PROFESSIONAL BOUNDARIES

AND ETHICAL CONDUCT

Debra Scott, MSN, RN FRE

Executive Director

Nevada State Board of Nursing

Understanding Ethics

Principle-based EthicsRules, codes,

standards

Professional

Ethics Virtue (Ideal)Based Ethics

Character

Consequences-

Based Ethics

Outcomes

How do Ethics Relate to Professional Boundaries?

Therapeutic relationships involve:

Fiduciary relationship Client vulnerability Professional influence Power differential

Professional Boundaries

Provides limits Produces consistency Defines power Responsibility rests with

the professional Provides credibility and

predictability

Continuum of Therapeutic Relationships

OVER-INVOLVE

D

OVER-INVOLVE

D

UNDER- INVOLVED

UNDER- INVOLVED

Types of Over-Involvement

Boundary Crossing

Boundary Violation

Sexual Misconduct

Warning Signs

Personal problems Secretive behavior “Super Nurse” behavior Special treatment Other warning signs

The Professional at Risk

Naïve Prince or Princess Wounded Warrior Self-serving Martyr False Lover/Mind Controller Dark King or Queen Wild Card

The Best Prevention

Be Aware Be Reflective Respect Feelings of

“Dis-ease” Keep Client’s Need

Paramount

Decision

Making Framew

ork

Is the behavior consistent with

your duty to always act in the best interest of

your clientDoes the behavior promote client autonomy and

self-determinationIs this a behavior you would want other people to know you have

engaged in with a client

PROCEED WITH THE BEHAVIOR

DO NOT PROCEED WITH THE BEHAVIOR

Identify the behavior

In questionIs the behavior

consistent within the ANA Code of Ethics

Is the behavior within nursing practice

standards from your board of nursing &

agency

No

No

No

No

No

No

Abstain From Behavior

Abstain From Behavior

Abstain From Behavior

Abstain From Behavior

Abstain From Behavior

Abstain From Behavior

Yes

Yes

Yes

Yes

Yes

Yes

Questions?

DEBRA SCOTT, MSN, RN, FRE5011 MEADOWOOD MALL WAY

#300RENO, NV 89502

888-590-6726NEVADANURSINGBOARD.ORG

REFERENCESNCSBN. (2007) Professional Boundaries; A nurse’s guide to the importance of appropriate professional boundaries. Chicago, IL: Web. 2 Mar. 2012NCSBN. (2009) Respecting Professional Boundaries. Chicago, IL: Web. 2 Mar. 2012NCSBN. (2009) Ethics of Nursing Practice. Chicago, IL: Web. 2 Mar, 2012NCSBN. (2012) Righting a Wrong: Ethics and Professionalism in Nursing. Chicago, IL: Web. 2 Mar. 2012