Nurse-patient relationship boundaries and power: A critical discursive analysis

Area of Science:

• Nursing
• Mental Health Care
• Psychology

Background:

• Nurse-patient relationships involve inherent power imbalances, requiring nurses to manage professional boundaries.
• Ethical guidelines provide a framework, but context-specific boundary setting is crucial for nurses.
• Understanding professional, personal, and private roles is key in mental health nursing.

Purpose of the Study:

• To explore how mental health nurses define their professional, personal, and private roles.
• To investigate nurses' experiences with maintaining professional boundaries in practice.
• To understand the implications of nurses' boundary perceptions on therapeutic relationships.

Main Methods:

• Critical discursive psychological analysis was employed.
• Data collection involved participant observations, individual interviews, and focus group discussions.
• The study included 16 mental health nurses from specialist and community settings.

Main Results:

• Nurses define professionalism as prioritizing patient needs, incorporating personal engagement while maintaining privacy.
• Maintaining professional boundaries presents challenges due to their subjective nature and patient variability.
• Boundary management can either reinforce or reduce the power differential in nurse-patient interactions.

Conclusions:

• Personal engagement is integral to professionalism in mental health nursing.
• Nurses face complex dilemmas when establishing and maintaining professional boundaries.
• Effective boundary management is essential for navigating power dynamics in therapeutic relationships.