Professional Boundaries- Communication – Flashcards

The results of these polls reflect the special relationship and bond between nurses and those under their care

abstains from attaining personal gain at the patient's expense and refrains from jeopardizing the therapeutic nurse-patient relationship.

is one that allows nurses to apply their professional knowledge, skills, abilities and experiences towards meeting patient needs. *It is dynamic, goal-oriented and patient-centered because it is designed to meet patient needs.

protects the patient's dignity, autonomy and privacy and allows for the development of trust and respect.

the spaces between the nurse's power and the patient's vulnerability.

the nurse's professional position and access to sensitive personal information.

an imbalance in the relationship.

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.

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.

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 the patient until harmful consequences occur. *Violations can also include such things as stealing

an extreme form of boundary violation and includes any behavior that is seductive, sexually demeaning, harassing or reasonably interpreted as sexual by the patient. Professional sexual misconduct is an extremely serious, and criminal, violation.

includes boundary crossings, boundary violations and professional sexual misconduct

involvement includes distancing, disinterest and neglect, and can be detrimental to the patient and the nurse.

True

What was the intent of the boundary crossing? Was it for a therapeutic purpose? Was it in the patient's best interest? Did it optimize or detract from the nursing care? Did the nurse consult with a supervisor or colleague? Was the incident appropriately documented?

-What is the length of time between the nurse-patient relationship and dating? - What kind of therapy did the patient receive? Assisting a patient with a short-term problem, such as a broken limb, is different than providing long-term care for a chronic condition. - What is the nature of the knowledge the nurse has had access to and how will that affect the future relationship? - Will the patient need therapy in the future? - Is there risk to the patient?

is sometimes difficult to discern. A nursing professional living and working in a small, rural or remote community will, out of necessity, have business and social relationships with patients. In these instances, it is extremely important for nurses to openly acknowledge their dual relationship with patients and to emphasize when they are performing in a professional capacity. The nurse must ensure the patient's care needs are primary. When this is not possible, nurses should remove themselves from the situation or request assistance from a supervisor or colleague.

Boundary violations are extremely complex. Most are ambiguous and difficult to evaluate. Boundary violations may or may not lead to sexual misconduct. In some cases, extreme sexual misconduct, such as assault or rape, may be habitual behavior, while at other times it is a crime of opportunity. Regardless of the motive, extreme sexual misconduct is not only a boundary violation, it is criminal behavior.

If the patient consents, and even if the patient initiates the sexual conduct, a sexual relationship is still considered sexual misconduct for a health care professional. Why?... It is considered an abuse of the nurse-patient relationship that puts the nurse's needs first

- Discussing intimate or personal issues with a patient - Engaging in behaviors that could reasonably be interpreted as flirting - Keeping secrets with a patient or for a patient - Believing that you are the only one who truly understands or can help the patient - Spending more time than is necessary with a particular patient - Speaking poorly about colleagues or your employment setting with the patient and/or family - Showing favoritism - Meeting a patient in settings besides those used to provide direct patient care or when you are not at work

asking questions about a particular nurse, or seeking personal information. If this occurs, the nurse should request assistance from a trusted colleague or a supervisor.

Consult with your supervisor - remember... *Patient safety must be the first priority. Nurses should be familiar with reporting requirements and the grounds for discipline in their jurisdictions; they are expected to comply with legal and ethical mandates for reporting.