Magazine article slams OH nurses
Alleges confidentiality breaches common
If you have the May 1998 issue of New Woman magazine in your waiting area, you may want to remove it so your patients don't see a potentially offensive article that alleges occupational health nurses routinely divulge confidential information in the workplace. The article has some occupational health professionals responding angrily.
Faye Searle, RN, BSN, is an occupational health nurse with New York Downtown Medical Associates, which contracts her services to Prudential Securities Inc. in New York City. She tells Occupational Health Management she has written a letter to New Woman complaining vehemently about the way occupational health nurses were portrayed in the article.
"I'm demanding an apology for all of us," Searle says. "I'm offended because they portrayed occupational health nurses as blabbermouths."
And that actually is pretty much what the New Woman article says about occupational health nurses. In an article, "The spy who hired you (p. 64)," the magazine offers a list of tips to protect your privacy in the workplace. Much of the advice is straightforward, cautioning women not to write private e-mail on a company computer, for instance. But then the article offers this advice to women:
"Don't reveal your medical history to anyone, if possible. Maybe you just went to the company nurse for an aspirin, but don't tell her about your hangover or your last visit to the gynecologist. Before you know it, the guy in the next cubicle will know your favorite cocktail and what kind of birth control you use."
The article also states that employee assistance programs in the workplace pose a threat to confidentiality because your counselor will be tempted to tell your employer what you reveal. Searle says such blanket statements are unfounded and encourage workers to mistrust the people who can be their best advocates in the workplace.
Searle's supervisor, director of nursing Nancy Vidal, RN, BSN, also was outraged by the article. She calls it "amazing and unprofessional. I just could not believe what was published. I usually read my New Woman and put it out in my waiting area, but not this one. Wouldn't that be wonderful if one of my patients was waiting to see me and picked that up to read?"
Vidal notes she was particularly offended to see such an insulting statement in a magazine aimed at working women, and in reference to a profession that traditionally employs mostly women.
"They wouldn't say that about doctors or attorneys, would they?" she says. "You wouldn't hear a reference made like that about a profession associated mostly with men. To read what they think about me as a nurse is very disheartening."
Calls to New Woman editor-in-chief Clare McHugh, asking for a response to the criticism, were not returned.
Vidal says the article is contrary to what she sees with most patients, who understand that a nurse is obligated to protect the patient's confidentiality. Nevertheless, she says she intends to raise the topic with the company's managers and suggest devising some way of reminding employees that their confidentiality is protected when they see a company nurse.
Searle says she occasionally has encountered workers who are concerned their discussions with her might not be protected. Such concerns usually are inevitable outgrowths of the type of information involved, rather than any distrust of occupational health nurses. Nevertheless, she doesn't want anyone needlessly encouraging workers to be suspicious of her.
"It can be dangerous if workers get the idea that there are some things they can't tell me," she says. "I may have to make some important decisions based on bad information, and that can have serious consequences in the workplace."
She recounts an instance in which a worker was being treated for feeling lightheaded and dizzy on the job, but she told Searle she had no illnesses. Searle thought the woman was hypoglycemic, but she later found out that the woman was being treated for a gynecologic cancer and a heart arrhythmia. Searle also says it is very common for a worker to report to her office for a rather benign need, such as a blood pressure check, and then reveal that the real purpose of the visit is to discuss something more serious and private.
"That's a great thing when they feel comfortable about coming to me with a need like that, even if they have to pretend they're coming for something else," she says. "They won't do that if they think I'm going to run out and tell everyone why they were here."
Ensure privacy for workers' consultations
She offers these suggestions for ensuring that workers feel confident that their privacy is protected:
· Tell the worker very explicitly that you will protect his or her privacy. Even if you think the worker should know that already, it's worth repeating at the moment the worker is the most worried.
"I tell the patient, 'It's up to you what your boss knows,'" she says. "'If you want to tell them, that's your decision, but I'm not telling them.' Once they realize that, they're much more comfortable.'"
· Give the worker physical privacy also.
If the worker seems unsure about what he or she wants to tell you or otherwise seems uncomfortable, offer as much physical privacy as possible.
"When I see that they're uncomfortable, I automatically take them into a more private room where I can sit and talk with the door closed," Searle says. "I tell [the employee] that what [he or she] says here stays in this room unless it's something that has to go in the chart. And then I tell [the employee] that the chart is confidential, too."
· Explain that records are secured from prying eyes.
"I make sure that people know the charts are physically locked up," she says. "I have no computer in my office, and I think that sometimes makes people more comfortable. Everyone's aware that there are ways to get into computer files. And while you can get into a locked cabinet too, you have to physically break into it."
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