Problematizing Boundaries of Care Responsibility in Caring Relationships

Area of Science:

• Nursing
• Philosophy
• Psychology

Background:

• Nurse-patient relationships can become demanding and, in exceptional cases, destructive.
• Patients may place significant, onerous demands on nurses.

Purpose of the Study:

• To explore the boundaries of care responsibility in destructive nurse-patient relationships.
• To understand how nurses navigate and establish limits when faced with excessive demands.

Main Methods:

• Hermeneutical approach incorporating phenomenological philosophy (Knud E. Løgstrup).
• Analysis of qualitative interviews from an empirical study of 13 nurses in somatic and psychiatric health services.

Main Results:

• Nurses confront onerous demands from patients and must set limits for self-protection.
• Managing patient acting out or opposition to care is experienced as highly unpleasant.
• Destructive caring relationships necessitate clear boundaries to prevent harm to nurses.

Conclusions:

• Boundaries are essential in caring relationships to manage onerous or destructive demands.
• Explicating boundaries protects nurses from unhealthy demands and reduces hazards.
• Examining destructive relationships preserves the status of both nurses and patients.