A student nurse is assigned to a clinical unit on which one of the patients is a nationally known celebrity. The student reads the chart to find out why the celebrity is being treated. The student who is not the assigned caregiver is:
motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience.
doing appropriate research about nursing care as long as information is not divulged.
violating the confidentiality of the patient's record.
neglecting the assigned patient load and should read the unassigned patient's medical record only after his assigned work is completed.
The Correct Answer is C
A. Motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience.
Accessing information without being the assigned caregiver is inappropriate, regardless of motivation, as it breaches confidentiality and privacy protocols.
B. Doing appropriate research about nursing care as long as information is not divulged. Even without sharing information, accessing a patient’s chart without need-to-know status is a privacy violation and does not constitute appropriate research.
C. Violating the confidentiality of the patient's record.
This choice is correct as the student is breaching confidentiality by accessing patient records without a care-related need to know. Only those involved in the patient's care should access their chart.
D. Neglecting the assigned patient load and should read the unassigned patient’s medical record only after his assigned work is completed.
Reading an unassigned patient’s record, even after finishing other duties, is still a breach of confidentiality.
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Correct Answer is C
Explanation
A. Speaking slowly and clearly in the patient's native language. While speaking clearly in the patient’s native language is helpful, it does not verify understanding. Feedback from the patient is necessary to confirm comprehension.
B. Asking the family members whether the patient understands. Relying on family members may not be accurate, as they may not fully understand the patient's level of comprehension.
C. Obtaining feedback from the patient that indicates accurate comprehension. Having the patient repeat the information back or summarize it in their own words ensures they have understood the communication.
D. Checking for signs of hearing loss or aphasia before communicating. Assessing for hearing loss or aphasia can be part of the process but does not confirm that communication was understood.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.