Professional Boundaries

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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.


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...
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