December 17, 2012 4 Comments
By: Jennifer Chaikin, RN-BC, MSN, MHA, CCRN Executive Director of Educational Initiatives, Nurse.com
I started writing this blog post about Jacintha Saldanha, the British nurse who inadvertently transferred a prank call to the hospital ward where the Duchess of Cambridge was receiving care, and I was going to talk about the lack of support she received. But now I write with deep sadness after hearing the news of her death. I’m asking myself, how could this have been prevented? Both the release of patient information and Saldanha’s tragic suicide.
If in fact she took her own life for reasons related to this unfortunate event (lighthearted fun as the Australian DJs called it), nurses around the world can certainly empathize with those possible feelings that Saldanha experienced. It’s a fact that when nurses make mistakes, people can die. Even if those mistakes are seemingly small, nurses still feel embarrassed, mortified, and we often take it very personally.
Let me guarantee you that nurses take patient confidentiality and protection seriously. This is one of the reasons nursing is the most trusted profession in the US – for 13 years in a row. I can’t count the number of times I’ve been working in a unit, caring for a patient, and had to figure out the correct way to identify and legitimize every single family member or friend that demands information. I’ve had to do this for many 12-hour shifts all while delivering quality, safe, and often times critical life-saving care. My colleagues and I have been yelled at, cursed at, and told at one time or another we would be sued if we did not provide that information.
But just for a minute take a walk in Saldanha’s shoes and imagine what it’s like for nurses trying to protect patient privacy over the telephone. How in the world are we supposed to know exactly who is on the other end? Sure, we try many things but there really is no fail-safe way … is there?
You may be thinking, the voice impression those DJs provided was hideous. But how many people do you think have heard the Queen on the phone before? And, as a nurse, would you expect a radio station to attempt such an outrageous invasion of privacy? Consider this, what if it was the Queen? What backlash would she have received if she refused to put the Queen’s call through?
These are all the same situations and feelings nurses have about family and friends of their patients every hour, of every day, of every year. We have all felt the holes in our stomach when we find out we were deceived. There are days we hope there are no phone calls from anyone regarding our patients just so we can avoid this scenario.
Back in the US, we have HIPAA. As it stands now in the UK, they have confidentiality law as it relates to physician-patient privilege only. After this tragedy will the British government consider other movements in patient privacy law? It’s horrible that it takes a tragedy like this to consider such action.
Back here in the US even with HIPAA, this scenario still plays out everyday with everyday people because, by the way, you don’t have to be famous to have your privacy invaded. Any family member or friend can pose as a person you will allow healthcare information to be given to.
Here’s my point: HIPAA is not enough. Hospitals, clinics, and any facility that holds protected health information must not just give the edicts that HIPAA demands. The law and government agencies must help hospitals develop ways to instruct healthcare professionals to deal with this privacy issue.
It is not enough to say, “Patients must give permission.” Tell nurses how. Tell us to use a “secret code word” for the family or use a portion of the medical record number. OR NOT! HIPAA should be more specific and tell us what this Act expects. Do this to help protect patients and families and those who save their lives and privacy, because what we have in place now is not enough.
Give nurses the power to act. A piece a paper, like HIPAA, is not and never will be enough.