Overstepping boundaries can undermine patients’ trust and respect – and may put your future registration at risk.
Overstepping boundaries can undermine patients’ trust and respect – and may put your future registration at risk
It is often said that we form assumptions of people within a few minutes of meeting.
When you tell someone you are a nurse it is likely you will be considered a ‘good’ person. This is because nurses are expected to be kind and caring, keep patients safe and offer a listening ear.
As a student you need to be aware that your behaviour and the image you project – in and out of working hours – can affect public perception.
People are often at their most vulnerable when accessing healthcare services. By behaving professionally and compassionately you can gain trust and respect, which in turn enables patients to become more involved in their care and wellbeing.
Zone of helpfulness
Trusting relationships require openness, honesty and close working with patients and relatives. There is a fine line between friendliness and being overly familiar. Sometimes nurses are so keen to be liked that they overstep boundaries, perhaps revealing too much about their personal lives, communicating outside work or even meeting in person. This lack of self-awareness can abuse trust and ultimately put patients’ welfare and safety at risk.
Professionalism and trust
The Nursing and Midwifery Council Code states that you must:
- Maintain clear professional boundaries at all times.
- Be honest, open and demonstrate professional and personal integrity.
- Act as a role model for students and junior staff.
- Remain objective and non-judgemental, treating everyone equally and fairly.
- Refrain from expressing personal beliefs or opinions in an inappropriate way.
- Acknowledge the impact your behaviour and actions may have on others.
- Follow the laws of the country where you work or are registered.
- Not knowingly cause distress or exploit a vulnerable situation or individual.
- Maintain your own health to the necessary standard to remain fit to practise.
Refuse all gifts except those considered trivial. Respond and reflect on any complaints against you, ensuring the care you give is not affected. Ensure all forms of communication are responsible and respectful of privacy.
On placement you should develop the ability to work in a therapeutic nurse/patient relationship. This is sometimes called the zone of helpfulness. As you progress and gain experience you may be seen as having more ‘power’ over patients, therefore it is important to reflect continuously on your professional boundaries, asking yourself:
- How do you define and maintain safe and clear boundaries with patients and relatives?
- How would you know if you were becoming too involved?
- How would you know if you were distancing yourself?
- What keeps you in the zone of helpfulness?
Social media can have positive benefits through the sharing of knowledge and networking. However, posting about incidents at work can breach professional boundaries. The Nursing and Midwifery Council Code’s standards include social media use, so stick to the guidance to protect yourself and your patients online. In particular:
- Never disclose information that could breach patient confidentiality.
- Be respectful online. Bullying, harassment and discrimination are never acceptable.
- Do not post images of patients or relatives without their consent.
- Refrain from making inappropriate comments about patients, relatives or colleagues.
- Don’t ‘friend’ or ‘follow’ people in your care.
Acting unprofessionally or unlawfully may put your registration at risk. Future employers are likely to check your social media profiles, so think before you post. If in doubt, don’t do it.