Nursing is a unique profession in that we must assist patients with rather intimate things at very private and vulnerable times in their lives. What are the professional boundaries nurses should establish?
One night during the last semester of nursing school, I went with some of my peers to celebrate the completion of an assignment. We went out dancing at a country place (not my usual style- I was in penny loafers) and we were having a great time.
One guy looked very familiar to me and he kept hanging around us, asking to dance and chatting. I mentally sorted through my whole life history trying to place this guy. School? No. College? No. Church? No. I simply couldn’t do it. But I knew I had seen him somewhere! He gave me his number at the end of the night.
Just as I was falling asleep, I remembered where I had met him. He was one of the patients on the inpatient psych unit during my clinical rotation there. Needless to say, I was rattled, and when I mentioned the story at our next post conference, it became quite the topic of discussion.
Some of the students thought it would be ok to call him because he wasn’t a patient any more. Others thought it was totally off limits. The professor indicated, among other things, that he could potentially be a patient in the future if his problem was one that could recur.
“Boundaries are mutually understood, unspoken physical and emotional limits of the relationship between the patient and the nurse.”
Establishing boundaries can sometimes feel like walking a tightrope. Our job, by its very nature, is emotionally and physically intimate. Whether assisting a family when welcoming their new baby into their arms, or holding the hand of a person dying all alone, it cannot be denied that there is a deep level of interaction not often found in other professions.
So how do you draw the line between professional and unprofessional?
Some margins are very clear cut and easy to recognize (a patient trying to get personal information about a nurse, sexual intercourse with a patient) but some are less clear (sharing stories, crying with patients).
The best way to recognize when you have crossed the professional boundary is when you find that you are putting your needs before your patient’s. Crying with a patient is not out of bounds. Crying with a patient because you just poured out a sordid story about your divorce- that is is out of bounds.
Your ability to care for each patient in your charge also matters.
If you are feeling emotionally tied to a particular patient, how will you manage to remain professional and courteous with the other five that are assigned to you during your shift? Nurses must be able to provide comfort, and yet disconnect enough to be able to switch into another gear that meets the other patients’ needs.
The nurse sets the boundary, not the patient.
If the patient is crossing a line, it’s up to you to keep your toes on the professional side of it. If you have already crossed that line, learn from it and if necessary, reset the boundary between you and that patient to a professional and therapeutic relationship.