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Professional Boundaries. Have you ever…. Shared your personal problems with a patient or their family? Given a patient a gift purchased with your own money? Socialized with a patient or their family outside of your professional capacity?
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Have you ever… • Shared your personal problems with a patient or their family? • Given a patient a gift purchased with your own money? • Socialized with a patient or their family outside of your professional capacity? • Accepted a gift of more than minimal value from a grateful patient or family member?
Have you ever… • Come in to work on your own time to be with a patient? • Given out your home phone number to a patient or family? • Initiated a discussion about your personal faith with a patient or family • Complained to a patient or their family about a co-worker or another patient?
If so… You have crossed the line
Professional Boundary • The spaces between the health care worker’s power and the clients vulnerability
Excursions into the Gray Zone • You purchase a special box of band-aids for a specific patient to help them cope with a procedure • You change your schedule in order to work when you know a specific patient will be admitted • Your patient’s mom grabs you a cup of coffee on her way back from the cafeteria
Regulatory guidelines • Nursing: • A.R.S. 32-1601 any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public… • Licensed Social Worker • A.A.R. R-4-6-1101 “provide treatment to a client only in the context of a professional relationship • Child Life Specialist Code of Ethics • Principle 10 – shall use integrity to assess and amend any personal relationships or situations that may interfere with their professional effectiveness, objectivity, or otherwise negatively impact the children and families they serve
Warning signs • Excessive self-disclosure • Secretive behavior • “Super nurse” behavior • Singled-out patient • Selective communication • Flirtation • “You and me against the world” behavior • Failure to protect the patient
Avoid the slippery slope • Do your actions contribute to the therapeutic client/patient relationship? • Is your behavior consistent with the patient’s care plan? • Who benefits from your actions - you or the patient? • If a respected colleague expressed concern about your behavior, how would he respond?
Policy Update • Maintaining Appropriate Professional Boundaries Policy: Key Points • Disclosure of personal information is prohibited • Socialization is limited to hospital sponsored events or as a representative of Phoenix Children’s Hospital • Patients or family members may never be invited to any team members personal event or celebration • Requests for assistance must go through the social work team.
Stay in the zone • Health care professionals and volunteers can be helpful, caring, empathic human beings and maintain professional parameters with which they effectively relate to patients and their families
References • Arizona State Board of Nursing (2007) Nurse Practice Act • Board of Behavioral Health Examiners 2006 Arizona Code retrieved June 16 2008 from http://www.bbhe.state.az.us/ADOPTED%20RULES.pdf • Child Life Council 2000 Code of ethical responsibility retrieved June 16, 2008 from http://www.childlife.org/The%20Child%20Life%20Profession/CodeofEthicalResponsibility.cfm • National Council of State Boards of Nursing (2007.) Professional Boundaries: A nurse’s guide to importance of appropriate professional boundaries. Retrieved from www.ncsbn.org on February 13, 2008.
