Nurses Safety



I am a first year student in nursing at university and have an assignment to write an essay in which I have to discuss one or more issues of communication in nursing. I have chosen to write my essay on confidentiality as an issue in nursing. I would love any ideas, suggestions, stories etc that anyone would like to share with me, either on the board or to my private email address that would give me an insight as to how you see confidentiality as an issue in nursing?





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Here's a good one about poor judgement on confidentiality.

My wife is a public health nurse who sees new mothers and babies and also deals with pregnancy issues. She got a case, 16 year old girl, 17 weeks pregnant, family upset and would like to discuss options. She makes an appointment and goes to the address she's given. Turns out to be the wrong address. She phones back, leaves a message for the girl to call her back. Calls back again, gets the girl's brother who tells her that his sister will be back in an hour or so. My wife asks for the address. It's our next door neighbours (we're new to the area, don't know everybody's last names yet).

Needless to say, my wife moves the case to another public health nurse. The girl left her (my wife) a message that she had had an abortion. My wife passed this on to the nurse seeing her. Today she found out that this nurse left a message on the family's answering machine telling them she had got the message about the abortion and layed out the symptoms and difficulties that could follow. Their office got a very angry and justified call from the girl's father as his two other boys who didn't know about the situation had heard the message. Ouch!

Anyway, just goes to show that some nurses just don't think enough about confidentiality.



just a question who was concerned about confidentiality when your wife told the story. she shouln't have

Ouch, good point....

It's a very difficult issue. I work on a reconstructive/plastic surgery unit and we recently had a patient admitted for a bilateral breast augmentation. She insisted that her husband should not be told about the nature of her operation and had, in fact, told him that she was in hospital for investigation of possible breast cancer.All the staff found it very hard to uphold this lie as the husband was extremely distressed at the prospect of his wife having cancer.

We had no choice but to withold information from a genuinely concerned relative.

What could we do? despite all arguments the patient insisted that we did not tell her husband and we had to uphold that right.

Some other areas to watch out for concerning breaks in confidentiality are messages left on answering machines and faxing information about patients to doctors, insurance companies, etc. When faxing make sure that you use a cover letter stating that this is confidential and dial the phone number very carefully. I sometimes ask patients if it is o.k. that I leave a message on their machine regarding their test or whatever.

I work in a newborn ICU. We have parents step out during bedside report between the nurses to help maintain confidentiality. Unfortunatly, the physician rounds are done at the bedside, and then the neonatologists dictate into their portable dictation machine at the bedside, with parents and many other visitors in the room. This is a BIG problem in our unit and we are attempting to deal with it. The neo's say that it's ok, because they have to dictate and the other parents will hear the stuff any way, but I don't know. Two biggies that were "mentioned" during rounds (in front of other parents) were, "This mom is a prostitute" and "this is the baby the mom attempted to abort and failed."

Originally posted by canoehead

I also spend some time in the ER and especially during busy shifts families loiter in the hallway, listening to talk at the desk, and peeking into treatment rooms. Generally the ones that are this obnoxious are also the type to challenge us with "but that's my mother/son/friend!" It is most common when the waiting area is full, and waiting time is long.

I especially hate the clients that demand to know why they have to wait so long. We can't very well tell them that bed 1 is having a heart attack, bed 2 needs three people to hold them down for a treatment, waiting for labs on beds 3 and 4, and the empty room they see is waiting on the ambulances bringing in an MVA. They just see one area with the curtain closed and empty bed and a nurse sitting waiting at the desk to triage or the ambulance. :mad:

:( Families, families my #1 stressor. I work in a 38 bed general ICU and it kills me when each and every individual family member, church member, friend, "just LIKE a sister", of a certain patient insists on getting updated from me. I always insist that there be ONE spokesperson (the wife/husband, mother/father, so on) and have THAT person talk to the doctors and receive updates from me and let him/her decide on what to tell the rest of the family. Granted- most of my patients on unable to make that decision for themself (too ill, intubated, etc.) in my unit. Of course - the majority of visitors just don't get- for which I respond "would you rather I take time away from taking care of your loved one???THANKFULLY, they cannot call directly to the unit and must call the ICU waiting room.

I work in a small hospital where you can pull up surgeries on the computer for the whole week. I was going to ambulatory surgery to have something done...well...when I came in to work one day and a Rn asked me what was wrong. I said what are you talking about? She said that she saw my name in the computer and just wondered. I do not feel comfortable with the fact that anyone can pull up that kind of info w/o a password. :eek:

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