Professional Boundary Violations

Professional Boundary violations are a common issue in the world of healthcare.  Boundary crossings are often innocent or well-intentioned. However, any boundary violation may result in unintentional patient harm.   This is why nursing programs spend such a significant amount of time discussing boundaries, the therapeutic relationship, and the multitude of ways a nurse can violate boundaries.

Whether you believe the allegations against you are true or unfounded, a strong legal defense is necessary for the future of your career and your reputation. Having worked as a nurse for 35 years before moving exclusively to the practice of nursing defense law, Barb Forshier is here to help you through these challenging times. Schedule a consultation now by calling Forshier Law at 612-236-5261.

What Are Boundary Violations?

The National Council of State Boards of Nursing goes into great detail about what constitutes a boundary crossing and what constitutes a violation. A crossing is a brief step over the line of appropriate behavior that occurs when a nurse tries to meet a client’s therapeutic needs. They are not violations, but they may be a red flag that future violations may occur.

Violations indicate a prioritization of the nurse’s needs over the patient’s needs. For a nurse, the goal of the therapeutic relationship is to meet the patient’s needs with their specialized training and knowledge. A boundary violation plays on the patient’s vulnerable position and may put them in a position where they are taking care of the nurse, having their own needs ignored, or embroiled in an inappropriate relationship with the nurse.

These violations take many different shapes. Common examples include:

  • A nurse oversharing details about their personal life. This is not always a boundary violation; in a therapeutic relationship, a nurse may share something about their personal life to provide comfort to a patient or show understanding. But when the information is shared for the nurse’s own benefit, it is a violation.
  • The patient providing for the nurse’s needs, either by providing money, keeping secrets for them, or providing emotional support.
  • The nurse becoming too emotionally close to the patient. The nurse may feel that they are the only one who can meet the patient’s needs, show favoritism, spend more time than is necessary with the patient, or keep secrets from the patient’s family.
  • Becoming romantically involved with a patient. Romantic or sexual involvement with a patient is a huge violation that takes advantage of the patient’s dependence on the nurse for medical care. Consent of the patient does not stop this from being a boundary violation. This is a very serious and often results in disciplinary action by the Boards of Nursing. 

Red Flags for Boundary Violations

Knowing the red flags for boundary violations can help you avoid unsafe situations or identify times when you need to step back from a patient’s care. Watch for these signs:

  • Showing favoritism to one patient over others
  • Meeting patients outside of work
  • Keeping secrets with or for a patient
  • Spending more time than is necessary or appropriate with a patient
  • Discussing personal or intimate details of your life
  • A patient attempting to give you money or other gifts because they know of your personal struggles or needs
  • Flirting with a patient or participating in behavior that an outsider might see as flirting
  • Speaking about your workplace or colleagues in a negative light with the patient or their family members
  • Feeling jealous when another nurse is assigned to a patient
  • Believing you are the only one capable of meeting a patient’s care needs

What to Do If You Have Been Accused of Boundary Violations

If you have received a letter regarding allegations of boundary violations, it is important to move quickly. Letters from the Board of Nursing usually have short deadlines for your response and failing to meet that deadline or leaving your response to the last moment can seriously negatively impact your claim. In Minnesota, the first a nurse may become aware of a boundary violation allegation is when a letter is received from the Office of the Attorney General. You will be asked to participate in a recorded investigatory interview. Be sure to seek legal counsel before you speak to them. 

Reach out to  an attorney who specializes in nursing  licensure defense.   It is important to be honest with your nursing license defense lawyer and not hide anything that you fear will make you look bad. An attorney with all of the information they need is better able to craft a strong defense for their client.

When choosing a nursing license lawyer, consider selecting one who focuses exclusively on nursing license defense. While many attorneys offer professional license defense in addition to other areas of practice, working with an attorney who only does license defense, who has devoted their entire career to the wellbeing and protection of healthcare providers will serve you the best. Barb Forshier has had a long career as an RN which has laid the groundwork for her vigorous defense of  nurses. She understands and empathizes with your situation. Not only will she advocate for you, she will educate you on what went wrong and how to avoid future license issues. 

Frequently Asked Questions

When is it safe to date a former patient?

The answer to this question is not cut-and-dry and involves a substantial amount of consideration. First, a patient must be a former patient before any romantic or sexual activity occurs. Under Minnesota state law 609.344, a psychotherapist who engages in sexual conduct with a patient while the therapeutic relationship exists is guilty of criminal sexual conduct in the third degree. Note that under Minnesota law,  nurses are held to this standard as an employee in correctional or secured treatment and certain other facilities. Consent by the former patient is not a defense.

Outside of the legal definitions, the Board of Nursing looks at these nursing board complaints individually. Generally, the more time that passes between treatment and dating, the less likely it is to be a boundary violation. The type of care received is also important. A nurse who sees a patient every day for five years as part of chronic illness treatment will have a different patient-nurse relationship than a nurse who sees a patient once for help with a broken leg.

We’re Here to Help

Never fear accepting the claims against you without defending yourself, especially at the expense of a career you love. Turn to us for the support and representation you need. Schedule a consultation now by calling Forshier Law at 612-236-5261 or reaching out online.