Protecting Privacy Involves More than Safegurading Information

Nurses and physicians have been charged with the nearly sacred duty of protecting patient privacy for as long as I’ve been a nurse and for decades before that. For the past several years, the importance of privacy has been elevated to a very serious, protect-it-at-all-costs-or-you-could-be-dragged-into-court status. In the role of patient, we’re signing papers right and left every time we visit a physician’s office or are admitted to a hospital. Nurses in those settings are making sure those papers get signed. We are all toeing a fragile line to keep names, medical histories, diagnoses and treatments tightly under wraps, which is as it should be. But, we need to remember that there are other kinds of privacy and they, too, need protection.

On a recent evening a friend took her elderly father to the local emergency room, soon after the father mentioned to her that he hadn’t urinated for two days. Without revealing everything that took place, I will just say that the nurse (male) shared explanations and asked questions regarding extremely personal activity. Necessary conversation? Yes (I guess). In the presence of the patient’s daughter and granddaughter? I think not.

I had a similar experience, coincidentally in the same emergency department, several years ago. I’d accompanied a male high school-aged exchange student there for treatment of a dramatically swollen ankle and red streaks up his lower leg. With no warning the physician began asking about the young man’s sexual activity. I was so taken by surprise that I did nothing to protest, but I felt then and still feel that the physician’s behavior was inappropriate.

Asking family or friends to step out of the room momentarily is perfectly acceptable and should be done (gracefully) more often. In the recent case, the patient is quite hard of hearing so the daughter thinks it’s possible that her father didn’t catch enough of what was said to be mortified, but the two females in the room report being uncomfortable. In fact, the granddaughter did leave the room during the conversation and, later, the nurse did offer an apology. I am not a prude—far from it, in fact. But, isn’t this a matter of courtesy and respect for both the patient and the family?

Privacy involves more that medical records and indiscriminate gossip. We need to pay attention to what we say, and in front of whom, just as we need to ensure our patients are modestly draped during exams and procedures—which, now that I think of it, we could also do a better job of.

How do you handle similar situations?