Boundaries in Health Settings: A Discursive Paper.

Abstract

All health professionals, including mental health nurses, use professional boundaries to support safe interactions with patients and family members. In contemporary health settings, however, the boundaries between personal, socio-cultural, professional, and virtual settings are not always clear. Boundaries can be explicit or implied, and change according to situation and circumstance. With the normalization of self-disclosure on social media platforms, together with the rise of lived and living experience stories about overcoming health challenges, boundaries between the personal and professional domains have become increasingly complex to negotiate. This discursive review explores the nature of relational boundaries in contemporary health settings and the practical challenges faced by health professionals when establishing boundaries in diverse situations. The paper also considers why boundary transgressions occur, including the notion of boundary creep; together with how boundary-setting can be improved. These improvements include seeking education and professional development opportunities on the issues characterizing contemporary health settings, critically self-reflecting in clinical supervision, clearly delineating boundaries to consumers, and constantly monitoring and calibrating professional boundaries to minimize crossings and transgressions.