An exploration of how the variety of nursing roles in services for adults with learning disabilities may impact on maintaining professional boundaries.

Recent scandals, such as the abuse at Winterbourne View, continue to draw public attention to the issue of the abuse of people with learning disabilities (Department of Health, 2012). Existing research into this area is often too simplistic, focusing on characteristics of the victim, perpetrator and settings in which the abuse takes place. Nurses in learning disabilities services have been suggested to occupy multiple roles (Golding, 2001); however, there appears to be a lack of consideration given to the impact this has on staff management of boundaries. Interpretative Phenomenological Analysis was used to explore the experiences of five nurses working in residential services for people with learning disabilities. Three superordinate themes were identified: (i) investment and enmeshment of one’s self in the role, (ii) unique setting and population and (iii) staff understanding and management of boundary crossings. Findings indicated that multiple roles, for these participants were irrelevant, and instead concerns around balancing client needs within service limitations and pressures were more salient. Additionally, participants appeared to lack a clear conceptualisation of boundaries instead focusing more on their relationships with service users and their understanding of what it means to provide good care, likening these to personal relationships. In addition, guidance and supervision was insufficient in meeting staff needs leaving service users vulnerable to abuse. Service level changes including supervision facilitated by an outside agent, and experiential training to challenge axiomatic thinking may support staff in managing the pressures and complexity of their roles