As nurses and nursing students, we take pride in being part of a helping profession. As a former critical care nurse, I enjoyed the “adrenalin rush” of knowing that I had helped save a patient’s life. The joy in nursing is realizing you have made a difference in someone’s life or the life of their loved one.
But what are professional boundaries, and how do we know if we have crossed them?
On Thanksgiving Day several years ago, I was working a very hectic day shift in the ICU. Throughout the day, I was thinking about getting home to my family and enjoying turkey dinner with them. As I spoke about this to another nurse during my break time, she told me that she was planning on staying late and eating dinner with a patient, instead of going home to her family. When I asked why, she said that the patient’s family had asked her to join them, and she didn’t know how to say no. At the time I thought, “How could I be so selfish in wanting to spend time with my family instead of with a patient?” It wasn’t until years later that I realized that my thoughts were actually “healthy”.
Many times in nursing, we want to be the savior, and we want everyone to think we are kind and giving all of the time. But we need to realize, we are human, and we have our own needs. It IS important to be professional, compassionate, dutiful, and competent at work, but it is okay to set limits. By denying our own needs, we can become resentful, “burned out”, and fall into the bottomless pit of feeling like we are in a thankless job. A few years later, I learned that this nurse had left nursing all together. I was not surprised. She had a pattern of using patients to meet her own needs for approval and acceptance and felt that if she said “no”, patients wouldn’t like her.
Maintaining professional boundaries means practicing nursing in accordance with the Nurse Practice Act. It has occurred to me many times throughout my career, that nurses may not even be familiar with the document that guides their profession. As student nurses, you will need to follow the guidelines set forth in the Nurse Practice Act. It will help you to understand your professional role as a nurse and how your behavior affects the vulnerable role of the patient.
But how do you know if you have crossed professional boundaries with a patient?
As a student nurse, here are some questions to ask yourself:
Do you give your home phone number or cell phone number to patients or families?
Do you tell patients or families details about your private life such as the state of your marriage or your “difficult” nursing instructor?
Do you ask your patient personal questions that having nothing to do with the medical care or condition you are treating?
Do you go above and beyond for a patient in hopes that they will tell you that “you are the best student nurse they ever had” or to put it another way, do you seek approval from your patients?
Do you think about a patient constantly when you are not at your clinicals? Do you wonder if any other student nurse can give your patient the excellent care that only you can provide?
Do your actions do more to meet your own needs instead of the patient’s?
If you answered yes to any of these questions, I would suggest that you review the Nurse Practice Act as well as talk to a trusted instructor or nurse mentor. You will want to avoid the pitfalls of going “above and beyond the call of duty”. Without the “emotional baggage” of crossing professional boundaries, you can then become the competent, empathic, and most of all, professional, nurse that you wish to become!
From Co-Author:
Kathleen Wedin, RN, BSN
Associate Director of Nursing
Brooklyn Park Campus