The novice nurse is learning about the use of boundaries in the ...

[NClaborn]

The novice nurse is learning about the use of boundaries in the therapeutic nurse-patient relationship. What examples will the nurse recognize as boundary violations? Select all that apply.
 
  1. Sexual misconduct
  2. Last-minute appointment changes
  3. Inappropriate self-disclosure
  4. Giving or receiving small gifts
  5. Disclosing bits of personal information

Question 2

The nurse manager is meeting with a staff nurse on the inpatient mental health unit for an annual employee review. When discussing the nurse's current concerns, the nurse tells the manager, I am having trouble sleeping at night thinking about that
 
  patient we had who was hospitalized for several weeks. I got so close to that patient and I wonder how she is doing. What is the manager most concerned about regarding the nurse's statement?
  1. The nurse is experiencing burnout.
  2. The nurse is experiencing insomnia.
  3. The nurse has crossed professional boundaries.
  4. The nurse has compromised his or her professional license.

[nyrave]

Answer to Question 1

Answer: 1, 3
Explanation: The National Council of State Boards of Nursing defines boundary crossings as decisions to deviate from a boundary for a therapeutic purpose, such as appointment changes, disclosing bits of personal information, or the giving or receiving of small gifts. These are small breaches with a likely return to expected limits of the professional relationship. Boundary violations may include inappropriate self-disclosure and sexual misconduct.

Answer to Question 2

Answer: 3
Explanation: The staff nurse has crossed professional boundaries, perhaps without realizing it, by getting too close to the patient. Setting and maintaining nurse-patient boundaries are essential skills for the psychiatric-mental health nurse. However, these skills are not easy to learn and these boundaries may be crossed at times. There is not enough information to determine if the nurse is experiencing burnout. Although the nurse appears to be experiencing insomnia, this would not cause the manager as much concern as a possible boundary crossing or violation. Though the staff nurse has inadvertently crossed professional nurse-patient boundaries, there is not enough information in the question to determine if the nurse has compromised his or her professional license.