Professional Boundaries Flashcards
professional boundaries
doctor-patient relationship
physical and emotional limitations
patient vulnerabilities
doctor vulnerabilities
boundaries
define the expected and accepted psychological, physical and social distance between practitioners and patients
boundary violation
represents a harmful crossing or transgression of a boundary
what are the personal space in feet?
4ft- business relationship
3ft- social relationship
1ft- intimate, can be threatening
who sets the boundaries of personal space?
THE PATIENT
typical situations patients feel vulnerable
requests for intimate details/personal information
owing doctor money
not questioning doctor’s decisions
due to personal circumstances
personal circumstances a patient might feel vulnerable
low education or income level emotional difficulties financial problemsmarital trouble disrobing/gowning exposure of sexual organs
how can you reduce the risk of vulnerability
communication explain all tests always ask permission explain types of treatment performed consent papers
how can you be aware of physical interactions
- perform all exams whenever possible, during normal business hours
- consider perfomring exams in a room near the front of the office
- consider chaperone when examining private areas
- exam gowns when necessary
- drape for privacy
- avoid removal of patient undergarments
- parent or guardian of same gender when treating a minor
what are the types of people who don’t establish boundaries?
flirtatious patient
predatory patient
patients with unrealistic expectations
flirtatious patients
may want a relationship
predatory patient
may be scheming (last patient of the day, blatant and intimidating with staff, disregard staff instructions, attempt to appeal to ego)
unrealistic patient
unconsciously idolize or see doctor as replacemnt for another important person from their past or present
how do you prepare for high risk situations?
establish a policy
train staff to be aware
recognize, respond and deal with aggressive patents
listen to staff even if it is against your ego
check with past doctors
understand diversity
comunicate effectively
chaperone in treatment room
concent for photography, medical or otherwise
further action to take for boundary crossing
seek help from a peer or your state’s association
document carefully and precisely as possible
terminate doctor/patient relationship
call malpractice carrier
