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Boundaries – whose issues?
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