Confidentiality of health care workers as patients

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by Gardengal
Nov 10, '02 Views: 2,935 Comments: 16

How do you help to protect the confidentiality of patients at your facility? How about if they are employees of your hospital? Do you do anything different to make sure that only those who need to know have access to their charts? How do you stop public conversation about private topics?

Do we guard our coworkers confidentiality or do we inadvertantly contribute to the breach? Are certain topics sensationalized? Do we share more information than we should when someone asks about them out of concern?

If you needed to be admitted to the hospital would you worry about this?
About Gardengal

Joined: Sep '02; Posts: 182; Likes: 1
critical care

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Nov 10, '02
Joined: Nov '00; Posts: 931; Likes: 18

When someone starts talking about a patient in inappropriate places (outside the report room), I always ask that we talk about it "later" or ask if they would like to go to "a better place to discuss this."

I've never had a patient that was also a coworker, but I'm sure that if someone was looking at the chart who wasn't directly assigned to their care, I'd be taking that chart to the med room and locking it down.

Confidentiality is enforced one person at a time, one moment at a time. Some may call me a ****h, and not like me because I won't participate in this gossip, but I wouldn't want my business spread all over a hospital, so I'm sure not going to participate in it to another.

BTW. If someone cared to make the complaint, the SBON can yank a license over this stuff. The SBON takes it very seriously, as we all should.
Nov 10, '02
Occupation: RN-i (RETIRED) Specialty: ORTHOPAEDICS-CERTIFIED SINCE 89 ; From: US ; Joined: May '00; Posts: 14,479; Likes: 2,298

That's why I always try to be admitted to a different hospital.

One time I was in "mine" and my NM came in and said she'd looked at my chart and could I come in on Saturday "just to be in charge." This was Tuesday the same day as a laparotomy and peritoneal laceration. I have never seen my hospital chart, why could she?
Nov 10, '02
Occupation: RN Joined: Aug '01; Posts: 2,276; Likes: 42

Working at a small hospital like I do, this is an issue that comes up often. One day during my shift, I was taking care of 3 employees of the nursing staff. If the patient doesn't want anyone to even know they are there, I do what I can about protecting their privacy, such as leaving the door closed and not talking about them with anyone unless it is directly related to their care. I was a patient in our ER the other day and of course half the people I knew came through (for other reasons, and happened to see me walking from the BR back to the exam room). So much for letting that keeping that cat in the bag. I would rather be a patient at my own hospital than another because I know the people I work with and trust them. Taking care of co-workers (or their families) can be a real challenge at times, but it can also be very rewarding....
Nov 10, '02
Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70

P_RN - wouldn't it have just warmed your heart to tell your manager that confidentiality applied to HER, too? If you're not caring for someone, what is in their chart is "off limits."

Last week a ward clerk wandered over to another nearby unit (cannot keep this woman tied to her chair for anything.) Pulled out a chart and started reading something. Charge nurse on that unit reminded her that it was a violation of confidentiality (it being not even *remotely* related to her job) and promptly ran her off.

I wouldn't be a patient in my own hospital knowing how many nosey people there are. At least somewhere else, you have some hope of being "anonymous." Only advantage to staying in my own facility is you get a private room (if at all possible) if you're a patient.
Nov 11, '02
Joined: Apr '02; Posts: 38,750; Likes: 16,271

I keep my mouth shut and refer all questions to the patient herself, if it is known she is admitted to my floor. it's as simple as that.
Nov 11, '02
Joined: Sep '02; Posts: 910; Likes: 9

I have a question regarding confidentiality. As a student, we are taught that whatever we talk about in post conference stays in post conference, well this past week I spoke about one of my patients in SDS with my instructor outside of clinical (not my current clinical instructor) because we were going over the heart and her situation was related and I thought he might have my answers. Would this be breaking confidentiality? I told him why she was there and where she ended up, and thought later on that he may have disapproved of the question, because of the confidentiality.

Also, a lot of us vent or tell of experiences or patients on this website (me included) Is this also breaking confidentiality? or is it pretty much safe since you can remain as anonymous as you wish to be. Me, if I have to vent, I try to keep it vague, like not telling which unit I am at, or keeping the patient info to a minimum given the small risk that a nurse or patient from this town could be reading my post and know who or what I am talking about.

