Table 2 Adaptive and Proactive Boundary-Crossings
Rings of the RToP | Adaptive | Proactive |
|---|---|---|
Innate | Boundary crossed - evaluating prevailing beliefs “There’s a phase that you go through where there’s hopelessness and there’s suffering because patients don’t see a way out, and we can’t seem to help them with their helplessness. So, that leads some to some spiritual questioning.” (p7) | Being asked to pray for cure/healing by a terminally ill patient, p7 felt like a boundary was crossed - providing ‘false’ hope to the patient though ‘cure/healing’ was still possible “I do have to think through it… what are the landmines and all that? What do I pray for and what do I not pray for? Because for us, praying for healing, you are in the middle of difficult grounds. So, I have to set up things that generally I feel I can pray for.” (p7) |
Individual | Boundary crossed - compromising personal interest “Over time, you learn to set your own boundaries so you can continue working happily.” (p1) | Boundary crossed - Being able to relate to a patient on a personal level can compromise professional detachment and affect judgement “When you see a young patient that is your age… you’re definitely going to try and help the patient even harder, do even more things for the patient.” (p10) |
Relational | Boundary crossed – causing distress “Initially, I brought work home. I realised over the years that my family cannot take all these sad stories… it distresses them.” (p3) | Boundary crossed - Allowing professional duties to trump personal relational responsibilities “Staying very, very late and going in unnecessarily on weekends and things like that and just scrutinising everything that you do… It’s also the mom guilt, that you’re balancing work and child and you’re thinking about your patients when you’re at home and you’re thinking about your child when you’re at work and things like that.” (p11) |
Societal | Boundary crossed - Creating distance “I don’t think you need to give 100% all the time. You can just give enough… because I think if you give your all, all the time then there’s nothing left to give.” (p8) | Boundary crossed- losing independence Seeking multi-professional perspectives can constrain professional development and practice “We encourage people to voice their opinions and thoughts for the patient’s management. So, even in my own team, I can sometimes have three different opinions from people of different seniority.” (p5) |
Multiple Rings | Reflecting on current practice Individual and Societal Rings “I start taking measures or strategies to relax and take time off.” (p1) | Reflecting on current practice Individual and Societal Rings I didn’t know whether I was deciding as a doctor or as a friend. And so, it became very tricky… And I didn’t know whether that (boundary-crossing) would be good for the patient and their family as well.” (p5) Individual, Relational and Societal Rings “I continued contacting her. We continued messaging each other and we’d almost chat like friends. I know it was very blurred and sometimes I was a bit confused.” (p3) |