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Boundaries and you - bestcareus.com

Boundaries and you March, 2013. Boundaries and you Training for Direct Care Staff Video Supplemental Material Designed to be used with the " Boundaries and You" Video Acorn's End Training & Consulting ( ) Stewartville, MN. & Community Care Staffing Network, Rochester, MN. Para-Professional Boundaries Inventory Take a few minutes to decide if the following activities are appropriate between a healthcare worker (you) and a patient/client, the family, or someone important to the client/family. Discuss with your co- workers and supervisor, circumstances and times when the activities are acceptable. Always Sometimes Never Activities OK OK OK. 1. Accept a gift from a client 2. Give a gift to a client 3. Give your own home address/phone number to a client 4. Go to a meal/break with a client 5. Meet the client after work to go to a movie 6. Give a client a ride to the airport 7. Send a greeting card/letter to a client 8. Discuss a co-worker's behavior with a client 9.

Para-Professional Boundaries inventory Take a few minutes to decide if the following activities are appropriate between a healthcare worker (you) and a patient/client, the family, or …

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Transcription of Boundaries and you - bestcareus.com

1 Boundaries and you March, 2013. Boundaries and you Training for Direct Care Staff Video Supplemental Material Designed to be used with the " Boundaries and You" Video Acorn's End Training & Consulting ( ) Stewartville, MN. & Community Care Staffing Network, Rochester, MN. Para-Professional Boundaries Inventory Take a few minutes to decide if the following activities are appropriate between a healthcare worker (you) and a patient/client, the family, or someone important to the client/family. Discuss with your co- workers and supervisor, circumstances and times when the activities are acceptable. Always Sometimes Never Activities OK OK OK. 1. Accept a gift from a client 2. Give a gift to a client 3. Give your own home address/phone number to a client 4. Go to a meal/break with a client 5. Meet the client after work to go to a movie 6. Give a client a ride to the airport 7. Send a greeting card/letter to a client 8. Discuss a co-worker's behavior with a client 9.

2 Share your own medical/surgical history with a client 10. Provide overnight housing for clients or client's family member(s). 11. Attend a client's (or client's family member's) wedding/. funeral/graduation 12. Visit the client after working hours 13. Recommend the name of a physician to a client 14. Stop at the client's (or family's) home after client dies 15. Borrow money or belongings from a client 16. Lend money or your belongings to a client 17. Discuss with client a fight with your spouse/friend 18. Pick up fast food for a client 19. Baby-sit for a client after work 20. Offer solutions to a client's personal problems 21. Smoke with your client or smoke in a client's home 22. Accept an alcoholic drink from a client Complete the inventory form and then plan to meet with other co-workers and a professional healthcare person such as your nurse supervisor. Your supervisor should help you decide was is and is not acceptable activities. Acorn's End Training & Consulting ( ) Stewartville, MN.

3 & Community Care Staffing Network, Rochester, MN. Likely Scenarios How would you and your agency handle the following situations? These situations are based on real incidents (names have been changed). Aisha is 25 minutes late for a two-hour visit to a client. On her timesheet she indicates she was there for the full two hours. When Aisha asks Hannah, her client, to sign the timesheet Hannah notes the difference in time and reminds Aisha that she was not there for the full two hours. Aisha tells Hannah, "It's not a big deal." Aisha also says to Hannah, "If you don't sign the timesheet I. won't come back and then you will not have anyone to help you.". Marc, a stroke survivor, cannot talk or use his right side. He can feed himself and make his own menu choice. One day, the dietary department sends a whole chicken leg and thigh instead of the meat without the bones. Marc knows from hearing other residents that Carl, the new aide helping him, comes to work hungry, has little money and works two jobs with no dinner break.

4 Marc offers Carl his chicken. Carl eagerly accepts the food, gets a paper towel and sits down to quickly eat it. Ethel's family brings in a box of her favorite chocolate candy. The family asks the staff to give Emily one piece of candy per night. There's enough in the box to last for a month. The next weekend the family notices the box is gone and correctly assumes the staff is taking the chocolate for their own enjoyment. Samantha (a social worker) approaches a Mary Jane (a resident assistant) in an assisted living facility and states, "Agnes needs help getting to the bathroom." Mary Jane replies they will be there as soon as she finishes washing the dishes and mopping the floor. Ben, an aide, shares details about his recent divorce with a client. The client later goes to the Director and asks what the facility is doing to support Ben. Sara, a homemaker who has several residents in a large senior apartment building, is chatting with one of her clients, Sue.

