Professional Boundaries Course for Nurses and Midwives: When You Need One

Written and reviewed by Dr Shehzad Iqbal, MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics · Updated 3 November 2026

When does a nurse or midwife need a professional boundaries course?

Each situation below is a point where a nurse, midwife or nursing associate is asked, or wants, to show what they now understand about boundaries.

• Contact after dischargeA text, a friend request or a visit to a former patient, or to a relative you met while you cared for them.
• Gifts, loans and moneyCash or a present from a patient or family, a loan, or help with a patient’s shopping, bank card or will.
• Over-involvementExtra time with one patient, sharing your own problems, or a promise of contact that the rest of the team did not know about.
• A colleague’s complaintComments, messages or contact that a colleague, a student or a healthcare assistant found unwelcome.
• Conditions or a manager’s action planA local action plan, an NMC interim order or conditions of practice that name professional boundaries.
• Planned CPDNo concern at all: you want boundaries covered for revalidation because your work is one-to-one, in the community, in mental health or in a patient’s home.

What does the NMC Code say about professional boundaries?

The NMC Code (effective from 31 March 2015, updated on 10 October 2018 to include nursing associates) places the boundary in standard 20, “Uphold the reputation of your profession at all times”. Standard 20.6 asks you to “stay objective and have clear professional boundaries at all times with people in your care (including those who have been in your care in the past), their families and carers”. So the duty covers former patients and relatives as well as the person in the bed today.

Three more parts of the Code are the ones an NMC boundaries case is measured against:

• Vulnerability. Standard 20.5: “treat people in a way that does not take advantage of their vulnerability or cause them upset or distress”.
• Gifts, loans and finances. Standard 21.1 asks you to refuse gifts, favours or hospitality unless they are trivial, 21.2 to “never ask for or accept loans from anyone in your care or anyone close to them”, and 21.3 to act with honesty and integrity in any financial dealings with people in your care.
• Colleagues and messages. Standard 20.2 rules out bullying and harassment, and 20.10 asks you to use spoken, written and digital communication, including social media, responsibly.

Our NMC Code explained guide covers the rest of the Code. For a sexual boundary, the NMC’s fitness to practise guidance on sexual misconduct (reference FTP-2a-ii) applies; our guide to sexual boundaries and sexual misconduct explains how it is read.

Professional boundaries for midwives and nursing associates

A midwife’s relationship with a woman and her family runs through pregnancy, birth and the weeks after, at home as well as in hospital, so the line between warmth and friendship is tested in a way that a short hospital stay does not test it. Contact on social media after the baby is born, an invitation to a family event, or a gift from grateful parents all fall under standards 20.6 and 21.1. Nursing associates are bound by the same Code, and in community and care home posts they are the professional the patient sees each day. Dual relationships, where a patient is also a neighbour, a friend or a relative of a colleague, are covered in the course section on boundaries with patients.

Will a boundaries course help with an NMC concern?

A course is one of the steps the NMC names. Its guidance “Has the concern been addressed?” (reference FTP-16b) lists a relevant course, reflection that gives examples of how you have applied what you took from it, an action plan, and supervised practice, and asks that each step be relevant, measurable and effective. The same guidance says that courses with a practical element and a formal assessment can carry more weight than online courses, so a nurse with a boundaries concern does best to put the course beside other evidence: a written reflection, a manager’s testimonial and the changes you have made on the ward.

Use the course this way:

1. Complete it soon after the concern is raised, so the certificate date shows that you acted before anyone asked you to.
2. Write a reflection against the Code, naming the standard concerned (20.5, 20.6 or 21.1 to 21.3), what happened, its effect on the patient or the colleague, and what you now do differently.
3. Show the change at work: how you now handle a gift, a request for your number or a message from a former patient, and who you tell.

How the case itself runs, from screening to case examiners, is in our guides to an NMC referral and the NMC investigation process, and our NMC courses guide matches other concerns to other courses.

Can a professional boundaries online course count for NMC revalidation?

Yes. NMC revalidation asks for 35 hours of CPD over the three years, of which at least 20 must be participatory, meaning activity with other professionals. A self-paced online course counts towards the 35 hours; for the participatory hours, add an activity with colleagues, such as a team discussion of a boundaries case. Each CPD record must name the part of the Code the activity relates to, so record this course against standard 20.6. One of your five written reflective accounts can use it too; our guide to reflective accounts for NMC revalidation shows the form, and CPD courses for nurses lists other subjects.

The professional boundaries course for nurses: price and Bulk Buy

Courses that sit beside it

A ward or practice buying for its team can use Bulk Buy: £200 for 3 courses, £300 for 5, £500 for 10. For help choosing, see which course do I need or book a free call.

Guides that help

The CPD courses linked from this guide, Professional Boundaries for Clinicians, Ethical Boundaries with Patients and Colleagues, Professionalism and Boundaries in Use of Social Media and Financial Integrity for Healthcare Professionals, are by Probity & Ethics, written by Dr Shehzad Iqbal, CPD certified and accredited by The CPD Certification Service (provider no. 13197) and offered since 2020.

Questions and answers