Boundary: something that indicates bounds (confines, restrains) or limits; a limiting or bounding line.
Boundaries in patient care are “mutually understood, unspoken, physical and emotional limits of the relationship between the trusting patient and the caring physician or provider”.
Health professional boundaries represent a set of culturally and professionally derived rules for how health professionals and their patients interact. Boundaries serve to establish and maintain a trusting provider-patient relationship and help clinicians maintain “justice and equity in dealing with all of their patients”, not only a special few.
When the limits of the provider-patient/family relationship are not clear or where normal professional boundaries are not respected, problems are likely to arise.
Common reasons for boundary problems:
- Personality styles or psychiatric disorders in which normal boundaries are not recognized or respected.
- Health professional stress/burnout
- Cultural misunderstandings
Warning signs and examples of potential boundary blurring:
- Gift giving from/to patient/family.
- Patients having or wanting access to provider’s home phone number, or other personal information.
- Patient/family expectations that the provider will provide care or socialize outside of clinical care settings.
- Patient/family requests that the provider participate in prayer.
- The health care provider revealing excessive personal information with patient/family.
See reference for more information.
Adapted from Barbour, LT. Professional-patient boundaries in palliative care. Palliative Care Network of Wisconsin. Fast facts and concepts #172. Bleeding management in hospice settings. Internet. Accessed on January 5, 2018.