Essential skills in nursing care and patient confidentiality

¶ … Skills Regarding Nursing Care

Nursing interventions are aimed at improving the overall health of the patient and to make him / her feel comfortable. Besides administering the medication as prescribed by the doctor, the nurse also has other interventions including regularly monitoring the patient's vitals, performing medical procedures, educating the patient and his family about the condition, etc. Nurses, being the main caregivers, are also involved in providing active counseling services for the family and the patients. In such cases where necessary the nurse refers the patient to other counselors. It is the responsibility of the nurse to ensure that the patient and his family are kept well informed and that they are not unduly stressed. The nurse has to manage all these without compromising the patient confidentiality. A brief overview of these important aspects of nursing care would provide better insight into the topic.

Patient Confidentiality

Nurses by nature of their profession have access to confidential information about their patients. However, professional ethics demand that nurses keep this information confidential. From the age old Nightingale pledge to the recent times when privacy acts such as the HIPPA (Health Insurance Portability and Accountability Act) are in place, it is clear that the nurse has a role to not only promote patient care but also to uphold patients' right to privacy and confidentiality. [Jeanette Ives Erickson,(2005)] In Australia too, the code of ethics for nurses provides the basis and the guidelines for ethical management of information. Nurses are also responsible for helping the patient take important decisions about his/her treatment. In other words nurses are fully aware of the legal as well as moral rights of the patients in determining their course of treatment action. [ANMC, (2005)] Confidentiality implies that nurses' share only pertinent health information with those directly concerned with providing treatment for the patient. As with all rules, there are some exceptions to the confidentiality provision as well and the nurse should evaluate the circumstances and do what is ethically right.

For instance, the nurse should exercise her discrimination to assess situations where confidentiality would cause harm to the society at large. A case in point would be a man diagnosed with HIV asking the nurse not to disclose the information to his wife. In this particular case, since maintaining strict confidentiality causes more harm, as the chances of the wife getting infected are high it is justified on the part of the nurse to disclose the information to the spouse. However, in other instances where the patient wants information regarding his prognosis withheld from his relatives, since there is no direct impact on others' health or safety, confidentiality acquires importance.

Conclusion

The nurse has a multifaceted role. The nurse not only performs medical procedures and administers prescribed medications but is also actively involved as the direct caregiver in assisting the patients in making informed choices about their treatment course. Nurses help family members understand the condition of the patient and keep them informed about the future course of action and the choices available. In other words, nurses are responsible for promoting the value of 'shared decision making'. Nurses help the client understand diagnostic tests and prepare them for the procedures. Nurses are also responsible for maintaining patient confidentiality and privacy requests. However the patient's right to confidentiality may sometimes be overridden by the threat to safety and health of others. The nurse should have the confidence derived from knowledge of ethical and legal principles to make responsible decisions that promote quality care.