Do we need HIPAA—for coworkers?

We hear so much these days about patient confidentiality, keeping medical records from being compromised, what constitutes “consent” to release information, and so forth. But can our own friends and associates count on us to keep their trusted information from becoming public knowledge?

To have earned the confidence of another person is a great honor indeed. It is difficult to find someone with whom one can share, and perhaps take counsel from, matters of a personal or professional nature. Most of us have experienced the fallout from gossip in the nurse’s station or at the lunch table. Information which has passed from one set of lips to several others is rarely the same as when it was first shared and can have very unpleasant consequences for the one who initially let slip whatever was given in confidence in the first place.

Previously I wrote an article on why nurses blog. In it I suggested one reason for blogging is the perceived anonymity which one hopes to achieve by using an avatar or user ID instead of one’s own name. As it is practically impossible to share “confidential” information on the Internet with anyone, it is more important to find someone with whom you can share your thoughts and problems without fear of exposure or betrayal.

There are times when being approachable is not only an honorable thing, it can also seriously impact another person’s life and limb. Particularly when one is dealing with teens and young adults who often desperately need to talk to someone outside of their own family or circle of friends.

Anyone who “accepts” the role of counselor, formally or informally, is subject to the same ethics as a priest, psychiatrist or therapist. There are only two occasions when a sacred trust can be broken: When there is knowledge of a crime or when there is a threat of danger to oneself or to others. In most cases, it is usually best to encourage the person to self-report the problem if no one else is in peril. Offer to go with them. Such honesty can go a long way toward someone keeping a job and getting whatever help is needed.

As nurses we have a professional responsibility to ensure patient safety. If we have knowledge that an error has been made which could potentially cause harm to someone, we have a duty to see that it is reported to the proper authority. This does NOT mean we go and gab about the person who made the error to the rest of the staff. He/she is probably upset enough from making a serious error in the first place. It is management’s job to address the problem with that person.

So, before you allow someone to confide in you, ask yourself if you can deal with whatever the secret is. If you can’t, encourage them to find someone else. Above all, do NOT use a person’s trust for any other reason than to help!

The human voice can never reach the distance that is covered by the still small voice of conscience (Mahatma Gandhi).