Also, does confidentiality include co-workers. My good friend is an RN working in OB and she has tons of stories to tell me. She never mentions names of patients, but does talk about her co-workers by name. Where do you draw the line between venting or gossiping about your coworkers to breaking confidentiality.

I understand what confidentiality is, but still some areas seem murky to me.
Nov 11, '02
Occupation: Nurse Joined: Jun '02; Posts: 651; Likes: 3

A case study is just that, no names, ward or bed numbers, dates etc. Gossip usually includes all of these, tell the gossip to bug off and learn from your case studies.
Nov 11, '02
Joined: May '02; Posts: 399; Likes: 8

Any patient's privacy is protected, but those that are flagged as confidential or VIP, the protection is stepped up a notch. We do computerized charting and a warning goes up before you access patient info that it's confidential. They do track who accesses the information and they will write up anybody who breaks confidentiality. We can't even access our own charts without a signed release on file in Medical Records. Employees have been written up for that, too.
Nov 11, '02
Joined: Jan '02; Posts: 5,673; Likes: 159

We try to suggest staff members who are hospitalized be made 'no information' status to ward off the many concerned questions (and also the nosy ones.)

If supervisors or staff ask me about so and so (and they're not NIP's) I give a generic reply "She's stable today and feeling better" then if they continue to pry I say "Would you like me to check with her to see if she's up to a visit from you? Then you can ask her yourself"

That usually shuts up the nosy ones and the truly concerned ones usually ask me to deliver a hello and get well message next time I make rounds.

I knew a nurse who sued her facility for breach of confidentiality after she found that everyone in the place knew her personal and private business, and it humiliated her (caused damage to her professional relationships in the facility)....she was justified in this I feel .

PRN that's awful...I can't believe a manager would do that ...well, wait a minute I guess I CAN believe it...<sigh>.

To switch gears a bit: Has anyone run into an ethical dilemna in this regard? Like a physician's report stating a severe, untreated psychiatric illness is at play in a coworker? Or seeing a positive illegal drug screen on a practicing RN??

I've had some difficult soul searches over the years when these sorts of things came up, but my conscience says confidentiality wins over duty to report to the BON or facility...BUT then I've also worried about potential harm to patients due to an impaired nurse ....what's everyone else think?? Has it happened to you? What did you do?

Great thread!!
Nov 11, '02
Joined: Nov '00; Posts: 931; Likes: 18

MattsMom, I sure do know what you mean about the ethical delimmas! I was working in a doctor's office and one of the patients was a nurse being treated for codeine addiction. The doctors had all refused to give her an rx for codeine anymore. Shortly after that I changed jobs to work in LTC. Guess who is there? And guess what keeps coming up missing on the narc count? Codeine! Finally, an investigation was done about the missing codeine (a substantial amount). Since I was one of the nurses, too, all of us were being scrutinized. So, do I tell what I know? Nope. Can't. Discussed it with the SBON. They said I had to maintain confidentiality, no matter what. Because what I knew of this nurse's addiction was obtained through a "professional relationship" with her and in the course of my duties at the other job. Hard to keep my mouth shut. But, I had to keep quiet anyway.
Nov 11, '02
Joined: Oct '00; Posts: 8,729; Likes: 8,412

If asked about a patient I say they are "better" if they are or "about the same" if they aren't. Any questions after that I say "I'm not really comfortable talking about private information."

The infection control nurse at our hospital refuses to abide by confidentiality. If an employee is admitted and grows something infectious she routes the report to employee health and they must follow up before the employee goes back to work. If someone is admitted to another hospital they have the advantage of privacy. Seems like there should be a limit on access by employee health to hospital charts.
Nov 11, '02
Occupation: Staff Development Coordinator Joined: May '02; Posts: 4

Confidentiality is really a big issue right now. As I posted on another thread, all healthcare facilities should be getting ready for HIPAA. The privacy rules compliance date is April 14,2003. Under this rule, if you are a patient in your facility you should receive the same Privacy and Confidentiality standards as any other patient. If you feel their was a breach in confidentialty you can send a complaint to DHHS for investigation. The fines will be pretty high, and not only apply to the facility, but the individual who disclosed the information. A crucial part to all of this is education of the staff. Even before HIPAA healthcare facilities had Privacy & Confidentiality Policies, but now with HIPAA something can be done about careless talking, snooping, or gossiping.

Confidentiality of health care workers as patients

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