PROFESSIONAL BOUNDARIES AND ETHICAL CONDUCT Debra Scott, MSN, RN FRE Executive Director Nevada State Board of Nursing

Understanding Ethics Principle- based Ethics Rules, 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- INVOLVED OVER- 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 Framework Is the behavior consistent with your duty to always act in the best interest of your client Does the behavior promote client autonomy and self-determination Is 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 question Is the behavior consistent within the ANA Code of Ethics Is the behavior within nursing practice standards from your board of nursing & agency No Abstain From Behavior Yes

Questions?

DEBRA SCOTT, MSN, RN, FRE 5011 MEADOWOOD MALL WAY #300 RENO, NV NEVADANURSINGBOARD.ORG REFERENCES  NCSBN. (2007) Professional Boundaries; A nurse’s guide to the importance of appropriate professional boundaries. Chicago, IL: Web. 2 Mar  NCSBN. (2009) Respecting Professional Boundaries. Chicago, IL: Web. 2 Mar  NCSBN. (2009) Ethics of Nursing Practice. Chicago, IL: Web. 2 Mar, 2012  NCSBN. (2012) Righting a Wrong: Ethics and Professionalism in Nursing. Chicago, IL: Web. 2 Mar. 2012