Show Copyright informationCopyright Jannetti Publications, Inc. Nov/Dec 1999 Access to the complete full textThis is a short preview of the document. Your library or institution may give you access to the complete full text for this document in ProQuest. Explore ProQuest Sheets, Vickie. NUR460: Module 6: Professional Boundaries Quiz1.Excessive personal disclosure by the nurse, secrecy, or even a reversal of roles isconsidered to be Get answer to your question and much more 2.Professional boundaries are limits that protect the space between the nurse’sprofessional power and the client’s vulnerability Get answer to your question and much more 3.Which of the following activities is NOT a potential professional boundary crossing orviolation? Get answer to your question and much more 4.Professional boundary issues are only applicable to nurses involved in a therapeuticrelationship with clients Get answer to your question and much more Topic: Professional/Nursing Boundaries Read the article below and answer the questions that follows that follows: Mary, a home health nurse, has been providing care to Dorothy for more than six months. The two of them have enjoyed pleasant conversations and discovered several mutual interests. Dorothy genuinely likes Mary and is grateful for the excellent care she's provided. Their friendly relationship has always remained on a professional level until today, when Dorothy overhears Mary telling a friend about her financial problems. When Mary ends her phone call, Dorothy offers to lend her money. Hesitant at first, Mary eventually accepts a loan and, in doing so, commits a serious violation of professional boundaries. Nurses inspire confidence in their patients by treating them professionally, objectively, and ethically. Patients and their families expect nurses to always act in their best interests and to adhere to the standards of professional conduct, while maintaining a respectful and professional relationship. But nurses have a type of authority and influence that comes from their professional position. Their specialized knowledge and skills, as well as access to private information, make the patient vulnerable. The inherent difference in this relationship requires boundaries to help nurses establish and maintain limits in their professional interactions with patients. By using professional judgment to determine and stay within appropriate boundaries, nurses can meet their patients' needs. On the other hand, nurses who put their personal needs ahead of their patients' needs will cross over these professional boundaries. These types of behaviors violate laws and regulations that are designed to protect the public, as well as meet the standards of professional conduct. Every nurse/patient relationship can be depicted on a continuum of professional behavior. At the center of the continuum is what is commonly referred to as the therapeutic nurse/patient relationship. This relationship protects the patient's dignity, autonomy, and privacy. Under-involvement by the nurse is characterized by distancing, disinterest, and neglect. These types of behaviors create an imbalance in the nurse/patient relationship. At the other end of the continuum is over-involvement. Almost all professional boundary crossings and violations occur at this end of the continuum. The continuum serves as a frame of reference for helping nurses evaluate their own and their colleagues' interactions with patients. Unfortunately, while some boundaries are clear cut, others may not be quite so easy to recognize at first. Let's take a look at the different types of over-involvement. We'll use a few examples to help us illustrate these behaviors. Boundary crossings, which are sometimes called boundary drifts, are brief excursions across professional lines of behavior. The behavior is often inadvertent, but sometimes the behavior can be purposeful and is used to meet a perceived therapeutic need. For example, Jack is concerned that his patient, Lucy, is becoming discouraged with her progress in physical therapy. Jack knows that Lucy is a fan of his Alma Mater's basketball team. So he gives Lucy a sweatshirt to wear during therapy. This is an example of an intentional boundary crossing with a specific therapeutic purpose in mind. Boundary crossings can sometimes occur in a therapeutic nurse/patient relationship, but these incidents should be evaluated by the nurse for potential consequences and implications to a patient because boundary crossings can sometimes lead to a boundary violation. Boundary violations result when there's confusion between the needs of the nurse and those of the patient. These violations are characterized by excessive personal disclosure by the nurse, secrecy, or even a reversal of roles. Let's say that Jack secretively gives Lucy a sweatshirt and tells her they should go to a game together wearing their matching sweatshirts. In this case, Jack is putting his own needs and desires before the patient's. The difference is context. In the second case, the act of presenting the exact same gift becomes a boundary violation. Mary's acceptance of a loan from Dorothy is another example of a boundary violation. By allowing Dorothy to learn of her financial issues, Mary disclosed too much information about her personal life. When she accepted a loan from her patient, Mary placed her personal gain ahead of her patient's best interests. Professional sexual misconduct is an extreme form of boundary violation. It includes any behavior that is