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Boundaries in the Nurse-Client relationship


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You work and live in a small community. You know almost everyone. What should you do if you 're assigned to care for someone​ you know personally? 

A: Discuss concerns with your supervisor and continue to provide care until the client decides if he/she would like another nurse.

That's not correct. Nurses use professional judgment to determine the appropriate boundaries of a therapeutic relationship with each client. The nurse — not the client — is always responsible for establishing and maintaining boundaries. (See Principle 1 in the Boundaries in the Nurse-Client Relationship).

B: Switch assignments with a colleague and avoid the situation all together.

That's not correct. Be transparent, therapeutic and ethical with all your clients and former clients. When the issues are complex and boundaries are not clear, discuss your concerns with a knowledgeable and trusted colleague. (See Applying the Principles to Practice in the Boundaries in the Nurse-Client Relationship).

C: Discuss boundaries with your supervisor and consider alternatives such as asking another nurse to take over care.

Correct! At times, a nurse must care for clients who are family or friends. When possible, overall responsibility for care is transferred to another health care provider. (See Principle 8 in the Boundaries in the Nurse-Client Relationship).

D: Accept the client assignment, discuss concerns with your supervisor and provide care, both as a nurse and a friend.

That's not correct. Nurses in a dual role make it clear to clients when they are acting in a professional capacity and when they are acting in a personal capacity. At times, a nurse may want to provide some care for family or friends. This situation requires caution, discussion of boundaries and the dual role with everyone affected and careful consideration of alternatives. (See Principles 10 and 9 respectively in the Boundaries in the Nurse-Client Relationship).

Understand that nurses who work and live in the same community often have a dual role. If you have a personal relationship with a client or former client, be clear about when you are acting in a personal relationship and when you are acting in a professional relationship. Explain your commitment to confidentiality and what the client can expect of you as a nurse. Consider the difference between being friendly and being friends. (See Applying the Principles to Practice in the LPN Practice Standard  Boundaries in ​the Nurse-Client Relationship).​​​​​​​​

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