Nurses are a critical part of society. Without them, the patient experience would look very different on almost every level. From providing life-saving care daily to educating patients and their loved ones about health concerns and potential treatments, these professionals shape the outcome of their patients. Nurses play such a big role in their patients’ lives, and the relationship between the two is quite unique.
Nurses walk a fine line between providing empathetic and friendly care and maintaining a strict professional boundary with their vulnerable patients. This balance can be difficult to uphold, especially as compassionate care is provided. It is critical that the boundary remains intact, however, in order to continue providing patients with effective care and respecting their rights as patients.
In this article, we look at how to protect the professional boundary between nurse and patient while providing compassionate care.
Why are Professional Boundaries Important?
Professional boundaries between nurses and patients are important for a few different reasons. By far the most important of these is patient safety. Nurses are duty-bound to act in the best interests of their patients at all times. This gives them inherent authority over the patients they serve. Think about the last time you saw a doctor or visited the hospital. Did any of the healthcare professionals tell you how to care for your health? And did you accept them at their word?
Patients are vulnerable in the hospital. Not only are they placed in a situation where they must allow someone else to make medical decisions on their behalf, but they also rely on the kindness of the nurses to make it through potentially painful and scary situations. To protect patients and ensure that they are not taken advantage of, even if done with the best of intentions, nurses must establish professional boundaries early on and avidly maintain them throughout the duration of the patient’s stay.
What are Professional Boundaries in a Nurse-Patient Relationship?
The professional boundaries between nurses and patients are defined by the National Council of State Boards of Nursing (NCSBN)as the “spaces” that separate a patient’s vulnerability and a nurse’s power.
Crossing professional boundaries includes the following:
- Sharing personal information.
- Keeping secrets either with or for the patient.
- Positioning themselves as a ‘super nurse’/implying that no one else can take care of the patient
- Showing favoritism.
- Taking sides in disputes between family members.
- Performing personal favors beyond the scope of work.
- Complaining about coworkers to the patient and/or their family.
The above list is not inclusive of everything that could happen but are a few examples of the most common complications that are involved with delivering compassionate care.
It is also possible for nurses to interact too little with patients. Under-involvement is just as harmful as over-involvement.
Note that not all nurses intend to cross these boundaries. In fact, some might not realize that they are doing anything wrong at the time. This is why it is so important to actively safeguard the professional relationship. Here are some of the things you can do to balance being compassionate with providing objective and professional care.
Treat all Patients Equally
This might sound obvious, but it is surprisingly easy to be friendlier to people with whom you relate. You might spend more time with a patient who is experiencing something that you have experienced than one who is experiencing something entirely different. To combat this, you must make sure that you treat all of your patients equally. This means spending the same amount of time with them (dependent on care needs, of course), being equally friendly to them, and treating them all with the same level of dignity and respect.
Another way to maintain professional boundaries is to behave professionally at all times. It might be tempting to be less formal with patients, especially when they are scared and in need of comfort. Behaving informally, however, can quickly spiral into an inappropriate relationship where nurse and patient behave more like friends than caregiver and patient. Reinforce the idea that nurses possess specialized knowledge applied to a patient’s specific needs.
Keep Patient Information Confidential
It is crucial to keep patient information confidential at all times. Remember that you are in charge of protecting patients and upholding their rights, including the right to privacy whenever possible. This includes social media – keep the boundary between your social media and your patients just as strong as the one between you and your patients.
Regularly Reflect on your Behavior
Reflect on your interactions with patients. Did you provide objective care? Did you ensure that you remained professional at all times? At times when you may have been too informal, it’s acceptable to change your approach and steer the relationship back towards something more professional.
How can I learn to Identify Professional Relationships and Maintain Boundaries with Patients?
In addition to the tips above, aspiring nurses can participate in nursing programs revolving around the patients they will most likely see during their work. Nurses focusing exclusively on adults, both young and old, might consider enrolling on an AGACNP program (Adult-Gerontology Acute Care Nurse Practitioner). These programs focus specifically on the vulnerabilities that nurses will likely see in their patients, which better enables them to safeguard against crossing boundaries. Just make sure that you pick a respected university, especially for online degrees. Baylor University, for example, offers an accredited remote AGACNP program.
Are you interested in becoming a nurse and learning how to uphold professional boundaries with patients? If so, keep our tips in mind as you begin your professional journey!