Ethics Of Professional Boundaries Term Paper Examples

Introduction

Boundaries, according to the Code of Ethics for Registered Nurses [CORN] (Canadian Nurses Association [CNA], 2008), are points in the “nurse-person” (i.e. professional-client) relationship that should not be allowed to change in order to avoid changes in the professional therapeutic relationship to an unprofessional and personal kind. The South Dakota Chiropractic Association (2007) defined it as “limits” for “safe connections” between people. In general, though, these boundaries pertains not merely to relationships but to professional ethical boundaries as well wherein the prescribed professional objectives (e.g. patient care or student education) become diverted and the professional relationship rendered ineffective or objectively biased.
Contextually, boundaries are about limits. Thus, this paper focuses on the professional limits and personal boundaries in the nursing and teaching professions, two crucial care professions that possess significant impacts on persons whether negatively or positively. The first section will discuss some, not all, professional and personal boundaries in the nursing practice based on the CORN of the CNA (2008). The second section will cover corresponding areas based on the Code of Professional Conduct for Teachers (CPCT) that The Teaching Council [TTC] (2012) as updated. The third section attempts to compare the two professional codes in terms of similarities and contrasts in their respective boundaries.

Ethical boundaries of nurses

In the CORN, the CNA (2008) provided clear guidelines for nurses’ behavior and decision making in different ethical experiences and situations (e.g. ethical problems, ethical uncertainty, and ethical dilemmas). First, the CORN sets a line between nurses and other healthcare professionals who may create conditions that are unsafe to patients due to non-compassionate, and unethical or incompetent behaviors. Section A, number 4 directs nurses, who find themselves in such a situation that already interfere with their ability to discharge their duty, to question and intervene in order to correct the unsafe conditions. They are also required to support fellow nurses who follow this rule. This prescription is reiterated in Section B, Number 6, which considers the action of others as a compromising factor beyond their control.
Second, the Code requires nurses to admit their mistakes that result to an adverse event; and take all actions needed to either prevent or minimize the harm (Section A, Number 5). It is a professional intellectual boundary that nurses need to recognize and respect so as to ensure patient safety protection despite competence limits. Going beyond this boundary can jeopardize the safety of the patient, which already violates Section A (“Providing Safe, Compassionate, Competent and Ethical Care”).
Third, in situations of conflict between community health rules and the patient’s rights to receive care, the Code requires nurses to take a balanced approach that does not violate the community’s rules while responding to the patient’s rights to care. In Section B, Number 2, nurses are expected to find the “least restrictive” healthcare approach given the situation. This advocates respect of the community laws and the patient’s rights.
Fourth, although required to openly, accurately, and transparently communicate health information to concerned patient or groups, nurses, the Code expects, should respect wishes not to be informed of health conditions or to defer decision making to family or community values. Numbers 2 and 3 of Section C requires that nurses differ the rule of transparent communication to explicit patient wishes. This guideline is consistent with Number 8 even in patient choice of lifestyle or treatment not favorable to good health.
Fifth, the Code (Section D, Number 3 and 5) also promotes the respect of the patient’s dignity, integrity, and privacy, including cultural uniqueness (e.g. values, customs, and spiritual beliefs), social and economic circumstances, and right for non-intrusion. Number 4 expects nurses to report violations of this kind.
Sixth, Section D, Number 7 covers the rule on professional boundaries, which prohibits the exploitation of patient vulnerability, trust and dependency for personal or personal gain, especially when such behavior may compromise the therapeutic relationship. This rule includes the prohibition for entering into personal relationships (e.g. romantic, sexual, etc.) with the patients.
Seventh, Section G, Number 3 and 4 expects that nurses should practice only within the limits of their competence and fitness to practice. Beyond their competence, nurses must seek the needed information or help from someone competent. Lack of needed physical, emotional, and/or mental capacity to practice safely and competently should be ground for not practicing even temporarily. Number 5 expects that colleagues violating these rules be reported or nurses take actions to protect the patient from such colleagues.

