Professional Boundaries: There are consequences for crossing the road

Professional boundaries are established to guard patients and staff.

A nurse manager expresses concern about an unlicensed staff member at a respite/crisis facility for people with a dual diagnosis of mental and developmental disabilities. The male worker is a Facebook friend of one among the feminine patients. The customer expressed sympathy for this worker. The client’s caregiver became very indignant when she learned in regards to the patient’s crush on a male staff member. The nurse-manager wonders what she should do in this case, because the worker has direct contact with all the power’s clients.

Defining skilled boundaries

These boundaries have been defined by various skilled health care associations and organizations. For example, the National Council of State Boards of Nursing, in its 2018 publication, distinguished between a nurse-patient therapeutic relationship and one which results in boundary violations “A Nurse’s Guide to Professional Boundaries”. According to NCSBN, the therapeutic relationship respects the patient’s dignity, autonomy and privacy and allows for the event of trust and respect.

Professional boundaries between nurse and patient respect the nurse’s authority and the patient’s vulnerability. When boundaries are violated, the needs of the nurse and the patient are confused.

NCSBN and other organizations describe a “professional behavior continuum” through which the therapeutic relationship is at the middle of the continuum, with under-involvement at one end and over-involvement at the opposite. Either extreme of the continuum may cause harm to the patient. For example, over-involvement may lead to keeping secrets from a patient or using social media to speak with that person. Insufficient involvement may lead to patient abuse or neglect. NCSBN warns that the imbalance within the continuum is gradual. Professional boundaries have been established for other health care professionals, including licensed and unlicensed personnel. One example is Ausmed in its article, “Understanding Professional Boundaries.” Defined as “rules and constraints that prevent the boundaries between career and client from blurring,” they assist maintain relationship balance throughout the therapeutic zone of the caregiver-patient continuum.

The nurse manager must intervene

The nurse manager is true to be concerned in regards to the male staff member’s behavior and apparent inability to grasp the potential consequences of his actions toward a female client in the power.

The nurse manager indicated that this social media post occurred after the client expressed sympathy for a staff member and the caregiver was upset with the client’s sympathy for him.

It is evident that the male worker has begun to expand the skilled relationship into a private one and continues to achieve this over the course of the skilled relationship. The nurse manager must intervene quickly to avoid any harm to the patient resulting from the clear imbalance within the therapeutic relationship that is amazingly necessary to the well-being of this particular patient. The first step a nurse manager can take is to talk confidentially along with his or her supervisor and the power’s CEO. If the power has a risk manager, she or he should be informed about this via an incident report. Once everyone seems to be made aware of the difficulty, they’ll discuss the male worker’s behavior with him. Hopefully they are going to then take appropriate motion, which should include counseling him in regards to the facility’s policy prohibiting this kind of behavior and why it’s inappropriate, and disciplining him in accordance with the power’s disciplinary policy. In addition, he ought to be informed that if he continues the connection and it becomes sexual, he could also be subject to criminal prosecution.

If the worker disregards this recommendation and any additional behavior continues, either with this patient or others, the worker ought to be terminated.

In the event of termination of employment, the power shall be required to send a report back to the entity or organization through which it obtained certification, if any. As he’s unlicensed, it might not be possible to submit a report back to the licensing committee. The patient’s caregiver must also learn of the recent posting and the motion taken by the administration against the staff member. He or she could have some effective ideas on the best way to help a patient who could also be understandably upset or hurt if the worker not works together with her or not works at the power.

Tips on your practice

Being a nurse manager is just not a simple endeavor. It requires outstanding leadership and a solid understanding of the best way to best manage staff and supply protected care that protects patients. It also requires a transparent commitment to Nurses’ code of ethics and interpretive statements. In particular, as stated by the nurse manager, she must protect the interest of the patient who’s in danger. As a nurse manager, it’s essential to also do not forget that you might be answerable for your individual nursing assessment and actions. Therefore, not intervening in a situation resembling this could be a violation of your code of ethics. Such violations may subject you to disciplinary motion under state nursing practice statutes and regulations. Additionally, if you happen to don’t intervene, you may face further charges for failing to report unethical, illegal or unsafe practices. You may be accused of unprofessional conduct that will are likely to deceive, deceive or harm the general public.

In short, a risk to a vulnerable patient that involves a violation of skilled boundaries should be eliminated as soon because it is identified.

Take these ethics courses:

Ethical theory provides a framework inside which nurses can evaluate the acceptability of actions and the morality of judgments. This program informs nurses about key terms, theories, and principles present in bioethics to assist ensure ethically sound decisions in patient care. The principle of well-being, that’s, beneficence, doing good and stopping harm, obliges the nurse to advertise the health and safety of patients in decisions made by them and for them. The principle of equality, or justice, requires that patients be treated fairly and equally within the decision-making process. In this module, we are going to explore these principles in additional detail and discuss methods for determining decision-making capability in borderline cases. This module defines the dilemmas and explains the arguments from different sides on three key issues: physician-assisted suicide, organ transplantation, and genetic testing.