You are an PGY1 working on the Emergency Department rotation. You have just seen a male patient whom you know to be your brother’s best friend. He is to be admitted pending treatment for testicular torsion. As you finish your shift that evening you bump into your brother. He asks you to tell him what’s wrong with his friend, who won’t tell him as he doesn’t want anyone to worry.
Rank in order the following action in response to the situation (1=Most desirable, 5=Least desirable).
A. Approach the patient alone and explain that your brother is here and asking you what is wrong.
B. Ask the patient what he would like you to say to your brother.
C. Take your brother to his friend and explain things in front of the patient
and your brother so that the patient can hear what you say.
D. Direct your brother to the nurse leader, who will explain what’s been going on.
E. Explain to your brother that you can’t reveal patient details without their
express consent regardless of who the people involved are.
Successful ranking:
1-E, 2-A, 3-B, 4-D, 5-C
This question highlights the importance of maintaining patient confidentiality regardless of your personal connections with a patient. In this scenario, you should therefore discuss with the patient what he would be comfortable with his relatives knowing and then explain politely to his brother that you cannot divulge any information without express permission from the patient. As you have not had any prior instruction from the patient to tell your brother about their admission, it would be unprofessional to break this trust. Similarly, asking a colleague to do this is inappropriate as well. Directing your brother to his friend is not necessarily wrong as this would not break confidentiality; however, by doing this you would also not be explaining to your brother why you are unable to say anything and the patient may not want to see any visitors.