Boundary Setting As A New Graduate Nurse Practitioner

Tuesday, July 14, 2020 Sacramento, CA, USA

Boundary setting is something I thought I had a handle of as a new graduate nurse practitioner. After all, I had worked as a registered nurse before becoming a nurse practitioner, and I have dealt with all kinds of personalities thus far in my healthcare journey. So, I should have a handle on this "boundary setting" thing, right? 

One lesson I've learned through my time so far as a new graduate nurse practitioner is this:  setting boundaries is not as easy as it seems, especially when you're setting them with other members of the team.



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A co-worker of mine told me a story when she herself was a new graduate nurse practitioner. She told me stories of how she would end up staying over a lot in the name of answering "that last page" or trying to help the team. It was a growing pain for her as she learned to set her boundaries. She told me it hit her one day. She realized that medicine is a 24-hour job and that there would be others to pick up from where she left off.

It doesn't mean slacking off and not getting important tasks completed during the shift, but it's knowing when to draw the line between the end of the shift and what can be passed on to the next person who is on. As she reflected back on her experience, she noted that by stretching herself thin, she set an expectation of herself for others. An expectation that, if paged after hours, she'll still answer.

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Looking back at my time in fellowship thus far, I remember a few days here and there where I would stay late as a result of answering "that last page." And this happened to me again recently.

I can't delve into the details of the page I received, but it was for a non-emergent issue that did not need to be resolved right then and there. She had paged after hours and after I had already completed hand off to the incoming provider. I decided not to answer initially, but ended up calling the nurse back after my coworker (different from the one who shared with me her lesson) told me that the nurse found her and told her to tell me to call her back. I called the nurse back, listened to the issue, and deemed it to not be critical. When I tried to set my boundary by telling her to please contact the service pager, needless to say, I was met with attitude. 

On the one hand, I get it. I know where this nurse is coming from because I was a nurse too working on the med-surg/tele floors on the evening shift. The shift was so busy and everything was task focused, really. As a nurse, I've been told by attendings before to call the oncoming attending for certain issues, and I had no problems with that. These were usually calls that were about 30 minutes before their change of shift. Now that I look back, perhaps they were in the middle of hand off too.

I know this is just the start of many other times I'll need to set my boundaries. I hope this process gets easier as I set my own expectations in practice for others. 

Do you have resources or tips to share for boundary setting? If so, comment them below!

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