It would be easy for Irene to partake in the practice of her colleagues, and easily divulge private information to appease the curiosity of the family and friends of the patient. However, this would not be the most ethical route. Irene encounters many ethical challenges and can be viewed as a pioneer in patient privacy advocacy in the case study. Irene has many challenges affecting her practice; return to a small town “friendly and informal care,” inquisitive community members, fax machine privacy issues, and colleagues with different views on ethical practice responsibilities.
Irene is concerned with keeping patient privacy and confidentiality. Although, she does work within a small community where most people know one another, it is not okay for her to share patient information. “The relationship is based on trust, respect and intimacy and requires the appropriate use of the power inherent in the care provider’s role” (CON, 2009). By sharing private patient information the patient-nurse relationship is no longer therapeutic in nature. Patients entrust their health information and concerns with the nurse with he expectation that it will be kept confidential and on a need to know basis within the circle of care. Settings & Smith, 201 0) The patient entrusts that, this very personal information is used solely for their benefit within their plan of care. Irene should also remind her colleagues of the Hippocratic oath, which states “Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private” (The Hippocratic Oath, 2002).
Private thoughts and actions done by patients when nurses care for them in possibly their most vulnerable state should not be shared unless the patient decides to do so. The only exception, which the patient should be advised of, is if the information shared may cause self-harm or harm to others. If harm is indicated, the information must be shared with the health care team and appropriate measures must be taken to ensure safety. Irene also has a concern with confidential laboratory results being faxed to her facility.
Her concern is that when the clerical staff species that information they view the results and can often be overheard conversing about the results of someone they knew. This action is very unprofessional, the clerical personnel are not trained on laboratory values, and therefore do not need to be reviewing the laboratory results. When confidential information is sent via fax, there is often a disclaimer at the bottom Of the page, stating that the information is private and intended Only for addressee. The clerical personnel are violating the privacy rights of the patient.
In this case it is the ethical responsibility of the nursing staff to intervene if others inappropriately access or disclose personal or health information of person receiving care” (Canadian Nurses Association, 2008, up. 13). Irene and the nursing team should explain to the clerical personnel that this is inappropriate and that actions like this will not be tolerated. Importance should be placed on privacy and confidentiality and the safeguarding of information to maintain a professional relationship (Canadian Nurses Association, 2008, up. 1 As a nurse, Irene has both “legal and ethical obligations to keep all such information confidential and not to divulge it thou the patient’s consent” (Settings & Smith, 2010, up. 7). Irene should remind her colleagues of their obligations and that personal information should not be discussed with members outside of the circle of care. If the patient were to hear that their privacy had been breached and did not approve of the nurses behavior the patient can file a formal complaint of professional misconduct with facility and the college of nurses of Ontario. One of the definitions of professional misconduct in the Nursing Act, 1991 is “giving information about a client to a person other than the client or his or err authorized representative, except with the consent of the client or his or her representative, or as required or allowed by law” (CON, Confidentiality and Privacy-Personal Health Information, 2009). A result of these actions the facility or college can precede with disciplinary actions, leading to suspension or loss of employment.
Perhaps Urine’s biggest problem and concern, is that her colleagues don’t see a problem with sharing private information with family and community members. Urine’s colleagues have worked at the facility for a long time and cannot recall ever hearing concern from anyone bout inappropriate sharing of information. Most of the colleagues do not see answering simple questions as problematic, and suggest that living in a small town encourages “friendly and informal care. Irene has informed her colleagues that she views this as problematic and that she is concerned with this practice. Irene should remind the colleagues that as a nurse, you are to follow the standards and guidelines set forth by the College of Nurses of Ontario in your nursing practice. Some standards that are not being practiced by these colleagues are confidentiality and privacy, and ethics. Irene and her colleagues need to address the ethical issue of maintaining the confidentiality and privacy of the patient health information they obtain while providing care.
In Ontario The Personal health Information Protection Act 2004 (APIPA), states that “information privacy is defined as the client’s right to control how his/her personal health information is collected, used and disclosed” (CON, 2009). Personal health information is any information with patient identifiers and can be in electronic, verbal and written form. A violation of patient rivalry is not solely based on name alone, a violation occurs if any information is shared that can be recognized and combined with other identifying information (CON, 2009).
Irene has been paying close attention to the situation and is concerned with the practices within the facility. Irene has examined her beliefs values and knowledge and now needs to consider those of her colleagues. Irene and her colleagues should gather policies and guidelines, ethical codes and legislation and discuss the privacy issue. From this discussion Irene and her colleagues would be able to identify strategies ND options about the privacy issue and how to refrain from discussing the information within the close-knit community.
From there, they can formulate a plan and decide the best way to move forward. I feel that Irene was more than right to be concerned and uncomfortable with the disregard for patient privacy by her colleagues. Irene grew up in the town she now works in; having recently returned Irene has a unique perspective being a new nurse within the community. She is able to realize that the standard of care, integrity and professionalism of her colleagues has been compromised. All persons deserve to be treated with respect and compassion.
Disrespectful communication, disregard for client privacy, or failure to involve patients in discussions that relate to them violates the nurse’s ethical responsibility” (Canadian Nurses Association, 2008). Prior to starting this essay, after reading the case study I thought that nurses were unprofessional and did not respect the rights of the patient’s privacy. Like Irene, I too have returned to the area I grew up in and often find myself caring for parents and grandparents of my won friends.
Having worked in a larger city before returning to the town in which I grew up in had never cared for anyone that I knew. Caring for familiar persons can be difficult and cause ethical dilemmas, so I can empathic with Irene. I have also encountered colleagues that chose not to respect patient privacy and “gossip” about patient’s diagnosis. At times have found it to be difficult finding a voice with colleagues that have been at the facility much longer than I have, but it is important as a nurse to intervene and advocate for patient privacy.
After completing this essay, my thoughts on patient privacy and confidentiality have not changed. I continue to feel that patient privacy should be upheld with the utmost importance. In regards to the ethical practice of privacy and confidentiality, I feel as though I am biased. Would not practice the sharing of private patient information with the public as Urine’s colleagues do in the case study as strongly feel that it is unprofessional and careless. After my research I am more aware of APIPA and what information is considered as personal health information.