Keep It Confidential

I'm so sorry if my recent posts on various topics are boring anyone ... I'm just going through a stage where various subjects are compelling me to write or comment, and it's hard to ignore when I have this outlet.

Today I was surfing through the entertainment news (I'm sorry to admit that though I'm highbrow enough to follow NPR and the BBC, I also like to catch E! and People online) and I was particularly disturbed by this story. There have been several instances of celebrity medical treatment status being leaked, but this was particularly disgusting because poor Farrah hadn't even told her family yet AND was even being treated under an alias.

Even before the days of HIPAA where medical privacy and disclosure were bound tightly by law, it has always been an ethical mandate that we in health care keep private information private. During every hospital orientation I have had, there is always a section on confidentiality and how you can be disciplined or fired for accessing medical information that you do not need to do your job. It's sometimes tough because I can take care of a patient for weeks in a row, but when they go to surgery, despite how much I want to know how they're doing - I legally have no right to know anything unless I am assigned to take care of them. Now I'm not going to lie, amongst nurses we often have some professional consideration for these circumstances. I remember having to be off for a weekend and a baby that I had taken care of for two months since his birth wasn't doing so well. If you're not a nurse, I can't even explain how easily and quickly we get attached to our patients. When it's someone you've taken care of for weeks, you are very much invested in their outcome. I would call in to the night shift nurse to "check" on him - not necessarily ask tons of specifics like what are his vent settings, chest tube output etc. etc. - but how is he doing? Ethically that's pretty grey given that I'm not currently working that shift and taking care of the patient, but it's FAR different than looking up patients I'm not even involved with.

When I worked in Columbia, MO which is a smaller town, I was confronted with situations more often that dealt with confidentiality. We were the biggest NICU in town, so if an acquaintance of mine had a neighbor or a family member with a baby in the NICU, it wasn't uncommon to be asked. "so is Baby X doing OK?" It usually was asked out of concern because in smaller towns, people tend to know each other. Those were times where it would be easy to say, "oh yeah, they're doing great" or "they're pretty sick" but I'd have to stick with the whole, "I really can't talk about that."

Another job that provoked similar questions was working in the Burn/Trauma unit and having patients who had made the news for dramatic fires, car crashes, accidents etc. and people wondering, "how is that college student doing who got caught in the fire?" Even though I was just a student nurse extern at the time, I still knew what was going on and people knew where I worked. Those types of questions were not uncommon and it required diligence to keep your mouth shut. I was working in the NICU at the time, but when a young, female police officer was shot (in the end fatally) by a teen aged suspect, it was all over the news for two or three weeks and was quite a high profile local case. After she died, several employees were disciplined and even terminated for accessing her medical records without cause - all worked outside the Trauma Unit. It may seem harsh, but after reading about the recent Britney Spears and Farrah Fawcett cases, I see where it's a slippery slope and clearly people have no sense. Especially when medical records are computer based and the system logs EVERY person who looks at a file. I know that I would be very upset if I were a patient at my hospital and my co-workers heard through the grapevine what I was being treated for or something specific about my health, let alone the whole flippin' world. I am glad to see that UCLA is taking a harsh stand, and I hope Farrah sues that individual for disclosing her medical information, because doing it for money?? Even more despicable in my opinion.