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Setting Boundaries as a Health Care Worker

Boundaries are essential to any healthy relationship – they establish how all parties want to be treated and what you can expect from each other. For individuals working in the health care field during the COVID-19 pandemic, boundaries help you protect your energy when so much is being demanded of you, both physically and emotionally. In MHA’s survey of health care workers in 2020, 76% reported exhaustion and burnout [1]. You can’t take care of others if you aren’t okay yourself, so it’s important that the people in your life are aware of your needs and boundaries during this time. 

What do boundaries actually look like? 

Boundaries can be defined in a variety of ways and often link back to our values, opinions, and beliefs. There are many different kinds of boundaries that you can benefit from setting. Physical boundaries refer to physical touch and personal space – this is a really important boundary to set in pandemic times, especially if you have contact with COVID-19 patients. Boundaries on time make sure you are giving enough attention to each part of your life, including work, relationships, and hobbies – this might look like turning down plans with friends for a night in by yourself. You can also set boundaries on how you spend your energy, like telling someone you don’t have the capacity to listen to them vent at the moment.  

It’s common to struggle with setting and enforcing boundaries. 

It can feel uncomfortable to call people out on their behavior or selfish to tell a friend that you can’t help them right now. While the conversation may feel awkward in the moment, making your boundaries clear is an act of kindness to both yourself and the people around you. It tells others what you need to be able to continue the relationship. When you advocate for your own needs, you prevent resentment from building. 

Boundaries can help prevent burnout. 

Trying to preserve the peace by not setting boundaries, or by allowing people to cross your boundaries, often leads to something that health care workers are already at high risk for – burnout. For any worker, burnout refers to the psychological reaction to prolonged exposure to job stressors. Many health care workers (HCWs) face frequent and intense stressors like disrupted sleep and witnessing death, and these job-related challenges have skyrocketed during the COVID-19 pandemic. Other causes of burnout include heavy workload, inadequate support, and interpersonal conflicts with coworkers – all things that HCWs have likely faced this past year. 

When burned out, boundaries are even more crucial. 

The symptoms of burnout frequently include emotional and behavioral challenges. You’re more likely to feel irritable, pessimistic, or hopeless, and your relationships may become strained. Physical effects, especially exhaustion, are common as well. To recover from burnout and provide the best care, you must identify your needs and hold yourself and others accountable for meeting them. 

How do I set boundaries without upsetting anyone? 

Enforcing your boundaries won’t always make people happy, but setting boundaries is for you, not anyone else. You have the right to set boundaries that work for you, and if someone else can’t operate within those, that is their responsibility. However, there are ways to go about it compassionately. 

  • Reflect on what you want and need. Are you happy with how you’re spending your time? Do the relationships in your life feel good? What do you want to prioritize? Know what types of requests you want to say “yes” to and what you don’t have space for right now. 
  • Be proactive. Don’t wait until someone crosses a boundary to say something – that’s too late to protect yourself and can leave the other person feeling confused. Try to speak up in the moment so that the boundary is clear and not crossed in the first place. 
  • Just say it. Using simple and direct language is the best way to establish a boundary. Don’t dance around what you’re trying to say or expect other people to read your mind.  
  • Reinforce it when needed. Even after you set a boundary, people may forget or think it isn’t still in place after time has passed. It’s okay to politely (but firmly) remind them that the boundary still exists. 
  • Offer relevant explanations and solutions. You don’t owe anyone an explanation of your boundaries if you don’t want to share, but giving some context can help others better understand where you are coming from. Suggesting solutions is a great way to show the other person you still care – if you turn down a coworker asking for help because you have a packed day, offer to check-in tomorrow morning when you have more free time to see if there’s anything you can do. 

1. Mental Health America. (2020). The mental health of health care workers in COVID-19.