Professional Boundaries

Working closely with patients at the end-of-life can be very rewarding, but it can also bring challenges for health professionals. This is especially true in end-of-life care where patients and families are in crisis. During this time, when therapeutic relationships are developing, the line between a professional and personal relationship can become blurred. [1]

For example, it is very easy to become close to some patients and their families / carers – you may find that you have a lot in common; the patient or family may look to you for support and guidance and rely on you for certain things; they may take you into their confidence and into their family. You need to be careful not to become too involved.

Maintaining professionalism can be hard at times as you may feel invested in the situation and in the outcomes. It is a good idea to remember the power imbalance within the relationship between yourself as a health professional and the patient / family / carer. However, it is important to remember that you are part of a team and that together you share the care of the patient. Talk to colleagues if you feel that you may be over-involved in a case. Self-care strategies are also helpful in separating work and life issues. In addition, professional supervision can be invaluable in helping you to maintain boundaries and to identify ways to maintain these.

Questions that can be used to explore boundaries include:

  • Is your relationship with the patient / family / carer adversely influencing your professional judgement?
  • Whose needs are being met through the relationship?
  • Would you feel comfortable or uncomfortable about colleagues or your manager observing your behaviour?
  • If challenged, can you ground your actions and interactions in the theories and values of your discipline?
  • Does the type of relationship you have with a patient or their family change your professional treatment or management
  1. Sanders S, Bullock K, Broussard C. Exploring professional boundaries in end-of-life care: considerations for hospice social workers and other members of the team. J Soc Work End Life Palliat Care. 2012;8(1):10-28.

Websites

This information is from the Services for Australian Rural and Remote Allied Health (SARRAH) website: From the Palliative Care Network of Wisconsin Fast Facts and Concepts:

Video

Self Care and Boundaries is a video by Elizabeth Causton, covering the importance of boundaries and self-care for caregivers in hospice and palliative care.

Allied Health

Clinical Evidence 

GPs


Last updated 14 February 2017