Ethics in nursing are often complicated, particularly when it comes to confidentiality. A nurse is expected to understand what is confidentiality and appropriately follow any guidelines required the by medical facility and state. The problem is that sometimes it is necessary for a nurse to speak out and make certain reports. Nursing ethics provide guidelines to determine when it is appropriate to keep information away from prying eyes and when it is necessary to speak about certain concerns.
Basics of Confidentiality
Before it is possible to determine when it is necessary to breach hospital guidelines, nurses must learn the answer to the question, what is confidentiality. The word has a simple meaning that is applied across the board in medical settings.
According to SurgeryEncyclopedia.com, confidentiality refers to the privacy rights of patients. Every patient in a medical setting has the right to keep personal medical history and details private from any potentially prying eyes.
As a nurse, it is important to keep patient information from leaking to any inappropriate source. In general, the only individuals with access to the medical files are the nurses and doctors who are directly involved in patient care.
Disclosure to Share Information
In certain cases, nurses might find that insurance companies require certain medical information before it is possible to bill the company. The problem is that confidentiality might limit the ability to share the details of patient health.
Due to the legal issues associated with confidentiality, nurses provide patients with disclosures to share information with appropriate parties. In most medical facilities, patients are required to sign a disclosure to share information with their insurance provider as necessary for billing.
The insurance provider is responsible for keeping personal medical information related to billing safe. Only the appropriate individuals or companies in the disclosure form are able to obtain information as appropriate for billing services. Nurses should ensure the paperwork is up-to-date before giving it to new patients or requiring existing patients to sign a new form.
While the question, what is confidentiality, is easily answered in theory, it is not easy to determine when ethical issues make it appropriate to share certain information. According to Maureen Beech on Nursing Standard, it is sometimes necessary to breach confidentiality when patient health is at risk.
At certain times, a nurse will need to stand up to physicians or share certain information to change medical practices for better patient care. Depending on the situation, the appropriate way to handle the details of a specific case will vary.
In most cases, a nurse should take measures to ensure identifying details about a patient are safely protected. Changing a patient name and avoiding any details that identify an individual during a whistle-blowing claim will protect the individual and help change medical practices.
Exceptions to Confidentiality
While confidentiality should always apply to patient health, certain exceptions to the rule exist. Depending on the situation, nurses are legally allowed or required to break confidentiality with a patient for the safety of the individual or a third party.
According to the University of Illinois at Chicago, nurses are able to breach confidentiality in cases where a patient makes a threat of self-harm or is potentially harmful to another individual. While the appropriate breach of confidentiality will vary based on the situation, nurses have an ethical responsibility to protect endangered third parties or the individual.
In cases of self-harm, a doctor or nurse may advise an appropriate family member about the situation to help prevent the risk that the individual will attempt to commit suicide or similar harmful acts. A nurse might also inform an appropriate doctor of the situation if it seems to be escalating.
In situations where a patient might endanger a third party, the doctor or nurse should inform the individual who is likely to end up hurt about the situation. For example, if a test shows that a patient has contracted a harmful infectious disease, then a doctor or nurse might inform a spouse or domestic partner about the situation to prevent the disease from spreading.
When it comes to determining what are confidentiality and when it should not apply, nurses face tough ethical issues. In general, nurses are expected to maintain patient privacy unless the patient allows a waiver. Only certain situations allow a breach in confidentiality due to the potential danger to a patient or identifiable third party individual.