1. Professional Boundaries

2. Overall Goal To educate staff on the importance of professional boundaries with patients and families of patients. To make staff aware of the warning signs associated with the impending violation of boundaries.

3. Objective 1.Recognize and describe professional boundaries. 2.Identify red zone and gray zone interactions. 3.Maintain professional behaviors that are within the zone of helpfulness.

4. Shared your personal problems with a patient or their family? Given a patient a gift purchased with your own money? Socialized with a patient or their family outside of your professional capacity? Accepted a gift of more than minimal value from a grateful patient or family member? Have you ever…

5. Come in to work on your own time to be with a patient? Given out your home phone number to a patient or family? Initiated a discussion about your personal faith with a patient or family Complained to a patient or their family about a co-worker or another patient? Have you ever…

6. If so… You have crossed the line

7. The spaces between the health care worker’s power and the clients vulnerability Professional Boundary

8. Maintain Appropriate Boundaries

9. Excursions into the Gray Zone You purchase a special box of band-aids for a specific patient to help them cope with a procedure You change your schedule in order to work when you know a specific patient will be admitted Your patient’s mom grabs you a cup of coffee on her way back from the cafeteria

10. Regulatory guidelines Nursing: A.R.S. 32-1601 any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public… Licensed Social Worker A.A.R. R-4-6-1101 “provide treatment to a client only in the context of a professional relationship Child Life Specialist Code of Ethics Principle 10 – shall use integrity to assess and amend any personal relationships or situations that may interfere with their professional effectiveness, objectivity, or otherwise negatively impact the children and families they serve

11. Warning signs Excessive self-disclosure Secretive behavior “Super nurse” behavior Singled-out patient Selective communication Flirtation “You and me against the world” behavior Failure to protect the patient

12. Avoid the slippery slope Do your actions contribute to the therapeutic client/patient relationship? Is your behavior consistent with the patient’s care plan? Who benefits from your actions - you or the patient? If a respected colleague expressed concern about your behavior, how would he respond?

13. Policy Update Maintaining Appropriate Professional Boundaries Policy: Key Points Disclosure of personal information is prohibited Socialization is limited to hospital sponsored events or as a representative of the institution Patients or family members may never be invited to any team members personal event or celebration Requests for assistance must go through the social work team.

14. Stay in the zone Health care professionals and volunteers can be helpful, caring, empathic human beings and maintain professional parameters with which they effectively relate to patients and their families

15. Arizona State Board of Nursing (2007). Nurse Practice Act Board of Behavioral Health Examiners (2006). Arizona Code Child Life Council (2000 ). Code of ethical responsibility National Council of State Boards of Nursing (2009.) Professional Boundaries: A nurse’s guide to importance of appropriate professional boundaries. References