Privacy and Discretion

People who live in private homes are able to take their privacy for granted, but that is not the case for residents of nursing facilities. They might wake to the sound of the breakfast cart coming down the hall, have someone come in and take their vital signs before they get up, and need others to do things for them that most people do for themselves in the privacy of their own bedrooms or bathrooms. As a certified nurses’ aid you will need to plan to preserve the residents’ modesty. The need for privacy includes the resident’s body, possessions, and information.

The resident’s person: Any time when you dress or undress a patient, be sure that the door is closed or that there is a curtain around the bed. When a physician has to examine a patient, a certified nurses’ aid can be enlisted to assist. If you are told to expose part of the patients’ anatomy for an exam, place a drape over the exposed part of the resident’s body before and immediately after the exam. Help the patient to dress as soon as the doctor leaves.

The resident’s property: Possessions that you would not want on public view can be put into cupboards or dressers. A bedpan is not attractive to have out when visitors come over, so put it away where it belongs when it is not in use. Any personal papers should also be placed in the dresser where the resident can find them easily but out of sight of visitors.

The resident’s information: When dealing with health, personal or family matters use discretion. If a patient needs to go to another facility for dialysis or chemotherapy, if there are others around, just say that it is time to go for a treatment without specifying what it is. The resident can decide how much to share with friends and family. Anything that happens in the nursing home must stay at the nursing home. If you discuss a patient in a restaurant, you never know when that resident’s relative could be sitting at the next table. If you want to share your knowledge of a case with a colleague or student who can learn from it, you may describe what happened with Mr. A. or Ms. B. without using his or her real name.

Medical records can be made available to the resident if he or she asks for them, but they should not be left lying around where visitors can see them. They should not be given to family members except with permission of the resident. Other than that, medical records should only be available to healthcare workers giving direct care to the resident. When in doubt, see your supervisor or the nurse in charge. If you get a telephone call from the resident’s doctor’s office asking for information, call the nurse in charge to the telephone.


Q.  Where should a patient’s files be kept to ensure their privacy?

A.  A patient’s medical chart and other documentation about their care should be kept out of view of visitors to the healthcare facility, healthcare team members who are not authorized to view these records and anyone else who could possibly read the records without permission from the patient.

Explanation:  A patient’s medical records and documents pertaining to their care should be kept at the nurse’s station or another secure area as set forth by the rules of your healthcare facility.  The records should not be left in a patient’s room or in common areas shared by multiple patients.  It should also not be left open and in view at the nurse’s station or in any other area.

Q.  Can a certified nursing assistant discuss the care of patient when the CNA is outside of the healthcare facility if they do mention the person by name?

A.  A CNA cannot discuss a patient’s care or condition out of the nursing care facility.  They can also not disclose any other information they know about the patient.

Explanation:  You cannot talk about a patient to anyone outside of a nursing care facility even if you do not mention the person by name.  All patients are entitled to privacy.  Information about their health and their lives should be private and should not be available to anyone other than those who are legally allowed to receive that information (such as their healthcare staff).  Even if you do not use a patient’s name, there is the possibility that someone would know who you are talking about and this would violate a patient’s privacy.

Q.  What things should you keep out of the sight of visitors and others who might enter into a patient’s room?

A.  A patient does not want others to know if they must use a portable urinal or a bed pan.  You should keep these out of sight within a patient’s room.  If a patient has private or personal paperwork, you should ask if they would like you to put them in a drawer or other private area within their room.

Explanation:  Never move a patient’s personal papers without asking for their permission and asking where they should be placed.  If a patient has other personal belongings that you do not think they would want just anyone to see, as if there is somewhere they would like you to place those items especially if they are expecting company.


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