Introduction
Ethical values and legal responsibilities are critical for health workers as they provide a foundation for nurses who handle difficult cases daily. The patient should always come first and foremost in the mind of a nurse. The nurse must appreciate the need to incorporate the patient’s unique perspective into care methods. This paper will consider two complainees from the AZBN board meetings, discuss the legal and ethical responsibilities that were breached, the potential negative impact of the case on the patient, and reflect on how these events have impacted my professional practice.
Description of Complaint Brought Against the Nurse
Brian Massey, the doctor, in this case, is accused of violating the Health Insurance HIPAA regulations. According to his lawyer, a video was posted online where Brian discusses the intense spiritual connection he had with his patient. The video was reported anonymously by a nurse for violating the privacy and confidentiality of the patient. His lawyer argues that the issue did not violate the patient’s privacy or confidentiality. The video does not include identifiable markers such as the patient’s name, phone number, or address. Violating the privacy and confidentiality of patients has serious consequences for the organizations, the patients, and the nurses. The two complainees for this case are the nurses who filed the case anonymously and the patient whose privacy was breached.
What Legal Responsibilities Were Breached?
The legal responsibilities that were breached in this case include: duty of care, the legal responsibility of nurses to protect patient information and the mandate of the nurses to advocate for patients.
Nurses have the legal obligation to protect patient information. They protect the rights of patients to decide with whom they want to share their details, under which circumstances, and when their individually identifiable health information will be disclosed (Ahmed et al., 2020). Individually identifiable health information, such as clinical research records, oral reporting, pictures, and mental health therapy notes, should be protected by health records and other personally identifiable information. This level of protection should be maintained throughout the treatment process and in all other settings.
The legal duty of care is the legal obligation imposed on individuals requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. The first element needs to be established to proceed with an action in negligence (Hartigan et al., 2018). Nurses have the legal responsibility to advocate for patient needs in all health care settings. Nurses must collaborate with physicians and other organizations to ensure that the needs of the patients are well cared for. Nurses need to put the safety of their patients first. This means ensuring that the patients are safe and healthy. The legal duty of care for nurses extends to ensuring the privacy of patients is maintained. If patients can prove that the nurses or doctors failed to act in line with the duty of care, they suffer harm. As a result, the nurse or doctor could lose their license and face serious financial consequences and possible jail time.
Ethical Responsibilities That Were Breached
The ethical responsibilities that were breached include: the ethical responsibility to treat patients with dignity and worth, and the principle of non-maleficence.
The first provision of the American Nurses Association Code of Ethics, in this case, was breached. The provision suggests that “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person” (Beltran-Aroca et al., 2017). Nurses need to demonstrate a high level of respect for all individuals allowing for dignity regarding care and communication. Patients and their families must be treated with respect and professionalism. This means preventing any form of stigmatization by identifying patients. Therefore, while the video lacked specific identifying markers, the description of the patient by the doctor may have led to other nurses, patients, and members of the community being able to identify the patient. They may have been discriminated against and stigmatized due to their ailment or other topics discussed in the video.
Additionally, the ethical principle of non-maleficence suggests that healthcare providers are obliged not to harm a patient. According to this principle, nurses and doctors should not reveal any information about their patients to others (Ahmed et al., 2020). Without knowing it, the doctor may have provided enough information to identify the patient, such as their disease, male or female when they visited the hospital, clothes they wore, and proximity to the hospital. Any external conflicts of interest and the nurse’s habits or ideas that clash with the act of being a nurse should be disclosed and resolved so that medical outcomes are not jeopardized (Hartigan et al., 2018). Collaboration with internal and external teams is essential for providing the best possible patient care. It is crucial to understand professionalism and how they relate to care delivery outcomes.
A Discussion of the Potential Negative Patient Effects Related to the Compliant
There are so many identifying factors that do not necessarily require disclosure of a patient’s name. As Brian’s lawyer argues that the video has no personalized features, it can share information directly with a patient (Ahmed et al., 2020). The first negative effect related to the complaint is that it affects the patient’s confidence in physicians. Knowing that a caregiver can publicly disclose essential information about the patient will impact the treatment process, affecting patient satisfaction and outcome (Hartigan et al., 2018). The second negative patient effect from the complaint is that the simple video has also impacted the community towards the facility and other healthcare institutions (Beltran-Aroca et al., 2017). The community’s confidence in trusting the health caregivers and the facility has diminished. People assume that the responsibility of nurses and doctors is to share their patient’s information with the world.
Considering that people from within the same community know each other better when they hear any disclosed information, linking it to a face becomes automatic. Therefore, to avoid such embarrassment, the community will choose to avoid going to the hospital altogether (Beltran-Aroca et al., 2017). This impacts the health outcome within the community, and it also promotes people living with their problems. Another possible patient effect from the complaint is that it increases the patient’s stigmatization. Some information is sensitive, and it can be directly linked to a specific patient. When such information is leaked to the public, even without mentioning the name, the patient will not have anything to hide or even vindicate themselves from the increased stigma (Ahmed et al., 2020). It is the responsibility of healthcare workers to protect patient’s confidentiality and information before, during, and after the treatment process. When this information is breached, the patient’s confidence and trust in the healthcare system drops significantly (Hartigan et al., 2018).
A Reflection on How This Experience Has Changed Your Professional Practice with Supporting Details
From the case of Brian, I have seen how patient confidentiality and limitation of who accesses what information and to which capacity is important (Hartigan et al., 2018). There is also a need to invest in a strong privacy mechanism to promote the public’s confidence in healthcare services. As a practicing nurse, the complaint has impacted my professional practice as it prevents my patients from disclosing critical information about their condition. Therefore, even after putting all the efforts to help the patient, administering the best treatment becomes difficult (Ahmed et al., 2020). The diagnosis and treatment process is critical for the general wellbeing of a patient. However, in my professional practice, I have been experiencing difficulty understanding the patient’s specific needs or administering the right medication for the specified condition (Beltran-Aroca et al., 2017). In return, this has led to an increased number of misdiagnoses and malpractice hence affecting my reputation and professionalism.
Additionally, it has become difficult to show professionalism and a genuine connection with the patient with this case in the public domain (Hartigan et al., 2018). As a practicing caregiver, striking a conversation with the patient makes it possible to understand their problem in detail even when they do not share it openly. However, when the patient is worried that whatever they say can be breached and made public without their consent, sharing their story becomes a problem (Beltran-Aroca et al., 2017). A diagnostic error can occur at any point during the diagnostic procedure, and the patient repercussions of these errors range from no harm to serious injury (Ahmed et al., 2020). According to Schiff and colleagues, not all diagnostic process errors result in a missed, delayed, or incorrect diagnosis, and not all errors (whether in the diagnostic process or related to misdiagnosis) result in patient harm.
References
Ahmed, W., Jagsi, R., Gutheil, T. G., & Katz, M. S. (2020). Public disclosure on social media of identifiable patient information by health professionals: Content analysis of Twitter data. Journal of Medical Internet Research, 22(9), e19746. https://www.jmir.org/2020/9/e19746/tweetations
Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M., & Muñoz-Villanueva, M. C. (2017). Confidentiality breaches in clinical practice: what happens in hospitals?. BMC medical ethics, 17(1), 1-12. doi: 10.1186/s12910-016-0136-y
Hartigan, L., Cussen, L., Meaney, S., & O’Donoghue, K. (2018). Patients’ perception of privacy and confidentiality in the emergency department of a busy obstetric unit. BMC health services research, 18(1), 1-6. https://doi.org/10.1186/s12913-018-3782-6
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