Staff-Patient Boundaries

CKennedy

Hello
Our unit has recently experienced some significant complications resulting from overstepped boundaries between staff and a patient. This nearly resulted in an involuntary discharge due to the ongoing behavior of the patient and will likely have serious consequences with the staff members involved.
Social workers are trained to have a strong sense of who we are with our clients and who we could be to them in spite of our actual actions or intentions; we learn about transference and counter-transference, and maintaining a helping stance at all times. We see it as the only way to keep the focus on their needs so that they can be empowered to help themselves.
I feel based on my experience in the dialysis unit that for other disciplines boundaries and professionalism may be taught or practiced as an ancillary skill rather than the core of the helping professions. I see some who have also very strong professional boundaries and others who really, really, do not. I don't know how other professions are trained, but I do know that in my own experience at the master's level, understanding one's role, function, and purpose as a social worker was the essence of the entire learning experience. The possibility of dual relationships and blurred boundaries (even with the best intentions) causing harm to a client was regularly addressed and explored during those two years post-grad. I was taught that self-disclosure and client privacy were essential to the helping relationship.
Here's two things I'd like to chew on with you all:
I'd love to hear what other social workers have to say about how you "stick to your guns" when it comes to pushing through a culture full of blurred boundaries, especially if you are also rural as is our unit. I'm holding a "discussion/Q&A" session available to all staff next month, but it isn't mandatory, so I'm concerned those most at risk of violating boundaries may not attend.
Secondly, I'm hoping this group might be another way to support each other as social workers to do what we know is right in the face of so many others in the unit pushing or crossing the limits. It's a tough job to be telling people how to behave when you are not the boss, but also tasked with being a kind of ethical conscience/patient advocate for the unit! Help and ideas on what has worked for you, or even just sharing your experiences with this would be supportive!
Thanks to all and Happy Summer!

ebaumann

Hi CK,

Thank you for your comments.

Does anyone else have anything to share related to boundaries in their facility?

Any advice towards having a training for staff?

Also any advice to the Network regarding education that we can create to provide to facilities related to boundaries.

Thank you!