Understanding Professional Boundaries
Published: 28 August 2019
Published: 28 August 2019
In a single day, healthcare workers may touch, dress, shower, feed, toilet, speak, console, cheer-up, and listen to one, or several clients; no small feat.
Of course, the carer-client relationship also creates an inherent power imbalance. Someone receiving care must be willing to hand over much of their agency and trust to their carers, with the expectation that this relationship is not abused.
In care settings such as residential aged care, the expectation that clients will have a safe and trusting relationship with members of the care team is directly tied to Standard 7 of the Aged Care Quality Standards: Human Resources.
The client-carer relationship is a unique one and may be difficult to navigate at times. The following article is intended to help you understand your role as a care provider, and how to avoid overstepping both personal and professional boundaries, which may compromise your duty of care.
We all have boundaries. These are the rules that govern how we interact in our relationships with others, indicating what we find to be acceptable and unacceptable behaviours (Bockarova 2016).
Everyone’s boundaries can be different. Knowing what your boundaries are comes from a personal sense of self-worth, and your personal values in life. Setting boundaries, however, is not always easy. It is a skill that can take time to get right (Bockarova 2016).
Professional boundaries are those rules and limits that prevent the lines between carer and client from becoming blurred.
Professional boundaries are set by legal, ethical and organisational frameworks to maintain a safe working environment for both the client, but also the caring staff too (Mable Technologies Pty Ltd 2015; Relationships Australia n.d.).
Some examples of professional boundaries may include:
(Acquired Brain Injury Outreach Service 2017)
Personal boundaries may be less-explicit than professional boundaries. They may include physical, emotional and mental limitations, which care workers adopt to protect themselves from being drawn in or becoming overly-invested in their client’s lives (Relationships Australia n.d.).
Personal boundaries allow healthcare workers to maintain psychological safety for themselves and their clients. (Relationships Australia n.d.).
Some examples of personal boundaries may include:
(Acquired Brain Injury Outreach Service 2017)
Realistically, boundaries will occasionally be crossed or blurred at various points in a carer-client relationship. This could be due to a particularly difficult situation, stress, bad luck or timing, or even manipulation by a client (Hardy 2017).
In these cases, it is your responsibility to avoid boundary crossings from becoming a pattern, and building into a harmful violation of the relationship (Clarke 2017).
(Clarke 2017)
Some violations are serious enough to become legal issues and reportable offences. All healthcare workers, including unregistered care workers, are subject to the National Code of Conduct for Health Care Workers. These ethical guidelines are essential to maintaining an adequate level of training and professionalism in the industry (Acquired Brain Injury Outreach Service 2017).
It is important to note that two sections laid out in the Code of Conduct, in particular, relate specifically to the following professional boundaries violations:
12. Health care workers not to financially exploit clients
- A health care worker must not financially exploit their clients.
- Without limiting subclause (1):
- a health care worker must only provide services or treatments to clients that are designed to maintain or improve clients’ health or wellbeing
- a health care worker must not accept or offer financial inducements or gifts as a part of client referral arrangements with other health care workers
- a health care worker must not ask clients to give, lend or bequeath money or gifts that will benefit the health care worker directly or indirectly.
13. Health care workers not to engage in sexual misconduct
- A health care worker must not engage in behaviour of a sexual or close personal nature with a client.
- A health care worker must not engage in a sexual or other inappropriate close personal, physical or emotional relationship with a client.
- A health care worker should ensure that a reasonable period of time has elapsed since the conclusion of the therapeutic relationship before engaging in a sexual relationship with a client.
The key to managing many of these boundaries is understanding the difference between a professional and a personal relationship and ensuring that your behaviour always remains on the right side of the line (Hardy 2017).
If you are unsure if what you are doing is crossing a boundary, ask yourself these five questions:
(Subscribers Only)
Question 1 of 2
Which of the following examples may indicate a crossed boundary?
Start an Ausmed Subscription to unlock this feature!
Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile