Professional boundaries separate therapeutic behavior of the registered nurse from any
behavior which, well intentioned or not, could lessen the benefit of care to clients, families,
and communities. Merriam-Webster's dictionary (11th ed.). (2005) defines “boundary” as some
thing that indicates or fixes a limit. Being clear about professional boundaries ; nurses must
maintain their professional boundaries and be aware of events or situations that may threaten
them. Boundaries are personal property lines that define who you are and who you are not. All
areas of our lives is influenced by boundaries. Physical boundaries help you determine who may
touch you and under what circumstances. Emotional boundaries help you deal with your own
emotions and disengage from the harmful, manipulative emotions of others. (Cloud, & Townsend,
1992). Mental boundaries give you the freedom to have your own thoughts and opinions. The term
boundary includes the notion of limits, lines or borders (Avis, Drysdale, & Gregg, 1983).
It is crucial for all health-care professionals to recognize the differences between therapeutic
relationships and other types of non-professional relationships. Boundary violations can harm
the client, the professional and others. The potential for harmful boundary incidents is decreased
when there is a good understanding of the issues involved. The ethical limits of relations between
registered nurses giving care and those persons who receive nursing care can be defined, and
boundary violations are described. Information on resources to help registered nurses is available.
Professional boundary issues arise for registered nurses outside of therapeutic relationships
with clients. There are registered nurses in teaching relationships with students, managing staff,
and in working relationships with co-workers or in other roles. These relationships are not
therapeutic ones, but they require trust. Registered nurses in any role can ensure that professional
boundaries are respected by following guidelines that are appropriate and ethical to the client.
CONCEPT ANALYSIS 3.
Guidance for appropriate conduct can be found in policies for faculty conduct,in educational
institutions, in research guidelines for researchers, and in personnel policies, labor law and
collective agreements for managers and staff (Chadda, 1998). The consequences for
crossing boundaries can be traumatic for the client and the nurse (Trudeau, & Gafner, 1988).
Boundary violations can happen gradually over time, or suddenly in a moment of opportunity
(NCSBN, 1995). According to the study of Gutheil and Gabbard (1993) nurses will be
challenged to reflect on the meaning of “professional boundaries” in their relationships with
clients and be better positioned to navigate the slippery slope (Guitheil & Gabbard, 1993) of the
therapeutic relationship and work with clients in a competent and ethical manner.
The purpose of this paper is based on Walker and Avant's (1995)strategy for concept
development. The aim of this concept analysis is to construct a concise framework, which is
centered on the exploration and definition of the nurse-client relationship: professional roles
and responsibilities. We will explore the creation and maintenance of boundaries as they pertain
to nurse-client relationship. Self-awareness and monitoring, debriefing, and availing oneself
to supervision and education are important tools in creating and maintaining boundaries, in the
final analysis, the nursing profession needs nurses who have the ability to make decisions about
boundaries based on the best interest of the clients in their care (Peternelj-Taylor, & Yonge 2003).
Review of Literature
It is possible to be under-involved or over-involved in a...