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Professional Boundaries
What Are Professional Boundaries?
Clearly established limits that allow for safe connections between service providers and their
patients
“Being with” the patient, not becoming the patient
Being friendly, not friends
The ability to know where you end and the patient begins
A clear understanding of the limits and responsibilities of your role as a service provider
The Importance of Boundaries
Role modeling to the patient healthy communication and professional relationships
Avoiding the “rescuer” role
Staying focused on one’s responsibilities to the patient & the provision of helpful and
appropriate services to the patient
Avoiding burn-out (“compassion fatigue”)
If working in conjunction with other services providers: maintaining a healthy, open,
communicating and functioning team
Maintaining one’s physical and emotional safety
Consequences of Having Loose/Poor Boundaries
Compassion fatigue – the service provider’s role may not feel sustainable
Potential for “splitting” on teams
Patient may not be given appropriate or helpful services, which could affect his/her
willingness to accept future services
Patient may feel betrayed, abandoned, and/or poorly served
Service provider may act unethically
The reputation of the service provider’s agency and/or profession may be compromised
Service provider and/or patient may be emotionally traumatized and/or put in physical danger
Techniques for Creating & Maintaining
Healthy Professional Boundaries
As early as possible in the relationship (ideally at your initial meeting/intake/ assessment),
establish clear agreements with the patient regarding your role as a service provider, your
availability, best ways to communicate with you, and what to do if you see one another in
public.
When boundary issues or warning signs appear, address these issues with the patient quickly.
Be sensitive to their feelings when doing this; emphasize the importance of and your
commitment to maintaining healthy boundaries.
Self-disclosure: if you do decide to tell a patient something personal about yourself, ensure
that the information is related to the patient’s goals. Too much self-disclosure shifts the focus
from the patient to the service provider and can confuse the patient in terms of roles and
expectations of the relationship.
Realize that how a patient interprets your words and actions might not match what you were
trying to communicate. With these sensitive relationships, you may need to frequently clarify
your role and boundaries and ask the patient to repeat back what you said to ensure that
he/she understands. This will also give the patient an opportunity to ask clarifying questions.
Use your supervisor, professional colleagues and/or a mental health professional as a sounding
board when you have questions or concerns regarding boundaries, and especially when
boundary issues are impacting your ability to provide objective, compassionate care. Also
consult with your supervisor or professional colleagues if you are feeling uncomfortable
about talking with your patients about boundaries.
Dual relationships: If you had a personal relationship with a patient before becoming the
patient’s service provider, realize that you must use your professional judgment when
interacting with the patient in social settings. Pay particular attention to the patient’s
confidentiality as well as his/her physical and emotional security. Situations in which one
person is in a position to hold power over the other person must be avoided if at all possible.
For supervisors: Recognize that questioning someone’s boundaries can create defensiveness.
Rather than instructing someone to “have better boundaries”, use open-ended questions to
help the service provider identify for him/herself that his/her work would benefit from the
establishment of clearer boundaries.
If you are working with a team of service providers, remember to promote and role model
positive, open communication and respectful sharing of information. Trust that team members
are fulfilling their roles as service providers, and remember that you can’t (and shouldn’t) “do
and be everything” for your patient.
Take care of yourself! Make sure you are getting enough sleep, eating well, spending time
with friends and family, exercising, seeking supervision as needed, and “leaving work at
work” to the greatest extent possible.
Medical Abbreviations
Abbreviation Word
Ă Before
@ At
ABD Abdominal
ABN Abnormal
Ac Before meals
Accep Acceptable
Adeq Adequate
ADL Activities if Daily Living
AKA Above knees amputation
ALZ Alzheimer Disease
Am Morning
Amb Ambulate
Amt Amount
AP Apical
A & PROM Active & Passive Range of motion
Approp Appropriate
Appt Appointment
ASA Aspirin
ASAP As soon as possible
ASHD Arterioclerotic Heart Disease
Assist Assistance
Assoc Associated
B & B Bed & Bath
Bg Blood Glucose FSBS
Bid Twice a day
Bilat Bilateral
BKA Below knee amputation
BM Bowel movement
B/P Blood pressure
BR Bathroom
BRP Bathroom privileges
BS Bowel sounds
BSC Bedside commode
BUN Blood urea nitrogen
C With
CA Cancer
CAD Coronary artery disease
Cap Capsule
Cath Catheter
CBC Complete Blood count
CBD Common bile duct
CBG Capillary blood glucose
Cc Cubic centimeter
