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Intimacy Boundaries Mental Health Nurses & Psychiatric Patients

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Questions:

1.After reading the list of possible boundary violations related to psychiatric nurses, I have witnessed a nurse purchase a beautiful hand crafted card for the price of five dollars from a patient, to give to her mother for her birthday. What do people think about this? Do you think this is questionable as a boundary violation?
 
2.It is apparent that the nurses (especially in mental health) are facing the dilemma of the validity and the effect of the certain acts,nurse therapeutic relationship only if such an act can assist and improve patients mental states and recovery?
 
 

Answers:

Topic 1

Similar to nursing practice, in psychiatric nursing, the nurse-client relationship forms the foundation in rendering therapeutic care to the patient by catering to the specific needs. It is essentially based on virtues such as respect, trust, faith, belief and professional intimacy that call for the appropriate utilization of the competency and authoritarian skills. The relationship is maintained within a set of predefined boundaries that clearly demarcates and distinguishes the differences between professional and therapeutic behavior in contrast to unprofessional and non-therapeutic behaviors. Psychiatric nurses normally engages in sustaining the therapeutic association with the clients by being respectful of the individual’s preferences, circumstances and experiences in conjunction with consistent compliance with the physical, mental, emotional, spiritual and cultural needs of the client (Stuart 2014). Therefore I feel the scenario as cited may be referred to as a boundary violation where the nurse has purchased a service from the client to satisfy her personal needs. Breach of conduct on the nurse’s part is evident as she has put her personal needs ahead of her client’s requirements thereby accounting for misuse of her power and authority. Lack of professional judgment is clearly evident as the nurse failed to determine the suitable restrictions of therapeutic relationship (Campbell, Yonge and Austin 2016).

Topic 2

The act of advocating and rendering care facilities for others often put the nursing staff working in various settings under enormous threats that they have to tackle. The situation is particularly challenging for the mental health nurses as they encounter dilemma in performing certain acts that might culminate in harboring unfavorable outcomes and adverse consequences. The risk of indulging in unacceptable behaviors might emanate from otherwise seemingly harmless act as perceived by the nurse herself. Stringent regulation and strict abidance by the professional boundaries are considered as safe practices to address the issue thereby avoiding unprecedented circumstances that might affect the patient safety (McClunie-Trust 2016). The progressive blurring of lines between formal and informal roles pertinent to professional associations is particularly dangerous leading to ambiguity and putting the safety of both the patients and physicians at stake. Hence I feel the nurses must be more careful in their pursuit of practice and refrain from attitudes that depict unfair treatment to others due to favoritism towards one client. Legal and ethical compliance to the standards of practice as proposed by appropriate authorities has the potential to resolve the issue allaying apprehensions of all ends concerned through following of uniform codes of conduct (Acmhn.org 2017).

 

References

Acmhn.org, 2017. Standards of Practice. [online] Acmhn.org. Available at: https://www.acmhn.org/publications/standards-of-practice [Accessed 2 Apr. 2017].

Campbell, R.J., Yonge, O. and Austin, W., 2016. Intimacy boundaries: Between mental health nurses & psychiatric patients. Journal of psychosocial nursing and mental health services, 43(5), pp.32-39.

McClunie-Trust, P., 2016. Professional boundaries-how close is too close?. Nursing Review, 16(4), pp.26-27.

Stuart, G.W., 2014. Principles and practice of psychiatric nursing. Elsevier Health Sciences.

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