just so different, not conducive to developing personal relationships for many different reasons.

I think it is nice to have my practitioners, especially the ones I see over and over, and with whom I have experienced a very intense experience, to become more than just my "nurse" or my "doctor." I trust them more. Our pts at the birth center always comment on how much more respected they feel, how much they trust us, and how they feel that we are honestly concerned with their wellbeing. We get comments all the time to the effect of "the hospital nurses are so cold," or "it seems like it's just a job for the hospital docs." The hospital setting is just different, designed to serve large numbers of people in an efficient (well, relatively) manner. It's not designed for close, personal care. Birth centers, LTC, and hospice are some settings that I can think of where the rules or definitions of "professional boundaries" are different than the acute care setting at the hospital.

It's a gray line. I think if it is a power thing, or feels wrong to anyone involved, then it probably is over the line. But different strokes for different folks, you know?

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Specializes in Med Surg.

Bordeaux, you and your wife need marriage counselling and soon. The number of times you say that this isn't romantic imply that you may fear otherwise; but the fact is, your wife is putting another married man's welfare ahead of her own husband and family and this is not appropriate or healthy for your marriage.

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Specializes in Neuro ICU, Neuro/Trauma stepdown.

We did a computerized learning thing about our policy that said some warning signs would be something to the effect of "thinking about your patient in ways that dont pertain to their care," and "spending more time then needed or finding yourself checking on this patient more frequently than others."

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Bordeaux67, I second what Sisukas said. Find a counselor and go.

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Specializes in student.

Joke: A practical nurse marries a rich client. Joke

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There have been several in our facilities over the years.

One NA married a client and ended up in debt over her ears when he absconded with all her credit cards...

One RN took home a borderline that covered her apartment in blood when he self mutilated...

Luckily it is increasingly less tolerated.

Becoming involved with a patient is NEVER professional. It is patient abuse

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I guess it's a mental thing with me, because I've never, ever had any attraction to anyone in a hospital gown. No matter how attractive, I just can't see them in that way. On the rare occasion over the years when men start being a little too nosy about personal info, first I start talking about my husband and five sons - if it continues, I just tell them we're not allowed to give out personal info.

I have always enjoyed taking care of my patients - and in LTC have gotten very fond of some of them - but when I walk out of the door, that's it.

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Specializes in ER/Geriatrics.
I guess it's a mental thing with me, because I've never, ever had any attraction to anyone in a hospital gown. No matter how attractive, I just can't see them in that way. On the rare occasion over the years when men start being a little too nosy about personal info, first I start talking about my husband and five sons - if it continues, I just tell them we're not allowed to give out personal info.

I have always enjoyed taking care of my patients - and in LTC have gotten very fond of some of them - but when I walk out of the door, that's it.

I agree totally......it is totally black and white to me........especially the patient/nurse relationship........as far as staff throughout the hospital I have no problem at all.......as long as there is professionalism going on....

IMHO

Liz

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Specializes in ICU, telemetry, LTAC.

Not a question of attraction, but I left a patient one morning with her having written her phone number on my hand. I put it in my book and never called her.

The reason I didn't call is that I thought she might be a frequent admission and it turns out I was correct. But I'd love to spend a day once in a while just listening to this sweet LOL while off work, and each of us has much that could be learned from each other. When CHF does finally take her home, I know I'll miss her greatly.

As time goes on I have discovered other reasons not to be personally involved with this lady outside of work. She switched physicians from one that I really believe had her best interests in mind, but not so good communication skills, to one whom I believe is nice to her but doesn't help her condition at all. I'd really be doing my license a disservice to get into ANY of THAT discussion with her. If I treated her like family, of course the topic would be discussed, since her current doc is one I wouldn't let touch my family members with a ten foot pole. Fortunately, her primary care doc gives excellent advice and she's listening to him, and her quality of life appears to be improving.

Sometimes restrictions on professional behavior really are there to protect the professional, even if we feel otherwise at times.

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Hi, this is a great question. Crossing the lines professionally creates harm to the patient/nurse relationships. This topic is discussed in these resources I found when recently I did a paper for my MSN ethics class. The Code of Ethics for Nurses from the ANA discusses this also nicely. Look up the articles and they will provide more in-depth inquiry into answering your questions.

;)

Canadian Nurses Association. (2003). Ethics in practice: Ethical distress in health care environments. Retrieved March 23, 2007, from http://www.cna-aiic.ca

College & Association of Registered Nurses of Alberta. (2005). Professional boundaries for registered nurses: The nurse-client relationship. Retrieved March 23, 2003, from http://www.nurses.ab.ca

Driscoll, K. M. (2004). Crossing professional boundaries: Ethical, legal and case perspectives. Rehabilitation Nursing, 29(3), 78-79.

Holder, K.V., & Schenthal, S.J. (2007). Watch your step: Nursing and professional boundaries. Nursing Management, 28(2), 24-29.

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Hi, I understand the concern. Boundaries have been crossed in this situation. I agree that it does create tension from your families perspectives. Look online and find articles regarding boundary crossing and have your wife read them. She may not see that she has crossed the line in her attempts to help this patient.

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