Disclosing personal info to patients

chris425 · Apr 25, 2007

Absolutely never share anything you are not comfortable sharing. Anyone who asks for the exact location of your home needs to be viewed suspiciously. Ask yourself, "Why does this person want to know where I reside?" Although I am not a member of the medical professional, I am in the unique position of being able to competently address the matter of Health Care workers' safety based upon personal experience.

My mother, who belongs to this forum/group, is a Registered Nurse. Two years ago a patient began stalking her. The patient had sought treatment from her at a primary care clinic almost daily for a period of approximately one month. Throughout the course and scope of these clinic visits, he would attempt to ask uncomfortable personal questions (where she lived, etc.) which she wisely never responded to -- probably on account of her previous experience working the Psychiatric Unit. He then began stalking her, both inside the clinic and following to/from work, both covertly and overtly. Prior to the acts of stalking, he did NOT present as having any unusual problems - did not seem overtly nosy or creepy in the beginning (ie - could be a friendly patient -- and maybe not). I am fortunate that he does not know our exact address as my Mom feels strongly that based upon his history he would have appeared at our home had he known the address.

All intermediate measures to include personally escorting my mother to and from work, police action, safety precautions/education proved ineffective in resolving the matter. Upon the advice of the primary law enforcement agency investigating this, she filed for an Emergency Protective Order, which the court granted the same day. He was even served with the Order by the Sheriff's Department the same day (in just about one-hour!), meaning the court's order had was now in full effect. Regretfully this was not sufficient. Ultimately she was compelled to resign her full-time position for safety reasons. During the subsequent court hearing to determine if the court's Emergency Protective Order should be lifted or remain in effect for three years, the patient completely lost it, reinforcing my relief over her immediate resignation. During the hearing his testimony was slurred, rambling and illogical. It focused on his belief that outside of the courthouse (prior to the instant hearing) he felt "the nurse" had approached him and yelled at him on the street by the entrance. This was actually excellent testimony because we had been late to court for the hearing and he was already seated in court upon our arrival. Not only was this witnessed by the bailiff, but I had also called to the court beforehand to advise that we were late -- traffic delays -- and asked the clerk to keep this case on the judge's morning docket.--The court was made aware of our delay en route.

His behavior in open court, while on the record, was so inappropriate that the Judge not only ordered the Restraining Order remain in effect permanently, but also added additional restrictions than we had petitioned the court for in the first place. Upon learning the courts ruling, this patient absolutely lost it. The judge had to end the hearing prematurely and retreat to her chambers. The bailiff had to physically remove him from the courtroom. All doors to the courtroom were locked while the court's order was drafted and presented to the judge for her signature. In the interim he stormed into legal aid wanting the injunction overturned. They refused to assist. The bailiff assigned two other officers to keep track of him and they were in constant radio communication verifying his location within the courthouse facility and observing his behavior. We were then given a safety escort by the Bailiff who took us down a locked, private stairway leading to the back entrance. The bailiff advised that a restrained person would not think to look for her at the back entrance.

I am not writing this to scare you in any way, as 98% of your patients are probably great -- or overtly nosy -- but not a potential safety threat. I do feel, however, that it may be helpful to learn how these safety threats occur and the effect they can have. Now especially in a small town, better to prevent any problems in the beginning than risk having a stalker. My other tips:

- Letting someone down easy is always nicer when you do not want to answer them, BUT do not feel you must always do this. It is OKAY to just say "No". Do not dance around the issue with --- Ah, it's just we're not allowed to give that out per policy, etc.

Just remember to say "No". No, I'm not going to answer that, No thats not appropriate, No I'm not comfortable giving that out or just plain NO. Any self-respecting patient will respect your response and probably feel bad for their intrusive questioning realizing it was out of line. Just the fact that you felt uncomfortable means the question was clearly out of line. If your 'not sure' then it probably was out of line -- especially when you take into account that nurses are NOT overly sensitive types to be upset by the slightest comment -- they are used to putting up with a lot.

- I would be careful responding to questions regarding marital status. (Especially if you are single). I do not know if most nurses do or do not wear wedding rings to work. My mother actually did wear her wedding ring to work -- every day. I think it is a very wise thing to do. If worried about your real ring being lost (like if you wash hands a lot), consider investing in a dime store 'Wedding' Ring to wear at work. Consider it your male repellent ring. You will probably get fewer personal inquiries if people know you are married. IF YOU ARE SINGLE: Wear a ring. When your fellow colleagues inquire, let them know its for safety reasons.

