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Borders, boundaries and consequences for nurses

We read with interest a well-written column by an oncology nurse about borders, boundaries and consequences for boundary crossings and violations. Let's begin by defining terms: the columnist writes that the National Council of State Boards of Nursing says "a boundary crossing" is a 'brief excursion across professional lines of behavior.'"

While a nurse may make an unplanned excursion that he or she truly believes will improve the life of a patient or caregiver, boundary crossings or violations can have serious repercussions, the oncology nurse writes. Small boundary crossings can in some cases result in a boundary violation, she notes, that "can have legal consequences or loss of your hard-earned license."

The nurse urges her peers to remember that they have access to personal and confidential information and they have knowledge of specialized medical treatments. Taken together, they give a nurse power. Even if some nurses might object to the word "power," the fact is that they have it and cannot afford to abuse it.

She urges nurses tempted to cross boundaries to first ask themselves a few questions:

  • Can you do this favor for all of your patients?
  • Will your action affect your co-workers?
  • Will the favor you do or action you take be viewed as favoritism?

Beyond legal consequences or licensing issues, the nurse also urges her peers to remember that "without clear boundaries, nurses have higher burnout, turnover, compassion fatigue" and other potential problems.

Nurses facing licensing issues can speak with an attorney experienced in representation in disciplinary matters involving RNs, LPNs and NPs.

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