CHF Congestive heart failure
Cg Caregiver
Cl Chloride
Cm Centimeter
CN Cranial nerve
c/o complains of
Constip Constipation
Coord Coordinated(d)
Cont(d) Continued(d)
COPD Chronic obstructive pulmonary disease
CPR Cardiopulmonary resuscitation
CPT Chest physio therapy
CRF Chronic renal failure
C & S Culture and Sensitivity
CSF Cerebrospinal fluid
CT Cat scan
CTA Clear to auscultation
CVA Cerebral vascular accident
CXR Chest X ray
D/C Discharge
d/c Discontinued
D & C Dilation & curettage
Decub Decubitus
Diam Diameter
Dimin Diminished
DJD Degenerative Joint Disease
DM Diabetes Mellitus
DME Durable Medical Equipment
DNR Do not resuscitate
DOE Dyspnea on exertion
Dr./MD Doctor
Drsg Dressing
DSD Dry sterile dressing
DTR Deep tendon reflex
DX Diagnosis
eg For Example
elim Elimination
EOM Extraocular movement
ER Emergency Room
ESRD End Stage Renal Disease
ETOH Alcohol
eval Evaluate
exac Exacerbation
exam Examination
exer Exercise
F Female
fc Foley catheter
FOB Foot of Bed
Fr French
Freq Frequency
FSBS Fingerstick Blood Sugar
f/u Follow up
FUO Fever of unknown origin
FWB Full weight bearing
FX Fracture
GB Gallbladder
GI Gastrointestinal
gm Gram
gr Grain
GT Gastrostomy tube
gtt Drop
Gt Tr Gait Training
GU Genitourinary
GYN Gynecology
HBP High Blood Pressure
H & H Hemoglobin & Hematocrit
HH Home Health
H2O Water
H2O2 Hydrogen Peroxide
HA Headache
HHA Home Health Aide
HHN Handheld nebulizer
HIV Human Immunodeficiency Virus
hx History of
HOB Head of Bed
HOH Hard of hearing
H & P History & Physical
hr or h Hour
hs Hour of sleep, bedtime
HTN Hypertension
Hx History
Hydra Hydration
ident Identify(ied)
IM Intramuscular
inj Injection
J tube Jejunostomy tube
I & O Intake & Output
IV Intravenous
K+ Potassium
Kg Kilogram
KVO/TKO Keep vein open
L Left
lab Laboratory
lac Laceration
lb Pound
LE Lower extremity(ies)
LFT Liver Function Test
lg Large
liq Liquid
LLE Left Lower extremity
LLL left Lower lobe
LLQ Left Lower quadrant
LOC Level of Consciousness
LPN License Practical Nurse
LPT License Practical Nurse
LPT Licensed Physical Therapist
LCTA Lungs clear to auscultation
LTG Long term goal
LUE Left upper extremity
LUL left upper lobe
LUQ left upper quadrant
LPN Licensed Practical Nurse
M Male
MAE(W) Moves all extremities well
Max Maximum
mcg microgram
Med(s) Medications(s)
Meq Milliequivalent
mg Milligram
mgmt Management
MI Myocardial infarction
min Minute/minimum (based on context)
ml Milliliter
mm Millimeter
mod Moderate
MOM Milk of magnesia
MR Mental Retardation
MRSA Methicillin resistant Staphylococcus aureas
MSW Medical Social Worker
MT Mobility Training
MVA Motor Vehicle Accident
NA Sodium
na Not applicable
NACL Sodium Chloride
n/c No complaints
NCP Nursing Care Plan
Neb Nebulizer
neg Negative
NKA No Known Allergies
NKDA No Known Drug Allergies
no. or # Number
noc Nocturnal
NPO Nothing by Mouth
NS or N/S Normal Saline Rhythm
NTG Nitroglycerin
n/v Nausea & Vomiting
NWB No Weight Bearing
O2 Oxygen
OASIS Outcome and Assessment Information Set
OB Occult Blood
Obs Observation
occ Occasional(ly)
OD Right Eye
oint ointment
OOB Out of Bed
OS Left eye
OT Occupational Therapy
OU Both eyes
oz ounce
PAC Professional Advisory Committee
P Pulse
p after
pc after meal
PCC Patient Care Coordinator
PCN Penicillin
PICC Peripherally Inserted Central Catheter
Per Through or by
PCS Patient Care Supervisor
perf perform
PERL Pupils equal & reactive to light
PERRLA Pupils equal, round, reactive to light accommodation
pers Personal
PI Performance Improvement
pm Night or evening
PN Progress Note
PO by mouth
POC Plan of care
prec Precautions
PRN As needed
prog Program(s)
PROM Passive Range of Motion
POT Plan of Treatment
PHC Primary Home Care
PP Private Pay
prog Progress
pt Patient
PTA Physical Therapy Assistant
PUD Peptic Ulcer Disease
Pulm Pulmonary
PWB Partial Weight Bearing
PT Physical Therapy/ Protime (based on content)
QA Quality Assurance
q Every
qam Every morning
qh Every hour
qhs Every night
qid Four times a day
qpm Every night
quant Quantity
Re: Regarding
rec Receive
recert Recertification
rehab Rehabilitation
req(s) Require(s)
Resp Respiration
Rt Right
RBC Red Blood Cells
RLE Right Lower extremity
RLL Right Lower Lobe
RLQ Right Lower Quadrant
RML Right Middle Lobe
RUL Right Upper Lobe
RN Registered Nurse
R/O Rule Out
ROS Review of systems
ROM Range of Motion
RSR Regular Sinus Rhythm
RUE Right Upper Extremity
RUL Right Upper Lobe
RUQ Right Upper Quadrant
Rx Prescription
s without
s/e Side Effects
SL Sublingual
SOB Short of Breath
SOC Start of Care
soln Solution
SNF Skilled Nursing Facility
S/P Status Post
spec specimen
SQ Subcutaneous
s/s signs & symptoms
ss half
ST Speech Therapy
STG Short-term goal
stat immediately
str Strength
superv Supervise
supp Suppository
Sx Symptom
SWA Social Work Assistant
sz seizure
T Temperature
tab tablet
TB Tuberculosis
Tbsp Tablespoon
TCDB Turn Cough Deep Breathe
TF Tube Feeding
TIA Transient ischemic attach
tid Three times a day
TO Telephone Order
tol Tolerate
TPR Temperate, pulse, respiration
Tsp Teaspoon
Tx Treatment
UE Upper extremity
UR Utilization Review
URI Upper Respiratory Infection
UTI Urinary Tract Infection
vac tubes Vacutainer tubes
VO Verbal Order
VS or V/S Vital Signs
vs versus
WC Wheelchair
WNL Within Normal Limits
x times
y/o years old
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