There is no privacy in hospitals.
This applies to staff and patients alike. For staff, it can be unpleasant and inconvenient. The doctors bedroom on ITU which has no lock, the bleep which is audible at the nurses' station should you be paged whilst in the nearby toilet, grill fronted lockers with contents visible in the changing rooms to name but a few.
But for patients the lack of privacy is even more of an issue. I am never surprised by the prevalence of constipation amongst inpatients using a bed pan behind screens in a 6 bedded bay while regularly being asked if they 'are finished'. I wonder why we pull the curtains around the bed space before a patient consultation. The implication that if we can't be seen we won't be heard is futile. My voice carries clearly despite the curtains and my direct questions, as well as the patients answers are heard by the other 5 patients. Such embarrassing lack of privacy is far from ideal and can be detrimental to the Doctor patient relationship. It becomes more serious when patient confidentiality is impacted upon and this is magnified in rural areas where patients are treated in their local hospital and they know, or know of, many of the staff. The reverse is also true with many staff and patients of comparable ages having attended school together.
I saw Mrs B in a typical 6 bedded bay. She was slightly odd and reticent when it came to divulging her medical history. A few probing questions yielded no positive findings and after deciding she was fit for her proposed operation and general anaesthetic I tried a final "is there anything else you think I should know?" but with no response I mentally shrugged and left the ward.
When she arrived in theatre reception the next day, she requested to speak with me again. I went out to the trolley bay and drew the curtains around to "exclude" the 2 other male patients who had arrived for their operations too. Again Mrs B seemed strange, embarrassed and uneasy. She asked me if she was going to be alright. I reassured her swiftly and she was brought around to my anaesthetic room. After siting her cannula she stopped me in my tracks and finally asked "Could I please, speak to you alone?" I looked at my anaesthetic nurse and the auxiliary present. Both stepped outside. Mrs B began "I'm being investigated for a rare inherited disorder at the Genetics clinic in the city. I don't want my family to know or to find out why I'm here. So far I've seen a nurse who lives on my street and my niece who was visiting a friend. I wanted to tell you in private. I don't know if it's important for my anaesthetic."
In a hospital where the paths of staff and patients can cross in various different roles it is understandably difficult for patients to be assured of privacy and confidentiality. It is a fact we should be aware of and take seriously to prevent important information being with held to the detriment of patient care.