Unit 4 - Boundaries

Question 1

define boundary

Answer 1

a point or limit that indicates where two things become different

Question 2

define boundaries

Answer 2

unofficial rules about what should not be done: limits that define acceptable behaviour.

Question 3

what are personal boundaries?

Answer 3

physical, emotional and mental limits

Question 4

what is the point of having personal boundaries

Answer 4

• allow us to separate who we are

- helps us express ourselves as unique individuals

Question 5

Whats is the systems theory?

Answer 5

• Explains the breaking of whole things into parts; and all things working together in a system
• used To understand biological systems, and systems in families and nursing care

Question 6

how are personal boundaries established?

Answer 6

• Know that you have the right
• Recognize needs and feelings
• Learn to say ‘no’
• Identify actions and behaviours
• Trust and believe in yourself

Question 7

what are some examples of unhealthy personal boundaries?

Answer 7

• always trying to please others
• Giving all you can
• Taking all you can
• Letting others define you
• Expecting others to fill your needs automatically
• Cannot say ‘no’
• Not speaking up
• Falling apart
• Falling ‘in love’ with anyone who shows you affection
• Accepting unwanted attention
• Touching without asking

Question 8

what are examples of healthy personal boundaries?

Answer 8

• Healthy self-confidence and self-concept
• In touch with reality
• Able to communicate with others
• Fulfilling relationships
• Stability and control over our lives

Question 9

the core of nursing is ______ relationships.

Answer 9

therapeutic nurse client relationships

Question 10

therapeutic relationships involve …..

Answer 10

• using nursing knowledge and skills
• applying caring attitudes and behaviour
• contributes to clients health and well-being
• trust, respect, empathy, professional intimacy, appropriate use of power

Question 11

explain the continuum of professional behaviour.

Answer 11

***under involvement: unempathetic, negligence, uncaring

*** zone of helpfulness: meets client’s therapeutic needs

***over involvement: favouritism, abuse, social contact

Question 12

what are the 4 components of a therapeutic relationship?

Answer 12

1) power
2) trust
3) respect
4) choice

Question 13

what nursing qualities are needed for therapeutic relations?

Answer 13

• Awareness of self
• Clarification of values
• Exploration of own actions with patients
• Use of self as a role model
• Altruism (sense of selflessness)
• Ethics and responsibility

Question 14

define professional boundaries

Answer 14

the spaces between the nurse’s power and the client’s vulnerability

Question 15

what is the purpose of professional boundaries?

Answer 15

• provide a sense of legitimate control in a relationship

- sets limits to the nurse-client relationship

Question 16

engaging a client in a professional caring relationship puts nurses at risk of…

Answer 16

nurses are at risk of overstepping their professional boundaries

Question 17

define Boundary Crossings

Answer 17

• Grey zones in the area of nurse-client relationship boundaries
• Brief excursions across the boundary lines, with a return to established limits of the professional relationship
• May or may not be harmful to the client and should be assessed on a case by case basis

Question 18

define Boundary violations

Answer 18

• The professional boundary has been crossed and is clearly not in the clients’ best interests
• includes acts of abuse in the nurse-client relationship

Question 19

what are the 5 types of boundary crossings?

Answer 19

1) self disclosure
2) gift giving
3) Commencing a social relationship with a former client
4) Commencing or escalating a social relationship with families of clients
5) Entering a therapeutic relationship with family, friends or acquaintances

Question 20

define self disclosure

Answer 20

• the revelation that occurs when a person reveals information about his/her self: ideas, values, feelings or attitudes, to another person

Question 21

what are the benefits of self-disclosure

Answer 21

• Client sees nurse as a ‘real person’
• Develop trust between nurse and client
• Encourages the client’s self-exploration and self-understanding
• Helps the client focus more clearly on the problems they are facing

Question 22

what problems occur with gift giving?

Answer 22

• not always clear when it is appropriate to accept gifts from clients
• Consider cultural beliefs and values of the client
• Assess the relationship
• Nurses must never solicit gifts from clients
• Be careful when admiring client belongings
• Cash should never exchange hands between clients and nurses.
• Always refer to agency policy on gift

Question 23

what are some strategies to promote boundary maintenance?

Answer 23

• Be aware of warning signs
• Don’t become dependent on clients to meet your social needs
• Avoid inappropriate self-disclosure
• Examine potential boundary issues
• Talk to trusted colleagues
• Seek out clinical supervision
• Contribute to meaningful practice guidelines

Question 24

define sexual misconduct

Answer 24

• an extreme form of boundary violation and includes any behavior that is seductive, sexually demeaning, harassing or reasonably interpreted as sexual by the patient
• romantic / sexual relationships between nurses and clients aren’t appropriate.

Question 25

boundary decision making framework.

Answer 25

Ask yourself:

1) Is it consistent with CNA code of ethics for RNs?
2) Is it consistent your region’s nursing practice standards?
3) Is it consistent with your duty to act in the best interest of your client?
4) Does it promote client autonomy and self-determination?
5) Is this an interaction you would want other people to know you had done with a client?