Question about confidentiality

Nurses General Nursing

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First, let me say that I love this forum, even when it's a bit sticky or controversial. I think healthy disagreement can be a good thing.

I do have a question about patient confidentiality. I've been out of nursing but plan to return soon. Maybe a lot has changed since I left, but I do remember that we were strictly taught to not discuss patients, their diagnoses, etc. In fact, we were told that there were liability issues even if we discussed patients without naming names if they could be recognized from our conversations.

I am surprised, then, to see patients and their cases and outcomes discussed so openly on the forum. If I were a patient, I think I could recognize myself from some of the content. Mind you, I enjoy it and learn from it, but it is a concern?

Just wondering.

I'm currently working on pre-reqs for nursing school, but have a degree in Psychology...when I was working on my undergrad, I had to take a course in experimental psychology and this very subject was pounded into our brains regarding ethics in testing and reporting.

You have two issues: Hospital policy and patient-caregiver confidentiality.

We were taught, as a general privacy rule, that you can mention any situation about any patient as long as identifying factors are not used.

For example, you never use a name, first or last, if you have to do something in writing you can make up a name or use initials. Age is not considered identifying factors. General profession is ok, but exact job title or place of employment should not be used. Marital status is ok, number of children is ok, but the children should never be mentioned as being male or female. Sexual orientation is ok (this could be a significant factor), but the place where someone is from is never relevant (but in nursing it might if someone has a disease that is highly contagious), and other identifying information about their hometown is usually not relevant.

Imagine, if you couldn't discuss anything, how this would limit care? Nurses couldn't compare stories and learn from each other. Situations could never be reviewed in a hospital staff meeting in order to improve care, or to educate inexperienced nurses, which is very valuable.

The hospital may have a policy (and you should check with that), but as far as what is considered general ethics? What I have described above is not a privacy violation.

The factors you have described are not privacy violations because they are conversations taking place between caretakers on a need-to-know basis. Discussing patient information on a public forum doesn't meet that criteria.

Just my opinion.

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There are several people on the forum who are not nurses. There's a thread where nurses post about errors they've made. ? Not so sure I'd put that out there.

Information is too easily obtained these days. Wonder if lawyers ever peruse the site?

I would seriously doubt that attorney's would be trying to make a living going through a website and then trying to track down a patient to see if they want to file a lawsuit for violation of privacy...and then privacy may not have even been violated.

The attorney would have a hard time even establishing if the patient existed.

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Yeah, I hardly think a lawyer is surfing this site trying to find clients. My point is that this is an open forum and lay people can use this site as well as nurses.

I don't care what others post; in fact, I enjoy the discussions about patients and their care. However, I think you have to be careful about what you put out there on the world wide web for all to see. I was just a little surprised to find some things discussed so openly.

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The factors you have described are not privacy violations because they are conversations taking place between caretakers on a need-to-know basis. Discussing patient information on a public forum doesn't meet that criteria.

Just my opinion.

We were told that the criteria that I have listed is ok for publishing for the public to read, and a message board is a form of publishing.

The professor that I had was a Clinical Psychologist, 30 years experience (was teaching school in retirement) and was on several registries for expert testimony in the court system.

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Specializes in Critical Care, Pediatrics, Geriatrics.

This is a tad off-topic, but I noticed today at work they just put up a sign that reads: "Do you have an extra $50,000-$250,000 you aren't doing anything with? If no, then you better be conscious of Hippa Violations!"

I thought that was pretty good!

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This is a tad off-topic, but I noticed today at work they just put up a sign that reads: "Do you have an extra $50,000-$250,000 you aren't doing anything with? If no, then you better be conscious of Hippa Violations!"

I thought that was pretty good!

They're pretty serious about that stuff. One of my docs hands out numbers to the patients in the waiting rooms so they don't have to call names. I guess I'm just an extremely cautious person, but I prefer to err on the conservative side.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

There have been cases where our members told of being recognised from what they posted here. I can only echo what trauma said.....

we do emphasize that putting out personal information on the internet; either by naming names or other identifying information or having your real name as your user name is very dangerous.
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There have been cases where our members told of being recognised from what they posted here. I can only echo what trauma said.....

Well, if a nurse posted enough information about where they worked they could be easily found. Like if someone posted that they worked in Charlotte, NC for a Neonatal Optomologist...that would narrow it down to under 5 in the entire city, because there are precious few with those credentials. Someone that lived there would be able to point it out in a skinny minute.

But the violation of privacy, I believe, is someone may always be able to recognize themselves, but is it truly THEM, that a healthcare professional is speaking of? Or just someone else with the same circumstances? Or is that same HC Professional speaking of a case they had 5 years ago?

That is where the proof becomes very difficult, if not impossible.

It's a much bigger deal inside of a hospital where family members that are not supposed to get information, do. The media, in certain circumstances, etc. Because someone could narrow down the current cases fairly quickly and a particular HC Professional could also be named, very quickly.

This forum is so vast.

At the hospital where my daughter was born, in the NICU, they put the date the baby was born, the birthweight, current weight and how long they had been in the hospital on every isolette (sp). The purpose was when they took mothers that were in high-risk pregnancy situations through for a tour and a consultation with the Neonatologists, they could get an idea of how small their baby would be at different ages and what it may be like at birth.

When I took my tour, I was expecting it to be very scary, but it was actually a relief...the babies were smaller than anything that I had ever seen, but nowhere near as small as I had in my head. This was very, very comforting.

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