- When you are asked a question, wonder WHY they are asking. Like where do you live (generally) might be okay -- if your comfortable with that -- but EXACT address. I'm more concerned with WHY does this person wish to know? Do they plan on 'visiting'? or are they just too stupid to realize that is not appropriate to ask. Also, I can understand a little old lady type asking, but a man (middle-aged or around your age) asking is just not right. I could see maybe a patient whose like a realtor asking out of habit like they do all and that would not raise alarm bells that they asked (although I would politely decline). I think any respectful male -- myself included -- would never ask where the nurse lives -- particularly a female nurse.

- For comments that are rude, just don't stand for it. Illness is not a license to be rude. As a nurse you treat the whole person, whether they like it or not. Try 'treating' their poor behavior by putting them where they belong. In addition to the other suggestions made by posters preceding me, you could probe them. Why am I going to hell for working on Sunday? or Would you like to be discharged right now (and not return until Monday) while the entire staff attends church and observes the sabbath? or "Ahhh, your right. I'll just withhold all your medication and oxygen and other treatment for the rest of the day so I can pray/worship/visit chapel so I don't have to worry about the eternal wrath" I think you should just tell them that was rude. Additionally, you could matter of factly document their comment in the chart -- and *genuinely* tell patient your concerned about their mental well-being since their making illogical comments (think it really is illogical if they feel the person HELPING and caring for them is going to hell -- particularly over something so mundane -- if they feel this way towards someone helping them maybe they really do have a problem!) Going the psych/concerned route might shut them up real fast.

- Religion & Politics. I always avoid this in virtually all relationships, be it personal or professional unless I already know that said person and I agree on the same principles and philosophies.

- Moderation. I believe that it is wholly appropriate to discuss personal information with patients, if it is the providers choosing. Just use your judgment if you WANT to share something personal with a patient. I'm going to go a bit off topic here ... since I'm sitting just waiting for a call right now ... I for one had a medical professional (PT) that was rendering treatment to me who I came to know well over the course of prolonged physical therapy appointments on a daily to every other day basis over several weeks following major surgery. We had come to like one another well -- same values -- liked to compare family photos (my pet, her child, etc) and during my final week she just out of nowhere went from saying how much she wanted another child to sharing (announcing) details of her expensive and frustrating attempts at getting pregnant (fertility). She did not say this one just one day -- like a being frustrated in the moment type thing. Rather, for the next several visits she talked about this (during down time) and over time offered updates when I saw her again. Although a bit unconventional (and I'm sure some would criticize her for sharing such information), she did use good judgment in that she did not announce this to all patients and only to a patient whom she both trusted and liked. From my prospective, it was quite helpful. After I stopped squirming over the topic, (my face turned red at first when the topic arose - but was face down on PT table) it actually made me feel better ... because despite my quite serious health status just at that time, it reminded me of the serious problems that other people were facing. To hear this from a health provider helped me to view her more as a person -- and to like and respect her more. After all here she was working all day with the more complex patients who had problems -- helping them -- but never once complaining about her own problems. Knowing her problem -- and heartbreak -- caused me to have greater respect and admiration for her.

Also there was one other time when a fair amount of personal information was shared. Five years ago I was admitted through the ER at 3am for an infection following a procedure. The RN I was assigned to was quite friendly (and it was dead when I arrived from the ER at 3am). When I saw the nurse I was quite surprised because she looked like she was my age -- I was 19 years old at that time. I was a little surprised when this friendly young woman wearing a bear mid-drift who looked like she was still a college student introduced herself as the nurse when I was wheeled off the elevator (the 40 yo woman nearby was not the nurse -- but the aid). After she got my history/medication, etc, she just hung out and chatted for a long time. We really had a lot in common and just clicked. After we started talking about our respective educational backgrounds (she had just received a 2 year nursing (RN) degree and I was a Junior in college) we started comparing each others birth dates and realized we were born within two weeks of one another in the same year. I never would outright inquire about her age, much less DOB just out of the blue. It just arose in the course of mutual conversation (not direct questioning). We were both ahead in our grades by about a year for our age. We just really clicked on the peer to peer level and chatted for a long time about schooling, where we were from (she was a travel RN from Virginia), the type of housing the agency put her up in, etc. She was just really cool and the best nurse in that hospital during my stay (this was a hospital that lost its JACHO accreditation shortly thereafter). My Mother even noted that this 19yo RN (and travel nurse no less) was the best out of all the nurses -- both ER & upstairs nurses). In that I was admitted for a serious, yet still unknown condition/prognosis it was really great to be able to connect with a nurse on the peer-to-peer level. Having that peer connection with the nurse treating me made it easier because once we connected as peers it made the medical aspect easier. She was able to relay to me the technical and medical information just like a peer in a social conversation. So that connection was quite good.

