Guidelines: Professional Boundaries

This guideline has been developed by Te Kaunihera Tapuhi o Aotearoa/ Nursing Council of New Zealand (“the Council”) to provide advice to nurses (and the public) on nurses maintaining appropriate professional relationships with health consumers. Nurses must be aware of their professional responsibility to maintain appropriate personal, sexual and financial boundaries in relationships with current and former health consumers and their families.

The role of the Council is to protect the health and safety of the public by setting standards of clinical competence, ethical conduct and cultural competence for nurses1. The Code of Conduct for nurses (Nursing Council of New Zealand, 2012) sets standards of professional behaviour that nurses are expected to uphold. It is expected that nurses maintain these standards of conduct within their professional practice and, to some extent, within their personal lives. The Code of Conduct for nurses, together with the competencies for nursing scopes of practice2 and other Council guidelines, provide a framework for safe and responsible nursing practice that protects public safety.

This guideline contains standards of behaviour from the Code of Conduct for nurses and more detailed advice on professional boundary issues and how they should be managed. It is not possible to provide guidance for every situation and nurses must develop and use their own professional and ethical judgment and seek the advice of colleagues and/or their professional organisation when issues arise in relationships with health consumers.

Different cultures may have different expectations, and understanding of relationships and boundaries. Culturally safe nursing care involves balancing power relationships in the practice of nursing so that every health consumer receives effective treatment and care to meet their needs that is culturally competent and culturally responsive.

Aotearoa/New Zealand is a small country and this guideline has been developed recognising that nurses are members of their communities and may have existing relationships with some health consumers. The Nursing Council is aware that for Ma ori and others, establishing connections and relationships of trust, are an important element of providing culturally safe care. The principles of the Tiriti O Waitangi/Treaty of Waitangi, partnership, protection and participation, are integral to providing appropriate nursing services for Ma ori. This guideline provides advice on professional boundaries when working with Ma ori health consumers.

This Guideline and the Code of Conduct for nurses contain the Council’s advice on professional boundaries. Documents developed in a joint project with the Australian Nursing and Midwifery Council (see references) have contributed to this guideline. The Council has further developed this guidance to recognise the context of nursing in Aotearoa/New Zealand and include more specific advice on sexual relationships with health consumers.