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13th November 2015

Boundaries – whose issues?

Do we pay too much attention to being professional, to the detriment of giving service users an opportunity to have real friendships and real social interaction?

One of the regular challenges facing direct care staff, particularly in small-scale community services or domiciliary care , is retaining a professional distance. Many times, people have struggled with the need to separate personal life from professional life; indeed, a regular theme in supervision has been ‘appropriate’ behaviour and conduct.

As a registered nurse, the code of professional conduct is very clear on the issue of boundaries. We are to “stay objective and have clear professional boundaries at all times“. We are urged to  “make sure not to express personal beliefs (including political, religious or moral beliefs) to people in an inappropriate way”. We must be cautious with social media use.

A different take

So I was personally and professionally challenged this week at a really rather unique event, hosted by a support provider with an interesting take on professional distance. In order to enrich the lives of the individuals they support, care workers are encouraged to ‘bring themselves to the job’. In other words, to show humanity, friendship and real regard for the service user, to become a personal friend and, in some instances, almost a member of the extended family.

The event was being hosted not only by the managers and workers, but by the service users themselves, who are really very profoundly learning disabled and have spent the large part of their life in institutional care.  To observe the interaction between carers and the cared-for was a revelation, as there was honest and genuine respect shown throughout. At no point in the evening were there awkward or uncomfortable points, although some of the stories shared were deeply moving and personal.

The interviewed support workers shared their experiences of having been inspired and privileged to meet and get to know the clients. They spoke warmly and with real enthusiasm about the relationships that were developing. Some expressed that this did not feel like a job at all. The value of sharing personal experiences and real human emotions with people whose lives had been damaged by isolation was absolutely clear.

Are boundaries necessary?

Reflecting on this as I drove home, I realised that some boundaries we imposed in being professional could act as obstacles to developing respect and understanding. For people with a learning disability , being able to have dignity and positive regard as an individual in your own right is difficult enough. Making friends can be challenging and opportunities to grow circles of acquaintances are rare, or contrived due to the limitations of time and resources.

Of course we should safeguard those who are vulnerable from inappropriate and risky intimacy with those in positions of trust. Of course we need to have some degree of space between our very personal world and the workplace. But let us be careful that in being professional, we do not disadvantage ourselves from achieving healthy and genuine friendships with people we support, allowing them to see us as not just ‘in control’ but as equal partners in the journey to greater independence.

Ginny Tyler – QCS Expert Learning Disabilities Contributor

2 thoughts on “Boundaries – whose issues?”

  1. Lesley Mowlabocus says:

    I am sad that you have only just realised this fact. We need boundaries but for far too long “professional” distance has completely cut the SU off from social interaction. It’s not just in LD but any care setting where social interaction is limited. If we care then we need to show that care with a human face. We have provided the care you talk about for 30 years and will continue to do so despite the de humanising CQC and never ending rules and regulations.

  2. Janice Openshaw says:

    I agree totally with Lesley. When we all go to work we all strike up friendships and interact with others about their lives. We go out sometimes with other staff meet their families laugh with them and be there for them in their hours of need. This is normal life. however when someone has a caring job role we are meant to treat the su differently and not build up friendships. I understand there has to be boundaries to keep all parties safe however in my 15 years of working in care I have found that the best carers are the ones that have compassion and want to treat the su in a way they would want their family treated. The carer may be the first and last person that su may see all day. I was told this story by my husband about a friend of my husband was working in the care sector for a while was sent to a lady who was in bed. She had a call for her tea and it was just a microwave meal. My husbands friend had been visiting her for a couple of weeks and said to the lady I bet she would rather have fish and chips for her tea. The lady said I would love that but there is never any time for the carers to do this for me as I only have a short call. My husbands friend said I will get you fish and chips but I may be later than normal on the call. The lady burst into tears and said no one has ever offered to do anything like this for me thank you so much. As a support worker myself this brought tears to my eyes. This man had not been in care long he does not work in care now as the pay was not very good however he said it was the best job he has ever done.We need these sort of people that actually think about what the SU really need sand make the SU feel valued keep them in contact with the world ( especially if they are bed bound or house bound ) and if that means talking about your family or theirs and building a friendship then that should be allowed to grow. I know so many people who have not been allowed to attend a funeral of someone they cared for as “its crossing a boundary”. What rubbish the carer has grown to know the person and their family and if they want to pay their last respect to someone they cared for what sort of person tells them they cant. Too many people do their job and walk away go home and dont think about it until the next day. In care you take the job home and hope the person is ok until you next visit them. t is not a job you can leave on the doorstep. The people that hold the care together are the ones who really see the needs of the SU and actually make the SU feel that they are part of society valued and not someone that we should treat differently due to policies procedures and regulations.

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