help

[michellemarie]

Confidentiality can breached if a client tells you if that he is thinking of committing suicide, or the client is at risk in harming others or themselves. Also, if a patient has been abused you can also breached confidentiality. Is there any other scenario where it can be breached?

[SopranoKris, MSN, RN, NP]

What do YOU think the answer is? We aren't going to do your homework for you :)

[Esme12, ASN, BSN, RN]

Michelle.....you have been told already...we are happy to help with your home work however we need your input first.

What are the laws about this?

OK, just send me the money and let's get to it.

I promise not to sell you out to your instructor for the obvious violation of your school's Academic Honesty policy.

But here's a freebie...

Confidentiality can breached if a client tells you if that he is thinking of committing suicide

This statement is completely false as stated. In fact, quite the opposite. Patients on psychiatric holds have a higher expectation of privacy than do medical/surgical patients. In the former case, I am prohibited from even acknowledging that they're with me.

Let's settle on a rate of $120 per hour... it keeps the maths simple.

That'll be $2, please. You can just send a Starbucks card if you'd like.

[Esme12, ASN, BSN, RN]

But here's a freebie...

This statement is completely false as stated. In fact, quite the opposite. Patients on psychiatric holds have a higher expectation of privacy than do medical/surgical patients. In the former case, I am prohibited from even acknowledging that they're with me.

Let's settle on a rate of $120 per hour... it keeps the maths simple.

That'll be $2, please. You can just send a Starbucks card if you'd like.

Be nice.....

[KelRN215, BSN, RN]

Confidentiality can breached if a client tells you if that he is thinking of committing suicide, or the client is at risk in harming others or themselves. Also, if a patient has been abused you can also breached confidentiality. Is there any other scenario where it can be breached?

This is not true.

Duty to warn applies in very specific circumstances. If your patient tells you "I have a gun and I'm going to kill my neighbor, Joe Smith, tonight at 5:42PM when he comes home from work because he's been sleeping with my wife", you have a duty to warn (if your state has such a law). If your patient simply says that he's mad at his neighbor who he believes is sleeping with his wife but expresses no specific intent to harm him or does not identify him, you have no such duty. This client may be "at risk" of harming his neighbor, but nothing he has said leads you to believe that he WILL.

You cannot break confidentiality simply for suicidal ideation. If your patient comes in saying he hates his life and wants to die, that in and of itself is not enough to break confidentiality. If he comes in and tells you he's going to go jump off the George Washington bridge when he leaves your office, as a reasonable clinician, you would not allow him to leave, call 911 and hope that the ER can get him on a hold.

There are certain public health issues that allow confidentiality to be broken. Reporting laws vary by state but certain communicable diseases are automatically reportable to the state and, when necessary, the state will contact persons who might have been exposed. Think of what could apply here.