Boundary Violations

Nursing is an occupation in which professionalism (or lack thereof) can have a significant effect on not only patients and their health, but the nurse’s relationships with colleagues, patients’ families and even their community. A nurse must exemplify professionalism, especially in an environment that creates increased risk for loss of life or further injury. There are many aspects that are involved with professionalism in nursing, and many expectations set up on the nurse.

Nurses play many roles in the healthcare field, can have many duties to fulfill under their licensure. It is important for a nurse of any degree, or licenses to know all of the duties that can be performed under their scope of practice. Olin (2012) states, “Scopes of practice are the same for every nurse at a basic level and very different by specialty.” Therefore, it is important to understand the scope of practice, that the nurse is licensed for. A nurse has many roles under the scope of practice that the nurse is licensed under. There are times when a nurse is asked to perform a task that isn’t under the nurse’s scope of practice and guidelines, and it is very important not to fulfill the task at hand if it

The framework for creating a therapeutic relationship is built on the nurse’s ability to show empathy towards the client. Empathy is being able to put oneself in the patient’s shoes, to feel the same things they feel

There are many ways of forming a relationship and gaining the trust and respect of the patient and I had to work out the different things that make a good therapeutic relationship. According to Hinchliff et al (2003) there are a number of important elements that make a good therapeutic relationship, but it is important to make clear that a therapeutic relationship is a formal relationship between a medical professional and patient. The Nursing and Midwifery Council (2008) maintains that at all times nursing staff must maintain appropriate professional boundaries in the relationships they have with patients and clients.

Nurse and patient relationships are referred to therapeutic relationships, they are a person-centred approach to care (Berman Et al 2012). For a therapeutic relationship to be effective in meeting the client/patient goals the nurse needs to ‘earn the person’s trust and respect.’ Berman Et al (2012) suggests that the trust and respect of a patient can be earned through ‘sound nursing knowledge and use of effective communication.’ This is reflected in the Nursing and Midwifery Board of Australia’s competency standards. These national standards that are regulated and followed by all nurses, they are updated regularly to remain contemporary and

This essay discusses public expectations of nurses, nurse-patient relationships and how to set their guidelines through professional behavior and professional boundaries, what they mean to nurses, and the connection between professional behaviour and professional boundaries.

According to the ANA (American Nurses Association), it is the duty of nurse to protect the patient’s rights, safety, health and advocate for the patient. By treating the patient in an open area, invades their privacy, can cause embarrassment and most of all jeopardize trust between the patient and care giver. This negligent care could also lead to legal ramifications in the future against the hospital. By breaking this trust, the patient may also omit valuable information that could affect their treatment ultimately causing them harm. Some patients may become noncompliant with their prescribed treatment. It is essential that effective communication between patient and care provider occurs at all times. . Healthcare providers are obligated to give safe and effective care.

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.

To meet competency standard two, registered nurses need to consciously and actively engage in therapeutic and professional relationships (Nursing and Midwifery Board of Australia [NMBA], 2016); Doherty & Thompson, 2014). Therapeutic nurse-patient relationships are built on trust, where the patient feels safe to be open and honest; enabling a productive relationship with positive patient-centred outcomes (Doherty & Thompson, 2014). A vital principal in delivering patient-centred care is to foster effective communication along with establishing personal and professional relationship boundaries (NMBA, 2016). This fundamental approach to care, ensures

A nurse is given an opportunity to help patients, either if its by helping them through a very serious sickness or just helping a patient get to the bathroom on time, or a time when happiness is overfilling the room and a child is being born. Registered nurses provide a wide variety of patient care services (Mitchell, p.12). A Nurse must always know where to begin and where to stop, as any other career in the health field there is always something that cannot be done by everyone but only the certified person, a nurse must always remain inside her scope of practice to prevent any misunderstandings. A nurse must also follow a code of ethics , the code of ethics of the American Association of Medical Assistants states that a nurse should at all times render service with full respect and dignity of humanity, respect confidential information obtained by a patients file, uphold the honor and high principles the profession and accept its discipline, and last but not least always want to improve her services to better serve the health and well being of the community. (Mitchell, p.65).

Nurses actively preserve the dignity of people through practiced kindness and respect for the vulnerability and powerlessness of people in their care… This vulnerability creates a power differential in the relationship between nurses and persons in their care that must be recognised and managed.7 A diagram representing a continuum of professional behaviour provides a picture of therapeutic versus non-therapeutic behaviour in the relationship between the nurse and the persons in their care.8

Creating a safe environment, promoting trusting nurse-patient relationship, and increasing patient’s quality of life are result of implementing this theory in practice. Even though creating a change in nursing practice might be challenging, but it is doable by identifying the goal, pathway to reach the goal, education, trainings, and using evidence based practice. The main point of creating a therapeutic communication is to build a trusting nurse-patient relationship, decreasing nurse and patient’s anxiety level, increasing the level of care and patient’s quality of life. (Jasmine,

Nursing surrounds the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the knowledge and skills of the nurse and relies on patient and nurse trusting one another. The use of nursing skills can ensure these boundaries are maintained, it allows for safe patient care. Professional boundaries are the line that nurses cannot cross, involving aspects such as patient confidentiality and privacy, ensuring legal aspects of nursing and the boundaries put in place are not breached. However, nurses accepting financial or personal gain from patient can also cross these professional boundaries. It is only through education in this area that the rights of patients can be preserved, as

A nurse-patient relationship is the basic requirements in all practice settings. Its usage is to manage communication between an organization and a public while maintaining boundaries in the therapeutic relationship. Based on Peplau’s interpersonal theory, communication takes place in a nurse-client relationship where therapeutic process occurs involving complex factors such as environment, attitudes, practices, and beliefs in the dominant culture (seu.edu, 2015). The actions of each person in a nurse-patient relationship is measured on the collaboration of their thoughts, feelings, and experiences. Nurse’s work to attain, maintain, and restore the patient’s health until patient have fulfilled the health care needs. Patient must be guided and provided a well-respected environment until a better health and specific needs are fully considered in the relationship. In this kind of setting, nurse’s must create relationship with patients by communicating receptivity, assimilating the concepts of empathy, trust, genuineness, respect, and confidentiality into their interactions.

Nursing is one of the most trusted professions in the community. This means that nurses are trusted to enter into therapeutic relationships that adhere to the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the professional knowledge and skills of the nurse and the patient trusting in the nurse’s ability to care for them. Professional boundaries are an intricate aspect of a nurse’s daily work. These boundaries are based on trust, respect and the appropriate use of power. Breaches can be classified as boundary crossings, boundary violations or sexual misconduct. Breaches of boundaries lead to violations of a nurse’s professional responsibility. Nurses must maintain