Patient Privacy: Nursing Guide

Patient privacy is part of every nurse’s job — but what does it really mean when you’re at the bedside? Imagine an 18-year-old girl in a hospital has just found out she’s pregnant. She hasn’t told her family yet, and she’s scared. Now imagine a clinician mentions this patient’s pregnancy in the hallway, or the patient’s chart is left open on a screen. She didn’t give permission for anyone outside her care team to know. That’s a breach of her privacy — and her trust.

Want to know how to protect patient information? This guide will walk you through the key principles, real-life risks, and practical steps nurses can take to ensure patient privacy and confidentiality are respected.

What Is Patient Privacy in Healthcare?

Patient privacy refers to a person’s right to control their health information — who can see it, how it’s shared, and when it’s discussed. This includes not just medical records and digital data, but also verbal conversations and details that could reveal a patient’s identity, such as their name, date of birth, diagnosis, or even the fact that they’re in the hospital.

According to the American Medical Association (AMA), health information privacy covers several key dimensions:

The Patient Privacy Framework: What Nurses Need to Know

So, what regulation has come to govern patient privacy? The answer is the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA. The HIPAA Privacy Rule is a specific part of HIPAA that focuses on protecting patients’ personal health information (PHI). It sets national standards for how healthcare organizations, insurers, and healthcare professionals — including nurses — must handle medical records and other sensitive information.

So, what rights does the Privacy Rule grant to patients? Under HIPAA, patients have several important rights regarding their PHI, such as:

• The right to access and obtain copies of their medical records.
• The right to request corrections or amendments to their health information.
• The right to receive clear explanations about how their information is used and shared.
• The right to control who can see or receive their health data, with certain exceptions.
• The right to request restrictions on some uses and disclosures of their information.
• The right to be notified if their privacy has been breached.

For nurses, health information privacy is both a legal and ethical obligation. Legally, laws like HIPAA set rules about how patient information must be handled. Ethically, privacy is about honoring a person’s autonomy and right to make decisions about their own information. It’s a way of saying, “Your story is yours to share — not ours.”

Who Can Look at Patient Health Information?

Only those directly involved in a patient’s care, treatment, or billing — and authorized by law or consent — are allowed to access their health information. Just because someone works in a healthcare facility doesn’t automatically mean they’re allowed to look at a patient’s chart. This access is strictly on a need-to-know basis.

Think of it like this: If you’re not providing direct care, coordinating services, or handling administrative tasks for that specific patient, you shouldn’t be in their chart. Examples of authorized individuals may include the following professionals:

• Nurses and healthcare providers directly caring for the patient
• Specialists or consultants brought in by the care team
• Pharmacists reviewing medication orders
• Billing and coding staff processing insurance claims
• Care coordinators or case managers arranging follow-up care
• Legal or compliance officers investigating authorized audits or reports

Here are some examples of individuals who are not allowed to access patients’ information:

• Nurses who are curious about a public figure or personal acquaintance but are not assigned to the patient
• Staff looking into charts to “help” outside their scope
• Non-clinical employees or nursing students asking to view the EHR for learning purposes without proper authorization

Violating these rules, even out of good intentions, is considered unauthorized access and can lead to disciplinary action, termination, or legal consequences. Patient privacy isn’t just about not sharing — it’s also about not looking when you don’t have a legitimate reason.

Everyday Risks to Patient Privacy in Hospitals

You don’t need a data breach or major hacking event for privacy to be violated. In fact, some of the most common threats to patient privacy happen during routine, day-to-day tasks in hospitals — often without anyone realizing it. From hallway conversations to unsecured screens, the following patient privacy examples show how easily HIPAA violations can happen:

• Saying full names, diagnoses, or procedures aloud in waiting rooms or open areas, like “Mr. Johnson is here for his HIV test”
• Leaving a patient’s informed consent or treatment plan where visitors or unauthorized staff members can see it
• Forgetting to log out of an electronic health record (EHR) system
• Discussing patient information in hallways, elevators, or breakrooms
• Sharing a patient’s story on social media
• Allowing students to listen to patient conversations without permission
• Using a personal device to photograph wounds or scans without proper consent or security
• Giving updates to family members without checking if the patient has approved it
• Throwing away a printout with the patient’s lab results into the bin in the hallway, where it can be easily retrieved by unauthorized visitors

Best Practices for Maintaining Patient Privacy

The American Nurses Association (ANA) makes it clear: Nurses have a responsibility to protect patients’ rights to privacy and confidentiality. This includes taking specific actions to ensure that privacy is upheld in every part of their care. Here are examples of ANA-recommended actions:

• Advocate for patient privacy: Nurses should support and promote policies that protect patients from unnecessary or unwanted intrusions into their personal lives.
• Protect all forms of confidential information: Nurses must keep all patient information private, including charts, computer files, conversations, images, therapy notes, and anything else that could identify a patient.
• Keep care settings private: Nurses should make every effort to keep the care environment as private as possible, from closing doors during exams to carefully handling paperwork.
• Educate patients on their rights: Nurses play an important role in helping patients understand their rights under laws like HIPAA, GINA, and the 21st Century Cures Act. This includes explaining how they can access, correct, and control the sharing of their health information.
• Address privacy violations promptly: Nurses must act when they see or suspect a breach of privacy and follow proper procedures to protect the patient.
• Follow patient consent guidelines: Nurses need to follow organizational policies and respect each patient’s decisions about who can see their health information and under what circumstances.
• Limit information disclosure: Nurses should only share the minimum amount of information necessary when disclosure is legally required or in situations that involve serious risk to the patient or public.
• Support organizational safeguards: Nurses should advocate for and adhere to administrative, physical, and technical safeguards that protect patient information.
• Report breaches without fear: Nurses should report any breaches of privacy and confidentiality, and organizations should protect those who raise these concerns from retaliation.

Privacy in the Age of Technology

As technology in healthcare rapidly evolves, so do the challenges of protecting privacy. EHRs, mobile devices, and cloud-based platforms make sharing patient information easier, but that also means nurses need to be extra careful to keep that data safe.

Here are some digital privacy tips you should keep in mind to protect patient information:

• Always log out of shared workstations or devices when you walk away, even briefly.
• Don’t share passwords or leave login credentials visible.
• Avoid texting or emailing patient details from personal devices, even if it’s convenient.
• Be mindful of auto-saved searches or autofill functions that might pull up patient names or histories inappropriately.
• Keep screens angled away from passersby in public or semi-private settings.
• Use secure platforms for telehealth visits and HIPAA-compliant email services to prevent data leaks.

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Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.