Setting Boundaries with Patients and Family Members

Ever find yourself dealing with an overbearing patient or patient’s family member(s)? This can be a difficult situation for anyone, especially nowadays. The healthcare industry is basically like a huge customer service center and it’s designed to cater to patients, in as reasonable of a way as possible of course. Patients and their families can sometimes make this a bit unreasonable, however… So, what do you do to set boundaries, to help them respect you and your time, and to help them respect the tasks involved with providing them with the best care (and customer service) possible? In this article, we’ll dive into a few tips and suggestions to help guide you in setting these all-too-necessary boundaries while you’re at work.

Firstly, when taking on a new admission or new patient, try to keep your questions short and to the point. Only ask for the information or questions about their conditions that you need to know in order to do your job in the best way possible. One way to make sure you stick to this piece of advice is to review the patient’s chart, progress notes, history and physical, labs, studies, etc. as much as possible before making contact and starting a conversation with the patient and/or family. Of course, this is an ideal situation which doesn’t always happen, but a nurse can wish!

Another basic strategy you can utilize is to enforce your facility’s policies. Whether this pertains to the number, frequency, and hours of visitation or their use of personal protective equipment. It could also extend to the patient and visitors’ conduct and behavior. With that being said, be sure to call for backup when patients and/or family members/visitors refuse to abide by policies. That should include but not necessarily be limited to the charge nurse and director of the unit, security, nursing supervisor, etc. It is not okay for physical boundaries to be crossed in any manner, whether sexually or violently. Call for help ASAP and protect yourself first and foremost. You cannot provide care to your patients if your own health and wellbeing is being compromised by others.

Here are a few last minute tips and pieces of advice. Try to cluster your care so as to reduce the number of times you’re in the patient’s room. The less often you’re in the room, the less chance for encounters there are. This doesn’t mean avoid the patient and/or compromise their care to avoid them…if that’s the case, you need to speak with a supervisor about a possible change in assignment. Additionally, try to have a back-up buddy who can “bail” you out of a situation if you’ve been caught up in their room for too long or who may be able to intervene as a mediator should that become necessary. Lastly, and of course this seems obvious, but avoid sharing personal information about your life with patients and their family. With that being said, this also includes avoiding the sharing of social media information. At times, it may be unavoidable for your patients and their family to know your full name because of the facility’s ID badge style. However, you have the power to restrict your social media accounts, make them private, and approve or deny followers of your accounts.

I hope this discussion has been helpful for the next time you encounter a difficult patient and/or family member or visitor. Until next time, happy studying!

Andra Alyse