Privacy Vs Observation

Human being has right to have privacy in all aspect of life. This right becomes more important when human being become a patient. Being working in pediatric unit we need to take care of not only the child but also the mother. On June10th, 2006, during daily round with my preceptor I use to maintain ward cleaning and uniformity. It is very difficult to maintain but we have to do it. In general ward we have five beds facing to each other. For our manager round we need to keep the curtain open. Other wise our manger does not like it. According to her "nurses can not observe the patients if they have covered with curtains". One of the mother said that she will not keep the curtain open. I requested her that please keep it open for some time and then just close it. After some time when I go back she again closed the curtain. When I asked her why she opens the curtains? She said that ok I understand that I need to keep the curtain open but I will not do it because there is male sitting just in front of my bed and I don’t feel comfortable. When I observed she was right. Out of five children two children were having their father as attendant.
After some time nurse on duty she open those curtains again while saying who is closing curtain I can’t observe all patients at one glance. Patient who was not feeling comfortable, she wanted to feed the baby. The other patients were having same concerns. But every one was in hurry to complete their job but no one maintained privacy even they did not drew the curtains. This was very embracing for patient. The other patients also were looking at each of them and they become unsatisfied. But the staff was use to of it and they didn’t feel bad. The whole day I saw same practice going on.
Later on when I reflect on what happened to the patient, I think over here the bill of right are violated. The health care team was not providing comfort to the patient as needed at that time. Besides this the health care team was also neglecting the privacy of the patient. As I came out from labor room I felt guilty and sad towards patient. It reminds me the situation which I had suffered. When my own daughter was admitted I was in private room but some of doctors they never bothered to knock the door and they use to enter immediately. They never wait for my answer that I will allow them to come in or not. First of all when I entered the ward they gave me a room where the father was attendant. I asked the staff on duty I can not stay in this room. I will not feel comfortable. The nurse on duty was in hurry she did not bother what I asked to her. Again I requested for another room they refused because they can not change bed in the night. Any how in morning they changed the bed. The whole night I spent sitting on chair. How I felt at that moment I could feel the emotions of those women in pediatric ward.
As I thought about above mentioned situation a question was triggering me within that, why the patient suffered that all. In the hospital patients are totally dependant on health care professionals and we nurses have to play major role in patients care by giving holistic care and doing advocacy for the right. In health care professionals the nurse is primary person who can listen to their patients and families and support them at the time of crises. The whole day I was feeling annoyed and could not concentrated on my other tasks.
When I came back, I had many question in my mind. Why the health care professionals neglected patient’s privacy? Why the doctor and nurses deal with patient as they are nothing? Why the health care professionals did not understood the facial expressions of patients? Why as student I did not advocate for my patient’s rights? Why the nurse removed curtains? Is this ethically right to remove curtains during routine hours? Nurse is a primary care giver of patient why the nurse was neglecting patient’s privacy. If one of her close relative will be there would she behave the same? Are we providing care according to our oath which we had taken while graduating. Further more, they were not allowed to bring food from out side, they have to pay extra amount to get food for mothers.
Ethics is a branch of philosophy that focuses on thinking about morality, moral problems, and moral judgments. In our daily practice, ethical issues may arise when our views differ from activities that might jeopardize patients or that are outside standard practice. In general perception of nurse is that they favor patient’s right and they do advocacy for the patients, but if we see this issue in our socio culture it is generally observed that the nurse are the one taking care of patient during stay in hospital. So it is her responsibility to maintain privacy during any procedure. While analyzing the situation, I came up with many possibilities that it could be happened due to negligence of health care professionals. Doctor might be very busy at that time and she might think as a doctor it is not her responsibility to draw the curtains or else no one thought about opposite gender in the general ward. All health professionals might want to give care to all patients while doing routine work also. As I observed the nurse on duty was alone and she could not rely on students. That’s why every then and now she was opening the curtains. She prioritized observation rather than privacy. As a student I did not perform my role as well at that time. Might be I was hesitating because the environment was new for me. What ever the cause of violation of patient’s right; it is our responsibility to give respect to our patients and their families as holistic approach. Family support is very important at the time of child admission. But it might be policy of hospital that they don’t allow any body inside the ward other then mother.
