Confidentiality in a position of trust

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Confidentiality is when a person disclosing their personal information to a person in a position of trust, reasonably expects the information disclosed to be protected. It's important for healthcare professionals to know that adherent to the confidentiality of patients can help draw the line on the amount of personal information that can be disclosed without consent. Confidentiality (NHS Code of Practice, November 2003)

For example, the relationships between healthcare professionals like nurses and their patients' centres on trust. This trust is dependent on the patient being confident that the patients personal information disclosed to the nurses will be treated confidentially and accordingly towards the rules and regulations which governs the profession of the healthcare professional, that is, the Nursing and Midwifery Council (NMC) Code 2008.

Having discussed my contact's experiences with nurses in an outpatient clinic, it was evident that, they have had several experiences with nurses who they felt were good, it includes communication and the holistic care of treating people as individuals and experiences like confidentiality and gaining patients consent are the experience they thought were not so good.

My contact Mr X, recalls that, though it was difficult for him to have a prolong communication without losing focus, the nurses spoke to him in an orderly manner which ensured he was well understood. Communication between him and the nurses was regular, which Mr X said, was very good and made him feel at ease with his condition.

The personal needs of Mr X for his condition, as he put it, was meet and he was treated as an individual with dignity and this made his family proud of the support they received from the nurses.

Mr X believes, this holistic care from the nurses re-assured him and with his family, it was much easier for him to adapt to life easily, recovering from his condition. This in my opinion, is what underpins the NMC's code of treating people with respect and as individual, I believe if all patients are treated with dignity and not discriminated in any way, it may if not help full recovery, speed up the process of recovery. The Code (NMC, 2008 p2)

However, other areas of experiences by Mr X at the Outpatient Clinic, as mentioned, is confidentiality and gaining patients consent are the experience he thought were not so good and could be improved. The nurses had broken his confidentiality, by informing his teenage son's what his condition was despite his repeated request not to inform them. Mr X claims, his teenage sons where in the middle of an external exams and did not want them worrying about his condition. During the discussion, it appeared due to Mr X's age and his metal capacity at the time off his condition, it was in his best interest if his son's, though, teenagers to know his condition to enable them understand his personal needs and to offer him the best love and care possible when is discharged. As gathered from the reading, in all circumstances, the patient is entitled to a confidentiality of the information about him. There is therefore a duty on every professional and indeed every employee to ensure confidentiality of information. (Diamond, 2008, p.170)

In view of the above, prior consent was not obtained from Mr X when the nurses and other medical professionals decided to inform the DVLA of Mr X condition which affected his driving capabilities during his condition. Mr X said, he was very 'angery' when he realised his driving licence had been suspended for a year due to his heath.

Drawing from the guidlines given to the heath professionals on disclosure of personal information about a patient without consent may be justified in the pubilic interest if the failurte to disclose may expose others to a risk of death or serious harm. However the healthcare professional still need to seek the patient's consent to disclosure if practicable, which was not necessary the case for Mr X. Confidentiality, September 2009, General Medical Concil,Supplementary Guidiance

In Mr X's own worlds, this made him feel as if, he 'had no controll' over his life and dicisions were being made for him whilst he was capable of doing so and this caused him unescessary pain and stress as he fought back to get his driving licence which he's had for more than a 40 years, resulting in a chronic pain and stress disorder. Ideally this is not the kind of holistic care we want heathcare professionals like nurses to offer patients / clients by making every decision for them. British Journal of Healthcare Assistants 4(10): Oct 2010

It is important as a nurse to remember to receive the patient with sensitivity as a nurse it as important to remember that older patients are more powerless than other patients. (Griffith R, 2009)

In conclusion, the use of clear and well understood language for communicating between patients and nurses as well as other healthcare professional is very crucial in determning the best possible care for individual patient. Its also important that nurses seek prior consent of patients before disclosing any personal infromation about patients. (NMC Code 2008, p.3, 4, 5). Patients confidentiality and consent when will kept, ensures the trust for nurses and other healthcare professionals working with the patients is preserved.

Improvements could be done to ensure confidentiality of petiants by seeking prior consent where practical and providing a hoilistic care to individual patients which will best speed recovery if not full recovery in the short possible time rather than providing just a general care to patients. Patients who are not acquiescent need more time, Patients with dementia, for example, who do not understand what is happening and who are defensive need to be met and helped to remember. It is important to try to reassure oneself, as a nurse, that the patient has heard and understands what has been said.

Doing this assisgnment has broaden my scope of understanding how vital it is to keep good and accurate records of information gathered from patients/clients and the need for consent from the patient to disclose any personal information to other relevant heathcare professionals who may come in contact with the patients to avoid potential mistakes and negligence.