Patient Privacy in a Shared Hospital Room: Right or Luxury?
Helen Malcolm, RGON, MN Lecturer, School of Nursing, Faculty of Medical and Health Sciences, University of Auckland
Reference: Malcolm, H. (2004). Patient privacy in a shared hospital room: Right or luxury? Nursing Praxis in New Zealand, 20(1), 28-35.
The expectation of personal privacy is reasonable, provided for by the law, and is a view supported by current literature. Yet in the hospital setting where patients are required to share a room with strangers it is questionable whether privacy is adequately protected. In this article the author discusses the New Zealand legislation aimed at protecting the individual’s right to privacy and concludes that practice may place healthcare consumers’ rights at risk. While patient privacy should be of concern to all health professionals, the focus here is on the nurse’s role in relation to recently formulated competencies published by the Nursing Council of New Zealand, which includes the recommendation that care be seen to exhibit an awareness of healthcare consumers’ rights to privacy alongside the expectation that nurses question practices that compromise patient privacy.
Patient privacy, health legislation, codes of conduct, nursing competencies
Nurses are in a privileged position, with the intimate nature of many nursing procedures often resulting in confidential revelations from the patient about their feelings, thoughts, past experiences and even matters concerning family members (Williams, 2001). Patient vulnerability and dependence on nurses and nursing care can bring about a special connection that does not exist in any other social setting (Lawler, 1991). A key component to any relationship, but particularly the nurse-patient one, is trust. Explicitly the patient places their trust and belief in the nurse, that she or he will provide suitable care and protection (Pask, 1995) which includes security of confidential information. Hoey (1998) regards privacy as a basic tenet of dignity and respect that patients can expect in their relationship with healthcare professionals. This view reflects that of MacNeill (1992) who, in reference to the patient-physician relationship, describes the moral view of confidentiality as “rooted in respect for individual’s autonomy over information about themselves as well as respect for the integrity and importance of the confidential relationship in which such information is shared” (p.169). While MacNeill is exploring the association between doctor and patient, this statement could equally apply to the patients’ relationships with nurses. International health-sector journals detail similar issues regarding privacy (Curtin, 1993; Erlen, 1998; Hoey, 1998) including use of health information for epidemiological studies (Vandenbourcke, 1998). Flegel and Lant’s (1998) study of health professionals’ conversations in a Canadian hospital elevator found that a large proportion of the comments overheard represented infringements of patient confidentiality. Although such discussions between health professionals are generally conducted to further the treatment of an individual it may disturb many people to know that their personal details are heard by others who have no right to such information.