Confidentiality Issues

One of the hardest things for many health care students and novice professionals to learn is how to maintain patient confidentiality. New laws have made this even more of an issue. It's only natural to want to rush home and tell your spouse about the celebrity you got to meet today and will be treating, but you can't do it. You can't discuss any client's care with your spouse, family, or friends. In reality, it does happen, but it is illegal unless it is done with great discretion to protect the identity of the patient.

Under new laws such as HIPAA, you must have express permission from the patient to discuss his condition or treatment even with any next of kin and family members. There are other privacy issues that have caused health care facilities to rearrange offices, designate new lines and waiting areas, and re-create forms and sign-in sheets to protect the privacy and identity of patients.

One of the easiest ways to deal with these issues is to neither deny nor confirm information, but to refer the person inquiring to the patient for an answer. Of course, you also need to inform the patient that this has transpired.

Essential

Trust is an essential element in establishing a professional-patient relationship. Patients need to know that they can safely discuss sensitive information with their health care providers and that the information will remain privileged. Exceptions to this privilege are rare but include public health issues such as sexually transmitted diseases, TB, or hepatitis, which require reporting.

If you are discussing a patient with a colleague, you need to be discreet and make sure that others can't overhear your conversation. Never reveal anything specific that could identify a patient if you aren't sure that you won't be overheard.

Records and charts must be kept confidential as well. Never leave documentation where it can be seen or read by others. If you have electronic access, be sure it's secure before leaving the workstation. Protect passwords.

Confidentiality also encompasses privacy. Always be sure that you close doors or curtains to protect a patient's modesty, dignity, and privacy. Use towels, sheets, gowns, and paper drapes to ensure the patient is not exposed.

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