Client confidentiality: who may know a client's health information
A client's information leaves your hands through three doors: care, consent or law. Four requests, and which door each one needs.
- Three doors only: care, consent or law.
- Family need the consent of a capable client.
- Being family, or being a nurse, never opens a door by itself.
A client's health information belongs to the client, and it leaves your hands through three doors only: care, consent or law. If no door opens, you share nothing. This guide follows four requests about one capable client in one morning.
Three doors: care, consent or law
| Who asks | The door | What you share |
|---|---|---|
| Her daughter, on the telephone | Consent | Only what the client allows. |
| The physiotherapist who treats her | Care | What the therapy needs, and no more. |
| A nurse from another unit who is her neighbour | None | Nothing. |
| A public health nurse, about the infection | Law | Only what the law asks for. |
The daughter: the consent door
A little before lunch, a caller says: “I'm her daughter. Just tell me her test results, she doesn't have to know I called.” Your client is capable, and she is on your unit with a reportable infection.
The daughter needs the consent door. So you tell her that you can't share that, and you ask your client first. Your client says: “Tell her I'm all right. The results, I'll tell her myself.” So that is all you pass on, and the results stay with her and the team.
The physiotherapist: the care door
The physiotherapist who treats her asks how she walked. That is the care door, so you share what the therapy needs, and no more.
The neighbour: no door opens
A nurse from another unit stops you in the hallway: “She's my neighbour, and I'm a nurse too. How is she really doing?” She gives your client no care, so no door opens, and you share nothing.
Public health: the law door
A public health nurse telephones about the infection. That is the law door. You confirm who is calling, you follow your employer's process, and you share only what the law asks for. Read more on reports the law requires: mandatory reporting for nurses.
Privacy laws differ between provinces. Follow your regulator and your agency's policy, and see the whole shift in client advocacy and confidentiality in nursing.