5 During the course of their conversation, Cheryl shares information with Sue about another person living in the building. Cheryl never gives the name of the person she is talking about, but Sue is able to figure out who it is and later confronts this person about the problems they are causing Cheryl. Ralph is a client who knows that Paul, his PCA, needs a new car and doesn't have a lot of money to purchase one. Ralph offers to sell his car to Paul and lets Paul know he can make monthly payments until it is paid off. Olivia is having financial difficulties. She prepares extra food for her client, Grant, and takes home the leftovers every night for her own use. Acorn's End Training & Consulting ( ) Stewartville, MN. & Community Care Staffing Network, Rochester, MN. Boundary Index Complete the following boundary index. Answer each question honestly. Never Rarely Sometimes Often Do you ever have difficulty setting limits with clients? Do you ever spend your own time (time when you are NOT.)

6 Being paid) with a client? Do you ever find yourself relating to clients as you might a family member? Do you feel that you are the only one that understands a client? Have you ever been told that you get too involved with clients or families? Do you feel that other staff members are too critical of your client? Do you ever feel that other staff members are jealous of your relationship with a client? Do you find it difficult to handle the client's unreasonable requests for assistance, verbal abuse or sexual language? Do you think of one particular client when you are away from work? Do you make special exceptions for a particular client that you do not make for other clients? Do you consider the client's needs as top priority or do you sometimes put your needs ahead of the client's needs? Would you want other people to know about your behavior or interaction with the client? When you have concerns about a client, do you discuss them with a co-worker or supervisor?

7 Do you treat some of your clients differently ( stay longer, arrange special times to care for them, share your personal information)? Have you accepted gifts from clients or their family members? Have you given gifts to a client or his or her family members? Do you share secrets with any clients? Modified version of the Exploitation Index (Epstein,1990). If you answered sometimes or often to any of the questions, you should know that this may be a possible area of vulnerability and you may be outside of the professional boundary. At a minimum, you should talk with a supervisor about these areas. If your response is rarely for one or more of the items, you need to determine if the behavior is an isolated event or is suggestive of a pattern of behavior that you should discuss with your supervisor. Acorn's End Training & Consulting ( ) Stewartville, MN. & Community Care Staffing Network, Rochester, MN. Would my Intervention Help? Complete the information below when having trouble deciding if something you would like to do for a family/.

8 Client would be in his or her best interest. There are no right or wrong answers. This tool will help you to see both the positive and negative outcomes of your decisions. After you have finished, you will need to weigh the outcomes to decide whether or not you will complete the helpful tasks. Please talk to a supervisor or another trusted person if you have questions or concerns. Think of a specific client (or family) when completing the information below. 1. I would like to help this client/family to: 2. Do I think this will be a one-time event/request? Why? 3. What are my intentions (the main reason I want to help this client)? A. B. C. 4. What would a trusted co-worker or supervisor think about what I want to do for the client? 5. Assuming he or she is able, what could I do to help the client/family do this without me? Possible positive outcomes for the client/family: Possible negative outcomes for the client/family: _____ Yes, I have decided it would be helpful to the client/family to do this task.

9 _____ No, I have decided it would not be helpful to the client/family to do this task. Acorn's End Training & Consulting ( ) Stewartville, MN. & Community Care Staffing Network, Rochester, MN. Boundary Guidellines Employers have a responsibility to let staff and clients know what is and is not appropriate behavior in the workplace. Employers also' need to establish guidelines to protect the health and safety of clients and staff. General appropriate for home care agencies, housing with services and long-term care setting include: Employees should not: 1. Accept personal favors, gifts or money from clients or families. 2. Accept or keep credit cards or other valuables of clients or their family members. 3. Sell items to clients or families. 4. Lend money, vehicles, equipment or a'.nything else to clients or families. 5. Borrow money, vehicles, equipment or anything else from clients or families. 6. Co-sign a loan for clients or their family members.

10 7. Give rides to clients or their family members (unless specifically approved by a supervisor). 8. Buy or trade possessions from clients !or families. 9. Have romantic or sexual relationships:with clients or their family members. 10. Verbally or physically abuse, threaten, or sexually harass clients or their family members. Observance of any such behavior is to be immediately reported to the supervisor. 11. Tolerate verbal or physical abuse, thr$ats, or sexual harassment from clients. Such abuse/behavior should be immediately reported to the supervisor. NOTE: Any behavior that is destructive or harmful to the client or the organization or has the appearance of a conflict of interest is prohibited. Prevention and Intervention Employers and employees are responsible for reducing the potential for boundary violations. As a healthcare worker, you are responsible to: Tell clients what you will be doing for them. Set clear limits in advance about what you can and cannot do for the client before the potential situation arises.


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