I have recently completed my rural practical in a small country town. The physio visited nearby towns as well, so in total I visited treated in 4 towns a week. The patients were mainly musculoskeletal outpatients, however, I did see a few inpatients. After the first week of practical I realised how important patient confidentiality is in a small community. It seemed like everyone was friends, if not related to one another.
Whilst on my rural practical I asked the physiotherapist about patient confidentiality. She said that patients aren’t afraid to ask what the previous patient was being treated for. I was quite shocked at this at first but after being there for a few weeks I realized that it was a very friendly community and people may have been asking about patient’s out of concern. When asled how the therapist deals with this she said that she explains to the patient that it isn’t her place to answer the question.
The physio also told me that even though there is a continence nurse at the health service she sees patients for their continence. This is because patients are too scared that people will see her going to the nurse, or even see their car parked out the front and will talk amongst the community. A physiotherapy appointment is believed to be more accepting.
This practical taught me to be even more careful about patient confidentiality. I couldn’t talk about any of the patients in public (even with no names or age) because everyone knows everyone and anything said will get back to that patient and could potentially upset the patient.
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On one of my neurology pracs, the supervising physio commented on her practise of not discussing patient's or their treatment in the elevator of the hospital. I had never thought about that before, but you don't know who is going to be overhearing what you say in the lift, and how that may affect other people, or if it can get back to the patient. Confidentiality is a really big thing, even in large metropolitan hospitals. Since then, I've always been reminded of her comment whenever I go in a lift.
Steph I encountered a really similar thing on rural prac as well - on a paeds placment where parents whose children had similar conditions would ask how particular treatments were working for another child. It can be hard to deflect the question without sounding rude and I generally resorted to directing them to chat to the other parents as "they would be able to give you insight into how the treatement may be affecting the child at home.." Although we all know we must always uphold pt confidentiality it can be really tough when people are just showing genuine concern for others!
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