Petronio & Sargent: Disclosure predicaments arising during the course of patient care Flashcards
What is the theme of Pertronio & Sargent?
Seeking and providing information
What is the title of the piece by Pertroio & Sargent?
Disclosure predicaments arising in the course of patient care: Nurses’ privacy management
How many strategies are there to manage disclosure predicaments?
4
What is the first strategy to manage disclosure predicaments?
Preemptive and Privacy Strategies
What are preemptive and Privacy protection strategies?
The essence of this strategy is to build a “privacy protection shield” to avoid becoming a co-owner of patient disclosures
Based on concerns about emotion toll the disclosure may take on nurses
What are two sub-strategies that are used?
- Avoid hospital units that routinely involve difficult disclosures
- Focus on work tasks to appear emotionally unavailable to patients
What is the second strategy to manage disclosure predicaments?
Variable Adherence to patient privacy rules
What is part of the variable adherence to patient privacy rules?
In both cases, patient’s ask that nurses follow their privacy rules, note that the nurses took different approaches to respecting privacy rules
Nurses often respond by placing responsibility for managing disclosure back on the patient.
What is the privacy rule?
You and someone else get to know this information
(example: pillow-rule) “do not tell so and so”
What is the third strategy?
Negotiating requests for involvement in private matters
Describe the third strategy.
Requests to get involved can exploit the trust/confidentiality a nurse has developed
While families often feel they are all inside a shared privacy boundary with the patient, nurses have a special professional obligation only to the patient
Family members sometimes resent that nurses co-own information they they do not co-own.
sometimes you need to violate to be able to ask for advice
What is the fourth strategy to manage disclosure predicaments?
Managing a disclosure need
Describe the fourth strategy.
Nurses consult with one another about difficult patient cases (in the patient’s medical interests)
Patients disclose to an individual nurse, but in practice this can amount to a disclosure to the whole nursing staff.
An example of turbulence (tension) in privacy boundary management
What is HIPAA?
The Health Insurance Portability and Accountability Act which provides standards for appropriately collecting, storing, and transmitting patients’ protected health information (PHI)
True or False.
In practice, maintaining confidentiality can be complex requiring a balance between concealing and revealing information to whom, how, when ,etc)
True.
