NewsLine - October 2011 - (Page 2)
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what happens in the patient’s home. Relationships often play out much differently than those which develop in a more public arena. There are, of course, serious boundary violations that can lead to criminal prosecution and legal liability. While these violations will be addressed in this article, they are the easy ones to spot and, in reality, are the most straightforward to deal with. So this article will focus more on the less-obvious boundary violations. The ones that are apt to elicit responses like “I don’t really see anything wrong with that” or preferably, “Ah… I never thought about it that way.” They are also based on real situations that I have learned about as different hospices have sought help in dealing with this difficult and prevalent problem (with names and other identifiers changed to ensure confidentiality).
to them when they come to understand this. Let’s take Paul for example: Paul is a hospice clinical social worker. For some reason that is not clear, Paul’s elderly patient wants to give Paul an extra computer printer that he has. When Paul comes to visit, the patient has the printer packaged in a box and ready for him. Paul accepts the gift without reservation. He doesn’t really need a printer, but if he doesn’t find a use for it, he will just give it to his neighbor who has three school-aged children. It seems innocent enough—after all, it is just a computer printer. However, several days later, the patient’s son calls the executive director of the hospice for which Paul works and is nothing short of irate. He tells the executive director that he just found out his father has given one of the staff the computer printer and in the box, along with it, was $100 in cash. The son wants the money and the printer returned immediately. Put yourself in the executive director’s shoes. Paul stated there was no money in the computer box and, from all of your dealings with Paul, you have no reason not to believe him. However, he didn’t report the gift to his supervisor,
so she had no idea that this situation had even occurred. He did not open the box in front of her or anyone else, so there is no verification that the box only held the printer. Consequently, there is no way for hospice leadership to defend the staff member. Had Paul been better able to maintain professional boundaries, his actions may have been easier to defend and he would have been better protected. To Protect the Patient All patients are vulnerable on many different levels. Keeping the relationship professional will protect patients and their families from being exploited during their time of vulnerability. To Protect the Agency Protecting the agency from professional liability issues is important, but it is equally important to protect the agency’s reputation. If a staff member violates professional boundaries and there is a misunderstanding or hard feelings, the agency’s reputation can suffer. The family Paul was caring for was very upset and financial restitution had to be made. However, the damage to the agency’s reputation was far greater than the $100 that had to be repaid.
The 3 Reason We Need Professional Boundaries
To Protect the Clinician While many clinicians will view boundaries as restrictive, confining, and just more rules to follow, professional boundaries are necessary to help protect them. I have found that clinicians are more likely to pay attention
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