Thursday, July 17, 2008

Tittle tattle in the corridors: confidentiality and all that::-


This post discusses the issues of confidentiality particularly in relation to blogging.

I am back on board having had a wonderful, much needed, break. It was great to be involved in my first ICM. Although there were some organisational hiccups it was a great experience. Now back to reality and there is plenty to do so not much time for blogging at present. There is an issue I do feel a great need to address however and this is about confidentiality and midwifery practice. This is of course an issue for all health professionals not just midwives. The other issue is around how shared experience contributes to learning within the profession and the value of blogs in facilitating this. I do not pretend to have the answers to how these contradictory issues can be managed but feel that this discussion needs to take place. As bloggers we need to develop some sort of best practice guidance around how to blog about professional issues. My friend and colleague Sarah Stewart has also been blogging about this issues recently.

Confidentiality
When we enter the midwifery profession we all sign a confidentiality agreement. We will only share information if it is necessary for the health and wellbeing of the woman or her baby and only to other health professionals involved in their care. This meets the requirements of the Privacy Act 1993. For student midwives to learn from the practice experiences they are having it is necessary that to share and reflect with lecturers. Women who have students working with them are made aware that this may happen. Students in our school have small tutorial groups where they can share their experiences, reflect together and promote safe practice and shared learning.

Despite these safeguards issues around confidentiality arise from time to time. During my career, from time to time, I have heard people talking in the corridors about something that has happened, I may well have been guilty of this myself. Sometimes a complaint is made because someone heard something in the supermarket, or the bank, or wherever about a patient. Blogging takes this illicit sharing of information to a whole new level. No longer is it a whisper in the corridor, it is a trumpet blast to the world. We always should have been aware of how we can properly share information to promote learning without compromising confidentiality but now it is urgent that we get on board with this. We need to be able to share and learn, we also need to protect confidentiality.

As midwives we are involved in the most intimate experiences of a persons life. We need to be trustworthy. We might know things about the woman the no one else knows. I might know the sex of her baby from scan, I might know that she is unsure of the paternity of her child, I might know that she cursed and swore through labour when normally she would never utter these words. Women need to trust us not to share this information with anyone. When other health professionals need to be involved in a woman's care we can share information which is relevant to this situation and only that.

So where does that leave us when we are blogging? How can we share experiences so that we can promote learning? To whom does the experience we are sharing belong? Is it ours to share? What about the other health professionals who may feature in our tales? How do they feel about having their practice exposed in this most public of forums?

I welcome your thoughts on this.



Image: Whispering, Saams photos on flickr.com

6 comments:

Sarah Stewart said...

And here I am being devil's advocate about this issue.

infomidwife said...

Hi Carolyn, good to see you back, I have only just got back myself. As I mentioned at the conference bloging is great so long as we remain professional and maintain client confidentiality. It is fine discussing issues but it is also important to maintain the clients anonymity unless you have the clients consent. My motto is always be careful about what you publish on your blog - read it and re read it - give it to someone else to read if you are not sure. The problem is once you hit the enter button its out there!

midwifemuse said...

I attempt to maintain my own anonymity in the hope that this will also protect the identity of any women/families I may blog about.
You discuss how midwives blogging about their experiences may promote learning. I hope that my entries may also enable any 'lay-person' to appreciate a midwife's working life and the constraints which may prevent us from providing the type of care women want.

Carolyn said...

I have been following your adventures Pauline, my goodness what a trip you have had. I had 7 weeks away an must post afew more photos. I have not really managed to get back into this blogging since I got back. I need to get my head around it all again really.
I am glad that you have contributed to this discussion. I do think it is and important one and I do not think there are any easy answers.
As health professionals we do have a responsibility to protect the information we a privy to about our clients and this includes their birht experience.
I totally agree with what you say here about obtaining consent to publish and getting feedback from someone else before you publish if you are discussing a clinical episode.
Do we have a responsibility to point out to bloggers, who are blogging about clinical practice, that they are breaching confidentiality?

Carolyn said...

Thanks for your comment here midwife muse. As I said I do think it is importangt to obtain consent to publish from the women who appear in our postings. However I have to say that your blogs postings have really brought home to me the reality of midwifery practice in the UK and you do this very well.
Reading your postings I often wonder how on earth you manage to get through the day. I wonder what the answer is for women in the UK? Should women be able to birth in the way that they want? What does it mean for society if women have to accept unnecessary interventions because the other options are not available to them?
I would include birthing in a hospital as an unnecessary intervention for many women.
I agree that blogging about your working day does make all of this incredibly real. How do you manage to do this and maintain anonymity?

Carolyn said...

Sorry Midwife Muse. I think you answered my last question. I think you said that by not revealing your own identity you protect the identity of the people about whom you blog. I would be interested what others think. Is this OK? Is there a legal perspective to this that can help us identify how, when and in what way it is OK to blog about clinical practice?

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