After experiencing I realize that being a nurse what ever resources are available we should try to cope up with limited resources and should work to raise the voice of patients’ rights. Further more psychological support is plays very important role while patient is in need. To over come the stress of pain and environment it is very important that at least we provide the privacy to the mothers. Being a nurse it is our responsibility to provide physical, psychological and emotional care to patient. According to American Nurse Association (2001)" The nurse safe guard the patient’s privacy…..the nurse advocates for an environment that provides the sufficient privacy including auditory privacy that protects the confidentiality of information." It shows that providing privacy is very important for a nurse.
When I remember my own situation, still I could not forget that moment when I spent the whole night just sitting on chair. I think it is responsibility of all health providing team to maintain privacy of any kind of patient. According to Elli and Hartley (2000) "The patient has right to every consideration of privacy ….. Privacy should be maintained during examination, treatment and procedure" (p.360). It seems that all health caregiver should take care of patient’s privacy. According to Tabak and Ozon(2004)" the patient’s privacy is key concept in relation ship between nurses and patients. Privacy is basic human rights respect for privacy by the nursing staff is essential for patient’s psychological, physical, spiritual and mental welfare" (pp-367). Moreover I felt that we don’t allow patients to follow their religious practices while they are in hospital. As American Nurse Association (2001)" To wear appropriate personal clothing and religious or other symbolic items, as they do not interfere with the medical procedure and treatment." However according to Tabak and ozon(2004) research shows that there was positive correlation was found between nurses attitude and perceived behavioral control in promoting the maintenance of patient’s privacy. Owing to overwork and lack of time, nurses may feel that their control over their behavior is lessened and therefore patient’s privacy may be harmed. Moreover if better educated nurses have broader knowledge and its expected that they demonstrate more positive attitudes and know the code of ethics and relevant laws addition to that better educated nurses usually hold managerial positions where they have to make many decision and work under the pressure of high work load and time.
As a nurse if the similar situation occurs in future, I will initiate role of advocator for my patient. I will conduct education session on patient’s bill of right and privacy for staff. I will also make different strategies like scenario based learning and role playing where nurse can learn how to rationalize based on reason and act in better way. Beside this I will also emphasis in grand rounds to doctor and nurses to respect patient’s right and reinforce to know ethical principles during their stay at hospital. I will also conduct seminars on privacy of patients for students so that they will learn before starting their job life. I will forward my observation to the hospital management as well so that they can also look for possible potential solutions.
In conclusion, I would say that the health care professionals especially nurses need to take leading role to satisfy patients need respect their rights and autonomy which in turn will raise the standard of nursing profession and definitely will improve patient care. Moreover providing privacy to patient when giving any kind of care and treatment it is very important component of holistic nursing care. Medical professionals should try their best to maintain maximum privacy while providing any kind of care to the patient. I would recommended all nurses to be care full about provision of privacy to the patient in providing care and treatment, which is one of the important right of all patients. Moreover, ongoing sessions should be held in individual unit bases for staff to emphasize the importance of patient’s privacy. With out providing privacy in care and treatment nurse are not able to provide culturally sensitive care to patients. This will help to bring insight in the nurses and other health care givers.


References
Tabak, N. &Ozon, M. (2004). The influence of nurse attitude, subjective norms and
Perceived behavioral control on maintaining patient’s privacy in hospital setting.
Ellis,J.R. & Hartley, C.L. (2000). Nursing in Today’s World: Challenges, Issues and
Trends (7th ed.), Lippincott.
Chinn. (1984). Professional Nursing Concepts and challenges. B.Standers Company.
London.
Lippincott. W, (2006) 8th ed. Manual Nursing Practice. Lippincott Company,
Philadelphia.