Why professional boundaries with patients is a delicate balance

One of the largest sectors that I work in with professional boundaries work is Healthcare.

Whether it’s in primary care supporting GP Surgeries, pharmacies, dentists or optometrists or in a secondary care setting such as Hospital Trusts or supporting Deaneries and GP Training Schemes, staff have really benefitted from having the time to examine how they can strengthen their boundaries.

It’s only natural to want to build rapport with patients, to support them, being there in the best and worst of times as they navigate their way through the pathway of support that they need.  The problem for the healthcare worker is about how much of the emotion of a situation do they bring away from each appointment.

The role of a guide versus a friend

I speak in the training about the concept of a guide vs. a friend when it comes to good boundaries.  A guide is there to support you, to help provide you with information, to point and signpost the way and enable you to take on the journey resourced and informed.  They can’t walk it for you or carry you up the path, after all they would then take their energy and resources, they are slightly removed from the outcome and yet highly empathetic

A friend is very emotionally invested in the person they are supporting them, loyal to them and often joining them on the journey, carrying them in times of need and being a heavily invested cheerleader.  They also feel a lot of sympathy for the other person.

The focus of attention should always be outwards

Let’s take a look at empathy and sympathy.

“empathy is now most often used to refer to the capacity or ability to imagine oneself in the situation of another, experiencing the emotions, ideas, or opinions of that person.”

“sympathy is largely used to convey commiseration, pity, or feelings of sorrow for someone else who is experiencing misfortune…You feel bad for them … but you don’t know what it is like to be in their shoes.”

It’s important to put yourself in the shoes of a patient to reflect on what’s occurring for them, but always the focus of attention of empathy should be externally directed.  It should be about the other person, what’s happening for them and what they need right now.  And for the person you’re supporting their attention should be inwards on themselves.

How does this create issues?

Problems come when you start directing your focus of emotion and attention inward on yourself, maybe the patient is going through something you or a family member have suffered from, maybe their situation is similar to you now or in the past.  Perhaps the patient is concerned about you rather than themselves.

When this switch happens, it’s a big red flag that your boundaries are affected.  Staying empathetic and avoiding slipping into becoming sympathetic is really important.

We spend time discussing this on the training courses, “how do you balance this in real-life?”. Being a guide is great as a concept but can be hard to hold on to in real life. 

So whether you are in a clinical or non-clinical role, investing in good professional boundaries training will pay dividends on your personal energy levels and the ability to remain focussed externally on the other person, in your role of a guide.

Contact me to discuss if you want 1:1 help, group support or training to get this balance right.