What would your response be if your 15 yr old patient asked you to withhold the results of a positive drug screen from her parents?
Recent polls of adolescent patients (under the age of 18) have shown a tendency to not seek medical care or treatment if that care cannot be independent of a parent or guardian. Among those patients polled, many of them stated that there were certain topics that they do not want their parents to know about (sexual activity, presence or treatment of STDs, and alcohol or drug abuse). Many said that they would prefer to have no treatment at all if notification of their parents was required. As an addiction nurse, some of your patients will be younger than the legal age of consent for treatment. Knowing the law and how it affects what information you can or cannot provide is crucial. The interviewer wants to know that you are not only familiar with the law, but that you are able to explain legal issues to your patient so that she understands.
"I have had patients in the past who did not want their parents to know certain test results. While I understand some situations may cause a patient to feel reservation about disclosing information, I would explain to the patient that, because of her age, I cannot keep the information regarding her test results from her parents."
"Every state has laws that allow minors to give their own consent for certain kinds of health care, such as emergency, general health, contraceptive, pregnancy-related, HIV or other STD, substance abuse and mental health care. Each state also has some laws that allow minors to consent for care if they are emancipated, mature, living apart from their parents, or older than a certain age. Many of these laws have been in place for several decades. It is commonly accepted that if an adolescent is allowed to give consent for healthcare, the information pertaining to that care is considered confidential. While many minor consent laws contain explicit provisions regarding the disclosure of information to parents, some do not allow disclosure without the minor's permission. Others, still, leave the decision about disclosure to the physician's discretion. With all of that in mind, I believe it is important for healthcare professionals to be aware of their state's laws regarding privacy and to also know the guidelines set in place within their facility."
"I have come across some difficult patients in my career as a nurse.I would say the most challenging patients are those who do not follow their treatment plan yet tell me that they are. It's hard to work around dishonesty, so I gently remind these patients that the only person they are hurting is themselves."
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