January 14, 2026

Practice Spotlight

Do you know when you crossed a professional boundary?

Your aunt asks if she can make an appointment with you at your private nursing care business.  She asks why she should spend her money elsewhere. You don’t know her well, only seeing her a few times yearly at family functions. 

Or perhaps you are employed with a unit that provides inpatient, outpatient, or community-based care when an old friend suddenly requires health care where you work. No other staff are available, and she needs care now. You are assigned to provide the initial assessment.

It is practically inevitable that someone in your circle of family, friends, or acquaintances will ask for or require care where you work at some point in your nursing career.

In both situations, providing nursing care to your aunt or friend is crossing a professional boundary. Nursing care to family, friends, or acquaintances is only meant for circumstances when other capable care providers are unavailable. Boundary crossing should only occur briefly to meet the client’s therapeutic needs. 

If you ever think you may decide to cross a professional boundary, ask yourself the following questions:

What other capable care providers are available?

In the situation where your aunt is asking you to provide care, you may feel that you are the most capable care provider in your area. It may or may not be true that no one else provides the level of service that you provide within the immediate vicinity. However, if the care is not emergent or urgent, consider the risks of saying yes to her request. It is essential that you evaluate objectively, based on her health care needs, not based on what you want. 

In the second situation, when your friend arrives suddenly, and no one else is immediately available, an objective assessment of whether another care provider can be arranged soon enough to meet the client’s immediate needs is essential. Assessing the urgency of her treatment needs and the potential to re-arrange care assignments will assist you in determining whether your friend’s health condition requires attention before other care providers become available. 

How will the client benefit? 

Deciding to cross a professional boundary should occur only for the client’s benefit.  Some examples include: 

  • an emergency or urgent situation where no other care provider is available, or 
  • offering limited personal information about a previous struggle to show commonality and inspire resilience. 

 If it is unclear whether the client would benefit, then crossing the boundary is not warranted. 

Would you be able to complete the necessary health history and assessment? 

A family member or friend might withhold some necessary health information that could jeopardize planning for or providing the necessary care. Perhaps they feel uneasy or may not trust you to maintain confidentiality with your family or social circle, even if you know that you would always respect confidentiality. 

Conversely, you may learn intimate or personal health details that you would not otherwise know, and this could be uncomfortable, impacting your ability to do all the necessary follow-up care. 

Will your family member or friend feel compelled to ask you to provide anything that you would not typically do (e.g. additional time, a discount, or other special care)?  

Personalized care is important, yet registered nurses (RN)s and nurse practitioners (NP)s are also expected to fairly divide and advocate for resources, based on health and social needs.  

For example, how will you respond if asked to spend more time with them, when you could be providing care to others? 

Or what if they say, “You don’t need to do all that, do you?” before handwashing, quality checks, documentation, consultation with other care providers, or any other aspects of care.

If you assess that there are contraindications to providing the treatment they want, what would you do?  

If your family member or friend minimizes the risks or insists on an unnecessary treatment, what would you do next?  

You are expected to share your reasoning and not provide the treatment when the care is not warranted. 

How would you handle the situation if you decide you must provide care to a family member or a friend, and they are dissatisfied with the treatment outcome? 

You may be competent to work with any client, even those who express dissatisfaction, but it can be more challenging if the client knows others in your personal circle. 

Have you considered all other relevant factors? 

A couple of other factors to consider include whether you would be able to meet your practice expectations and your employer’s policies.

What to do if you do cross a professional boundary

After crossing a professional boundary, you may wonder what you should do next. Boundary crossings are intended to be brief excursions across the line to further meet the client’s health care needs, with a clear return to established professional boundaries.  

Boundary crossings turn into boundary violations when they focus on the registrant’s personal needs and/or risk disruption of the therapeutic relationship. They include, but are not limited to, getting something physically, financially, socially, or emotionally from the client. 

To recover after you’ve crossed a professional boundary, consider the following:

  • Acknowledge that you crossed a boundary and you are accountable.   
  • Gain clarity on the situation, asking yourself what led you to cross the boundary.  
  • Evaluate the positive and/or negative impact on the client’s health outcomes. 
  • Think about the perspective of the others and how their trust in you or your competence is impacted.  
  • Take steps to reset the professional boundary with the client, focusing on the client’s needs and care plans.   
  • Clarify your role and the service expectations. 
  • Seek support from a colleague, manager, friend, or professional to ask for feedback on your behaviour and motives. 
  • As necessary, take steps to withdraw from or terminate the relationship, transferring care to another appropriate care provider. 

We can all be faced with the potential for boundary crossing to progress to boundary violations. If you suspect that someone is violating professional boundaries, and continue to wonder what the damage is, consider how boundary violations impact:

  • the client,  
  • all other clients,  
  • staff on the team, and  
  • trust in your own profession.   

 

If you have concerns or questions, you can connect with a Quality Practice Consultant at practice@crnm.mb.ca or  204-774-3477 / 800-665-2027 (Manitoba toll-free) 

 

References 

CRNM (2025). Professional Boundaries.  

BCCNM (2025) Boundaries in the Nurse-Client Relationship.