Sunday, March 10, 2013

Confidentiality

 I’m assuming most NP programs are similar to this one and that we meet weekly with our instructor to discuss patients, clinicals and any concerns. For our primary care we are all located in different large busy clinics throughout the metropolitan area. These clinics are not in any way upscale or suburban; they provide services to the inner-city and underserved populations. But this is also where we get the best experience, because many of these patients are train wrecks with extensive problem lists.
 
Nobody has dropped out, so my cohort remains the same ten people after 18 months. We now know each other all too well. These weekly sessions lead by our instructor is a chance for us to decompress from the stresses of everything going on. Of course our favorite topic is patients and their comorbidities.

Everything we talk about is confidential. But we laugh at our patients, we feel for our patients, we get frustrated with our patients and we really care about them. It helps because we know we are not alone in the decisions and mistakes that we make. They are learning points. Our instructor with her decades of experience has some of the best and funny stories about patients and mistakes from her past.   

I want to blog about some of my patient encounters, but it still feels uncomfortable to post anything outside of the classroom for fear of being recognized. Even without identifying points in a post, all those confidentiality, HIPAA and ADA laws make me overly cautious while still in school.

7 comments:

PediNP said...
This comment has been removed by the author.
MamaDoodle said...

Since graduating 6 months ago, the only thing I'm missing is those clinical conferences. The free discussion of our experiences with our patients was the best learning experience I had. You can learn pathophysiology and disease management out of a text book but there's no substitute for real discussion when learning the nuts and bolts of actual patient care.

I understand your hesitation about writing related to privacy concerns. For this reason I've rarely written about my experiences and then only from the perspective of how the interaction affected me.

Good luck to you as you head through the final stretch before graduation!

PediNP said...

I have been thinking about this very topic myself lately. Last week my manager gave me a hard time about giving my patients my email address, and told me communicating with them in that format was a HIPAA violation. As much as I enjoy writing my blog, I have decided that it is a risk I no longer wish to take.

I"ll keep reading yours tho!

NP Odyssey said...

MamaD,
Clinical conferences will be missed.

PediNP,
It is OK to write you just have to write like the doctors do on their blogs and avoid identifiers.
Doesn't the clinic have its own email system for patients?

PediNP said...

They are developing a patient portal, where the patients can communicate with the clinic electronically. We have our own email, but according to the manager, our firewall isn't strong enough. I don't buy it, but that is how it is where I work.

With regards to the blog, I tried to write without patient identifiers, but I still realized that if someone wanted to see themselves in those stories, they could. It is just too risky.

NP Odyssey said...

PediNP, Best of luck. If you want to blog again just start new, and let me know where you post.
I know a few people who have done that because they told someone at work about their blog and it snowballed. So they started again anonymously.
Now I worry about Blogger becuase of Google+ it is hard to separate accounts. I might try Wordpress or something else in the future.

A Doc 2 Be said...

NP - I don't Google+ with this account. I found out it was linked to my real name, and I've unlinked that account. I think you can still do that to protect your (and everyone else's) anonymity.