Professional Boundary Violations

Manfrin-Ledet, Linda; Porche, Demetrius J.; Eymard, Amanda S.

doi:10.1097/nhh.0000000000000249

Cited by 15 publications

(9 citation statements)

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“…The importance of professional boundaries is well established in nursing, and is part of the standard of care for a therapeutic relationship . Nurses commit “boundary crossings” when doing tasks that are brief excursions intended to benefit the client . However, HC aides hold a different societal position from nurses and historically in the USA have been seen more as informal care providers than professionals .…”

Section: Discussionmentioning

confidence: 99%

“…37 Our Phase 1 formative research showed that in-service trainings and client intake assessment are crucial intervention points in addressing aide health and safety concerns 10 The importance of professional boundaries is well established in nursing, and is part of the standard of care for a therapeutic relationship. [40][41][42] Nurses commit "boundary crossings" when doing tasks that are brief excursions intended to benefit the client. 41 However, HC aides hold a different societal position from nurses and historically in the USA have been seen more as informal care providers than professionals.…”

Section: Possible Interventionsmentioning

confidence: 99%

“…[40][41][42] Nurses commit "boundary crossings" when doing tasks that are brief excursions intended to benefit the client. 41 However, HC aides hold a different societal position from nurses and historically in the USA have been seen more as informal care providers than professionals. 43 For example, although states such as Massachusetts exceeded federal requirements, on a national policy level HC workers were not covered under the Fair Labor Standards Act until 2015 for basic occupational rights like minimum wage and overtime pay.…”

Section: Possible Interventionsmentioning

confidence: 99%

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“That's not my job”: A mixed methods study of challenging client behaviors, boundaries, and home care aide occupational safety and health

Karlsson

Markkanen

Kriebel

et al. 2019

American J Industrial Med

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Introduction Home care (HC) aide is among the fastest‐growing jobs. Aides often work in long‐term care relationships with elders or people with disabilities in clients’ homes, assisting with daily activities. The purpose of this mixed‐methods paper is to elucidate aides’ experiences around the boundary‐challenging behaviors of clients asking for services beyond aides’ job duties and to identify possible interventions. Methods A cross‐sectional survey of HC aides in Massachusetts (n = 1249) provided quantitative data. Post‐survey qualitative data were collected from nine HC aide focus groups (n = 70) and seven in‐depth interviews with HC industry and labor representatives. Results Quantitatively, aides who reported often being asked to do tasks outside their job duties were more likely to report abuse (prevalence ratio [PR] = 1.93; 95%CI: 1.47‐2.52 for verbal, PR = 1.81; 95%CI: 1.13‐2.91 for physical/sexual) and pain/injury with lost work time or medical care (PR = 1.58; 95%CI: 1.11‐2.25). They were also less likely to want to remain in their job (PR = 0.94; 95%CI: 0.89‐1.00) or recommend it to others (PR = 0.94; 95%CI: 0.90‐0.98). Qualitative data showed that clients’ requests for tasks beyond job duties were frequent and can lead to injuries, abuse, and psychosocial stress. Yet, requests often reflected genuine need. Helping clients stay at home, compassion, and feeling appreciated contributed to job satisfaction; therefore, aides can feel conflicted about refusing requests. Conclusion Client task requests outside HC services are a complex problem. Employer support, training, care plans, and feeling part of a care team can help aides navigate professional boundaries while delivering high quality care.

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Section: Discussionmentioning

confidence: 99%

Section: Possible Interventionsmentioning

confidence: 99%

Section: Possible Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

“That's not my job”: A mixed methods study of challenging client behaviors, boundaries, and home care aide occupational safety and health

Karlsson

Markkanen

Kriebel

et al. 2019

American J Industrial Med

View full text Add to dashboard Cite

show abstract

“…This continuum promotes an ideal of correct behaviour for professional practice (National Council of State Boards of Nursing 2014; Nursing and Midwifery Board of Australia 2010; Nursing & Midwifery Council 2015; Nursing Council of New Zealand 2012). Violations of boundaries such as excessive self-disclosure and acceptance of gifts are seen as transgressions within the relationship (Manfrin-Ledet et al 2015). The nurse is expected to be responsible and maintain professional boundaries as these “are the spaces between the nurse’s power and the patient’s vulnerability” (National Council of State Boards of Nursing 2014, p. 4).…”

