Nurses work in dynamic environments and need to have the proper skills and competencies to provide safe, ethical patient care (Ranjbar et al., 2017; Raso et al., 2019). Psychiatric nursing is a specialized nursing profession focused on the care of people experiencing mental health distress and crisis. Western Canada recognizes psychiatric nursing as a distinct profession and has specialized undergraduate psychiatric nursing educational programs including a Bachelor of Science in Psychiatric Nursing and a Bachelor of Psychiatric Nursing. Canadian entry level competencies for psychiatric nurses include the ability to establish, maintain, and negotiate professional boundaries within the context of a therapeutic relationship (Psychiatric Nurse Regulators of Canada, 2014).

An important competency required by psychiatric nurses involves development, maintenance, and termination of the therapeutic relationship (Ashton, 2016). The therapeutic relationship has been described as asymmetrical (Bag, 2022) because psychiatric nurses work with people in vulnerable states and are in positions of power. Professional boundaries are used to maintain the integrity of a therapeutic relationship (Austin et al., 2016). Professional boundaries are defined as “the mutually understood physical, emotional, sexual, and social limits of a relationship” (Valente, 2017, p. 45).

Psychiatric nurses are responsible for upholding professional boundaries as an aspect of ethical care provision (Bag, 2022). Given that the ability to establish, negotiate, and maintain professional boundaries has been identified as an entry level competency, it is the responsibility of psychiatric nurse educators to prepare students to perform this skill (Psychiatric Nurse Regulators of Canada, 2014). Therefore, boundary instruction needs to be incorporated into the curriculum.

Within academia, ethical care provision is embedded into the formal psychiatric nursing curriculum through course objectives and evaluations. The formal curriculum is structured and planned to prepare students to meet the entry level competencies defined by the profession (Hafferty, 1998). Additional aspects of the curriculum, including the informal and hidden curriculum, have implications on how professional boundaries are taught, understood, and practiced.

Unlike the formal curriculum, the informal and hidden curriculum is not standardized (Akçakoca & Orgun, 2021) and varies across nursing programs. The informal curriculum involves relational learning (Hafferty, 1998) of professional behaviors through interactions with educators, peers, clinical instructors, patients, and healthcare professionals. This relational learning can occur through formation of peer relationships, mentorship, and faculty role modeling (Raso et al., 2019). The hidden curriculum also includes aspects of relational learning such as implicit communication of common values, attitudes, norms, and behaviors (Hafferty, 1998) associated with nursing. The hidden curriculum serves to identify what is considered ‘good’ or ‘bad’ practices in health care (Hafferty, 1998). Therefore, it is important to consider the formal, informal, and hidden curriculum given that student psychiatric nurses must enact this skill within clinical practice.