Finally, I have safety related resources in the form of professional articles, journals, occupational specific guides geared specifically for Health care Workers, to include OSHA's most current Health Care Worker Safety guide, that I would be willing to furnish to anyone. I am pleased to have been able to share this quite detailed information with others who may find themselves in the unfortunate position where they can benefit from the information contained herein.

On a personal level, best of luck to both you and anyone in this situation. Please feel free to direct any inquiries or requests for publications to me through the e-mail feature of this account.

Altra, BSN, RN · Apr 25, 2007

A couple of replies to this thread specifically addressed the OP being chided for working on Sundays. I went back & re-read the OP, twice, and can't find that in there anywhere.

The questions the OP says she is encountering do sound like fairly typical small-town/rural America small talk, IMO. I'm not denying that some may be taken aback by these quite personal questions -- these are not things that I myself would ask a stranger. But it is a cultural norm in some areas. If the OP is getting these same types of questions from multiple patients/families ... do you want to label the entire town rude, or possibly could you accept it as part of the local color?

I grew up mostly in heavily Catholic areas of the northeast. However, during my high school years my family relocated to a southern state, although it was an urban not rural area. Even in that urban, more "cosmopolitan" area we found ourselves continually asked, "where do you go to church?" We learned that it was much more about small talk than personal judgements.

There tend to be a multitude of threads here at allnurses.com regarding tolerance of diversity. Are we forgetting to be tolerant of the cultural quirks of rural Christians of conservative denominations?

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KellieNurse06 · Apr 25, 2007

Oh that's a piece of cake! I have a friend who is a nurse who taught me well on this type of thing...you just simply turn it around right back to them with the same question.............and if they don't stop asking until you answer them just tell them you don't discuss any of your personal life at the workplace...end of story....... Works like a charm!

Tweety, BSN, RN · Apr 25, 2007

Are we forgetting to be tolerant of the cultural quirks of rural Christians of conservative denominations?

One should be cognizant of the culture they reside in for sure. I grew up in a semi-rural area of North Carolina, and unfortunately found the conservative Christians to be quite intolerant and not worthy of my respect. Of course I demanded tolerance of them, and had to in turn give it back. Sometimes though you get what you give. But that was outside of nursing. As a nurse, I have to be tolerant of the diversity of my patients. Not just the Christians, but the drug addicts, criminals and sinners alike. So you are making a good point that I essentially agree with.

(By now my skin is flame retardant and I don't need a suit). I don't mean to Christian bash, just sharing my experience, and I won't allow that in this thread. As well as I'll be wary if Christians gather and whine about mistreated they are in today's society.

Nurses who work Sundays should be respected by their patients. But we should understand culturally why they are asking "why aren't you in church today?" I usually give patients a break and let them babble on about whatever they want to talk about and can steer them away from my personal business. Most people want to talk about themselves anyway. :)

walk6miles · Apr 25, 2007

I am so happy to get this off my chest! I work in a cardiac unit now; having spent 18 years in Open Heart/Transplant Recovery (it's nice to have a conscious patient!!).

I frequently work with another nurse who is a bit younger than I. She is a good nurse BUT she has a hearing deficit and refuses to use a hearing aide.

Our unit is quite small and close to another treatment area - there is always a crowd coming or going.

This nurse has repeatedly told the story of her unhappy marriage; her personal beliefs and feelings to her patients - her comings and goings, etc.

ad nausea.

I have spoken to the manager of the unit about the loud, intimate conversations and there have been many complaints from her patients because she asks her assessment questions loudly and invariably repeats some of the patient's reply back so that (as one patient stated: "all my personal information was spread around for anyone to hear:.

I have on one occasion given my patients sleeping pills; they were awakened repeatedly by her noisy cell phone conversation.

Any suggestions??

PsychRN-Kris · Apr 26, 2007

If I'm not comfortable discussing what ever the question asked is I just say "Oh, I don't discuss that with any of my patients. It's personal." Then I smile politely.

bethin · Apr 26, 2007

Thanks for all the replies. I think next time I'm asked about kids and husbands I'm going to tell them that I nagged my last husband to death and now I'm just sticking to dogs. At least they don't need 3am feedings.

Since I've been on high dose steroids I've been asked when my baby is due. Last weekend a visitor asked me this as they walked by the nurse's station. I told them I was 5 months pregnant - with twins. When I went into the room where the visitor was she told her husband that I was pregnant with twins and he should be easy on me.

Should have seen my coworkers faces when they heard I was pregnant. They started planning a shower until I corrected them.

