Career advice

Maintaining professional boundaries

Keeping the balance right in nurse-patient relationships is vital to protect yourself, your patients and avoid burn out.

Maintaining professional boundaries is vital, says health coach Mandy Day-Calder 

A trusting relationship is fundamental for effective nursing practice. Patients need to feel safe in your care and have faith that you will act in their best interest at all times. 

Professional boundaries
Picture: Getty

You will see your patients at their most vulnerable, physically and emotionally. Their barriers will be down and they may share intimate feelings. Your role, as stated in the Nursing and Midwifery Council code, is to hold back these emotions, act with integrity and maintain clear professional boundaries at all times.

Protection

All relationships need boundaries, which help define what is expected and what is acceptable. As well as protecting patients and the public, maintaining professional boundaries is vital for a nurse if you want to avoid burnout and enjoy a lengthy career.

Most patients do not choose to enter a nurse-patient relationship – they do so because they need care and attention. Regardless of the circumstances, patients expect nurses to care for them in a compassionate manner, protect them from harm and provide information and advice. 

Within the varied scope of nursing, the exact nature of boundaries may vary. It is normal, for example, for community nurses to visit a patient’s home, but this would be unacceptable for a nurse working on a hospital ward. You should assess what is expected of you within your scope of practice and ensure the relationships you form are therapeutic in nature. 

Self-awareness

There have been several high-profile media cases where nurses have clearly overstepped the limits of their professional interactions. But boundaries can sometimes be breached in subtler ways. A patient may ask questions about your family, for example, and you end up revealing more about your personal life than is appropriate.

Although many patients enjoy social interaction or even banter with healthcare staff, the responsibility is on you to maintain the balance of emotional closeness and professional distance. It is a good idea to get into the habit of looking at your relationships and asking yourself honestly: 

  • How is your work-life balance? The more you are able to relax when off-duty, the more refreshed you will be at work.
  • Are you giving equal care to all your patients? It is likely you will have more in common with some patients than others, but you must avoid showing favouritism. 
  • Do you have colleagues, friends or family you can confide in? Your patients may express interest in your life but it isn’t appropriate to ask them for personal advice.
  • Are you respecting privacy? Do not share your mobile number, or ‘friend’ or follow patients on social media. 

If you are not acting in your patients’ best interest, you need to take a step back and examine your intentions. This can be challenging and requires a high level of honesty and self-awareness, yet failing to do so can result in an abuse of trust and can even put patients’ safety and wellbeing in danger.


Mandy Day-Calder is a freelance writer and life/health coach 

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