Research informs us that boundary violations occur in increments. They begin with thoughts or fantasy, and then crossings . Brief boundary crossings can be intentional for therapeutic reasons, or inadvertent and thoughtless. Crossings generally produce no long-term effects but should be evaluated for potential long-term consequences or implications for the patient and nurse. Unchallenged, these crossings may become more frequent until a violation is committed which could potentially harm a patient . Violations often result from confusion between the needs of the nurse and those of the patient