The circle of care is a term of art which refers to the group of care providers surrounding a patient. This includes not only nurses, physicians, and other health care professionals, but also some others not so obvious, like the patient’s family and indeed, the patient herself.
Patient YZ comes arrives unwillingly by EMS into the Resus room the other day with a problem which could prove embarrassing both professionally and personally. Pt YZ also is a former employee of Acme Regional, now dismissed, and is now engaged in some very complicated litigation with the health corporation.
So we — meaning the Emerg staff — treat YZ as we normally would a patient in her condition. We weren’t even aware of YZ’s problems with Acme Regional until a steady stream of managers started washing up in the department, like so much flotsam. They would peek their head through the Resus Room doorway, verify it was her, and then would retreat to the patient quiet room to have animated conversations. I have never seen as many nursing managers park themselves in our emerg, including the VP of Nursing, various program managers, and YZ’s former boss — and the presence of any of them had nothing to do with the patient’s actual care. It was a nasty confluence of high-powered, sanctimonious nurse managers gossiping, backbiting, and generally engaging in quality self-righteousness.
It was, in short, disgusting.
At which point I started to get very, very annoyed. Clearly this was violation of patient confidentiality. So when one of the managers wanted to see the chart, I refused. You, I said, are not directly involved in her care — and it’s none of your friggin’ business.
“But,” she said “I’m in the circle of care.”
No, honey. I’m in YZ’s circle of care. The emerg doc is is in her circle of care. The lab tech is, the RT is, and her partner is. YZ’s poor embarrassed family is in the circle — you don’t think her husband didn’t notice all his wife’s former associates loitering around the patient quiet room? And quite possibly her lawyer as well, because I can see, being psychically gifted, another lawsuit for gross breach of confidentiality.
You, on the other hand, actually belong to a subset of nurses I am ashamed to be associated with.
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