Occupational Health Nurses (OHNs) and confidentiality
I'm an occupational health nurse (OHN) in a small community hospital. I'm frequently asked by my manager to allow staff from human resources, other managers and/or corporate lawyers to access employee files as they do not understand my obligation to maintain confidentiality of the client's chart. How should I handle such requests?
While conflict between your commitment to your employer and to your client is difficult, you have an ethical, statutory and professional obligation to maintain the confidentiality of information obtained through the nurse-client relationship. An employee who receives care from an OHN is the nurse's client. Sharing the client's information without his/her consent or the consent of his/her legal representative is a breach of confidentiality.
This obligation is stated in the CNO’s Code of Conduct:
Nurses protect the privacy and confidentiality of clients’ personal health information as set out in CNO’s Confidentiality & Privacy – Personal Health Information practice standard and the Personal Health Information Protection Act, 2004.
Nurses do not share clients’ personal health information, unless for therapeutic reasons and only in compliance with laws and standards of practice governing privacy and confidentiality.
As well, section 1(10) of Ontario Regulation 799/93 under the Nursing Act, 1991 states that it is professional misconduct to give:
Information about a client to a person other than the client or his or her authorized representative except with the consent of the client or his or her authorized representative or as required or allowed by law.
While in law, records kept in the course of a business are owned by the business, this refers to owning the actual paper or computer. It does not entitle the employer access to the client's health information. In order for these individuals to gain access they would need to provide you with consent from the client, a court order or a subpoena.
