college of dietitians of british columbia

College of Dietitians of British ColumbiaCollege of Dietitians of British Columbia

To Do or Not to Do?To Do or Not to Do?

Personal Boundaries for Health Personal Boundaries for Health Care ProfessionalsCare Professionals

Peter Lam, RD, Chair, Patient Relations Committee

To Do or Not to Do?To Do or Not to Do?

To Do or Not to Do?To Do or Not to Do?

To Do or Not to Do?To Do or Not to Do?

Cliché conversation

Reporting facts

Ideas & judgements

Feelings & emotions

Peak communication

Adapted from: College of Physical Therapists of Alberta. Therapeutic Relationships: Establishing and Maintaining Professional Boundaries. www. cpta.ab.ca; accessed 09.16.2008.

What is a Personal Boundary?What is a Personal Boundary?

What is a Personal Boundary?What is a Personal Boundary?

Common Boundaries Crossed…Common Boundaries Crossed…

• Self disclosure• Giving or receiving gifts• Dual relationships• Ignoring established conventions• Rescue fantasies• Becoming friends• Romantic relationships• Touching

Adapted from: College of Dietitians of Ontario and Richard Steinecke. 2008. Jurisprudence Handbook for Dietitians in Ontario. 2nd Edition. Chap. 10: 114-23.

Sexual MisconductSexual Misconduct

Can be consensual…

Sexual MisconductSexual Misconduct

Can be insidious…

Sexual MisconductSexual Misconduct

Definition can be very broad…

XXX

Don’tsDon’ts

• Don’t make suggestive/ seductive comments or gestures

• Don’t take a sexual history unless indicated

• Don’t comment on a client’s body or sex life

Don’tsDon’ts

• Don’t date a client

• Don’t talk about yourself unless relevant to client care

DoDo

DoDo

• Document, document, document…

Touching a ClientTouching a Client

DoDo

• Obtain client consent

• Acknowledge the client may change their mind

• Avoid causing unnecessary hurt

• Show respect

DoDo

• Provide a reassuring and relaxed atmosphere

• Use gloves as indicated

• Provide explanation throughout procedure

• Check for level of understanding

DoDo

Touch only when necessaryTouch only when necessary

How to protect yourselfHow to protect yourself

ConfidentialityConfidentiality

Watch out for…Watch out for…

• Spouse, family or care giver seeking information

• Third parties who pay for the treatment seek info for treatment: Blue Cross, WCB, etc.

• Legal authorities seeking information where refusal may constitute “obstruction”

DoDo

• Obtain consent to consult with or share information with other health professionals

• Respect the client’s choice for professional recommendations

• Appreciate diverse professional perspectives

Do’s and Don’ts Pop QuizDo’s and Don’ts Pop Quiz

Scenario: You hire a client to do your house cleaning… What is the primary concern?

a. You are seeing a client in your home

b. You should not be paying money to a client

c. House cleaning is a demeaning service to perform

d. Your dual relationship will create conflicting duties

Do’s and Don’ts Pop QuizDo’s and Don’ts Pop Quiz

If a client expresses a romantic interest in you, which of the following applies?

a. There is no boundary crossing unless you respond

b. You should transfer the client

c. You should politely explain that you can only have a professional relationship with the client

d. Tell the client to “hold that thought” until after treatment is completed

Do’s and Don’ts Pop QuizDo’s and Don’ts Pop Quiz

If a client tells a sexual joke, what should you do?

a. Laugh so that the client does not feel bad, but tell the client not to do that again

b. Laugh only if no other clients are present, but tell the client not to do that again

c. Report the client on a mandatory basis for sexual abuse

d. Politely advise the client that such comments are not appropriate in the treatment setting

Do’s and Don’ts ChecklistDo’s and Don’ts Checklist

1. Is this in the client’s best interest?2. Whose needs are being served/ met?3. Could this action affect my services to the

client?4. Could I tell a colleague about this?5. Could I tell my spouse / partner/ significant

other about this?6. Am I treating the client differently?7. Is this client becoming special to me?

Thank You!Thank You!

Questions?

www.collegeofdietitiansbc.org

Phone: 604.736.2016Toll free in BC: 1.877.736.2016