Setting Healthy Boundaries

By Althea Aubrey, RN, BSN
Director, Medical-Surgical Nursing, Methodist Dallas Medical Center

Life’s exciting when you’re a new graduate nurse. The possibilities are limitless and your zest for your career and your patients is boundless. Sometimes, when I’m working with new nurses, it is a challenge to nurture their positive spirit and instill the importance of setting healthy boundaries. Grasping the concept of healthy boundaries at the beginning of a career can pay off when clinicians hit the occasional bumps in the road.

I first experienced the need for healthy boundaries early in my career when I was an oncology nurse. After six years of caring for cancer patients, I reached the point where I knew I couldn’t do it forever. John was a leukemia patient for whom I cared during his hospitalization until he died. About six weeks later, my supervisor asked me how I was doing. “Fine,” I told her. But, being the wise, veteran nurse she was, she asked me stop by her office after my shift was over.

“Al,” she said, “your light is not shining anymore.” I burst into tears. I knew I was grieving for John. Thanks to her support and that of the hospital chaplain, I was able to process what I was feeling, see why I became a nurse in the first place, and understand how I could continue my career.

We all carry invisible buckets which hold feelings. Every patient we have puts a little into our buckets. Those feelings can be good and not so good. When we lose a patient, that emotion goes into the bucket as well. If we don’t have a good work/life balance, the bucket will overflow at the most inopportune moment.

Setting healthy boundaries not only establishes a barrier against built-up stress which ultimately leads to burn out, it also provides an appropriate emotional attachment between the nurse and his or her patients.

Here are four tips I’ve found useful in setting healthy boundaries for myself.

  • Maintain appropriate relationships with your patients. Patients are not your friends, they are you clients. They are relying on you to help them get better through your experience and skill.
  • Identify a good friend, preferably in the health profession, who “gets it” when you say you’ve had a tough day. He or she can help you sort through your issues and solve the problems.
  • Identify a good friend who is not in health care. This friend can say to you, “I’m sorry it was a tough day. Now, let’s go get something to eat.” This is a friend who won’t let you wallow in your self-pity.
  • Establish “me” time. I’ve found that my best “me” time is before I get to the hospital to begin my day. Even if it’s just 15 or 20 minutes, I can read something that’s a positive affirmation, something that gives me a lift, something I can model for my staff. This habit helps me affirm that life is good, then I can share it with at least one person every day.

When there are clear boundaries, the results benefit everyone. If you’re ready for a brilliant move, consider Methodist. Visit