Alternative Text Option: Professional Boundaries

Introduction

Welcome to the simulation learning experience. During this experience you will be interacting with a scenario between a health care administrator (HCA) and a client. The experience is presented in the following format:

• Scenario description
• Video scenes
• Questions for points
• Prompt to move to the next level
• Opportunity to play again

Scenario Details

When a patient discloses their personal information to the HCA or other members of the health care team this is an example of professional intimacy. Remember, a HCA is accountable for setting the boundaries of the therapeutic relationship.   In this experience you will meet a client who has completed an encounter with their health care provider and is now approaching the health care administrator with requisitions that contain personal health information. The client now has questions for the health care administrator.   Let’s see how it goes!

Learning Objectives

• Recognize the impact of poor therapeutic communication in health care settings.
• Identify the benefits of therapeutic communication techniques in health care settings.
• Adjust communication to meet the client’s health care needs in health care settings.

Please be advised that some viewers may find the following scenes upsetting or triggering.

Professional Boundaries Scene 1

Congratulations you have reached level 1!

To reach level 2, choose your next move.

Do you want to answer a question for 2 points.

Question: Consider the video you just watched.

Which effective questioning technique did the HCA use in this opening scene?

1. General Lead – invites the client to expand upon their concerns
2. Silence not responding
3. Open ended question inviting the client to say more
4. Closed question – seeking a yes or no answer

Solution: Answer 1 is correct. The HCA start the interaction with a general lead which helps the client to expand their concern.

Or you can Watch the video again for 2 points

Let’s see what happens next.

Watch Professional Boundaries Scene 2

What did you notice about the HCA’s response?

To earn more points choose your next move.

Answer a question for 2 points

Question: Is it appropriate that the HCA would share health information about their sister?

1. Yes, the health care administrator is trying to build a connection to the client by sharing a similar experience.
2. No, the HCA is breaching privacy by sharing personal health information about their sister. Displaying to the client that the HCA can not be trusted.
3. Yes, it is helpful for the client to know what to expect based on the HCA’s sister’s experience.
4. No, oversharing personal information turns the focus to the HCA and not what the client needs.

Solution: Answers 2 and 4 are correct. Breaching personal information is unlawful and displays the HCA can not be trusted, which does not help build a connection with the client. Oversharing personal information turns the focus away from the client.

Re-watch the video for 2 points

Will this get better, stay tuned!

Watch Professional Boundaries Scene 3

Congratulations, you have made it to level 3!

To continue to earn points choose from the following.

Answer a question for 2 points

Question: Which blocks to therapeutic communication did you identify that the HCA used? Choose all that apply.

1. Personal Opinion
2. Generalization
3. Making Observations
4. Acknowledgement

Solution: Answers 1 and 2 are correct. Myths about medication is the HCA’s personal opinion and the focus is away from the client; and just because the HCA sister is taking multiple medication does not mean that this applies to this client’s situation. There is no thought as to how this will impact the client’s concerns. The HCA does not observe that the information they are sharing is exacerbating the client’s concerns and therefore misses acknowledging how the client is feeling.

Re-watch the video for 2 points

How will the health care administrator answer the client’s question. Stay tuned!

Watch Professional Boundaries Scene 4

Doesn’t look like the client’s health care needs will be met.

Let’s see how this could be done differently.

Congratulations! You have reached level 4.

To earn more points choose your next move!

Answer a question for 3 points

Question:Identify examples in the scene in which the HCA is dismissive towards the client’s concerns. Check all that apply.

1. The HCA states that the situation could be life threatening. The client states “that is terrible” and looks worried, the HCA’s response is “mmmh yea” and shifts their focus on a task.
2. The patient asks for bi-monthly appointments and the HCA response with “it could be worse”.
3. The HCA states “you’ll be fine” to the patient.

Solution: All answers are correct. The responses of the HCA dismisses the patient concerns and feelings.

Answer a question for 2 points

Question: Identify examples in the video in which the HCA did not stay within their scope of practice. Choose all that apply.

1. The patient questions the care plan, the HCA helpfully refers to other patient’s experiences so that the patient will know what to expect.
2. The HCA indicates that client will be fine because there is an adjustment period that the HCA sees all the time in other patients.
3. The patient questions the care plan, the HCA refers to other patient’s experiences instead of referring the patient back to the health care provider.

Solution: All answers are correct. The HCA should not be giving medical advice but instead should refer the patient back to the health care provider.

Re-watch the video by 1 point

Now let’s see how this could be done differently.

Watch Professional Boundaries Scene 3

Seems to be going better, let’s keep watching.

Watch Professional Boundaries Scene 4

Reflection

Did you notice the HCA adjusted their communication in the last two scenes?

• Why did the HCA adjust their communication?
• How do you think the HCA knew that they needed to adjust their communication?
• What was the immediate result you noticed in the client’s verbal and non-verbal communication?
• What specific therapeutic communication techniques did the HCA use?

Summary

Therapeutic communication with clients is essential. HCAs should maintain a professional boundary when communicating with clients. Oversharing personal information no matter how well-intended moves the focus from the client on to the HOA and blocks communication. HCA should continue to develop their therapeutic communication competencies by recognizing and adjusting their behaviours to meet the client’s health care needs.

Therapeutic communication is complex and requires a lifetime commitment of reflection, practice, making mistakes, and learning from those mistakes. 

Game Over