Maintaining Professional Boundaries

The nurse-client relationship is one of immense trust and responsibility and must always focus on the needs of the client. As well as the rules regarding dignity, consent, confidentiality, and clinical ethics, the area of professional boundaries is an essential consideration for solo practitioners.

As regulated professionals, you will recall from your training that healthcare providers are bound by rules and ethical guidelines surrounding patient care. Consideration must be given at all times regarding putting these into practice. The nurse-client relationship must always focus on the needs of the client, and maintaining professional boundaries is crucial for self-employed nurses.

Setting and Following Appropriate Boundaries

It is important to set and follow appropriate boundaries with your clients. A nurse who even accidentally violates a boundary can damage the nurse-client relationship and harm the client. It is essential not to abuse power in any way and to treat the client ethically in a therapeutic and transparent manner.

• Friendly, but Not Friends: Be friendly, but not friends with clients. Clarify the subtle differences when necessary. Always remember that the responsibility lies with you as the nurse to establish and maintain clear boundaries.
• Professional Judgment: Often, boundaries are clear-cut, but at times they require professional judgment. Recognize when your professional relationships are moving towards a non-professional situation and take immediate action.
• Continuous Assessment: Continuously exercise professional judgment and caution when involved in self-employed nursing. Transparency and continual assessment and reassessment regarding your relationship with clients are integral parts of professional practice.

Handling Boundary Challenges

Remember that the client is vulnerable and that you hold a position of power and potential influence that must not be abused. These boundaries may be especially hard to identify in small communities where you may also be involved in other areas of the community, perhaps in a personal capacity.

If you are ever in any doubt, talk it over with a trusted colleague or contact your regulator for further guidance.

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Related Resources:

• British Columbia College of Nurses and Midwives
• College of Nurses of Ontario
• College and Association of Registered Nurses of Alberta
• College of Licensed Practical Nurses of Alberta
• College of Registered Nurses of Manitoba
• College of Licensed Practical Nurses of Manitoba
• Canadian Nurses Association
• Canadian Nurses Protective Society
• Canadian Association of Foot Care Nurses

For further reading, you might find these articles helpful:

• Conflict of Interest: What To Consider
• Five Best Practice Tips on Risk Management and Quality Improvement for Solo Practitioners
• Understanding Business Use of Home Expenses for Taxes Purposes
• Five Simple Ways to Attract New Clients

By following these guidelines, you can ensure that your independent practice operates ethically, maintaining the trust and safety of your clients and upholding the integrity of your professional reputation.