Nursing is a profession built on empathy, dedication, and resilience. We care about and are dedicated to both our patients and our teams. We’re also really tough. Sometimes we are too tough for our own good. What many call resilience can be a dangerous thing.

This resilience often causes us to make decisions or accept things that might not be good for us. We know that we CAN, so we think we SHOULD. We often struggle with setting healthy boundaries, not just in our careers, but in our lives. 

You see, the type of person who becomes a nurse is generally a very giving person. We have a natural tendency to want to serve others. This is a good thing. It’s part of what makes nurses so amazing. Unfortunately, it can be very difficult for us to turn this off. 

When we talk about boundaries in nursing, we often talk about the nurse-patient relationship. This is a very important boundary, but it’s not what I’m talking about. I’m talking about setting healthy boundaries in the nurse-employer relationship and even in the many different relationships with people in your lives. Yes, setting boundaries with people you care about is not only a good thing to do, it’s actually good for the relationships.

Why Boundaries Matter in Nursing

The reasons why boundaries are important in the nurse-patient relationship are well documented and, for many of us, obvious. However, the reasons why the sort of boundaries we’re talking about here matter are not really talked about so much. Here are some of the ways that these sorts of boundaries impact nurses:

MENTAL HEALTH

Many, but certainly not all, of the mental health struggles we face are a result, at least in part, of our inability to set healthy boundaries. Recently, on LinkedIn, I wrote a post talking about my own struggle with this. The weight of the many things that I had taken on seemed to come crashing down on me as I drove home from work. The result was me shaking and crying, with tightness in my chest and palpitations. My lack of boundaries had led me down a path that took me to that moment. 

I think most of us have experienced something similar. 

RELATIONAL HEALTH

As nurses, we work long hours. We work nights, weekends, and holidays. This alone can put a strain on our relationships. It becomes even worse when we fail to set healthy boundaries. Our inability to say no to extra shifts or that last-minute call-in often results in us missing more family events than we’d like to. Trust me, this has an impact on all the important relationships in our lives.

PHYSICAL HEALTH

Working 12 hours is tough. AND, how often are those 12-hour shifts actually only 12 hours? First, we have to add 30 minutes for our lunch break. Then there is time after your shift to finish charting or wrapping up other things that you may not have gotten done. Then we take and do this 3-5 times per week, sometimes even more. This WILL take a toll on your body over time. 

As you can see, failing to set boundaries can impact all of the 6 Pillars I write about in my book.

Common Boundary Challenges Nurses Face

Most of us would willingly admit that boundaries are important. Yet, many of us struggle to set them. Here are a few reasons why:

• GUILT: Many nurses feel guilty at the very idea of setting boundaries. We feel like we are letting others down.
• FEAR: This may be a fear of rejection, retaliation, or just fear of what others will think.
• PEOPLE PLEASING: Many of us struggle with this felt need to make everyone happy.
• EXAMPLES: Many of us have never seen what healthy boundaries look like.

For more, check out this article: https://www.thewomensvault.com/setting-boundaries-barriers/

Types of Boundaries Nurses Should Establish

Ok, now that we’ve established why boundaries are important. Let’s look at some types of boundaries nurses need to set:

WORK

Staffing is not your responsibility… unless you’re a manager or administrator, then it is your responsibility. But, for the rest of us, staffing is not our responsibility. Decide how much extra you will or will not work, then set that boundary. Decide what things you will or will not miss in your personal life for the sake of work.

RELATIONAL

Nursing often means missing family events, but it doesn’t have to. If you choose to stay bedside in a hospital or other 24-hour setting, great. Do what works for you and your family. Even with this, be intentional about the sort of events you will or will not miss in your personal life. Maybe you don’t make it to every practice, but when the big game comes, you need to be there. 

Being a nurse doesn’t mean you HAVE to miss events. Early in my career, when our kids were small, we would adjust our holiday celebrations to fit my work schedule. Maybe we would do Thanksgiving on Sunday, after church, instead of Thursday. Maybe we would open Christmas gifts on Christmas even, instead of Christmas morning. Maybe a birthday party would be on Saturday, instead of the actual day. You get the idea.

As my kids got older and had more events, this changed. You see, I had committed that I was going to be at ALL of my kids’ stuff. My parents, for a variety of reasons, struggled to be at my events, and I was determined not to let that happen to my kids. I was going to be there so much that it would become annoying. I told my wife that I was going to keep showing up until the kids ask me to stop. Then I was going to keep showing up, cause I’m grown and do what I want. The funny thing is, they never got annoyed with my presence, and they never asked me to stop showing up.

We are often told that “real nurses” are the ones who work bedside in the hospital. Well, that’s crap. I made the decision to seek a Monday-Friday, 8-5 type job a number of years ago so that I could always be there for my kids. The result was that the band’s trailer has almost no miles over the past seven or eight years that it wasn’t attached to my truck. There are plenty of this sort of job out there, and there is no shame in taking them.

SOCIAL

Time with friends and family is so important. It is not just fun, it’s a vital part of a self-care plan. At the same time, it can be yet another drain on you. There are times when your friends will invite you to something and you really don’t want to go. It’s ok to say no. Let me say that again, it’s ok to say no. 

You don’t have to say yes to every social event or call for help. Yes, there are for sure times when a friend calls for help and you NEED to be there for them, but when it’s not one of those moments, it’s totally ok to say no. The ones that care about you will get it. The ones who only care about what you can offer them, might get angry. 

Strategies for Setting Healthy Boundaries as a Nurse

1. Reconnect with who you are: Take time to consider who you are. Yes, nurse is a part of your identity, but I don’t think any of us would say that it is the most important part. So, take time to think about all the parts of who you are. This is one of the exercises I go through in the companion workbook to my book, The Restored Nurse.
2. Identify what matters most: Once you’ve identified who you are, take time to consider which parts of you are most important. Put those in order from most important to least. For me, my top three are: child of God, husband, father, in that order. Your list may look very different, but put the top five or so in order.
3. Name your values: Now that you’ve identified what matters most, name your values. For me, my relationships with God, my wife, and my kids are the top. This means that I have to build my life in such a way that feeds those relationships. Name your values, then write them down. Once you’ve decided what your values are, you know where your boundaries are, because it is anything that goes against those values.
4. Communicate your boundaries: This is not to say that you have to go out and make some grand statement about your boundaries, but when someone threatens your boundaries, you do need to make it clear where your boundaries are. You can do this with love and respect, but you need to do it. If someone violates a boundary that you have not communicated, that’s not on them.

Choose guilt over resentment

If I could boil this entire post into one statement, it would be something I’ve heard from my favorite podcaster many times: “Choose guilt over resentment.” Dr. John Delony says this frequently on his podcast, The Dr. John Delony Show.  

Ok, but what does this mean?

When setting boundaries, there will be times when we feel bad about enforcing them. Your manager, or your favorite coworker, calls and asks you to come in. Because you care about your team, you may be tempted to come in. You might think, “The extra money would be nice.” But then you remember that your son has a baseball game that night. If not missing your kids’ events is a boundary that you’ve set, then the obvious answer is “no”. Still, you feel guilty.

Over time, saying yes to things you don’t want to do in order to avoid feeling guilty can lead to resentment. This is what Dr. John is talking about. It’s better to feel guilty for a little while for saying no than to grow resentful of the person asking.

I get it, boundaries are hard, but they’re also vital. 

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