How To Set Boundaries at Work as a Nurse

10 Min Read Published June 24, 2022
How To Set Boundaries at Work as a Nurse

It’s been a trying month for me because your girl got COVID, and talk about bad timing! I caught it at a time right before I was supposed to start a new job. I was offered a great nurse practitioner position and I was supposed to start on June 5th, but I was exposed to COVID the last week of May.

So obviously symptoms kicked in - really bad. I let the potential employer know that I was sick. And, well, their response was definitely NOT what I had expected. They wanted me to complete orientation, online, while I was extremely sick. I stood up for myself and set a strict boundary - I chose to not respond to their communication attempts (they sent several emails!)

Let’s talk more about setting boundaries. In this case, although I was excited to start a new position I obviously needed to put myself and my health first. So I had to set some boundaries with a future employer. 
It’s important for all nurses to learn to set boundaries with their own employers. 

This content used under license from "Ask Nurse Alice."
  

Why Setting Boundaries Is Important for Nurses

Boundaries are very important when it comes to communicating with your job and in fact, boundaries, in general, are important because they help protect a person's personal and mental space, much like fences between neighbors.
They involve the physical and emotional limits of what's appropriate behavior between people.

People typically learn their boundaries either during childhood, during their upbringing or when they're around a certain group of people for a long period of time.

Research indicates that people with healthy, flexible boundaries have better well-being, self-control, and self-esteem. And there are different kinds of boundaries including:

  • Physical boundaries
  • Sexual boundaries
  • Mental boundaries
  • Emotional boundaries
  • Material and financial boundaries
  • Time

When you exercise a boundary, it can make you feel uncomfortable. And actually, that is one of the tell-tale signs, that a boundary is actually being crossed. Your body will actually let you know. So, pay attention to how your body responds! 
Ask yourself, how did it make you feel? 

That Time An Employer Crossed My Boundary

I’ll tell you how I knew that my potential new employer had crossed a boundary with me. I communicated via email that I was too sick to start the job and that I would need to delay my start date, or I would completely understand if the need was urgent and they needed to rescind my job offer to fill the vacancy.

I was totally okay with whatever was going to happen. To be honest, I really didn't care. I didn't care because I was sick. I already had a job and my priority at the time was getting better.

So, I communicated with them and I just let it go. I was focused on myself, and my well-being, trying to make sure the rest of my family didn't get it. Of course, I was expecting a response from them but not the response I got.  I thought at this stage in life, people would be better. They responded by asking me to still do the online orientation and send the certificate of completion of the health stream.

I thought to myself - Lady, I'm not doing a damn thing related to work and especially when I've not officially started! For many reasons:

  • I'm not on the clock.
  • And because I’m not on the clock, I’m not going to get paid for this.
  • Do you think it's okay for me to work “remotely” because I'm at home sick? What do you think I'm doing at home?  RED FLAG! Loud bells, whistles, and alarms started ringing. To me, that was showing a complete lack of consideration. I thought that was the most absurd thing to ask of me, knowing I was sick. 

Their response was a huge RED FLAG! Alarms literally started going off in my head!! One of the quickest ways to determine if a work boundary has been crossed is to ask yourself how you feel about a particular situation and pay attention to your gut instincts.

So I know you guys are like, Ooh, what did you do next? I didn't respond. I didn't need to. I said what I had to say. I don't need to communicate when I'm sick. That's my boundary.

I kept seeing more emails come through. So, I eventually did respond, and here’s what I said - 
“My apologies for not being able to respond to all of the prior emails, I am sick. I'm off of work. And if you need a doctor's note, I can provide that for you.”

Now, if you’re familiar with HR - you know, they are NOT supposed to be bothering me with work stuff when I’m off, and in this case, I’m not even off work - I haven’t even started working there yet!

Where I’m at Now With the “Job”

So currently I have a doctor's note that I've provided to say that I'm currently ill and need to be off of work, but here's the crazy thing - I don't even work for them yet. I've not even started. I'm not on the clock. I'm not earning or using sick time with them. I'm not benefiting anything from the organization. It was a job that I planned on starting. But there was a change and sometimes life changes. Things will happen that can alter the trajectory of our life, and I'm okay with that. I was okay with it from day one.

I sent the email explaining I'm sick and have to delay the onset of my orientation. However, if the needs are such that you need to rescind the job offer and extend it to someone else to meet organizational needs - I understand. Either way, I will be okay, with or without this job. Will I ever start this job? I'm not really sure.

Boundary Setting Can Feel Uncomfortable

When you exercise a boundary, it can make you feel uncomfortable. And actually, that is one of the tell-tale signs, that a boundary is actually being crossed. Your body will actually let you know. So, pay attention to how your body responds! 
Well, you gotta ask yourself, how did it make you feel?

Sometimes, as nurses, we feel bad for not going to work. Like, “oh my gosh, I feel so guilty. Oh my gosh, who gives two shits when you are sick?  I understand that we want to contribute and help. And we don't want to see coworkers have to pick up the brunt of the work, but do they really? Not usually, they always find someone else.” There's always an FTE who's going to slide in or hospitals will block some beds to keep the census manageable.

