Close

Maintaining Professional Boundaries

Maintaining Professional Boundaries

The therapeutic relationship between an RT and their patient/client is one of empathy, trust and respect. It is important to acknowledge that there exists within this relationship an inherent power imbalance. The RT has access to specialized knowledge, and privileged information that the patient/client does not have. The RT also has the ability to advocate on behalf of the patient/client. Therefore, it is essential that RTs respect the relationship they have with their patient/client through effective communication, patient/client centered care and the maintenance of professional boundaries.

In a therapeutic relationship with a patient/client, the best interests of that individual are paramount, unless doing so would endanger the welfare of others. The patient/client’s vulnerability places the obligation on the RT to manage the relationship appropriately. Examples that the RT may be crossing professional boundaries in the RT’s therapeutic relationship are:

9

Disclosing personal problems to a patient/client;

9

Accepting gifts from a patient/client that could potentially change the nature of the relationship and influence the level or nature of care;

9

Spending time outside the therapeutic relationship with a patient/client; or

9

Becoming “friends” on social media.

RTs also have professional relationships with all other members of the healthcare team with whom they interact with as they carry out their duties. In some of these relationships, a power imbalance exists. (e.g., staff RT supervising Student RTs, Charge Therapist overseeing newer staff RTs). It is essential for the RT to adhere to the same standard for the maintenance of these professional relationships as they do in their therapeutic relationships.

An RT, acting in a Clinical Instructor capacity at a teaching hospital, receives a “friend request” on Facebook by a Student RT currently rotating through the hospital. The RRT accepts and they begin an exchange on-line of personal comments and photos. Has the RT crossed the professional boundaries?

The ethical principle involved is to act fairly.

Because an imbalance of power exists between the staff therapists and students, the RT is advised against engaging in a personal relationship with this individual and accepting a friend request. This may violate workplace conflict of interest policies, as well as cross professional boundaries.
An RT who works in a sleep lab is asked out on a date by a patient/client who had been assessed in their lab a week earlier. Has the RT failed to maintain appropriate professional boundaries?

The ethical principle involved is to act fairly.

Unfortunately, even when acting fairly, one can be perceived as otherwise (giving preferential treatment, for example). The RT would violate professional boundaries if the patient/client continues to be cared for at the sleep lab where the RT worked. The only way that a personal relationship would be permissible is if the therapeutic relationship had officially ended, and this must be clearly documented.