Professional Boundaries: The Destruction of the Humanity of Nursing?

NurseTogether recently published an article discussing professional boundaries in nursing.  Boundaries have been defined as “the mutually understood, unspoken physical and emotional limits of the relationship between the patient and the nurse.” (Farber, N, Novak, D, O’Brien, M. Love, Boundaries and the Physician-Patient Relationship, Arch Int Med 1997;157: 2291-2294.)

The key to maintaining professional boundaries in nursing is to avoid switching the caregiver role. This can occur when the nurse shares intimate details about the nurse’s personal life, financial woes, or complaints about co-workers or work conditions with a patient.  These seemingly harmless personal details may evoke sympathy from the patient, making the patient want to care for the nurse. The article, linked above, lists 12 warning signs of unhealthy boundaries and discusses situations posing particular problems for nurses.

Legally, the nurse is responsible for maintaining appropriate professional boundaries. Although the Colorado Nurse Practice Act does not by its plain language prohibit professional boundary violations, such boundary violations may represent a failure to meet the generally accepted standards of nursing practice.  A failure to meet the generally accepted standards of nursing practice constitutes unprofessional conduct in Colorado and is grounds for disciplinary action.

What struck me as I read this article were the comments made by nurses who believe that professional boundaries force them to abandon the caring and humanity of nursing.   They discuss being distant and not wanting to share of themselves.  One nurse suggested that patients should be instructed regarding the topics that are “off-limits” with their nurse.

Professional boundaries are intended to protect the patient and to ensure a clear understanding of the nurse/patient relationship.  Professional boundaries are not intended to prohibit a nurse’s caring, compassion, or empathy. But  is that how boundaries are being interpreted in practice?  If so, the professional boundaries intended to protect the patient may just end up destroying the humanity of nursing.

This post is intended as informational only and does not constitute legal advice. If you, or someone you know is engaging in, or is accused of, professional boundary violations, consult with an experienced Colorado Nurse Defender before making any statements.

The Law Office of Karen M McGovern, LLC, is an experienced law firm specializing in criminal and professional license defense. Call 303.260.6444 for a free consultation or contact us through our website – www.mcgovernlawoffice.com.

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Denver Professional License Defense Attorney Karen M. McGovern releases her new website!

Providing insightful, comprehensive defense is always Karen McGovern’s paramount goal. She is well positioned to handle cases involving both state and federal regulatory agencies, as well as those taking place in criminal court. When you retain Karen McGovern, you will never have to feel anxiety over the hassle and expense associated with retaining  two separate attorneys one to defend the criminal charges and another to defend the professional disciplinary action.  Instead, you can feel confident that Karen McGovern will resolve the criminal and disciplinary matters promptly and efficiently.

An active registered Colorado nurse and former assistant attorney general, Karen McGovern is particularly attuned to the needs of nurses facing professional regulation. She has an in-depth understanding of licensing board procedures and will carefully prepare the strongest case possible on your behalf. Prior to any case proceedings, she will discuss with you the potential outcomes of your legal matter and offer insight into how the board might rule.

Visit our website at www.mcgovernlawoffice.com and check out the new format. If you find yourself in need of a Colorado Nurse Defender, call The Law Office of Karen M. McGovern, LLC at 303.260.6444 for a free consultation.

ART IMITATES LIFE

Two of today’s most popular cable TV dramas portray nurses diverting pain killers from the hospital.  And while the storylines of Officer Cooper’s ex-wife, the nurse, stealing pain killers from the hospital to ease his pain, and Nurse Jackie’s appropriating of pain killers from the hospital pharmacy to feed her addiction are easily classified as “theatre,” the diversion of controlled substances by healthcare workers is a very real issue.

The United States Drug Enforcement Administration regulates the storage and distribution of controlled substances. Although most healthcare workers strictly adhere to DEA regulation, there are professionals that divert controlled substances for their personal use, the use of friends or family, or to sell the drugs for profit.

In response to problems with diversion, the DEA has tightened regulations. Now controlled substances and other addictive medications are kept in locked storage cabinets.  These cabinets often require a security code that is individualized to the healthcare worker or scanned fingerprints to access the medication.

Unfortunately, these security measures have directed the diverter’s attention toward the patient’s medication.  In February 2010, a Denver surgical technician was sentenced to 30 years in prison for diverting pain medication intended for patients undergoing surgery.  This technician self-injected the pain medication and then refilled the used syringes with water or saline, placing them on the surgical tray for use on the patient.   The surgical technician was afflicted with Hepatitis C and reportedly transmitted this disease to at least 18 patients through her diversion.

There are serious criminal and professional licensing implications for healthcare workers engaging in, or accused of, the diversion of controlled substances.   A criminal conviction for diversion could result in a prison sentence, and the professional licensing board could seek revocation of your professional license. There are also serious consequences for those practitioners holding a DEA registration, including revocation of that registration.

This post is intended as informational only and does not constitute legal advice. If you, or someone you know is engaging in, or is accused of, the diversion of controlled substances, consult with an attorney experienced in both criminal and professional license defense, a Colorado Nurse Defender, before making any statements or speaking with the police, the licensing board, employers, or even peer assistance.

The Law Office of Karen M McGovern, LLC, is an experienced law firm specializing in criminal and professional license defense.  Call 303.260.6444 for a free consultation or contact us through our website – www.mcgovernlawoffice.com.

The Devil is in the Details

Many of my cases involve nurses facing potential disciplinary action related primarily to their failure to keep up with the “administrative” details required to maintain a nursing license in Colorado.

It is imperative that licensees keep their contact information updated with the Colorado Division of Registrations/State Board of Nursing. The Division/Board mails license renewal information and complaints issued pursuant to section 12-38-116.5 of the Nurse Practice Act to the nurse’s address of record. Both license renewal information and complaints are time sensitive materials and a nurse’s failure to timely respond may constitute unprofessional conduct resulting in disciplinary action against the nurse.

So while you may not consider updating your contact information at the Colorado Board of Nursing to be your first priority when moving or changing jobs, you may want to contemplate the time, costs, and emotional toll involved when faced with potential disciplinary actions against your nursing license for simply failing to be mindful of the details.

This post is intended as informational only and does not constitute legal advice. If you find yourself facing disciplinary action by the State Board of Nursing, please contact an  experienced Colorado Nurse Defender.