Friday, 28 September 2018

Professional Boundaries in Nursing


Nurses have come a long way since the 19th century, and these days, they are required to have awareness and knowledge of how vital professionalism is. As a nurse, I know that I need to have excellent communication and interpersonal skills. During the working hours, I will be required to take decisions quickly in order to ensure the health and wellbeing of the patient. Sometimes a nurse comes across a lot of marital and other problems, but professionalism lies in her skills of managing both the personal and professional lives efficiently. According to the ANA Code of Ethics, a nurse should maintain dignity and serve patients in the best possible ways (2017). It made me understand that my decisions can impact patient care and the overall health care system, so I need to be careful in this regard.
During my time at the nursing school, I have been taught the fundamentals of patient care, and I am expected to demonstrate a high degree of dedication and altruism. I will have to sacrifice myself during my professional life and may have to work under pressure to ensure the provision of quality care to my patients. I have also learned that a nurse has to see patients of all races, colors, ages, backgrounds, and religions, which means there is no room for discrimination while working at the hospital. The job of a nurse is not only to see patients during the working hours but also to assist and support them morally whenever they are in need (Barnes, 2014).
According to Hilary Barnes, professional boundaries are one of the primary considerations in the relationship between a nurse and the patient. In a healthcare center, they represent the ethical, professional and legal standards a nurse has to maintain at any cost (Barnes, 2014, p. 138). It is the responsibility of a nurse to be honest with their duty and the patients while staying in their limits and not showing attitude to anyone. There are some standards and policies set by every hospital, and all medical professionals are to work according to them. Professional boundaries ensure that the requirements of patients are taken care of without any discrimination. Nurses have to establish limits and boundaries for themselves while performing their duties. For example, if the nurse is dealing with a patient in the emergency department, they need not get personal with the sufferer and must stay in the limits. At the same time, they should not allow any of the patients to talk anything out of context. Any behavior or action in the nurse-patient relationship that benefits the nurse or the client personally is the violation of rules and regulations. It is often referred to as the boundary violation and can result in the termination of the nurse (Azhagesan, 2017).
As a nurse, I know the worth of helping the ill in an uncertain situation, but sometimes, I am prevented from helping them or providing them with timely care. An incident took place the previous month when the dues of a patient were unpaid. The patient belonged to a backward area and had come to our hospital for cancer treatment. However, neither the patient nor their family could bear the costs of chemotherapy. In the beginning, they managed to pay for the treatment and the medications, but after some days, they started complaining about the fee of the doctor and the high prices of medicines. It was the time when my professionalism was being judged; I was confused about whether to help the patient or not. Finally, it was decided that the patient would be assisted privately, without any charges. They were asked to visit a clinic where I and a friend of mine, who is a doctor, see patients in the evening. I understand that it was a repercussion of a breach of professionalism (Murphy, 2014) and I was not supposed to call them to a private clinic; given the critical situation of the patient as well as their financial status, I took this decision, and there are no regrets since saving the life of a needy was more important to me than anything else.
After this incident, it was realized that nurses should focus more on their career and maintain the professionalism. The three simple ways I have opted for are taking care of the privacy of patients, being polite and courteous to everyone, and working extra hours without expecting a salary increment, whenever needed. First of all, patient privacy should be the priority of every healthcare professional. I feel that a nurse needs to follow the rules and regulations of the hospital in this regard. There is no need to share the case history reports with anyone, and they must abide by the privacy rules of the healthcare center. Secondly, I tend to be polite and courteous, keeping my personal issues aside. Even when the day is hectic, and nurses have a lot of patients to treat, they should never lose the temper. I strongly believe that it is one of the primary manners while interacting with anyone, whether he is a patient, doctor, supervisor or a peer. Finally, a nurse should not work for money (Başçı et al., 2016). As I move forward in my nursing career, I will be more than happy to spend hours in the hospital, assisting doctors in surgeries and operations, and helping patients recover from the disease at a fast speed.
In conclusion, nurses can open the doors of endless opportunities for themselves if they choose to stay professional and avoid reacting negatively to an uncertain situation. The success in the healthcare industry lies in how dedicated and hardworking nurses are. They are to serve the humanity, so they should learn how to practice with compassion and respect for the inherent dignity (2017).

References
Barnes, H. (2014). Nurse Practitioner Role Transition: A Concept Analysis. Nursing Forum, 50(3), 137-146. doi:10.1111/nuf.12078
Azhagesan, C. (2017). Role of Nurse in Polypharmacy. Nursing & Healthcare International Journal,1(4). doi:10.23880/nhij-16000123
Murphy, E. A. (2014). Healthcare Reform—A New Role for Changing Times: Embracing the Clinical Nurse Leader Role—A Strategic Partnership to Drive Outcomes. Nurse Leader, 12(4), 53-57. doi:10.1016/j.mnl.2014.05.010
Başçı, A. B., Özyurda, F., & Yılmazel, G. (2016). The Level of Work Related Tension and Role Conflict-Role Ambiguity Status of Nurses Working in Ankara University Hospitals. Journal of Academic Research in Nursing. doi:10.5222/jaren.2016.051
Faith and Ethics, Covenant and Code: The 2015 Revision of the ANA Code of Ethics for Nurses with Interpretive Statements. (2017). Journal of Christian Nursing, 34(4). doi:10.1097/00005217-201710000-00023