Professional Boundaries for Nurses and Midwives

8 min read Last updated June 2026

Professional boundaries are the foundation of safe, trusted nursing and midwifery care — yet they are among the most common reasons concerns are raised. This guide explains what the NMBA means by professional boundaries, where the line falls between a therapeutic and a personal relationship, and how to protect it in everyday practice.

Key takeaways

The NMBA defines professional boundaries as the limits that protect the space between a professional’s power and a person’s vulnerability.
The NMBA Code of conduct for nurses and Code of conduct for midwives (2018) set out what is expected.
Boundary crossings are often brief and well-intentioned; repeated or serious ones become violations.
Sexual or intimate relationships with people in your care — and generally former patients — are never acceptable and are treated as the most serious breach.
Gifts, social media, self-disclosure and dual relationships are the everyday risk areas to watch.

What are professional boundaries?

The NMBA describes professional boundaries as the limits that protect the space between a professional’s power and a person’s vulnerability — the borders that mark the edge between a professional, therapeutic relationship and a personal one. The power in that relationship sits with the nurse or midwife: you hold clinical knowledge, access to intimate information, and often physical proximity at a moment when the person in your care is unwell and dependent. Boundaries exist to keep that relationship safe, effective and centred on the patient’s needs — not your own.

What the Code of conduct requires

The NMBA’s Code of conduct for nurses and Code of conduct for midwives (2018) set the standard. In relation to boundaries, they require you to:

be aware of the inherent power imbalance between you and the people in your care;
establish and maintain clear professional boundaries, and be alert to the risk of over-familiarity;
avoid conflicts of interest and the added complexity of caring for someone with whom you have a pre-existing personal relationship;
never engage in a sexual or intimate relationship with a person in your care — and generally not with a former patient either; and
recognise when over-involvement is developing, and take action, including reporting where appropriate.

Crossings, violations and misconduct

Boundaries are best pictured as a spectrum. In the centre sits the healthy therapeutic relationship; at one end lies under-involvement (distancing, disinterest, neglect), and at the other over-involvement. Most difficulties arise at the over-involvement end, where behaviour moves through three stages:

Boundary crossing — a brief, often well-intentioned step outside the usual professional relationship, such as a small favour or a personal disclosure. A single crossing may be harmless, but it is a warning sign.
Boundary violation — a more serious or repeated departure that puts the patient at risk of harm or exploitation.
Professional sexual misconduct — the most serious breach of trust, and never acceptable in any circumstance.

Common risk areas

Gifts and money

Accepting significant gifts, tips, loans or bequests — or lending money to a patient — blurs the relationship and can create obligation. Small tokens of thanks may be acceptable within your employer’s policy; anything beyond that warrants caution and a conversation with your manager.

Social media and communication

Accepting friend requests from current patients, messaging them privately, or contacting them outside clinical channels are frequent sources of notifications. Keep professional and personal accounts separate, and remember that the Code applies online exactly as it does in person.

Self-disclosure and over-familiarity

Sharing a little of yourself can build rapport, but repeated personal disclosure, seeing a patient outside work, or treating one person as “special” are signs the relationship is drifting.

Dual relationships

In small towns and close communities you may be asked to care for a neighbour, friend or family member. Where you can, arrange for someone else to provide that care; where you cannot, be explicit about the professional nature of the relationship and document your reasoning.

Practical safeguards

Pause and ask whose need is being met by what you are about to do.
Follow your employer’s policies on gifts, social media and private practice.
Document decisions that could later be questioned, and the reasons for them.
Talk to a trusted colleague, manager or your professional association early if you feel a relationship shifting.
Transfer care to another practitioner when a personal connection makes objectivity difficult.

When a boundary is breached

Where a boundary is crossed, the NMBA’s response is proportionate to the risk. Outcomes can range from a caution or conditions on registration through to referral to a tribunal, which for the most serious violations can reprimand, suspend or cancel registration. If you are facing a concern, our guide to NMBA complaints and investigations explains what to expect and how to respond.

Related CPD courses

Strengthen the judgement this article describes with CPD designed for Australian practitioners:

CPD courseEthical Boundaries with Patients and Colleagues CPD courseProfessionalism for Healthcare Professionals CPD courseEffective Communication for Healthcare Professionals

Continue the Nursing & Midwifery Board series

Complaints and Investigations Explained Reflective Practice and Insight for Nurses and Midwives

Frequently asked questions

What are professional boundaries in nursing?

They are the limits that keep the nurse–patient relationship professional and therapeutic, protecting the space between the nurse’s power and the patient’s vulnerability, as defined by the NMBA.

Can I accept a gift from a patient?

A small token of thanks may be acceptable within your employer’s policy, but significant gifts, money, loans or bequests should be declined as they can compromise the professional relationship.

Can I be friends with a patient on social media?

Accepting friend requests or privately messaging current patients is a common source of notifications. Keep professional and personal accounts separate; the Code of conduct applies online just as it does in person.

Are relationships with former patients allowed?

Sexual or intimate relationships with people in your care are never acceptable, and the NMBA generally regards relationships with former patients as inappropriate given the lasting power imbalance.

What happens if I cross a professional boundary?

The NMBA responds in proportion to the risk — outcomes range from a caution or conditions on registration to, for the most serious violations, referral to a tribunal that can suspend or cancel registration.

This article is general information for education and CPD purposes. It is not legal advice and does not create a practitioner–adviser relationship. If you have received a notification, seek advice from your professional indemnity insurer, your union or professional association, or an independent lawyer experienced in health practitioner regulation. Healthcare Ethics Courses is an independent education provider and is not affiliated with, endorsed by, or acting on behalf of Ahpra or the NMBA; regulator names are used for reference only.