Maintaining professional boundaries with residents/service users, colleagues and families

Professional boundaries with residents and/or service users

To ensure maintaining professional boundaries and the safety of residents and/or service users, professional boundaries are in place. In order to determine the exact details of these boundaries, we must:

• Make sure you are familiar with the standards of your regulator and employer as part of your professional role

• Make note of any local policies regarding confidentiality, dress code, electronic communication, lone working, physical contact, and risk management.

In a more general sense, some suggested practice principles for professional boundaries between staff and residents/patients/service users include:

• Ensure that you do not have a sexual relationship or a harmful emotional attachment with a member of your household who is currently in your care.

• Using your professional relationship as an opportunity to establish a relationship with a family member of a patient or resident, for example, scheduling home visits to get to know a family member of the person you are caring for

• The confidentiality rights of residents, patients, and service users should be respected

• Keep in mind the recommendations of your regulator and your local organization when using social media. Healthcare practitioners’ relationships with patients or service users may be altered by social media, which blurs the lines between their professional and personal lives

• Professional boundaries can be compromised if involvement in financial transactions with residents, patients, or their loved ones (other than those included in a contract for the provision of services) is permitted.

• In situations of care, avoid dual relationships whenever possible. People who have dual relationships know each other in more than one environment. For example, a family member who lives in the care home where you work. Staff members must be aware of potential harm from dual relationships where they are unavoidable. And they should endeavor to take steps to minimize the risks.

• To be able to establish a trusting and therapeutic relationship with patients, it is important to consider the preferences of the patient when undertaking care.

Boundaries with colleagues

Relationships between residents and staff are not the only instances where professionals should set boundaries. As well as the relationships that staff develop with one another, there are also aspects of the work environment to consider. Employees feel supported, safe, and comfortable at work when there are boundaries within a healthcare workplace. Developing strong, collaborative relationships between healthcare professionals occurs when workplace policies specify the behaviors that are (and are usually not) appropriate for that work environment.

It is necessary for you to analyze your local codes of conduct. By doing so, you will be able to obtain a more detailed understanding and ability of maintaining professional boundaries you need when working with other members of your team.

Any time you work with other healthcare professionals, you should be aware of several types of boundaries:

• Boundaries related to timing

  The importance of respecting someone else’s time cannot be overstated. When you arrive on time for your shift, you will respect others’ time, and make sure they aren’t forced to work on jobs they will not be paid for. Moreover, you can understand that colleagues have responsibilities outside of the office.

• Boundaries in intellectual thought

  Working with co-workers can sometimes cause you to disagree with their ideas or methods. In order to engage in a respectful discussion about your differing opinions or practices at work if you disagree intellectually with someone, it is important to know how to discuss them calmly and kindly. Whenever people express prejudice against others, workers should be aware of their right to remove themselves from those situations.

• In terms of physical boundaries

  People are different physiologically – some can stand longer than others, for example, while others cannot. Taking breaks and respecting the needs and requirements of individuals are important. In some situations, people have physical limits regarding contact and touch with other people. You should always ask for permission before hugging someone if you do not know their boundaries.

• Emotional boundaries

  Working in the care sector can be stressful, and everyone should feel supported to share their feelings and constructive feedback in a safe and non-judgmental environment.

• Material boundaries

  There is a concern regarding colleagues’ personal property, which needs to be respected. It is likely that most people can recall incidents where food was taken without permission from the staff room fridge, or work shoes were taken without permission. Violations of material boundaries are evident in these examples. In order for colleagues to be respectful of one another’s physical properties, they should ask before borrowing something and respect their colleagues’ right not to borrow.

Boundaries with families

Residents’ and patients’ families and loved ones should be regarded equally when dealing with maintaining professional boundaries. It is critical to respect your family’s time, along with their intellectual, emotional, physical, and material boundaries. This is the same way that you respect the boundaries of your colleagues at work.

It may also be difficult to protect resident or patient confidentiality when maintaining professional boundaries when working with families. To put it simply, confidentiality means not disclosing information about a patient or resident to anyone else. This is unless you have the patient or resident’s consent or you need to protect someone’s safety. As part of this process, we communicate with the loved ones and families of residents and patients.

Families and loved ones may be anxious for updates regarding the care and condition of a family member, which can be an extremely difficult issue to navigate. Residents should be allowed to give you their direct consent before sharing information. This is so you can understand who they are willing to share information with, and who they do not want their information shared with. In addition, ask them whether any information they would like to remain confidential, and what information they are comfortable with you disclosing to them. House owners should be asked to specify which information they would like to be made public and with whom. In these circumstances, they are not capable of making informed decisions about information sharing.

As a general rule, unless someone has previously indicated otherwise, they would prefer to have those closest to them kept informed of their general condition and prognosis. This is because they lack the capacity to make a decision about information sharing. (General Medical Council, Using and Disseminating Information for Direct Care).

In order to avoid compromising confidentiality, it is critical to understand what it means (including but not limited to):

• Detailed medical information about someone

• People’s social situations are described in this information

• Medical, social, or educational information about an individual

• Having an idea, having concerns, and having expectations