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You are reviewing your recent social media messages and notice that a co-resident has written a highly negative comment about a patient’s situation. There was no specific patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians that were being described.

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You are reviewing your recent social media messages and notice that a co-resident has written a highly negative comment about a patient’s situation. There was no specific patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians that were being described.

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Dr Ahmed a consultant from another department approaches you (as a resident) and wants to check Mrs. PJ’s charts. You reply, that she is not their patient, and you’re uncertain whether you’re allowed to share it with him? He replies, “Fine but, give me the charts anyway, I may have a reason in the near future, so don’t get upset”, physician replied.

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Dr Ahmed a consultant from another department approaches you (as a resident) and wants to check Mrs. PJ’s charts. You reply, that she is not their patient, and you’re uncertain whether you’re allowed to share it with him? He replies, “Fine but, give me the charts anyway, I may have a reason in the near future, so don’t get upset”, physician replied.

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You are final year medical student making rounds with the attending physician and a resident on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found that they were positive, but your resident was unable to check the culture results himself before rounds. When asked by the attending physician, the resident replies that the culture results are not yet available.

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You are final year medical student making rounds with the attending physician and a resident on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found that they were positive, but your resident was unable to check the culture results himself before rounds. When asked by the attending physician, the resident replies that the culture results are not yet available.

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Confidentiality - Dr Ahmed is not the patient's consultant and it would be a breech of confidentiality to give the patient's information to another doctor without the patient's consent. We have consent to the patient's information, not Dr Ahmed

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Integrity - doing the right thing and not giving Dr Ahmed the charts even though no one is watching to make sure that the patient's privacy is protected

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Wouldn’t give them the chart
Explain that it isn’t personal and that there are rules you have to follow

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Advocacy - by protecting the patient's information you are advocating for their confidentiality

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Person would understand why you refused permission
You could communicate effectively about it

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Individual - move forward explaining that providing the patient's charts is a breech of patient confidentiality
Institutional&Council - if it gets to the point where Dr Ahmed continues to ask for the chart then more strict provisions may have to be taken to ensure the confidentiality of the patient

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Partnership - need to work with the physician, need to speak up and advise that the cultures are back, possibly results can be reviewed together to see next steps for the patient

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They check the result when you alert them
They review it on time as sepsis is time dependent
Ensure your approach is appropriate with good communication

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Advocacy - advocate for the patient by saying that the results are back/available, not advisable to without information about sepsis (time-sensitive matter)

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Go forward saying that results are available/back for review without giving/drawing on any conclusions

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Individual - advise that the results are back in interest of wanting to provide the best care for the patient
Institutional/Council - resident possibly doesn't feel like they are in a safe environment to disclose that they didn't have time to check results (this then puts a patient with a possible life threatening illness at risk)

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Breech of confidentiality - even though no specific name of the patient was used they could figure out that the case is about them, physicians and nurses can also be identified by the case

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Possibly reach out to this co-resident and advise that it may be best to take down this negative comment about the patient's situation. It reflects badly on the care of patients and is a situation that could be easily identified

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Working in partnership - passive aggressive behaviour shown (instead of running to social media to share this negative experience speak to the individuals responsible in person)

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Take down the comment and have better communication

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Individual - recognize that they can't discuss their work and concerns like that online, everyone can interpret different situations online differently (everyone doesn't have the full story)
Institutional - make sure that the environment is one that is supportive, positive and welcoming to open communication to discuss any issues that arise instead of sharing them on social media for everyone to see
Council - have a concrete set of rules and guidelines that detailed what is allowed and what isn't allowed to be shared online, if sharing online occurs make a distinctive guideline of what is okay and what is not okay, and what is allowed and what isn't allowed.