One of the key foundations of modern healthcare is trust between patients and their medical caregivers. However, sometimes that trust can prevent safe and proper care. Check out this Nursing 101 guide on the various situations to break patient confidentiality.
Situation I: Your Patient Is in Immediate Danger
The most common situation in which nurses break patient confidentiality is typically when their patient is in immediate danger. In these scenarios, if withholding sensitive patient information has a high probability of inflicting more harm or suffering on the patient, nurses are obligated to intervene. This response falls under the same category as other duty-to-protect responsibilities, similar to a caregiver’s duty to disclose child abuse to law enforcement.
So when does an emergency constitute a nurse’s duty to protect? When faced with these situations, the acting healthcare provider must ask themselves three questions before breaking patient confidentiality:
- Is significant harm likely if I do not disclose information?
- Will failing patient confidence effectively prevent harm?
- Are there any other possible solutions that are less intrusive?
If you can fully justify the need for breaking patient confidentiality after considering these factors, then your duty to protect is warranted.
Situation II: Your Patient Is a Public Health Concern
HIPAA and other doctor-patient confidentiality rules can endanger surrounding communities’ well-being, especially during an endemic viral event. For example, patients with highly infectious diseases have fewer rights to medical privacy than other individuals simply for the benefit of the greater good. When nurses discover patients with these illnesses, they often must report the diagnosis to state and federal health departments. Additionally, healthcare providers must instruct patients on the proper steps to limit viral spread following their diagnoses. Of course, if the patient does infect another individual accidentally, the nurse (as well as the state or federal health department) cannot disclose any identifying information.
Situation III: Your Patient Is a Threat to Others
This situation is uncommon for many nurses; rather, it’s often more typical in therapeutic and counseling care. However, patients sometimes become a significant threat to others, including nurses, additional medical staff, other patients, clinic visitors, and even themselves. Basically, nurses must disclose confidential information to relevant law enforcement if there is a high probability that it will protect others. For example, you can tell the police about pre-existing mental health conditions if it helps them control the situation more effectively. However, law enforcement cannot request a patient’s sensitive information without the proper warrants and paperwork.
The importance of patient confidentiality within modern healthcare is indisputable. However, there are situations where nurses must break patient confidentiality for the greater good. Follow this Nursing 101 guide to ensure the best possible care for your patients.