Section: The Nurse As Multi-beingmentioning

confidence: 99%

Kenneth Gergen’s concept of multi-being: an application to the nurse–patient relationship

Hechinger

Mayer

Fringer

2019

Med Health Care and Philos

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The nurse–patient relationship is of great significance for both nurses and patients. The purpose of this article is to gain an understanding of how the individual is constituted through a focus on the execution of the patient’s and nurse’s role in the joint relationship. The article represents a social-constructionist consideration using Kenneth Gergen’s concept of multi-being. Gergen’s notions of the self as a multi-being focuses on the individual’s relational character through former relationships and social interactions. Gergen’s concept is applied onto nurses and patients as individuals to gain an understanding of the broader institutional and social context of each role and their interactions within the nurse–patient relationship. The article focuses on the nurse–patient relationship in general with regard to specific challenges in the home care setting. Various demands and experiences from a myriad of past relationships merge as potential actions for nurses and patients during the forming of a relationship. Nurses as multi-beings see themselves confronted with guidelines and legal conditions, their own as well as the patients’ expectations and the actual possible forming of a relationship in the light of daily nursing care. Patients as multi-beings experience an extended social environment that comprises the nurse–patient relationship while simultaneously having to cope with illness and increasing care dependency within their own homes. Discrepancies can be observed in the relationship with regard to the inherent human qualities, the demands of forming a relationship, and the actual relationship arising due to framework conditions.

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“…The scope of this problem has not been investigated adequately (Swiggart, Starr, Finlayson, & Spickard, ), especially in nursing (Manfrin‐Ledet, Porche, & Eymard, ), a profession in which the risk of sexual misconduct is high because nurses often spend long hours with their patients and the care that they provide often involves close proximity to patients (Bachmann et al, ; Griffith & Tengnah, ). This prolonged closeness may make it more difficult for nurses than other health care professionals to maintain clear roles and boundaries (Bachmann et al, ).…”

Section: Introductionmentioning

confidence: 99%

Crossing the line: Sexual misconduct by nurses reported to the National Practitioner Data Bank

AbuDagga

Wolfe

Carome

et al. 2018

Public Health Nursing

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Objective The objective of this study was to examine nurse sexual‐misconduct–related reports in the National Practitioner Data Bank (NPDB) and to compare them with reports for other types of offenses. Design and Population We analyzed NPDB’s reports of adverse state nursing board licensure actions and malpractice payments for all nurses from January 1, 2003, to June 30, 2016. Results Overall, 882 nurses had sexual‐misconduct–related reports. Most were aged 35–54 (63.2%), male (63.2%), and registered or advanced practice nurses (61.5%). The disciplinary actions noted in the 988 nurse sexual‐misconduct–related licensure reports were more frequently serious than those noted in the 207,023 reports for other offenses committed by nurses (90.8% vs. 74.8%, respectively; p < 0.001). Of the 33 nurses with sexual‐misconduct–related malpractice‐payment reports, 48.5% were not disciplined by any state board of nursing for these offenses. Three‐quarters of the victims in the 47 sexual‐misconduct–related malpractice‐payment reports were female, with “emotional injury only” reported as the severity of injury in 91.5% of these reports. Conclusions Very few nurses have been reported to the NPDB due to sexual misconduct. We welcome a zero‐tolerance standard against sexual misconduct involving patients by all types of health care professionals, including nurses.

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Professional Boundary Violations

Cited by 15 publications

References 0 publications

“That's not my job”: A mixed methods study of challenging client behaviors, boundaries, and home care aide occupational safety and health

“That's not my job”: A mixed methods study of challenging client behaviors, boundaries, and home care aide occupational safety and health

Kenneth Gergen’s concept of multi-being: an application to the nurse–patient relationship

Crossing the line: Sexual misconduct by nurses reported to the National Practitioner Data Bank

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