In this video below, Jodie and Michael, clinical education liaison manager at the University of Queensland, discuss ways to set and communicate expectations for allied health student placements:
Professional boundaries and ethical practice
In health care, we deal with vulnerable clients, and our professional boundaries may be tested. Professional boundaries identify the rules and limits to guide appropriate conduct of the health professional and the client, ensuring a safe working environment for the client and health professionals.
Professional boundaries are guided by legal, ethical, organisational, and professional codes of conduct or frameworks. While concepts of ethical practice and codes of conduct will be introduced by universities prior to placement, it is important that professional boundaries are included as part of the orientation to placement to ensure that students have a clear understanding of what is expected of them.
You may wish to refer students to their relevant health profession code of as part of a self-guided orientation activity.
Useful topics to discuss may include:
|Ethical issue||Orientation considerations|
Within Australia, confidentiality is governed by Information Privacy Acts and Hospital and Health Boards Acts.
|Boundary transgressions and work relationships||
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.