I can deal with the pts who are just making conversation and are lonely. They don't bother me. I never did have patience when it came to nosy people.

bethin · Apr 26, 2007

I am so happy to get this off my chest! I work in a cardiac unit now; having spent 18 years in Open Heart/Transplant Recovery (it's nice to have a conscious patient!!).
I frequently work with another nurse who is a bit younger than I. She is a good nurse BUT she has a hearing deficit and refuses to use a hearing aide.
Our unit is quite small and close to another treatment area - there is always a crowd coming or going.
This nurse has repeatedly told the story of her unhappy marriage; her personal beliefs and feelings to her patients - her comings and goings, etc.
ad nausea.
I have spoken to the manager of the unit about the loud, intimate conversations and there have been many complaints from her patients because she asks her assessment questions loudly and invariably repeats some of the patient's reply back so that (as one patient stated: "all my personal information was spread around for anyone to hear:.
I have on one occasion given my patients sleeping pills; they were awakened repeatedly by her noisy cell phone conversation.
Any suggestions??

Can you report this as a HIPPA violation? I would personally be humiliated if the nurse loudly repeated my answers about my 'habits'. Most employers require that their nurses be able to see and hear with help with devices within normal limitations. If she has this hard of a time hearing, how is she going to hear a cry for help? If she has the device she should use it. Patients have the right to privacy and she is infringing on that right.

Speaking so loud that she's waking patients who have had a sleeping pill?? Outrageous!

I_am_Julia · Apr 26, 2007

dance around the question and basically say i do a bit of it all. personal questions are a pet peeve on any job for me.

i work in a small rural hospital. i work weekends only, 12 hr shifts 7a-7p. what do you say when you are asked quite often your religion, when you go to church, what church you attend, are you married, children, etc? i've even been asked on a sunday no less, have i heard the truth concerning jesus christ and have i accepted him as my personal savior. i've been offered bibles that my religion would frown upon. i was born and raised catholic but my current hours do not allow me to attend church, which i already feel guilty about. i hate saying "none of your business" which it isn't. once, i disclosed to an elderly woman when she asked if i was married, dating or had kids that i had none of the above. she called me an old maid and said that the odds of me getting married at my age are less than me being involved in a terrorist attack. i've been asked the exact location of my house, my parents names, etc. not all of these people who ask are elderly, some are middle age and should know better.
sometimes i feel like lying and say i'm married, with 2 kids, and i'm atheist and i live on mars.
what do you say when asked these questions? how do i tactfully put that their questions are out of line and have nothing to do with the care i provide? oh, and i've been told countless times i'm going to hell for working on a sunday.

saraltx · Apr 27, 2007

I'm a student just starting out to think about different things I will be confronted with in my future career. I agree with what was said about keeping private stuff private towards patients, and that there is no need to share more information than one is comfortable with. Everyone's idea of what is appropriate information to share is different, so saying NO should not be taken as an offense. I am a private person and like to keep my professional and private life separate. So on reading this thread, I'm wondering what other nurses think about discosing personal info to co-workers? on my clinicals in school I often thought that some nurses are overly inquisitive about other's private life. Such as if a patient asks you "Are you married etc." it seems easier not to answer than if co-workers ask the same thing, because we spend more time with co-workers and coming across as rude might create a bad work environment and I have heard so much chatting about personal stuff among the nurses that it seens all but expected to answer. Am I the only one who does not like the thought of sharing my private life with my co-workers?

I_am_Julia · Apr 27, 2007

Just say something cute like... "I am every woman" and laugh it off. I don't respond to personal questions at all. It hasn't created a bad environment for me. However, if you socialize with your co-workers outside of work it is more apt to happen than now, witht he personal questions that is.

I'm a student just starting out to think about different things I will be confronted with in my future career. I agree with what was said about keeping private stuff private towards patients, and that there is no need to share more information than one is comfortable with. Everyone's idea of what is appropriate information to share is different, so saying NO should not be taken as an offense. I am a private person and like to keep my professional and private life separate. So on reading this thread, I'm wondering what other nurses think about discosing personal info to co-workers? on my clinicals in school I often thought that some nurses are overly inquisitive about other's private life. Such as if a patient asks you "Are you married etc." it seems easier not to answer than if co-workers ask the same thing, because we spend more time with co-workers and coming across as rude might create a bad work environment and I have heard so much chatting about personal stuff among the nurses that it seens all but expected to answer. Am I the only one who does not like the thought of sharing my private life with my co-workers?

teeituptom, BSN, RN · Apr 27, 2007

Im always willing to talk about things like Golf, how importtant Golf is, How necessary Golf is, How Fun Golf is, Golf Jokes.

I also talk about how stupid GW Bushie is.

I chat about family friends. Afterall Ive been in this ER for almost 20 yrs. I easily know half the town and the other half knows me.