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Emotional Wellness and Stress Resilience
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Elizabeth R. Click, Alyssa Vela
Understanding and applying one’s limits with respect to time as well as physical and emotional energy is critical for maintaining emotional wellness and preventing fatigue and burnout. Boundary setting is applicable to personal and professional situations. Boundary setting acknowledges the finite resources each person has and can allow for select use of such resources (Mellner et al., 2014). Emotional boundary setting is relevant to the patient-facing work done by nurses. Research acknowledges the emotional toll of nursing, and that individual and contextual factors play an important role in protecting nurses from emotional and psychological exhaustion (Kinman & Leggetter, 2016). For professional boundaries with patients and coworkers, professional boundary-setting appears to play an important role. A study on the well-being of nurses who provided at-home care to older adults specifically noted the importance of boundary setting for job satisfaction and well-being (McGarry, 2010).
Attitudes to death and dying
Published in Catherine Proot, Michael Yorke, Challenges and Choices for Patient, Carer and Professional at the End of Life, 2021
Catherine Proot, Michael Yorke
There is a form of reciprocity that may come from a relationship between a professional and a patient who is dying and their loved ones. Working at relational depth (Mearns & Cooper, 2005), professional boundaries may become blurred into a shared humanity where being there for each other is healing for the professional as well as the patient. All are human, and all share the burden of loss as well as the reality of our mortality.
Sticking to the Rules Professional and Unprofessional Behaviour
Published in Clare Gerada, Zaid Al-Najjar, Beneath the White Coat, 2020
Given the changing nature of medicine, with less formal, more collaborative working and with fuzzy boundaries created by social media, it is becoming harder to maintain clear professional and personal borders between patient and doctor. I have lived and worked in the same geographical area for three decades. I often meet with patients at social events, my children attended the same school as my patients’ children, I shop in the same places and use the same local restaurants. I have had to learn, as had my father 30 years before, how to navigate and maintain boundaries alongside my changing identities as parent, mother, student, citizen, friend and local doctor. This can be difficult, but vital for the practise of safe medicine. By its nature, medicine involves an intimate and personal relationship with one’s patient, and this has to be predicated on trust. All of this can be undermined by doctors who do not respect professional boundaries.
An integrative review of the qualities of a ‘good’ physiotherapist
Published in Physiotherapy Theory and Practice, 2023
Michelle J. Kleiner, Elizabeth Anne Kinsella, Maxi Miciak, Gail Teachman, Erin McCabe, David M. Walton
Physiotherapist and patient perspectives on being ethical as a ‘good’ physiotherapist included agreement on the importance of safety, confidentiality, and privacy. While physiotherapist perspectives framed these aspects of being ethical within the discourse of maintaining professional boundaries, patients highlighted more personal dimensions, such as trust and being respected as individuals and equals. This suggests a desire for sharing of power. Engaging in dialog as equal partners, and identifying needs with patients rather than positioning physiotherapists as distant ‘experts,’ may be considered as part of beneficence, and as respectful of patients as “moral discussion partners” (Praestegaard and Gard, 2013). Greenfield (2010) and Romanello and Knight-Abowitz (2000) cautioned that when caring is framed as a responsibility in a professional code of ethics, care becomes rules-based which limits physiotherapists to a contractual obligation rather than an ethical relationship. These authors endorse an ethic of care based on Noddings (1984) exploration of caring as a moral orientation to decision-making based on receptivity, engrossment, and reciprocity in relationship. In support of a relational ethic of care, Romanello and Knight-Abowitz (2000) called for physiotherapists to relate with their patients as ‘subjects’ rather than ‘objects.’
Physical Touch in a Changing World: Guidance for the Mental Health Nurse
Published in Issues in Mental Health Nursing, 2021
Michelle Cleary, Catherine Hungerford
Professional boundaries, which may or may not include explicitly stated rules, enable nurses to guard against professional impropriety, limiting the multiple meanings that can be made by the recipient of physical touch (National Council of State Boards of Nursing, 2018). For example, a nurse who respectfully informs a patient, prior to touching them, of what is about to occur and why it is necessary, provides the cues by which a patient can interpret the interaction. In contrast, physical interactions that are not explained or not part of everyday routine will very often become the ‘slippery slope’ towards boundary transgression. This suggests the need for nurses to know the difference between a boundary crossing and boundary violation (Calmes et al., 2013)—for example, a crossing may include expressive touch, but a violation departs from accepted practice, leaving open the door to the potential harm of the patient.
Caring for Children with Non-Accidental Head Injuries: A Case for a Child-Centered Approach
Published in Comprehensive Child and Adolescent Nursing, 2020
Kristy-Anne Gibbs, Annette Dickinson, Shayne Rasmussen
To be able to do their job and shield themselves from this emotional turmoil the nurses described how they consciously work toward creating and maintaining professional boundaries. Some refer to this as wearing their ‘professional hat’ signifying a difference in thought processes and behavior around these families when worn. A protection against the emotional outrage that might occur as described by Alice: Otherwise I will just get caught up and it’s human nature that you’re just, “Oh my gosh, here we go again.” You know? … . if I didn’t have my hat on and I was outside, I would be like, “Oh my gosh.” It’s while I’m working I just have to remember I have a practice to practise. (Alice)