Setting Professional Boundaries in Healthcare: What Every HCP Should Know

Did you know that even seemingly casual conversations at work can cross the line into sexual misconduct if the topic or tone is inappropriate? Setting boundaries starts with understanding which behaviors are considered right versus wrong and ensuring the wrong ones dont occur or persist.

Read more to learn about setting appropriate boundaries in healthcare.

Inappropriate Behaviors at Work

Working in healthcare is already challenging enough, but coming into work and facing difficult working relationships with colleagues can make the job even more challenging. Workplace rivalries are well-known and have been studied extensively, and abuse from patients is a common focus of healthcare literature today. However, discussions about how to manage working relationships between healthcare personnel (nurses, allied health professionals, ancillary staff, etc.) arent as popular but can be equally difficult.

For example, delegation to assistive personnel can challenge working relationships if not handled effectively. Inappropriate behaviors between patients and colleagues arent just those that are conventionally considered inappropriate (i.e., sexual misconduct). They also refer to behaviors that would otherwise seem harmless.

Setting boundaries refers to standing up to inappropriate behaviors from patients or colleagues, as well as standing up against toxic work environments. From staff shortages to complex care, the healthcare setting can be a challenging yet rewarding work environment. Healthcare worker burnout is on the rise due to toxic work environments, such as:

• Incivility/bullying
• Discrimination and exclusion (age, ethnicity/race, religion, disability, gender/sexual orientation)
• Unsafe and excessive workloads (i.e., high patient care loads, lengthy overtime)
• Unsafe/poor physical working conditions

While it may seem obvious that the above behaviors/situations in the workplace are inappropriate, these actions have been defined this way by national organizations based on ethical standards and principles. Healthcare professionals (HCPs) must use these same standards as a basis for standing up for themselves.

Boundary Setting

Professional boundaries in healthcare can be defined as the limits placed on acceptable interactions between HCPs and patients. As mentioned above, setting boundaries starts with understanding which behaviors are considered right versus wrong and ensuring the wrong ones dont occur or persist. How, then, can HCPs ensure respectful, healthy professional relationships and work environments? HCPs must define their standards and ensure the offending individual or entity knows the behavior is inappropriate and should stop.

Define Standards

Before setting boundaries, HCPs must understand what it means to have professional standards. This means that an HCP cant set appropriate boundaries if they do not have standards for how they want to be (or should be) treated at work. National professional and ethical standards in health care are established by organizations, such as the American Nurses Association, the Association for Respiratory Care, the American Physical Therapy Association, and the American Occupational Therapy Association. The following themes are present in various healthcare codes of ethics:

• Respecting the dignity of all people
• Maintaining respectful, civil interactions with other HCPs
• Not engaging in harassing behavior physically, verbally, mentally, or sexually

Each code of ethics outlines detailed actions to follow that expand beyond this short list. There may be times when a behavior may not be defined in a workplace policy as right or wrong.

For example, addressing a provider by their title and last name instead of their first name (i.e., Dr. Smith instead of Joseph). This action has been established as culturally acceptable in the healthcare space. But what if an HCP prefers to be addressed by their full name rather than a nickname (i.e., Samantha instead of Sam)? The HCP has established this standard for themselves and must ensure that patients and colleagues understand their preference.

Once you understand what is considered appropriate in the workplace and have established standards for yourself as a professional, you can begin to set boundaries to ensure those standards are upheld.

Enforce the Boundary

After establishing a standard, the HCP should make it clear to the patient or colleague that the behavior is wrong, inappropriate, or not preferred, and should stop. This is key in establishing boundaries. You can speak directly to the individual, or you can seek help by reporting the behavior to a supervisor and following the chain of command. It all depends on your workplace policy. Depending on the type of offense, you may be required to report the behavior.

For example, sexual misconduct is considered an extreme form of unacceptable behavior that is reportable. Casual discussions between coworkers about one anothers individual sex lives may be considered a form of sexual misconduct. Offering compliments about a patient or colleagues physical appearance can also be perceived as sexual misconduct. Because sexual misconduct can be criminal in some cases, many organizations require employees to report this behavior immediately.

If you want to learn about more inappropriate work behaviors and how to set boundaries, take the CEUFast course titled Establishing and Maintaining Professional Boundaries. In this course, you will not only gain knowledge on the types of inappropriate behaviors and how to address them, but you will also learn how to address any barriers you might face when attempting to stand up for yourself at work.

Bottom Line

Setting boundaries in healthcare is an ethical responsibility (not a choice). HCPs are required to uphold ethical standards at work. Maintaining respectful, healthy relationships with patients and colleagues promotes non-toxic working environments, and HCPs should strive to eliminate any personal barriers that may limit their ability to speak up.

About the Author:

Charmaine Robinson, MSN-Ed, BSN, RN, is a nurse writer with a background in medical-surgical nursing and nursing instruction.

Charmaine is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your healthcare provider for any health-related questions or concerns.

If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions