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Setting boundaries in allied health

How to Set (And Maintain) Boundaries In Allied Health Work

Allied health professionals are highly motivated, high-achieving, highly empathic individuals—there is a reason we did not become investment bankers or cut-throat entrepreneurs.

The potential pitfall of such personality types is that we fall into the trap of sacrificing our needs for the needs of others. In short, we are people-pleasers.

We don’t have to give up our desire to make a difference to others. We just have to temper it with treating ourselves like we treat others.

Think of your favourite colleague. Would you want that person to:

  • Work beyond their hours, pay-scale, or current capacity?
  • Prioritise work time over family time?
  • Fill service gaps that are beyond the remit of their own team?

I expect the answer to all three questions would be ‘no’.

Can you extend this thoughtfulness to yourself?  If you are not doing this currently, then this article is for you.

An empowered team

If you are feeling the pressure to work beyond your current capacity, it may be due to a lack of boundaries in your team culture.

Poor work boundaries are linked with being in an unempowered team. We all feel the social pressure to conform.  If we don’t say ‘yes’, then work will fall to a colleague.

So, what if the whole team can become empowered?

Here’s what an empowered team member can look like:

  • They know what the service is commissioned to provide
  • They know what resources are available
  • They know what their role is in the team, and the role of others
  • They know the referral criteria and the care pathways that are offered
  • They understand the prioritisation system
  • They know what is expected of them in their day-to-day work
  • They have some autonomy in decision-making which is appropriate to their experience and skills
  • They can give feedback about how the service is working
  • They are working to common goals in order to improve the service
  • They can contribute ideas to how the service might work better.

If you think your team has some work to do on these points, then speak to your manager. Their job will be easier if everyone on the team has a shared understanding of their remit. It is easier to plan for the future as well as manage the current situation if we are clear about what our priorities are. It may take some time to thrash out the finer details, and it may be that some changes are needed. But this is an opportunity for creative thinking, which is another AHP strength!

Once you are clear as a team about your remit and roles, you can have open conversations. You can hold one another accountable to your work boundaries; you can talk about what you are and aren’t commissioned to do, and you can refer back to the prioritisation system.

how to set boundaries in allied health

Your personal boundaries

Your personal boundaries at work are also important. These may not be the same as those of your colleagues, because of your personal circumstances, priorities, and roles and responsibilities.

Think about some of these questions

  • What are my official working hours? How flexible am I prepared to be? How ‘early’ is early and how ‘late’ is late?
  • How long do I take for lunch? Why is it important that I have a lunchbreak?
  • What are the non-negotiable items in my calendar? (These can be professional and personal.)
  • What are the benefits and risks of me taking on additional clinical responsibilities? Are the benefits of developing my professional skills worth the personal risks of over-extending myself?
  • Which projects do I need to be part of? If I accept this piece of work, what work am I not able to do?

This might seem like a lot of questions, but it is worth taking the time to write down answers. You are more likely to remember them and use them in your decision-making when you are put on the spot.

 

In-the-moment practical strategies when you are under pressure to say ‘yes’

Now you are clearer about your personal boundaries and you are part of a more empowered team, but you still need some practical strategies for when you are put on the spot.

Here are my top tips for managing personal boundaries in the moment:

  • Don’t reply straight away; make it obvious that you are thinking; look away, say “Hmmm…”. This will immediately send a strong message: you are no longer a pushover!
  • Ask for time to think about it. If it isn’t a strong ‘yes’ for you, then you need time to consider it. Ask the person when they need to have an answer.

 

The ‘at-home’ deliberations

You then need to make time to think about whether to say yes or no: where do you think best? In the car on the way home? On a walk? Cooking dinner?

Try to make space every day for thinking. That way we check in with ourselves, and we have space to think about the demands that are being placed upon us.

Once you have your space to think, there are some important questions to ask yourself.

  • If I say ‘yes’ to a request, what am I saying ‘no’ to? Think about your other work responsibilities, but also think about your personal life. Will it mean being exhausted when you get home to your family? Will it mean you have less time for self-care?
  • If I say ‘yes’ to this, what will happen next time? If I say ‘no’ to this, what will happen next time? You may be setting up a pattern that leads ultimately to burnout.
  • What resources do you need for this to be a clear ‘yes’? Do you need more information? Do you need an assurance that you will then have two days off? If you are doing someone a favour, then this should be equitable, and there should be a trade-off.
  • Are you solving a problem that is not yours to solve? Are you disguising a problem which needs to be tackled more proactively? If there is a service gap, it is better that this is recognised at a management level.

 

The Benefits of Clear Boundaries

All of this may seem like it is a lot of work. It is, initially, but once you have taken yourself through these questions, you will have clarity.

You will have a much better idea of your team priorities and your personal priorities. You will get better at working through the deliberations, and you will see patterns. The process will be less effortful and more automatic as you practice.

The benefits of enforcing a boundary are myriad—it is more reassuring to the people who work with you when they know that they can trust you to say what you want.

A lot of relationship angst is caused when we can’t say what we want, and we expect the other person to be a mind-reader. If you tend to be a people-pleaser, the chances are that you also have a tendency to quietly harbour resentments: you suppress your needs, but they come out in different ways. There will be ‘leaks’ in your behaviour, and you will carry an energy that is palpable to your colleagues. Your resentment at being taken for granted might suddenly burst out, by being snappy, or sarcastic.

If we say yes to everything at work, we inadvertently make it more difficult for our colleagues. They feel the pressure to do the same.

It is empowering for your colleagues if you can openly say what you need. If you can do it, then so can they. You are modelling how to take care of your own needs in order to be a more effective professional. If you are the person who says when you need to take a break from a meeting, you can guarantee that three other people were ready for a break. It will be helpful for your colleagues to hear you say “I need to take some time to think about that.” They will also feel able to use the technique. There will be less staff sickness and absence in a team that has healthy boundaries; team members will stay in the job for longer, have more energy and creativity, be clear in their role, and have a more positive attitude.

If you want this for your favourite colleague, is it time for you to want it for yourself?

 

alison battye article authorAlison Battye is a lead Speech and Language Therapist with the NHS, and author of Self-Care for Allied Health Professionals: from Surviving to ThrivingWho’s afraid of AAC: the UK Guide to Augmentative and Alternative Communication, and Navigating AAC: 50 Essential Strategies and Resources for Using Augmentative and Alternative Communication. Alison is passionate about mental wellbeing of health professionals. She has practised yoga and meditation for as long as she has been an Allied Health Professional and this informs her approach as a therapist and a team leader. Connect with Alison Battye on Instagram.

 

How do you set boundaries as an AHP? Please leave a comment below, or add to the conversation on our Community Forum. To receive regular updates on allied health topics, events, jobs and services, subscribe to our Allied Health Insights  newsletter.

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