Patient Care

Patients must trust their health care providers to get the best care. If they do not trust the nurses providing their care; this can severely affect the care they receive. The diagnosis could be wrong if the patient provides inaccurate or incomplete information about their symptoms and history. If the patient is reluctant to share their private information their care givers will be treating them as if they had blinders on. Only the external information can be seen not the underlying cause of disease. If the medical profession did not have an understanding with the public that their secrets will not be revealed to any one without the patient's permission getting accurate appropriate care would be very hard. Patients would be afraid to be honest about problems that could affect every part of their life.
Legislation was passed to protect patients after AIDS epidemic of the 1980's. Not understanding how AIDS was acquired and passed on to others made every one fearful. Private health information cannot be revealed to any one without permission of the patient not even to their closest family members or to the patient's employer. We must encourage honesty from the patient to be able to effectively treat their problems.
Legislation has been passed to protect patients with psychiatric problems because the diagnosis of mental health issues can be devastating to a patient. Patients are entitled to a certain amount of privacy regarding their mental health problems as long as they are not a danger to themselves or others.
Every health care provider involved in the care of a patient has obligation to protect the private health information of every patient in their care. Many health care providers can be involved in the care of each patient. They work together to provide the best care for the patient. All organizations involved in providing care are required to protect the private information for their patients. These organizations require everyone involved in patient care or who have to have access to the information involved in patient care to have classes in confidentiality and they are required to sign confidentiality promises. Not only do the people who come in contact with information must understand about confidentiality but also computer security must be regulated to protect all patient information. The Health Information Portability and Accountability Act of 1997 (HIPAA) requires institutions to protect patients privacy and information about their health care. (Bord, Burke and Dudzinski (2013))

What happens if family members are asking questions about the patient's diagnosis and treatment? Even the closest family members are not entitled to knowledge of the patient's information with consent of the patient. Even if the diagnosis could directly harm the spouse the health care provider is not the one to reveal this to that spouse. It is still remains for the patient to reveal this information or sometimes the public health department may be required to inform injured parties such as sexual partners of a patient with a sexually communicable disease. The public health law requires the public health officials to inform people if their partner had a sexually communicable disease had conflicts arise with the AIDS epidemic. Sexually transmitted diseases have devastating effects mostly if they go untreated or if the patient is pregnant and does not receive prenatal care but AIDS changed everything about this issue. Passing laws to protect AIDS victims make it harder to be sure their partners were informed. The original public health law was to protect the innocent they would talk to anyone with a sexually communicable disease and trace all their partners and the partners of each of the partners that they found. They did this to stop the spread of disease and make sure the unknowing victims got treatment. Another issue involved in tracking sexually communicable diseases was because in the 1940's some experiments were carried out on poor blacks that they pretended to treat while they were testing the effects of the disease unchecked. Congress had to pass laws to compensate these victims and their families mostly families as the original victims were long gone when the lawsuit that ended in compensation for them was enacted.
As nurses we must be vigilant about HIPPA unintended disclosures can occur anywhere. Health care providers hurry to the bedside or department if they have been called to come in public places like an elevator or the cafeteria they must be careful not to discuss the patient. Even without mentioning the name talking about details of the case may be enough for other people in the elevator or other public place to realize you are discussing their loved one. The more unusual the case the more we want to discuss it but if it is unusual it is more likely someone near may recognize you are talking about someone they know. You may not mention the name even but if they recognize who you are talking about and go to report you they probably will not remember you did not actually mention the name. It does not matter if you did not say the name they caught you talking about a patient and they figured out who it was so you are in trouble. People can lose their jobs by revealing private information about patients. Don't let this be you. Always watch what you say in public. Be sure to put all materials with patient names and information in proper containers for shredding when you are finished with it if it does not go on the chart. No piece of paper with any identifying information should ever go in the regular trash. It must always be shredded. All institutions have shredder boxes under lock and key on ever floor due to the harm in placing information in the regular trash.
Several doctor's offices, banks and government offices have made big headlines on the news because people have gone through their trash and found protected private information about customers. Lawsuits against these companies have resulted from these findings. Identity theft is big business in this country we need to be aware that everyone needs a shredder at home because regular trash picked up is not taken to an incinerator but to a landfill and people made their living by going to the landfill or dumpster diving to find what they can make money on and names, birth dates, social security numbers names of our loved ones can all be used for identity theft. Even the patient's private information can be used for identity theft as well as the HIPPA issue. Violating a patient's right to privacy should always be on our mind whether we are taking notes on a patient or discussing their care.

Always be aware of your surroundings when talking about patients my Mom has told me that family members have come around the corner and gotten very upset when they hear the nurses discussing them or their loved one. Sometimes they were not even talking about a patient or family member the person just assumed it from what they heard. In the hospital where I shadowed in Labor and Delivery every 2 or 3 feet they have a laminated and framed sign that says do not linger in the hall outside the room if you cannot be in the room go to the waiting room and it says it is to protect the confidentiality of the patients. Even with the signs I saw that to point to the sign several times a day to get people not to be hanging out and listening to the nurses. I noticed that the people do move easier because of the official sign than they did before they were put up. They originally had an open waiting room across from the postpartum nurse's station but had to enclose the waiting room because of visitors listening to them when the doctor called and they had to answer questions about the patients.
Confidentiality can be breached in certain cases.
Third parties persons or groups access to get medical information or records is strictly legally enforced but the law has found a few important exceptions.
One exception is the safety of other people specifically.

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