Exploring mutuality within the nurse-patient relationship.

This article explores the concept of boundaries within the nurse-patient relationship. Drawing on child development theories the authors explore the difficulties of boundary maintenance and link this to the professional aspects of therapeutic alliance. The ability to establish clear boundaries between ourselves and others is closely related to the capacity to function as a healthy adult and as such may be said to play an important role in the development of mental health difficulties. However, it is generally accepted by psychological theorists that a certain amount of projection and transference are likely to occur in every two-person relationship and as a result boundary confusion is likely to be experienced by both parties to a greater or lesser extent in the nurse-patient relationship. If, as is currently asserted by the nursing profession, the nurse-patient relationship is based on the principle of equality then it follows that both the nurse and the patient carry equal responsibility for maintaining the boundaries within which their interactions take place. The authors argue that it may be more appropriate to think in terms of a relationship founded on the concept of 'mutuality'. Such a position enables the concept of therapeutic reciprocity to be embraced alongside the reality that ultimately it is the nurse who carries the responsibility for 'holding' the boundaries within which the relationship is 'acted out.'