Breach of Confidentiality?

  1. My class in nursing school was trying to figure out if this was a confidentiality breach:

    You are working as a nurse on the floor of a hospital and see a person that you know from outside of the hospital. You make eye contact and say hello. Later you stop by the room to say hello to the patient and their hospitalized family member, who is also an old friend. You both talk a little bit about how you and your family are doing and how the patient and her family are. The patient shares some details about why they are hospitalized.

    Was this a breach of confidentiality? No personal information was shared without the patient's consent, nor was anyone else- healthcare team or otherwise- told of the conversation. Our instructor says it was, stating that the nurse should not acknowledge anyone that she knows and the acknowledgement was a breach of confidentiality.

    Opinions?
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  2. 41 Comments

  3. by   caliotter3
    I can see the argument for both ways, but think it is over the top to tell employees they can not say hello. After all, do they want complaints about rude staff, a very possible reaction from the person who you refuse to acknowledge?
  4. by   Chin up
    Bull crap. We are humans, not robots. We are to acknowledge everyone the same. Peace!
  5. by   threelittlebirds
    What we were taught was that we could be pleasant, but no more than we would be with any other stranger... unless they initiated more interaction. For example, you could make eye contact and say hello, but unless they started up a conversation, or invited you into the room to chat, you would carry on with your day as if you hadn't seen them there. In the same vein, if you see a prior patient at the grocery store, you should act the same way- unless they come up to you and say hello. And even then, you wouldn't bring up their reason for being hospitalized or comment on the situation unless they started talking about it. My understanding is that you take cues from the patient, so as to not overstep...

    Of course, I'm still in school myself, so this is just my understanding of what my instructors have told us
  6. by   Chin up
    I will say, I have pretended to not, see someone while working, or other places if I thought it would embarrass them. Once eye contact made, I always speak and if it us awkward, will try and act dumb, so as not to embarrass. But that is more a courtesy, than following a policy. I think it goes under the rule...manners. But that is a whole different story...
  7. by   Whispera
    I think if you had seen the paperwork about the person you know and had gone in to say hello then, it MIGHT have been a tangled situation, but to say hello and talk to someone you know who happens to be a patient where you work....this is absolutely NOT a breach of confidentiality. Where it would become a breach is if you would tell people outside the hospital anything about the person's hospitalization, or share personal details about the person with staff, that aren't relevant to his or her care.

    Confidentiality rules/laws are intended to protect people from prying eyes and nosey minds, blabby mouths, and stupid lack of care of information, not to keep us from being caring human beings. Imagine if you ignored a friend, how the friend would feel? Would that help him feel cared-for in your facility?

    Like Chin Up said, we're humans, not robots. I'd like to add, we're CARING humans, not furniture.
  8. by   tablefor9
    Sorry, but one can't ignore *anyone* in the hallway. I don't know that I would have stopped by the room without a direct invitation to do so, unless it was my personal family or that of my very best friend, however. I work in women's services, and maybe the lady from church doesn't want me to know about her breast revision...
  9. by   Chin up
    Quote from threelittlebirds
    What we were taught was that we could be pleasant, but no more than we would be with any other stranger... unless they initiated more interaction. For example, you could make eye contact and say hello, but unless they started up a conversation, or invited you into the room to chat, you would carry on with your day as if you hadn't seen them there. In the same vein, if you see a prior patient at the grocery store, you should act the same way- unless they come up to you and say hello. And even then, you wouldn't bring up their reason for being hospitalized or comment on the situation unless they started talking about it. My understanding is that you take cues from the patient, so as to not overstep...

    Of course, I'm still in school myself, so this is just my understanding of what my instructors have told us
    In school or not, this is common sense. Kudos! Peace!
  10. by   BabyLady
    Quote from ashepherd
    My class in nursing school was trying to figure out if this was a confidentiality breach:

    You are working as a nurse on the floor of a hospital and see a person that you know from outside of the hospital. You make eye contact and say hello. Later you stop by the room to say hello to the patient and their hospitalized family member, who is also an old friend. You both talk a little bit about how you and your family are doing and how the patient and her family are. The patient shares some details about why they are hospitalized.

    Was this a breach of confidentiality? No personal information was shared without the patient's consent, nor was anyone else- healthcare team or otherwise- told of the conversation. Our instructor says it was, stating that the nurse should not acknowledge anyone that she knows and the acknowledgement was a breach of confidentiality.

    Opinions?
    Breach of confidentiality?

    Uh no...because you didn't tell anyone about the fact that the patient was in the hospital, you did not access their records when you were not assigned the patient. You saw them in plain view and talked to them...they may have thought you were rude if you did otherwise and any medical information that they told you they VOLUNTEERED to share with you...and I am sure you are planning to keep that to yourself.

    No, no violation.

    Instructor is beyond wrong and I cannot believe she told a group of students that.

    Now...if you saw, let's say, a patients name you knew on a chart and then took it upon yourself to visit that room? Then yes...b/c that puts them in an uncomfortable situation..but if you saw them and you were friends, that is different.
  11. by   JSlovex2
    i can see this being a breach of confidentiality. what if i went to the hospital and was accompanied by my husband. what if two weeks beforehand i had gone out with my girlfriend to a bar without my husband knowing and that's where i met "the nurse who came by to say hello"? i'm gonna get, "who was that? how do you know them?" my husband isn't like that, but there are people who are. i can see it getting sticky with opposite sex scenarios too. what if the nurse was my ex husband's sister and just a day earlier i had told my husband i haven't seen any of his family in years and then she comes in chatting about things that make it obvious that's a lie - even, "well, you know mom had surgery." husband would be thinking, "hmm. how would you know that?"

    maybe not a great example, but you get the point.

    i think if you're not directly caring for the patient it would be best to wait until the patient is in the room ALONE before going by to say hello. i think a family member being present is what puts the breach in there.
  12. by   Otessa
    Quote from ashepherd
    My class in nursing school was trying to figure out if this was a confidentiality breach:

    You are working as a nurse on the floor of a hospital and see a person that you know from outside of the hospital. You make eye contact and say hello. Later you stop by the room to say hello to the patient and their hospitalized family member, who is also an old friend. You both talk a little bit about how you and your family are doing and how the patient and her family are. The patient shares some details about why they are hospitalized.

    Was this a breach of confidentiality? No personal information was shared without the patient's consent, nor was anyone else- healthcare team or otherwise- told of the conversation. Our instructor says it was, stating that the nurse should not acknowledge anyone that she knows and the acknowledgement was a breach of confidentiality.

    Opinions?
    Absolutely say hello in the hallway- if they acknowledge you with eye contact,if they look away they may not want you to know if they or their loved ones are in the hospital-going to their room? -no, Unless you were specifically invited, -if you searched them out after you said hello and then decided to visit-um, no.....
  13. by   classicdame
    our facility expects us to be friendly. I have been in the situation described. I acknowledged the person but did not ask why they were there. I just said if I can help in any way let me know. I run into church friends a lot, but I stick to my mantra and it seems to work.
  14. by   merlee
    This has become harder and more complex than ever. Where to draw the lines?

    If you work in the same community that you live, you will at some point 'bump' into a former pt/client. I have managed to just smile and nod and then keep moving unless THEY stop me. And then I acknowledge that I was the nurse they knew.

    I have rec'd calls from families long after I cared for them to come to funerals, and then they usually tell everyone else who I am.

    It's a very fine line; better to err on the HIPAA side!

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