Persuasive writing assignment: Client Confidentiality

Client Confidentiality: Inappropriate Viewing of Client Records

Adam McFarlan
Humber College
Legal, Professional & Ethical Issues in Nursing Practice
NURS217

Introduction
The topic being presented is confidentially and privacy, one of the practice standards of
the College of Nurses of Ontario (CNO). The newspaper article that I have chosen Former SAH
nurse suspended for snooping (Della-Mattia, E., 2015) covers a situation where a (now)
former nurse, Marcella Calvano, pleaded guilty to professional misconduct for snooping
into the personal health files of 338 clients of the Sault Area Hospital. Calvano had been
working in the intensive care unit and emergency department but transferred to the
surgical unit wing. Calvanos access to electronic records for emergency patients was never
cut off as they should have been and Calvano had full access to client names, date of birth,
primary complaint, diagnostic imaging results as well as lab results. Although Calvano has
not reportedly used the information for personal gain she has been suspended by the CNO.
The controversy in this case is that information about more than 300 clients, which
should have only been disclosed to healthcare workers within each individual clients circle of
care, was breached and private information was disclosed to someone outside each clients circle
of care. I feel this is an important issue because client information is an intensely private matter.
It can include information such as test results which the client may not want many people having
knowledge of or the client may simply not want their name released for personal reasons. Clients
may be concerned about their private information being safe and I believe it is important for
hospitals and their staff to maintain that privacy to ensure that clients maintain a peaceful state of
mind.

Body
One of the core practice standards of the CNO is Confidentiality and Privacy which states
the importance of maintaining a clients privacy: Nurses have ethical and legal responsibilities
to maintain the confidentiality and privacy of client health information obtained while providing
care (CNO. Confidentiality and privacy Personal health information. Pg 3. 2009). A
clients personal health information is very much like their property. They have the right to
it and willingly disclose it to the trusted healthcare team working with the client. CNO
states that The legislation recognizes that personal health information belongs to clients
and is simply being housed in health care facilities. (CNO. Confidentiality and privacy
Personal health information. Pg 6. 2009) Accessing or disclosing a clients personal health
information without their knowledge or consent is very much a theft of the clients right to
privacy. Information gathered for the purpose of client should only be used for the purpose
of caring for the client and should stay with the team managing the clients care as they are
the staff to which the information is relevant as emphasized by the CNO. A nurse is
responsible for ensuring that she/he uses client information only for the purpose(s) for
which it was collected. (CNO. Confidentiality and privacy Personal health information.
Pg 5. 2009) A nurse should ensure that it remains secure within the health care team. It is
also important that incoming clients trust hospitals and their staff because they may
withhold important information which could pertain to their care if they fear their
personal information being released. If a nurse did want to look at a clients medical
records they would first need tot get direct permission from the client to view their health
history such as the article Privacy and Confidentiality of Patient Information: Challenges for
Nursing states, When nurses want to access the health records of patents not directly

under their care, they are ethically bound to notify those patients before doing so and,
whenever possible, should obtain permission. (Milholland, D. K. 1994).
Disclosure of personal information may in fact lead to harm for the client inside and
outside the healthcare setting. For example with information such as a clients full name, family
contacts, medical history and health card number the client could be scammed for money or even
identity theft (?) with this information. Additional psychological harm can come to the client if
they wish to have their information such as their name or a diagnosis of cancer remain private. If
such information is released they could become distressed and feel betrayed by the healthcare
system.
There are legal implications to breaching a clients confidentiality such as the
Personal Health Information Protection Act, 2004 (PHIPA) which sets consistent rules for
how client information is managed and the clients right concerning their personal health
information. The PHIPA states that A person is guilty of an offence if the person wilfully
collects, uses or discloses personal health information in contravention of this Act or its
regulations. (Personal Health Information Protection Act, 2004, Law Document English
View. 2015) This means that if a healthcare worker outside the clients circle of care
discloses or simply collects personal health information, they can be charged for acting
against the PHIPA and it can also very likely result in a suspension from the CNO. The
hospital may also be at fault for breaches in privacy and a hospital staff member who
breaches the PHIPA can cause their hospital or facility legal consequences.
There are some opinions that counter the idea that viewing client information when
outside the clients circle of care is unethical like the idea that if the information is not

leaked to parties outside the hospital such as the news that no harm is done, this opinion of
no harm, no foul is unreasonable in that a clients right to privacy is still being breached.
Another differing opinion is that if the client is unaware that their privacy is being
breached that no harm is done, this opinion is also countered by the fact that it is still a
breach of the clients privacy and even if a client is unaware their privacy was breached it
may still come forward to them later that their personal health information was accessed
by someone outside their circle of care like how in the article Former SAH nurse
suspended for snooping where the nurse Calvanos accessing of client information outside
her circle of care went on between 2011 and 2012 without being found but was caught
afterwards and once a breach of client privacy has been found it cant be simply undone.

Conclusion
The right to privacy and confidently is an important part of the nursing profession
and the breaching of client privacy to view a clients health information when the viewer is
someone outside the clients circle of care is highly unethical. The breaching of a clients personal
health information is a breach of a clients right to privacy and can also have legal repercussions.
It can lead to the client not trusting the ability of the healthcare system to competently hold their
information and they may even choose to not disclose information to the healthcare system in the
future. A clients personal health information belongs to them and it is a privilege for the circle of
care for that client to have access to that information and a healthcare member outside that circle
of care looking into that information is a theft against that clients right to privacy.

Citation
Personal Health Information Protection Act, 2004, Law Document English View. (2015,
July 1). Retrieved September 29, 2015. (Current edition)
Milholland, D. K. (1994). Privacy and Confidentiality of Patient Information: Challenges
for Nursing. Journal of Nursing Administration, 24(2), 19-24.
(2009). Practice Standard: Confidentiality and privacy-Personal Health Information.
College of Nurses Ontario, 1-6. (Current edition)
Della-Mattia, E. (2015, May 6). Former SAH nurse suspended for snooping. Sault Star.
Retrieved from http://www.saultstar.com/2015/05/06/former-sah-nurse-suspended-forsnooping