seductive, sexually demeaning, harassing, or reasonably interpreted as sexual by a patient. Professional sexual misconduct creates a breach of trust, and this is an extremely serious violation of the nurse's professional responsibility to a patient. Violations of the Nurse Practice Act are addressed by boards of nursing. Depending on the laws and regulations of the jurisdiction, as well as the severity and context of the boundary crossing or violation, consequences may range from verbal warnings to license suspension or revocation. So, how can we identify potential boundary crossings and violations before they happen? Nurses who display one or more of the following behaviors should examine their patient relationships for possible boundary crossings or violations. Excessive self disclosure, secretive behavior, special treatment, flirtation, or overprotective behavior, any of these behaviors may indicate a shift from the therapeutic nurse/patient relationship to over-involvement with the patient. Once a nurse becomes over-involved in the patient's world, the professional relationship is betrayed. Many of these behaviors may have a reasonable explanation. However, if a pattern emerges, it's time to stop and evaluate the behavior and possibly talk with a colleague or mentor. The earlier a nurse evaluates behaviors and seeks help, the greater the chances of returning to the therapeutic nurse/patient relationship. Take the case of Katie, a nurse caring for a late-stage cancer patient, Cindy. Cindy's husband Joe is having trouble coping with his wife's illness. Wanting to comfort Joe, Katie has drifted from conversations with him outside his wife's room to having coffee with him in the hospital cafeteria. Now, Joe is calling Katie at home and posting comments on social media, saying she's the only person who really understands what he's going through. Uncertain what to make of the situation, Katie talks to her nurse manager, who helps Katie understand that while her intentions are good, her actions constitute inappropriate over-involvement with a patient's family. Because she is open to assessing her professional relationships and sharing her concerns with her manager, Katie is able to return to patient-centered care before a boundary violation occurs. If Katie hadn't recognized the warning signs and talked to her manager, the crossing could have escalated to a boundary violation. Boundary crossings can happen to any nurse. The key to avoiding them is continual alertness, self-evaluation, and emphasis on the patient's best interests. In respecting professional boundaries, nurses protect their patients, themselves, and the profession. Questions: 1a. Identify and explain 4 boundary crossings that can be identified in the article. 1b. Provide the violations for each of the 4 boundary crossings that you identified in question 1a 2. Explain what could have and should have been done or said to prevent all these incident/violations. 3. What are the most important lessons you learned from reading this article that will help you in your nursing career? Answer & Explanation Solved by verified expert Rated Helpful <p>at, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, da</p> Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet Unlock full access to Course Hero Explore over 16 million step-by-step answers from our library Subscribe to view answer
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gue m risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellente gue gue icitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet a e vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, acinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing el Step-by-step explanation itur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce du
m risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam ri ipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor gue amet, consectetur adipiscing elit. Ncing elit. Nam lacinia pnec facili
gue ng elit. N iscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, c Student review 100% (1 rating) Easy to follow Thorough explanation Clear formatting "Thanks ." What are ethical boundaries in nursing?In nursing and midwifery, professional boundaries may be defined as 'limits which protect the space between the professional's power and the client's vulnerability' and allow for safe, objective and effective engagement with a person (Nursing and Midwifery Board of Australia, 2010).
What are some examples of professional boundaries in nursing?What are Professional Boundaries?. Sharing personal or intimate information.. Flirting or indiscriminate touching.. Keeping secrets with or for patients.. Acting as if you are the only one who can care for or understand the patient, positioning yourself as the “super nurse”. What is a boundary violation?Boundary violations involve transgressions that are potentially harmful to or exploitative of the patient. They can be either sexual or nonsexual. They are usually repetitive, and the therapist usually discourages any exploration of them. By contrast, boundary crossings are benign and even helpful breaks in the frame.
What happens when professional boundaries are crossed?Boundary violations can cause distress for a client, which he/she may not recognize or feel until harmful consequences occur. This might include a betrayal of trust, respect or intimacy between the nurse and the client, and may cause physical or emotional harm to the client.
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