Professional Boundaries and Ethical Conduct
PROFESSIONAL BOUNDARIES
AND
ETHICAL CONDUCT
Debra Scott, MSN, RN FRE
Executive Director
Nevada State Board of Nursing
Understanding Ethics
Principlebased Ethics
Rules, codes, standards
Consequences-
Based Ethics
Outcomes
Professional
Ethics
Virtue (Ideal)
Based Ethics
Character
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
UNDER-
INVOLVED
OVER-
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
Yes
Yes
Identify the behavior
In question
No
Is the behavior consistent within the
ANA Code of Ethics
No
Decision
Making
Framework
Yes
Is the behavior within nursing practice standards from your board of nursing & agency
No
Yes
Yes
Yes
Is the behavior consistent with your duty to always act in the best interest of your client
No
No 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
No
PROCEED WITH THE
BEHAVIOR
Abstain From Behavior
Abstain From Behavior
Abstain From Behavior
Abstain From Behavior
Abstain From Behavior
Abstain From Behavior
DO NOT PROCEED
WITH THE
BEHAVIOR
Questions?
DEBRA SCOTT, MSN, RN, FRE
5011 MEADOWOOD MALL WAY #300
RENO, NV 89502
888-590-6726
NEVADANURSINGBOARD.ORG
REFERENCES
NCSBN. (2007) Professional Boundaries; A nurse’s guide to the importance of
appropriate professional boundaries. Chicago, IL: Web. 2 Mar. 2012
NCSBN. (2009) Respecting Professional Boundaries. Chicago, IL: Web. 2 Mar. 2012
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
