1. College of Dietitians of British Columbia To Do or Not to Do? Personal Boundaries for Health Care Professionals Peter Lam, RD, Chair, Patient Relations Committee

2. To Do or Not to Do?

4. Cliché conversation Reporting facts Ideas & judgements Feelings & emotions Peak communication Adapted from: College of Physical Therapists of Alberta. Therapeutic Relationships: Establishing and Maintaining Professional Boundaries. www. cpta.ab.ca; accessed 09.16.2008.

5. What is a Personal Boundary?

7. Common Boundaries Crossed… Self disclosure Giving or receiving gifts Dual relationships Ignoring established conventions Rescue fantasies Becoming friends Romantic relationships Touching Adapted from: College of Dietitians of Ontario and Richard Steinecke. 2008. Jurisprudence Handbook for Dietitians in Ontario. 2 nd Edition. Chap. 10: 114-23.

8. Sexual Misconduct Can be consensual…

9. Sexual Misconduct Can be insidious…

10. Sexual Misconduct Definition can be very broad… XXX

11. Donts Dont make suggestive/ seductive comments or gestures Dont take a sexual history unless indicated Dont comment on a clients body or sex life

12. Donts Dont date a client Dont talk about yourself unless relevant to client care

13. Do

14. Do Document, document, document…

15. Touching a Client

16. Do Obtain client consent Acknowledge the client may change their mind Avoid causing unnecessary hurt Show respect

17. Do Provide a reassuring and relaxed atmosphere Use gloves as indicated Provide explanation throughout procedure Check for level of understanding

18. Do Touch only when necessary

19. How to protect yourself

20. Confidentiality

21. Watch out for… Spouse, family or care giver seeking information Third parties who pay for the treatment seek info for treatment: Blue Cross, WCB, etc. Legal authorities seeking information where refusal may constitute obstruction

22. Do Obtain consent to consult with or share information with other health professionals Respect the clients choice for professional recommendations Appreciate diverse professional perspectives

23. Dos and Donts Pop Quiz Scenario: You hire a client to do your house cleaning… What is the primary concern? a.You are seeing a client in your home b.You should not be paying money to a client c. House cleaning is a demeaning service to perform d.Your dual relationship will create conflicting duties

24. Dos and Donts Pop Quiz If a client expresses a romantic interest in you, which of the following applies? a.There is no boundary crossing unless you respond b.You should transfer the client c.You should politely explain that you can only have a professional relationship with the client d.Tell the client to hold that thought until after treatment is completed

25. Dos and Donts Pop Quiz If a client tells a sexual joke, what should you do? a.Laugh so that the client does not feel bad, but tell the client not to do that again b.Laugh only if no other clients are present, but tell the client not to do that again c.Report the client on a mandatory basis for sexual abuse d.Politely advise the client that such comments are not appropriate in the treatment setting

26. Dos and Donts Checklist 1.Is this in the clients best interest? 2.Whose needs are being served/ met? 3.Could this action affect my services to the client? 4.Could I tell a colleague about this? 5.Could I tell my spouse / partner/ significant other about this? 6.Am I treating the client differently? 7.Is this client becoming special to me?

27. Thank You! Questions? www.collegeofdietitiansbc.org Phone: 604.736.2016 Toll free in BC: 1.877.736.2016