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1. Recap from Year 1: Nursing and the Law

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1. Recap from Year 1: Nursing and the Law

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Confidentiality is part of common law as well as being enshrined in the NMC (2018) Code. Refresh your knowledge of nursing and the law by referring back to Jane Davies' presentation on this topic from Year 1 (HC1243 - Becoming an accountable professional)

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Recap from Year 1 (HC1243) Nursing and the law Jane Davies

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2. Introduction to Confidentiality in Children and Young People's Nursing

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2. Introduction to Confidentiality in Children and Young People's Nursing

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This introductory section provides an overview of confidentiality in CYP Nursing.  Please work through the powerpoint slides before moving onto the next section.

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HC2241 Introduction to protecting confidentiality in CYP

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3. Case Study: Kathy, a nursing student (From Cornock and McAlinden (2018)

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3. Case Study: Kathy, a nursing student (From Cornock and McAlinden (2018)

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Whilst on lunch break in the coffee bar in the foyer, Kathy, a nursing student, has her friends enthralled as she tells them all about her morning's experience in the A&E Department.  You wouldn't believe it, she says, as she tells them all about the young person who came in with an overdose, the 13 year old who turned out to be pregnant and the road traffic collision caused by the local school bus driver.  The coffee shop is used by everyone, not just nursing staff.  Some visitors are listening.

Do you think that Kathy has done anything wrong? Has she breached any of her patients' confidentiality?

She is in a public area discussing patients with her friends; it doesn't matter if Kathy's friends are nurses or not.  The only time you should discuss patient information is when the other individual needs the information in order to care for that patient.

However, has she passed on any patient details? From the information we have it does not appear as if Kathy is actually naming her patients when she is discussing them with her friends.
Does this mean that she is maintaining her patients' confidentiality?
NO
Kathy may breach confidentiality even if she does not pass on the patient's name.  It all depends upon the information Kathy is disclosing to her friends.  If one of the visitors listening in to Kathy's conversation is able to identify one of their neighbours from the information that Kathy is sharing, such as how they were dressed and some identifiable feature such as a mole in a particular place on their face, or their job (such as local school bus driver), Kathy will have breached her duty of confidentiality to those patients.

Even if Kathy does not provide identifiable features in her discussion with her friends, the question to be asked is why she is discussing her patients with her friends in a public place.  Whilst this may not be breaching any law, it is unethical in that it shows a lack of respect for her patients.

So has Kathy done anything wrong?  YES she has.  At bet she has shown a lack of respect for her patients.  At worst she has breached their confidentiality and the duty of care she owes to them.

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Read this extract from an article by Cornock (2011) on how confidentiality applies to children and young people.

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Extract from Cornock (2011) Confidentiality and the child

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5. When breaching confidentiality is permitted

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5. When breaching confidentiality is permitted

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Read these powerpoint slides for information on when breaching confidentiality is necessary and permitted.

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HC2241 When is breaching confidentiality permitted

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Amber a third year nursing student talks about confidentiality (from Cornock and McAlinden 2018)

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Amber a third year nursing student talks about confidentiality (from Cornock and McAlinden 2018)

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"Confidentiality can be a complex issue particularly with changing family dynamics.  I find confidentiality is even more complex in children's nursing than it is in other areas of nursing as it can be difficult to know who you should and should not share information with.  I have been involved with the care of an adolescent during my training who didn't want his parents to know about his health issue and this was a difficult situation to manage."

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Children Act. 2004.

Cornock (2011) Confidentiality: the legal issues. Nursing Children and Young People 23 (7), pp. 18-19.

Cornock, M. and McAlinden, O. 2018. Law and Policy for Children and Young People's Nursing. In: Price, J. and McAlinden, O. Essentials of Nursing Children and Young People. London: Sage, pp.119-132.

Data Protection Act. 2018.

Department of Health. 2007. NHS Information Governance: Guidance on Legal and Professional Obligations. London: Department of Health.  Available at: https://www.gov.uk/government/publications/nhs-information-governance-legal-and-professional-obligations [Accessed: 27 August 2021].

Hendrick, J. 2010. Law and Ethics in Children's Nursing. Chichester, West Sussex: Wiley Blackwell.

McNee, P. 2021. Ethical Issues. In: Brimble, M. and McNee, P. Nursing Care of Children and Young People with Long-Term Conditions. Chichester, West Sussex: Wiley Blackwell. p.p. 145-170. *Particularly the case study relating to confidentiality on P149*

NSPCC. 2014.  Information sharing and confidentiality for practitioners - things to know and issues to consider. Available at:  https://ipswichandeastsuffolkccg.nhs.uk/LinkClick.aspx?fileticket=k0jCC7t4KBc%3D&portalid=1 (Accessed 27.8.21.)

Noiseux et al. 2019. Children need privacy too: Respecting confidentiality in paediatric practice. Paediatrics and Child Health. doi: 10.1093/pch/pxy047

Nursing and Midwifery Council. 2018. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. NMC: London.

UNICEF. 1989. UN Convention on the Rights of the Child. Available at: https://www.unicef.org.uk/what-we-do/un-convention-child-rights/ (Accessed 27.8.21.)

Image sources: Student nurses. Available at: https://emedia1.nhs.wales/HEIW2/cache/file/8EC77F0F-0B9B-8DE1-A8A97B8BB0180D7A_carouselimage.png (Accessed 27.8.21)
Emoji https://static.wixstatic.com/media/38c5b0_1037b4e6ac63482798e5d812a483e4ed~mv2.png/v1/fit/w_400%2Ch_400%2Cal_c/file.png (Accessed 27.8.21)

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6. Information sharing and confidentiality for practitioners- things to know and issues to consider 

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6. Information sharing and confidentiality for practitioners- things to know and issues to consider 

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More child/young person specific information from the NSPCC on confidentiality and information sharing.

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NSPCC (2014) Information sharing and confidentiality for practitioners- things to know and consider