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Breach of confidence




My friend, who chairs the nursing department at a local university, told me about a serious medication error made by “Jane,” a staff nurse at the local hospital. She learned about this information from Jane's nurse-manager.

I suspect the nurse-manager felt obligated to “warn” the university because Jane represents the university as a clinical instructor. I also suspect my friend told me about this because I was Jane's nurse-manager and a former faculty member at the university.

What are the legal, ethical, and privacy bounds of confidentiality among professional colleagues?—H.H., WIS.

Engaging in gossip is one of life's great temptations, and many people rationalize sharing confidential information as necessary to “warn,” or “protect,” others. In fact, it's unethical and destructive. In this situation, the lack of confidentiality could also discourage nurses from reporting medication errors in the future.

Institution policies on confidentiality and risk management clearly define the extent and limit of reporting responsibilities. I suspect the nurse-manager broke her hospital's policy when she shared this incident with someone at the university. I'm also certain that no university policy requires notification of “former faculty and hospital managers” about medication errors at the hospital.

I advise you to get out of the gossip loop. If any more “confidential” information comes your way, refuse to hear it. Simply say, “I don't need or want to know this.”

Susan A. Salladay is an independent consultant in bioethics based in Spokane, Wash. Address your questions to: Ethical Problems, Nursing2005, 323 Norristown Rd., Suite 200, Ambler, PA 19002.

© 2005 Lippincott Williams & Wilkins, Inc.