Managing expectations, professional boundaries and ethical practice

Within Australia, confidentiality is governed by Information Privacy Acts and Hospital and Health Boards Acts.

 
Health professionals are legally obliged to protect consumer health information.  With growing technological changes such as social media, use of electronic tablets and phones from work to/from home, it is becoming more difficult to maintain one’s privacy. Students, therefore, need to be mindful of their communications both in and out of the workplace. You may like to refer your student to your organisation’s policy relating to privacy and confidentiality, and the use of social media and technology as part of their orientation, as well as the relevant State or Territory Hospital and Health Board Act.

This can include romantic or familial relationship with clients or student supervisors. These boundary transgressions are considered a breach of professional boundaries.  Other considerations, such as picking up someone’s shopping for them or taking them to the bank on the way home from the hospital during a home visit, may not be so easy to define.  Introducing this topic and related expectations for student behaviour will ensure that students understand how to navigate or seek assistance to manage possible areas of concern.

Consumers have the right to choose health care based on the best information available to them at that point in time. This is termed informed consent.   Informed consent, including its components and how to gain and document consent, should be discussed with the student. Relevant resources include the informed consent policies and procedures in your organisation and those found on the Australian Commission on Safety and Quality in Healthcare website.

Competence or capacity refers to the client’s ability to make decisions regarding their health care, living arrangements or financial situation.  Capacity can be assessed by a multidisciplinary team including the treating medical practitioner, occupational therapist, psychologist and psychiatrist.  If a client is deemed competent to make their own health care decisions, their ability to make sound decisions needs to be respected by you, regardless of what your belief of what the 'ideal' treatment recommendations might be.  A collaborative approach to care ensures mutually set goals and outcomes while working within professional boundaries.  It is important that the student understands their role in the multidisciplinary team, and how to interpret team assessment and decisions relating to capacity.

Clinicians are provided with a multitude of therapy tools and resources to facilitate client care.  The sources of these resources and tools may be biased.  Wherever possible, health care professionals need to reduce bias associated with recommending particular medications, equipment options or organisations based on their own commercial or personal gain. There should be a focus on evidence based, client centred care.  Explaining resource selection and use within your team, as well as guidelines relating to the use of resources by students on placement should also be included in their orientation.