Professional Boundaries and Expectations for Nurse-Client Relationships - Essay Example

The patient-nurse relationship is highly professional and therapeutic (RCN, 2010). Within the broader precinct of interpersonal interaction and delivery of care, the need to maintain professional boundaries in the nurse-client relationship becomes a hugely pertinent issue. Professional boundaries are defined as ‘lines which separate the therapeutic behavior of a registered nurse from any behavior which, well-intentioned or not, could reduce the benefit of nursing care to patients, clients, families, and communities’ (CRNNS, 2002).

Julie is a practice nurse at a healthcare center in a small Scottish village that serves the people of the village and surrounding areas. Within the small community, local pubs remain the only outlet of socialization where they tend to meet the locals. Hence, there are opportunities for breaching professional boundaries when casual acquaintances might require their professional expertise. Julie meets Sam when he comes for an appointment with GP. He also shares his medical history. But when she is asked by Sam to join his pub quiz team, she is confronted with the dilemma of nursing ethics. She knows he has a history of depression and she is also aware that there is a high possibility of meeting Sam socially as there are only two pubs in the village.

     Sam has told her that he has felt suicidal in the past but manages his depression by socializing. Julie knows that Sam has not divulged his suicidal tendency to GP. Confidentiality and trust are intrinsic parts of nursing paradigms. But, as Sam has shared the information of his suicidal tendency within the professional environment of a health clinic, she must inform of the same GP. The suicidal tendency in a patient with a history of depression is a serious issue. Thus, when Julie shares the information with GP, she is within her professional boundary of confidentiality as the information has serious implications for the patient (NMC code, 2008). Depression is a mental illness and suicidal tendencies could greatly risk the welfare of the patient (Hope, 2004). At the same time, it is also in line with the law and therefore disclosure of the information is absolutely right and does not breach the components of confidentiality within nursing practice.

     The issue of conflict of interest is not applicable in the case when Sam asks Julie to join his pub quiz. Conflict of interest arises when the therapist or nurse has a personal interest or relationship that can adversely impact the professional judgment. Sam is not the patient Julie. Moreover, casual relationships within small communities are normal. Being friendly is part of the professional relationship as it involves winning the trust of the patient. But it is equally important to know that Sam has problems of depression with suicidal tendencies. As such, even within a casual relationship, there would not be equal distribution of power and consequently, it is advisable that she refrains from joining the pub of Sam even on a casual basis.

In a small community, especially when the socializing avenues are few, the casual relationship with locals is normal. As practice nurse, Julie has more power as a nurse as she is better equipped with professional knowledge and skill. But in a casual relationship, power distribution needs to be equal which would not be the case with Sam as he has a history of depression that could seriously influence his power of decision making and judgment.