Ethical boundaries of teachers

The Code of Professional Conduct for Teachers (CPCT) that the TTC of Ireland (2012) established emphasized the key professional role of teachers as educators. It prescribes four central ethical values in the profession: respect, care, integrity, and trust. However, it recognizes seven factors that are beyond the teachers’ professional control, which can be categorized into three areas: (a) engagement factor (e.g. with parents, the community, and with students); (b) resource factor (e.g. availability); (c) educational factors (e.g. opportunities for professional development; rapid changes in the profession); and environmental factors (e.g. legislations, economy, society, etc.).
First, the CPCT makes it clear, in Section 2.5, that teachers should “avoid conflict between their professional work and private interests,” which can potentially compromise the teacher-student relationship. Second, Sections 3.3 through 3.10 clearly limits any personal behaviors of teachers when such could violate legal precepts (e.g. legislations, school policies, etc.) and jeopardize the student welfare, such as ineffective communication with stakeholders (e.g. students, colleagues, parents/guardians, school management, etc.), inappropriate behaviors, carrying illicit materials (e.g. images), and working under the influence of any substance that ruins “fitness to teach.”

Similarities and Contrasts

Similarities: The primary similarities between the CORN (CAN, 2008) and the CPCT (TTC, 2012) rest on its commonality of purpose in caring for their respective clientele (that is, patients and students/pupils, respectively) with professionalism, integrity, respect (e.g. of clientele diversity), and mutual trust. Despite the differences in contexts, both professions are expected to ensure the safety of their charges against the limit of their competence and from unsafe colleague behaviors. Both professions are also empowered to report on colleagues whose behavior constitutes potential risks to the clientele [CORN Sec. A, No. 4; CPTC Sec. 3.5]. However, the CPTC is only implicit in the reporting part. Both codes also agree on the hazards of interest conflicts [CORN Sec. D, No. 7; CPCT Sec. 2.5].
Differences: Despite the important similarities between the CORN (CAN, 2008) and the CPCT (TTC, 2012), important differences do occur. First, the CPCT has less major boundaries compared to the CORN. In fact, there are boundaries of unclear definition in the CPCT. For instance, Section 3.5 prescribes the reporting of threats or adverse events related to students. Unlike CORN, it only implies reporting on inappropriate and unsafe colleague behavior towards students.
Second, both codes recognize situations of unavailability of adequate resources and support in effectively performing respective jobs. However, CPCT included this as factors ‘beyond control’ of teachers without prescribing concrete options in handling the situation. It is also assumed that support from the organization or the team may not be available at times. Conversely, the CORN presumes that support to nurses who reached competency limit is always available on demand either from the institution or from other members of the team. It the situation of insufficient resources, CORN prescribed a course to follow.
Third, and finally, both codes recognize the limits of competency in every professional care providers, beyond which continued participation in the care could put the clientele to unnecessary risks. The CPCT, however, accepted it resignedly with no prescriptive actions to pursue in correcting this educational boundary. There is an underlying presumption of ‘take it, or leave it’ attitude towards the clientele when it comes to competency limits of teachers. The CORN, conversely, is more proactive and clear-headed. It expects nurses to seek the help of their supervisors who are expectedly more competent than them in taking over the discharge of their duties.

Conclusion

It is beyond dispute that the CORN (CAN, 2008) provides a clearer, more specific, and essentially practical set of guidelines compared to that of the CPCT(TTC, 2012) with regards to setting boundaries in the nursing and teaching professions, respectively. Moreover, the CORE provides more boundaries to nurses that CPCT to teachers. This may explain the violation cases in the UK (Henley, 2000), for instance.
Thus, the one essential difference between the CORN and the CPCT is their authorship. The CORE emerged from the efforts of the CNA while the CPCT from the regulatory initiative of TTC, which may explain the differences in specificity and concreteness of actions to be taken in specific circumstances. The CNA is motivated to provide the clearest guidelines possible for their colleagues in the profession; while the Teachers Council has regulatory enforcement in mind, which allows it to be more general in prescriptions and perhaps as an attempt to avoid at being more specific in expectations. While professional contexts may differ, CPCT could have been framed more clearly so as to provide a more practical set of guidelines for teachers in caring for students.

References

Canadian Nurses Association. (2008, June). Code of ethics for registered nurses (2008
Centennial Edition). Ottawa, ON. Retrieved from http://www.cna-aiic.ca/~/media/cna/files/en/codeofethics.pdf
Henley, J. (2009, September 23). “Blurred boundaries for teachers.” The Guardian. Retrieved
South Dakota Chiropractic Association. (2007). “South Dakota chiropractic professional
boundaries training.” DC Online. Retrieved from: http://www.dconline.cc/SDCA_%20PB_Training2.htm
The Teaching Council. (2012, June 19). Code of professional conduct for teachers (2nd
Edition). Ireland. Retrieved from: http://www.teachingcouncil.ie/_fileupload/Professional%20Standards/code_of_conduct_2012_web%2019June2012.pdf