Kathryn Owens

Congratulations to Kathryn Owens, CHT, recipient of the 2011 Wesley Watkins Scholarship Award

“What are the Professional Boundaries in the Dialysis Clinic?”

Professional boundaries in the dialysis clinic is one of the most difficult and misunderstood topics that we face in caring for our dialysis patient. I believe this is due, in part, to the fact that we see each other so frequently and we get to know one another quite well.

It is our job as health care providers in the dialysis unit to help our patients feel comfortable and safe, to educate, to encourage and to support them. It is not our job to be their best friend, complicate matters, or in any way make them feel we value one patient over another. A care giver may feel naturally drawn to certain patients. Each patient should be treated equally and fairly in spite of any connection we might feel toward a particular patient.

Favoritism also should not be shown to the patients who are easier to get along with. When favoritism is shown, it may cause others to feel insecure and uncomfortable. Some examples of showing favoritism might be giving and receiving gifts or cards, becoming “friends” on Facebook, sharing phone numbers, and borrowing or loaning items. Experience proves that patients hear and see everything that goes on in the clinic, and they know when this takes place.

Yet another area where professionalism is often breeched is with ones co-workers. It is imperative to never speak badly of another staff member, especially in the hearing of a patient. When a patient is questioning the competence or judgment of a staff member, they should be directed to the proper person to whom they should report their concerns. Do not be enticed to give your opinions about their particular situation.

Patient confidentiality has received a lot of attention over the last few years. This is another area to maintain your professionalism at all times. HIPPA (Health Insurance Portability and Accountability Act) regulations are very clear on the boundaries that should not be crossed in this regard. Each individual unit should have policies and procedures in place as well.

Dealing with loud, unhappy and sometimes hostile patients can also test ones professionalism. Approaching an upset patient in a quiet, calm, yet confident manner sometimes helps diffuse the situation. Some good responses to dealing with an upset patient might be listening without giving your input, and then knowing when to turn the situation over to your LMSW, Charge Nurse or clinic manager if it becomes apparent they are not deescalating. Do not let your emotions dictate your response. This usually does not help the situation.

We, as health care providers in the dialysis clinic, have the unique opportunity to take a difficult situation (being on dialysis) and to help our patients survive, and hopefully thrive, while maintaining a professional approach to this challenge. Are you up for it?

Submitted by Kathryn Owens, CHT

BONENT member since 1996

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