We have to stop feeling bad when we can't go to work because we're sick. That's so ass-backward. You can't take care of someone sick when YOU are sick.

How To Know When You Need To Set a Boundary

When you exercise a boundary, it can make you feel uncomfortable. And actually, that is one of the tell, tell signs, that a boundary is actually being crossed. Your body will actually let you know. So, pay attention to how your body responds! 
Well, you gotta ask yourself, how did it make you feel? 

1. You feel guilty
Sometimes, as nurses, we feel bad for not going to work. Like, “oh my gosh, I feel so guilty. Oh my gosh, who gives two shits girl? You are sick. I understand that we want to contribute and help. And we don't wanna see coworkers have to kind of pick up the brunt, but do they really? Not usually, they always find someone else.” There's always an FTE who's gonna slide in or they're gonna block some beds.

We have to stop feeling bad when we can't go to work because we're sick. That's so ass-backward. You can't take care of someone sick when YOU are sick.

2. Listen to your gut instinct
In my example above, their response was a huge RED FLAG! Alarms literally started going off in my head!! One of the quickest ways to determine if a work boundary has been crossed is to ask yourself how you feel about a particular situation, pay attention to your gut instincts.

Your body will respond to a boundary being crossed before your mind does. So, if you're feeling uneasy or uncomfortable or even nauseous about something - pay attention! That may be a sign that a boundary has been crossed.

Tips For Setting Boundaries as a Nurse

So when it comes to boundaries, it's really important that you set limits with your colleagues, your managers, and your supervisors. So here are some tips for setting boundaries at work.

  • Address the issue directly and calmly with the other person
  • Involve the supervisor or manager if the other individual fails to respect your boundaries
  • Knowing the chain of command at work will help you. So if you're having difficulty or a problem with a colleague or a manager, and you can't speak to them directly, look for your organization's chain of command - or, go directly to Human Resources for help.
  • Know your workplace policies and procedures

Now my example above might be a little bit different because this was a new job and I hadn’t started yet. But let's say this was a job that I was already in and I was sick and I needed to be off. Yes, I would say I'm sick and be off. However, if there was an upcoming deadline I would send an email as a heads-up and hand off my current work to someone, but I'm not gonna sit there and debrief you on everything while I’m sick. You have to read my email, look through any documents I send, and figure it out. Otherwise, this project is on hold until I return.

When you are off from work, you are off from work. When you are home from work and you answer an email, work on a project, do payroll, or do anything related to work -  you're working. And when you work you should be getting paid. When you are sick and off from work, you are entitled to be off and healing. You do not need to be answering emails or doing any of that shit. You're not supposed to be working outside of work hours. So if you're answering emails on your day off or from home when you're sick, you're actually still working and on the clock and you're supposed to be getting paid.

4 Different Ways To Say “No”

“No.” is a complete sentence! But, a lot of people have a hard time telling others “no.” If that’s you, here are some other ways to say “no.” 

  • I would love to, but my plate is really full right now.
  • I would if I could, but I'm unable to help with that right now.
  • I really appreciate the invitation, but I'm not interested in participating right now .
  • Thank you so much for thinking of me. Let me get back to you. I need to look at my schedule and my current commitments.
  • Thanks so much. But you know, I'm overly committed already, perhaps in the future I can help you.

You don’t have to provide an explanation and there are ways to say no to things without actually having to explain the why.
The one that I really like right now is “I would love to, but my plate is really full right now.” So there, I've said no, I'm not able to participate. And if anyone ever tries to follow up with you, like, well, what are you working on? That is none of their business. And that should be a red flag and a time for you to ask yourself, do I want to work for someone with this type of leadership style because they can't take no for an answer.

Set Healthy Boundaries in Your Everyday Life

  • Practice saying  “No” more often
  • Be accepting when someone else tells you “no”
  • Respect others' values, beliefs, opinions, time, and how they want to spend their time. 

If you are someone who has a difficult time saying no, or you're having trouble accepting no from others or you're someone who can't clearly communicate your needs or your wants, or you compromise your personal values, beliefs, and opinions to satisfy other people, or you use manipulation to get others to do something, they don't want to do you - my friend, YOU need to work on your boundaries. You need to work on establishing healthy boundaries for yourself. So you can also receive and respect the healthy boundaries of other people.

Know Your Worth

  • There will be other jobs. It’s important to never ever give a job that much power over you, where they have control of your mood, your happiness, and your finances.
  • You are important.
  • You are number one.
  • You are your first patient.

Just as much as you are a badass and advocate for your patients on the floor, you should use that same energy to advocate for yourself. Don't ever, ever, ever let anyone threaten your healing - are worth so much more. 

Alice Benjamin
MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC
Alice Benjamin
Nurse.org Contributor

Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, also known as Nurse Alice, is a cardiac clinical nurse specialist and family nurse practitioner with over 23 years of nursing experience specializing in cardiology, critical care and emergency medicine. She is the host of the Ask Nurse Alice Podcast; an NBC Los Angeles Medical Correspondent and CEO of Nurse Approved. You can follow her at asknursealice.com, on Twitter and Facebook at @AskNurseAlice, and on Instagram at @asknursealice

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