Professional boundaries Flashcards
Self-disclosure: scenerio that is ok vs not ok
OK:
- Meets the therapetuic needs of the Pt
- E.g. validate their concerns and offered an option they may want to consider
Not OK:
- Putting your needs ahead of the Pt’s need
Receive a gift or not?
Consider:
- Intention behind the gift
- Affect your clinical decision?
- Change the nature of the relationship
- To the team/person?
- Do the Pt have any expectation from you after receiving the gift? (provide more Rx session, longer Rx session)
- Potential cost of the gift (snack vs gold bracelet)
Colleague treat relative/close & intimate relationship
- Inform manager and express my ethical concern
- Contact College to determine best course of action
- PT can’t treat persion with close relationship excep in an emergency
- Colleague should be referring their sister to another private clinic vs treating them themselves–>impair a PT’s professional judgement
Dating a Pt?
- Zero-tolerance policy
- Regulated Health Professional Act: sexual abuse when…
- Sexual intercourse/physical sexual relations
- Touching of a sexual nature
- Behaviour or remarks of a sexual nauture
Does not matter if the Pt start the relationship
Does not matter if the Pt consent to the relationship
Found guilty of sexual abuse–>lose license
Pt flirting with you
- My responsibility to maintain professional boundaries & recognize potential inappropriate interactions
- Not ignore the situation–>silence could be misinterpreted by the Pt
- Respectful conversation with Pt
- I think they mean well
- I feel the relationship is moving in an inappropriate direction
- I want it to stop
**If the behaviour did not change after the conversation–>DC the pt and provide them with alternative providers for treatment - I would document the interaction and plan of action
Previously flirty Pt rubs their hand against your back
Immediately address the situation
- I think you are a good person
- I feel very uncomfortable when you touch me like that
- I want you to sotp doing that
tell them that the behaviour needs to be stop
DC them from my care and find them an alternative PT
Point to note when ask Pt to disrobe
- Safe and comfortable environment
- explain the purpose-accurate Ax
- Let Pt know the body parts that need to be exposed
- Draping option and ensure adequate clean draping materials
- Reassure Ax can still carried out with shirt on but Ax may not be that accurate-Let Pt know their options before making any choice
Pt consent to disrobe
- Keep communicating with the Pt (feeling of safety)
- Communicate the plan for Ax including how I would be therapeutically touching them
- Check in with Pt ensuring comfort
- minimizing the amount and time their back was exposed
Pt consent to disrobe and wanted draping
- Drape the Pt appropriately, according to the pathology and Pt’s need
- Let Pt hold onto draping material–>control and comfort concerning draping
Pt refuse to disrobe
- assess their back to best of my ability
See a PT colleague date a Pt and holding hands
Professional boundaries are being crossed
- I would report the situation to the College
I would only include the name of Pt if I have been given consent to do so
- RHPA: you must report to the college if you have reasonable grounds to suspect abuse of a Pt. There can be a 25000 fine if you are found guilty of not reporting
Can you treat your spouse?
- Spouse are not exempt from the definition of sexual abuse
PT treat spouse, complaint of sexual abuse was made, PT could be found guilty and lose their license
Unless it was an emergency situation and in this case, fee would not be charged
Definition of Relative
- Spouse
- Parent
- Child
- Sibling
- Relative through marriage/adoption
Dating a FORMER Pt?
NOT recommanded, it is possible to date a former Pt if all the following apply
- At least 1 year has passed since the Pt was DC from PT care
- No imbalance of power between the PT and Pt
- No dependency on the PT by Pt
PT colleague flirting with the Pt
Immediate infrom
- manager/PT in charge of the issue
- College and report the incident–>College can then investigate the matter further
Social media: maintain professional boundaries
- Use a professional use account
- Make my personal profile private
- Avoid adding Pts to personal social media channels
- Keep the content in my professional account, accurate and within my SOP
Pt add you on social media
Remain professional and not accept the frd reqeust
- If accept–>blur the boundaries of the therapeutic relationship
At the start of the next appointment, I would explain why I cannot accept their friend request
-Address this immediately–>maintain a clear professional boundary and keep the lines of communication open with my Pt to avoid any confusion on their end
Document the interaction in their chart
Pt act inappropriate and disrespectful to PT & other Pt
Let the Pt know they are inappropriate
- Pull the Pt aside and have a convseration about their behaviour
- Let the Pt know I think they are being inappropriate and disrespectful and I would outline what the problem behaviour is
- Why inappropriate
- Ask Pt to change their behaviour, outline my expectation, consequence that will result:
Immediately ending the session, DC the Pt from the care
Monitor the situation
- FU with the affected Pt and the inappropriate Pt
* If stops–>continue to treat
* If continues–>Despite all reasonable steps to manage it–>stop Rx and DC
Document all interaction and the outcome
