Patient Boundaries

One of the keys to doing hospice for a long time (I've been at it for 7yrs) is keeping focused on the fact that you are there to do a job- keep your patients and their families as comfortable as they be for the amount of time you have them. Don't share personal information with them- for example they should not know the names of your kids/pets/etc. One of the chaplains and several Sw's have often said that if they are asking you about personal information it's often because they want to talk about theirs. Which is what we are there for. Also remember that these folks have had a life before you came into it, and you are barely a speck on the story of their life. Of course some folks will get to you more than others- these are the folks who it would benefit you from every now and then asking another nurse to go visit. And never underestimate the value of your Sw's and CHPs to help you with things- as some pts will definitely resonate with you more than others. Also keep in mind that even if pts/their families tell you that 'you don't even need to knock, you're one of the family'-you are not and it is wrong to give the family another loss to grieve when that pt dies.

Thank you so much for your advice. It makes a lot of sense.

I have a question in regards to patient boundaries. I have experienced several deaths but for some reason a recent one really got to me. Do you find that you are more attached to some patients to others? How do you establish boundaries? I am particularly fond of older people and am wondering if this had an impact on my reaction. What advice do you have for a nurse that is new to hospice in regards to boundaries while still providing good patient care?

IMO it is good to have a therapeutic caring relationship with family and patient in hospice. Having said that boundaries are very important in home care. I usually do not talk about my own life. If it is to the benefit of the patient I sometimes tell them I also have family because people like to relate but no details/names. Don't do things like food shopping or running errands. Come on time but also leave on time. It is normal that we get feel different about different patients and sometimes somebody touches our heart in a special way. But it should not feel disabling to you.