Practical tips to set boundaries, stay compliant, and protect your license.
Candy Finley, RN, IgCN, Clinical Nurse Educator II - November 26, 2025

Understanding Your Scope in Home Infusion

Home infusion therapy (HIT) puts you in patients’ living spaces as both a clinician and a guest. Without immediate backup like in hospitals, your scope of practice becomes critical for patient safety and to protect you and your license.

The isolation factor matters.

• There’s no charge nurse down the hall or doctor making rounds—it’s just you, your training, and whatever situation unfolds.

Why Boundaries Get Blurry

• Gray areas emerge constantly.
• You’re there for IVIG/SCIG therapies, monitoring infusion sites, assessing therapy-related complications, and patient education—not diagnosing new conditions or adjusting unrelated medications.
• When patients mention blood sugar issues or show you concerning wounds, the pressure to help is real, but stepping outside your scope risks both patient safety and your career.
• Your scope is defined by credentials, state regulations, employer policies, and pharmacy protocols.

Staying in Your Lane

• You need to operate within the defined scope of practice established by your credentials, state regulations, employer policies, and pharmacy protocols to ensure safe and compliant nursing services.
• Use clear boundary-setting language: “I’m here specifically for your infusion therapy—that’s what your authorization covers. But I can contact your doctor about that concern.”
• Ensure all documentation is thorough and complete and promptly communicate any issues requiring additional follow up through the appropriate chain of command.
• When you notice immediate safety concerns (allergic reactions, abuse signs, fall risks), assess and report through appropriate providers—don’t diagnose or treat independently.
• Build your contact network and keep numbers for prescribing physicians, pharmacies, supervisors, social workers, and case managers up-to-date and ready.

The Three-Question Test

Before any action, ask yourself:

• Is this within my scope of practice?
• Do I have an order for this?
• Am I qualified and authorized to do this?

If any answer is no, stop and get clarification.

Understanding Difficult Behaviors

• Look beyond the behavior to the cause.
• Fear, pain, previous bad experiences, and feeling powerless drive most “difficult” reactions.
• Anxiety and depression don’t always look like sadness. Sometimes they manifest as anger, resistance, or missed appointments.

Really listen.

• Sit with concerns before jumping to reassurance: “I hear you, that sounds really scary” builds more trust than immediate clinical explanations.

Practical Strategies That Work

• Establish routines.
  • Doing things in the same order each visit helps patients relax because they know what’s coming.
  • Skip the medical jargon and make it simple. Say “I’m going to connect your IV line now, you’ll feel some pressure” instead of “we’re going to access your port.”
  • Involve family strategically. Sometimes their presence helps; other times you need privacy for real conversations.
• Problem-solve collaboratively.
• When facing resistance, ask “This isn’t working for you—what would make this easier?” Simple changes like visit timing can transform interactions.

Protecting Yourself

• This work drains you emotionally.
• Sitting in your car processing difficult visits is normal, not weakness. Talk to coworkers and vent when needed.
• Pretending the emotional toll doesn’t exist leads straight to burnout.
• The goal isn’t never feeling frustrated. It’s recognizing when you’re getting there and not letting it affect patient care.

Bottom Line

While some encounters may feel “challenging” the truth is that most patients are simply feeling fear: fear of the unknown, of worsening symptoms, and loss of independence. Recognizing that their reactions usually stem from anxiety rather than defiance allows us to treat them with compassion and provide more meaningful care.