Communication discussion board- intro to professional nursing

A Nurse’s Guide to

Professional
Boundaries

A nurse must

understand and apply

the following concepts

of professional

boundaries.

3

Y

ear after year, nursing tops national

polls of the most widely respected and

trusted professions. The results of these polls

reflect the special relationship and bond between

nurses and those under their care. Patients can

expect a nurse to act in their best interests and

to respect their dignity. This means that a nurse

abstains from attaining personal gain at the

patient’s expense and refrains from jeopardizing

the therapeutic nurse–patient relationship. In order

to maintain that trust and practice in a manner

consistent with professional standards, nurses

should be knowledgeable regarding professional

boundaries and work to establish and maintain

those boundaries.

4

A therapeutic relationship is one that allows nurses to
apply their professional knowledge, skills, abilities and
experiences towards meeting the health needs of the
patient. This relationship is dynamic, goal-oriented and
patient- and family-centered because it is designed to meet
the needs of the patient and family. Regardless of the
context or length of interaction, the therapeutic nurse–patient
relationship protects the patient’s dignity, autonomy and
privacy and allows for the development of trust and respect.

Professional boundaries are the spaces between the
nurse’s power and the patient’s vulnerability. The power of
the nurse comes from the nurse’s professional position and
access to sensitive personal information. The difference in
personal information the nurse knows about the patient
versus personal information the patient knows about the
nurse creates an imbalance in the nurse–patient relationship.
Nurses should make every effort to respect the power
imbalance and ensure a patient-centered relationship.

Boundary crossings are brief excursions across
professional lines of behavior that may be inadvertent,
thoughtless or even purposeful, while attempting to meet
a special therapeutic need of the patient. Boundary cross-
ings can result in a return to established boundaries, but
should be evaluated by the nurse for potential adverse
patient consequences and implications. Repeated boundary
crossings should be avoided.

Boundary violations can result when there is confusion
between the needs of the nurse and those of the patient.
Such violations are characterized by excessive personal
disclosure by the nurse, secrecy or even a reversal of roles.
Boundary violations can cause distress for the patient, which
may not be recognized or felt by