Nursing Professional Boundaries There are boundary issues in every aspect of nursing practice.
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These two sets of companion Codes, together with other published practice standards e.
These guidelines are designed to be read in conjunction with the above Codes and provide more detailed guidance and discussion in relation to the sometimes challenging area of managing professional boundaries; that is, identifying and differentiating the boundaries between professional relationships and personal relationships.
In doing so, these guidelines aim to protect the community by helping to prevent distress, confusion, harm or abuse of people being cared for by nurses.
It is intended this resource will stimulate reflection, stimulate discussion and guide decision making in all aspects of the relationship that is established when care is provided by nurses to people in the course of their professional role, in all practice settings.
For nurses who also practise as midwives a separate but consistent set of guidelines has been developed for midwives to complement the equivalent codes of professional onduct and ethics for midwives in New Zealand and Australia. A nurse enters a therapeutic relationship with skills and knowledge that include a great deal of personal information about the individual in their care; and the authority to provide the care required by the individual.
The power imbalance present in a professional relationship places the recipients of care in a position of vulnerability and of potential exposure to exploitation or abuse if that trust is not respected. Nurses have a responsibility to ensure that a relationship based on plans and goals that are therapeutic in intent and outcome is maintained.
This means that it is the responsibility of the nurse to maintain their professional and personal boundaries, as well as assisting colleagues and the people in their care, in maintaining theirs.
When a nurse crosses a boundary, they are generally behaving in an unprofessional manner and misusing the power in the relationship. 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.
This zone is where the majority of interactions between a nurse and a person in their care should occur for effectiveness and the safety of that person.
For this reason they are not discussed here in detail as the focus of the document is on the over-involvement end of the continuum. Context refers to the environment in which nursing is practised, and which in turn influences that practice. Boundaries give each person a sense of legitimate control in a relationship.
Professional boundaries are the limits to the relationship of a nurse and a person in their care which allow for a safe, therapeutic connection between the nurse and that person and their nominated partners, family and friends. The power of the nurse comes from the professional position and their access to private knowledge about the person in their care.
Boundary crossings can result in a return to established boundaries but should be evaluated by the nurse for potential consequences and implications to the person who is or has been in their care. Repeated boundary crossings should be avoided.
Boundary violations can result when nurses confuse their needs with the needs of the person in their care. Such violations are characterised by excessive personal disclosure by the nurse, secrecy or even a reversal of roles.
Boundary violations can cause distress for the person who is or has been in the care of the nurse. This may not be recognised or felt by them until an event or other harmful consequences occur, which can be much later. Sexual misconduct is sexual assault. The priority for nurses is planning care around meeting the therapeutic and care needs of persons entrusted to their care.
Nurses do not withhold care from a person as a punishment and recognise that any intent to cause pain or suffering as a retaliatory action in response to the behaviour of a person in their care is improper and unprofessional.
Nurses reflect on their own needs, behaviours, values and attitudes and beliefs and are conscious of their potential impact in therapeutic and professional relationships with people in their care. Nurses are aware of the potential for personal discomfort for both the person receiving care and themselves when care involves touching, holding, other personal contact or invasion of personal space; and respond appropriately.
Care is optimised when nurses and persons receiving care do not engage in dual relationships, for example where the nurse has a personal or business relationship, as well as a professional one with that person.
Where dual relationships in therapeutic care situations are unavoidable nurses are aware of the potential for harm and take all steps to minimise the risks.
Nurses establish and maintain the boundaries in their professional relationships with persons receiving care; and where necessary communicate these to that person. Nurses recognise variables such as the care setting, community influences, the needs of the person and the nature of care or therapy they require affect the delineation of boundaries and respond accordingly.Professional Boundaries Essay - 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.
Professional Boundaries Essay. frequently work in situations where the boundaries of the nurses are being tested. Their respond to these “tests” is a matter of nurses and professional integrity, by virtue of the power inherent in their professional role are expected to do the right thing even it is not always clear what “doing the right thing” might look like.
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