A gerontological nurse is reviewing a journal article about legal issues and nursing practice. The nurse identifies which situation as a matter of public law?

A. "Provided you signed a directive on admission, your records will not be made public."

This response may not be entirely accurate or reassuring for the client. While directives or forms signed upon admission might address aspects of confidentiality or consent, they typically pertain to specific legal or medical procedures rather than general confidentiality protections. Additionally, stating that records "will not be made public" might oversimplify the issue, as confidentiality extends beyond just making records public and involves safeguarding information from unauthorized access or disclosure.

B. "Privacy legislation ensures that your medical records will not leave this hospital."

While privacy legislation does indeed protect the confidentiality of medical records, this response might be overly restrictive or misleading. Confidentiality protections extend beyond the physical location of the hospital and involve various legal and ethical standards governing the handling and disclosure of health information. The statement could give the impression that the client's information is completely confined within the hospital, whereas confidentiality extends to all interactions involving healthcare providers, insurers, and others involved in the client's care.

C. "The law protects your right to confidentiality and health information from being released into unintended hands."

This response accurately conveys the essence of confidentiality protections under the law. It reassures the client that their health information is safeguarded against unauthorized disclosure and emphasizes the importance of confidentiality in healthcare. By mentioning "unintended hands," it underscores the broader scope of confidentiality beyond just making information public. This response is likely to provide the client with a sense of security regarding the privacy of their medical information.

D. "Anything that is discussed between us is confidential and will not be shared with anyone else."

While this response emphasizes the confidentiality of discussions between the nurse and the client, it might oversimplify the issue. Confidentiality in healthcare extends beyond verbal exchanges and encompasses all forms of health information, including medical records, test results, and treatment plans. While it is essential for the client to understand that their conversations with healthcare providers are confidential, they should also be aware of broader confidentiality protections governing their health information within the healthcare system.

A. Dependency:

This client, who was once a successful bank president and active community leader, may struggle with the loss of independence and the need to rely on others for daily care. Feelings of dependency can be particularly challenging for individuals who were once highly independent and influential.

B. Mortality:

Mortality is a universal concern for individuals, especially as they age, but it is not specifically tied to the client's previous occupation or lifestyle before entering the nursing home.

C. Family:

Although family is important, the scenario does not specifically indicate any issues or changes related to family dynamics that would be the primary focus. The primary concern would be the client’s adjustment to the new living situation and the associated loss of independence.

D. Unemployment:

Unemployment is not relevant in this context, as the client has been retired since age 70.