How do you maintain boundaries with patients in distress?

As a patient advocate, you may encounter situations where patients are in distress, whether due to physical, emotional, or social factors. While it is important to empathize and support them, it is also essential to maintain healthy boundaries that protect your own well-being and professional integrity. In this article, you will learn some tips on how to do that effectively.

1 Identify your role and limits

The first step to setting boundaries is to clarify your role and limits as a patient advocate. You are not a therapist, a friend, or a family member. You are a trained professional who can help patients navigate the healthcare system, access resources, and communicate their needs and preferences. You cannot solve all their problems, nor should you take responsibility for their outcomes. Be honest and realistic about what you can and cannot do, and communicate that clearly to the patients.

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Nikko Paolo Bautista, IE, MMHoA, FISQua

FISQua-Quality&Safety | Data Privacy | Digital Transformation | Risk and Compliance | Governance | Open Network LION
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It is important that you have your Quality Department where you have a patient experience officer or related key position that handles in dealing with patients concerns in their care in the hospital. Also if you have such key personnel, it is important that if things start to escalate in a situation that could interrupt the operations, you should document the concern and have your patient experience officer or related key personnel take over the situation in order to avoid disruption of services. #qualityhealthcare #patientsafety #patientexperience

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2 Practice self-care and resilience

Working with patients in distress can take a toll on your mental and physical health. You may experience compassion fatigue, burnout, or vicarious trauma. To prevent or cope with these effects, you need to practice self-care and resilience. This means taking care of your basic needs, such as sleep, nutrition, and exercise, as well as finding ways to relax, recharge, and cope with stress. You may also benefit from seeking support from your colleagues, supervisors, or professional counselors.

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Indiana Womack

State-certified Peer providing housing advocacy, crisis intervention, and other behavioral health services
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As many of us in the helping professions are oriented towards others' needs, it can feel difficult, wrong, or selfish to take time for yourself. For myself, I found it helpful as a new healthcare worker when my counselor told me: Practicing self-care is a way to protect your ability to serve your clients. Although the desire to care for yourself independently is a healthy one, if you are struggling to want that, examine whether you can relate it back to your values and goals. Thinking of it as a necessary ingredient to the services I provide helped me to get over the mental hump and place self-care higher in my priorities.

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3 Establish and enforce boundaries

Once you have identified your role and limits, and practiced self-care and resilience, you need to establish and enforce boundaries with the patients. Boundaries are the rules and expectations that define how you interact with them, such as when, where, and how often you communicate, what topics you discuss, and what behaviors you accept or reject. Boundaries help you respect your own needs and values, as well as those of the patients. To establish boundaries, you need to be clear, consistent, and respectful. To enforce boundaries, you need to be firm, assertive, and respectful.

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4 Recognize and respond to boundary violations

Sometimes, patients may violate your boundaries, either intentionally or unintentionally. For example, they may call you outside of working hours, ask you for personal favors, or share inappropriate information. When this happens, you need to recognize and respond to the boundary violations. Depending on the situation, you may need to remind the patient of the boundary, explain the consequences of violating it, or end the interaction. You may also need to document the incident and report it to your supervisor or the appropriate authority.

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Nikko Paolo Bautista, IE, MMHoA, FISQua

FISQua-Quality&Safety | Data Privacy | Digital Transformation | Risk and Compliance | Governance | Open Network LION
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In terms of boundaries, the Quality Department should be active in developing clearly the policies and procedures that should incorporate the concepts of person-centered care wherein we provide what matters most to the patient but at the same time the patient should also respect the rights of the healthcare staff who is taking care of him/her. Despite the development of the policies and procedures, it is important that the Quality Department develop programs for cascading and dissemination together with a training program to instill in them the process in responding and understanding boundaries that should not be violated by the patient. #qualityhealthcare #patientsafety #patientexperience

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5 Seek feedback and guidance

Setting and maintaining boundaries is not always easy or straightforward. You may encounter challenges, dilemmas, or conflicts that require feedback and guidance. For example, you may be unsure how to handle a complex or sensitive case, or you may face ethical or legal issues. In these cases, you should seek feedback and guidance from your peers, mentors, supervisors, or experts. They can offer you advice, support, or referrals that can help you improve your skills and resolve the situation.

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6 Review and adjust your boundaries

Finally, setting and maintaining boundaries is not a one-time event, but an ongoing process. You may need to review and adjust your boundaries as your role, goals, or circumstances change. For example, you may need to change your boundaries if you switch to a different setting, population, or specialty, or if you face a personal or professional crisis. You may also need to adjust your boundaries based on the feedback and guidance you receive, or the outcomes and impacts you observe. Reviewing and adjusting your boundaries can help you stay effective, ethical, and healthy as a patient advocate.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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How do you maintain boundaries with patients in distress?

1

2

3

4

5

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1 Identify your role and limits

2 Practice self-care and resilience

3 Establish and enforce boundaries

4 Recognize and respond to boundary violations

5 Seek feedback and guidance

6 Review and adjust your boundaries

7 Here’s what else to consider

Patient Advocacy

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How do you maintain boundaries with patients in distress?

1

2

3

4

5

6

7

1 Identify your role and limits

2 Practice self-care and resilience

3 Establish and enforce boundaries

4 Recognize and respond to boundary violations

5 Seek feedback and guidance

6 Review and adjust your boundaries

7 Here’s what else to consider

Patient Advocacy

Rate this article

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