Protecting Patient Privacy in Nursing Practice

Table of Contents

Abstract

Recognizing a patient’s need for privacy is very important in the practice of nursing. The concept of privacy pertains to all areas of human activity in society and appears in the literature of several different disciplines. In the nursing profession, privacy is equally recognized as a very critical issue that must be carefully handled. Because of the nature of their job, nurses face numerous situations which require them to know or handle information that is very private to patients. To avoid getting into trouble, therefore, nursing practitioners must exercise due diligence in executing their duties. They must uphold integrity to the highest standards to guarantee privacy for patients. In all undertakings, patients must be assured of their privacy.

Introduction

The concept of privacy pertains to all areas of human activity in society. It appears in the literature of several different disciplines, including psychology, sociology, anthropology, political science, law, architecture, and design professions. According to Buppert (2008), privacy may be described as a psychosocial reality that exists within a matrix of political, technological, psychological, and evolutionary phenomena. Some scholars have, however, argued that the origin of man’s need for privacy lies in his or her animal origins and that human beings and animals share several basic mechanisms for claiming privacy among their fellows (Hegner, Acello & Caldwell, 2009).

In general, human beings, as well as animals, will always look for moments to be excluded from others. Privacy is also recognized as one of the most important concepts in nursing. As noted by Klosek (2010), there are several vulnerable and intimidating situations in which a nurse may invade a patient’s privacy. It is, therefore, obvious that intimacy is a relevant responsibility in the nursing profession.

Risk of Breaching Patient Confidentiality

As already stated, patients have a right to confidentiality. Breach of privacy is a serious concern and can be the basis for a lawsuit by a patient (Buppert, 2008). It can also be malpractice and hence the basis for disciplinary action by a state’s board of nursing, and a violation of state and federal laws. Under the new federal regulations, a patient who feels that a nursing practitioner has violated his or her privacy rights can complain to the US Office of Civil Rights (Buppert, 2008). As a result, the office may investigate and if a nursing practitioner has failed to comply with the government’s recommendations aimed at protecting patient privacy, he or she may end up being fined.

Nursing practitioners can breach a patient’s confidentiality in several ways. They include talking about a patient within earshot of others, releasing medical information about a patient without prior written permission, leaving a telephone message on a patient’s answering machine, discussing a patient’s condition with his or her family members, leaving patient’s records within view, discarding un-shredded duplicate records, and giving a patient’s name and address to a vendor (Hegner et al., 2009).

A patient has a right to consent to the care given and a right to refuse any care that is offered. A nursing practitioner has a legal responsibility to provide a patient with enough information about the risks and benefits of care being offered so that the patient can make an informed decision to accept or reject it (Lindh et al., 2009). Informed consent involves the disclosure of material risks of care and requires that a patient be competent enough to understand the risks and make a judgment about accepting care. The doctrine of informed consent requires that there be no coercion in getting a patient to consent to care. Although the law of informed consent is physician-oriented, it can be expected to be upheld when a nursing practitioner is a caregiver (Lindh et al., 2009).

The doctrine of informed consent arose from a societal desire to discourage persons from unauthorized touching of others (Yeung, Escalante & Gagel, 2009). The predisposition against non-consensual touching expanded when applied to the practice of medicine. In medicine, the requirement is that a physician must both inform a patient about what is to be done and obtain the patient’s consent before administering any treatment.

Even though the doctrine of informed consent is grounded in the law of battery, the objective of the courts in applying the doctrine of informed consent has been more involving than the simple avoidance of one person’s unauthorized touching of another (Yeung et al., 2009). The majority of courts have adopted a self-determination rationale for informed consent which means that a person has a right to determine what shall be done with his or her body.

According to Klosek (2010), nursing practitioners who want to avoid the risk of violating the informed consent doctrine are required to do many things. They should give patients information on risks, benefits, and alternatives to any invasive procedure, and obtain written consent to the said procedure. They should also find out what the state law requires regarding informed consent for specific tests, treatments, and procedures. In addition, nursing practitioners should give patients the risks, benefits, and alternatives to any treatment including prescription medications, and ask for their agreement to the treatment.

It is also helpful for the nursing practitioners to document that the risks, benefits, and alternatives of the treatment have been given to the patient and that the patient agrees to the treatment. In some cases, the nursing practitioner must establish whether the patient is in a good condition to give consent. A patient who is unconscious or mentally retarded, who has been adjudged to be insane and cannot read, write or hear, or who is under the influence of sedative drugs or alcohol is not competent to give consent (Klosek, 2010). Except in instances of an emergency, nursing practitioners should avoid treating such patients unless a parent or court-appointed guardian is available to give consent.

Conclusion

Patients in a health care facility give up a good bit of control over their lives by putting them into the hands of caregivers. In exchange, patients assume that certain of their rights will be assured and this includes the right to privacy. It is, therefore, important for patients to be certain that their privacy will be protected. Even though a nursing practitioner performs the most intimate procedures for the patients, he or she must do so in a way that neither exposes them unnecessarily nor embarrasses them.

Nursing practitioners should, for example, assist with meeting a patient’s privacy by knocking and saying the patient’s name before entering a room. They should use curtains and screens around beds during personal care, cover the beds with a bath blanket and expose only the area to be worked on.

References

Buppert, C. (2008). Nurse Practitioner’s Business Practice and Legal Guide. Sudbury, MA: Jones & Bartlett Learning.

Hegner, B. R., Acello, B. & Caldwell, E. (2009). Nursing Assistant: A Nursing Process Approach – Basics. Clifton Park, NY: Cengage Learning.

Klosek, J. (2010). Protecting Your Health Privacy: A Citizen’s Guide to Safeguarding the Security of Your Medical Information. Goleta, CA: ABC-CLIO.

Lindh, W. Q., Pooler, M. S., Tamparo, C. D. & Dahl, B. M. (2009). Delmar’s Comprehensive Medical Assisting: Administrative and Clinical Competencies. Clifton Park, NY: Cengage Learning.

Yeung, S. J., Escalante, C. P. & Gagel, R. F. (2009). Medical Care of Cancer Patients. Shelton, CT: People’s Medical Publishing House – USA.

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