A breach of confidentiality???

sunnygirl272 · Jun 29, 2002

Originally posted by fergus51
...As for this board, I don't think any identifying info should ever be given about a patient, and the patient shouldn't be discussed if they are "newsworthy" and could be easily identified. I became concerned when I read a post about a 26 week old premie who had suffered a gun shot wound in utero. I discussed it with my nurse manager and she feels that it would be too easy to identify someone like this, so it would be a breach of confidentiality to discuss it....

ohhh..fergus..how kind of you to be concerned about our professionalism, enough to discuss us w/ your nurse mgr....:stone :idea: wait....i wonder if you are the narc.....ooops...did i just type & send that? dang cast keeps getting in the way....

Home Health Columnist / Guide · Jun 29, 2002

Some info to ponder.

NETIQUETTE

http://avinformatics.org/newslter/1992/sepoct92.txt

Core Rules of Netiquette

http://www.albion.com/netiquette/index.html

From Hippocrates to facsimile. Protecting patient confidentiality is more difficult and more important than ever before

http://129.128.91.75/mlsci/professional-ethics.html

Student Nurses Pose HIPAA Challenges: De-Identification, Minimum Necessary (when using patient information)

http://www.aishealth.com/Compliance/Hipaa/RMCStudentnurses.html

Little off topic but interesting read:

Guidelines for the Clinical Use of Electronic Mail with Patients

http://www.amia.org/pubs/fpubl.html

oramar · Jun 29, 2002

I saw a philosoper name of John Lucas on tv. He is a professor of Philosophy at some Ivy league school. He gave a view of privacy and confidentiality that was historic in its focus. He opinion is that the age of privacy is over. He said the concept of privacy was unheard of until about 400 years ago. He says it's time has come and gone. He said that people will continue to fuss and fume over it for sometime to come but you all can just forget it. In addition I saw a young computer genius who was frustrated by the out of touch politicians to which he was giving testimony at senate hearing on privacy. He burst out and told them there is no such thing as privacy anymore, everybody can know anything about anyone if they care to do so. Of course that does not release us from our responsibilities or the probability that we might be sued.

zumalong · Jun 29, 2002

I so agree Heather. This issue of confidentiality is a mute point--I will use different patients blended into one in order to teach my students. It makes it more human. I would never break confidentiality of a patient. (let them prove it--innocent until proven guilty I say) Either sh** or get off the pot.

NurseDennie, BSN, RN · Jun 29, 2002

Originally posted by fergus51: I became concerned when I read a post about a 26 week old premie who had suffered a gun shot wound in utero. I discussed it with my nurse manager and she feels that it would be too easy to identify someone like this, so it would be a breach of confidentiality to discuss it....

It seems to me that if this or any other specific thing that had been discussed here was "too easy to identify" then that must mean that the details have been perhaps been in the news reports or something. Seems to me that if it's easy to identify then it's already out in the public, and discussion wouldn't be a problem with confidentiality. JMHO

Love

Dennie

ceecel.dee, MSN, RN · Jun 29, 2002

In the hospital, where someone might ask a specific question about a specific patient (the housekeeper may ask, "is that Theresa's ex-mother-in-law?") (medical records may ask, "is she still drinking?") (lab may ask,"what is his dx?")(front desk may ask,"is she pregnant?"), there is the rule of ON A NEED TO KNOW BASIS ONLY.

On this board, we post in generalities. No names, no institutional names, lots of "you get the picture" phrases with the story telling. One story may top another, but most of us come across the same or very similar situation sometime in our career, dependant of course on our area of specialty, and the story could be any one of ours. How is that breeching confidentiality codes?

Careful,yes..........but don't we live that way already?

fergus51 · Jun 30, 2002

Originally posted by sunnygirl272

ohhh..fergus..how kind of you to be concerned about our professionalism, enough to discuss us w/ your nurse mgr....:stone wait....i wonder if you are the narc.....ooops...did i just type & send that? dang cast keeps getting in the way....

Umm, seeing as none of you work with me and I was discussing it in generalizations (notice the phrase "someone like this") I wasn't too worried about narcing. As far as I know most of you aren't in Canada and this incident took place in the US. Not that it is any of your concern what I discuss with anyone. If you have a problem with me personally you can pm me rather than accusing me of something I didn't do on this thread.

fergus51 · Jun 30, 2002

Originally posted by NurseDennie

It seems to me that if this or any other specific thing that had been discussed here was "too easy to identify" then that must mean that the details have been perhaps been in the news reports or something. Seems to me that if it's easy to identify then it's already out in the public, and discussion wouldn't be a problem with confidentiality. JMHO

Love

Dennie

JMHO, but that's only true if you are talking about ONLY what is already in the media. If I treated that baby and went on to talk about his labs, his parents attitudes, etc. then I don't think that's allowed.

P_RN, ADN, RN · Jun 30, 2002

I visited a former co-worker on our sister unit....other end of the same floor. When I got back about 5 minutes later my NM asked me what I was doing over there (probably imagined I was looking to transfer!!).

I told her I'd been to see G______.

WOW the NM got all bent outta shape and said that was a breach. Technically that was, but as she was manager of both units she probably had more info than I did. Maybe I should have said I was applying to transfer.......nah I'd still be under her hoof.

Another time a housekeeper came up to the desk with a handful of papers she found on the floor near the FAX machine (ours was in an office between the two units, not on the unit itself) There were lab reports, physicians' dictations, and such. She said she only read them all to see where to take the papers. Hmmmmm.

And what happens if a FAX goes to the wrong person?

How about charts in a carousel, there for anyone to see?

adrienurse, LPN · Jun 30, 2002

I think we're all better off not disclosing the city/town we work in and especially not the facility's name. We have to be as general about the details we disclose as possible.

I for one could really get in trouble for breaching confidentiality here. In my province it is against the law and carries a fine of $50,000 if prosecuted.

Now what details released to anyone not directly caring for the patient, constitute a breach of confidentiality, depend on where you live and where you work. This may be worth checking into so you can know your rights. It's really tricky, a person needs to decompress when she/he gets home from work -- should they truly get in trouble just for talking about their day with their spouse/bb?

Apart from whether or not you have the potential for being caught, it also depends what the potential for negative consequenses are. Telling your spouse about about so and so pooping all over the place this morning is harmless, but what if a family member of that person is sitting behind you on the bus and overhears, puts 2+2 together and takes offense. You can get into a lot of trouble.

Just be careful!

Stargazer · Jul 1, 2002

NRSKaren, thanks for posting those articles. The one on patient confidentiality vis-a-vis email communication was particularly relevant to my job--I've already forwarded to all the clinicians in my dept. and to a couple of folks in Risk Management.

Home Health Columnist / Guide · Jul 1, 2002

Glad you found info helpful.

Here is another site with many useful HIPAA articles:

http://www.aishealth.com/Compliance/HIPAAResource.html