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Seasoned with Sage
Breaking Confidentiality


I broke the C law--not on purpose. And what is the C law? Let me tell you a story. Early one morning I received a letter, which read:

"Dear Nurse,

Thank you for your email, but we feel our son needs to see a doctor as his cough sounds terrible. He complains of being constantly tired, unable to sleep, and states that you do not let him sleep in the health center. As his parents we expect you to meet our request. We hope to avoid taking this matter further."

I respond:

"Dear Parents,

We will be happy to arrange for your son to see the doctor. I do feel that he is not looking after himself, particularly in regards to his smoking, since he has asthma. It's a very worrying combination. He has also been away this weekend, and I know he was at a big party and found very inebriated. He really needs to rest."

Later that evening, in the corridor...

"Hey, Dave" I called out. Dave was only ten or so feet in front of me, walking with a group of friends. He turned at my call. "How's the cough?" I asked. His face hardened.

"Fine. Thanks for sticking your nose in my business, Sir. Thanks a lot." His voice dripped with sarcasm, and he had a hostile glint in his eye.

I stopped in my tracks, caught off guard. Dave had never spoken that way before to me or to anyone that I knew. I motioned for Dave to come forward. "Come here, please" I asked quietly. “Dave, I did as I was instructed.”

"What are you talking about?" I asked. "Thanks for telling my parents that I smoke. It's none of your business." I took a moment to collect my thoughts.

"You've got a short memory Dave. After all we've done for you. And now you're angry because your parents know you smoke. Are you going to stop smoking now?"

Dave stood arms-length from me, his arms crossed across his chest, his feet in a wide stance. He looked ready to attack. "Yeah. Don't have a choice, or my parents will withdraw me. Who the hell are you to stick your nose in my business?" he repeated.

I had heard all I needed.

"You want me to feel bad because you're going to stop smoking?" My voice raised a couple of octaves. "Who looked after you when you broke your collar bone? Who looked after you when you smashed your face on that rock and needed surgery? Who visited you in hospital every day? Who brought your friends in to visit you because you were bored? Who stitched you up when you sliced open your arm? Who drove you from classroom to classroom in the snow when you sprained your ankle?"

Dave stood there, his mouth hanging open. His friends had taken a step back, in shock at seeing me tear Dave to pieces. It was a side of me very few had seen.

"Well, I have my rights. I pay your wages," stammered Dave. As stunned as Dave and his friends already were, they were still unprepared for my next onslaught.

"Your parents practically ordered me to take you to the doctor. Your parents are providing for your healthcare, and they need to know the facts. You want me to feel guilty that you have to give up smoking? Well I'm sorry for caring. You think I'm doing this for the money? You don't pay us to care.

“Caring people are what we are. Next time you come here, we'll do it without the caring. You can't pay for that. You need to go away and think things through. Oh, and one last thing, don't ever speak to me like that again, or you'll see a side of me you won't like."

With that I strode past him without a backward glance.

The next morning

"Dear Nurse,

Thank you for your reply. This is unpleasant information for us; it is the first time we've heard about this; we appreciate your frankness. It is extremely worrying that he smokes with his asthma. He was in hospital several times when he was younger because of his asthma. We will be dealing with this matter immediately. Again, thank you for your honesty."

Later in the morning

"I'm very sorry sir," said Dave. He was sitting in the chair opposite me. His girlfriend had convinced him to come and seek me out.

"Do you mean it?" I asked.

"Yes," he replied. "I just never thought things through. I'm an idiot."

"Yes, you are an idiot, but we still like you."

Dave burst out laughing. "You're the only person that makes me laugh when I'm sick," he said.

"It's just part of the job, although it's a shame they don't pay me more for the humor," I added. Dave got up, shook my hand, and left the room.


Read more Seasoned with Sage articles

3 Responses to “Breaking Confidentiality”

  1. Bonnie Says:

    Great story! There are not enough CARING people out there. Keep up the good work =)

  2. Jason R. Thrift Says:

    Sounds to me like this young man has a bit of a wild streak!

    You obviously had been witness to the results of his debauchery, and perhaps finally you had seen enough. This was especially true when the parents lashed out at you, to a certain degree, with their letter. Obviously they wanted an answer and deservingly so.

    One thing though–maybe there was a better way to handle this, so that the confrontation in the hallway would never have happened? He seemed open to you, willing to tell you what he had been up to so readily that perhaps he saw you as a parent figure. He was obviously beginning to reach out for help, whining to his parents about his ailments and coming to you a lot for every injury in the book.

    Now, if Dave is under 18, you were well within your bounds with responding. But if he is an adult, and I get the feeling we’re talking about a college age kid here, you should have gone to him first with this letter. He obviously could talk to you and I’m sure he would have opened up about this to you. Perhaps together, or even with his consent, then you could have told his parents. At least, that’s how I would have handled it.

    It just seemed that you responded to the parents, rather than thinking this through first and deciding what was best for Dave and what would also keep the peace not only between him and his parents, but between you and him. I think they would have much rather heard it from him, than from you. There’s nothing wrong with being a little personal with the people we take care of, far from it. But there is a thin line between personal and ethical.

    I’m just not one for confrontations. I try to avoid them as much as possible because I believe it creates a lot of animosity. There are ways to confront issues without being so stand-offish. And I do know from experience with some teenie bops, typically confronting them just makes them dislike you and feel they can’t trust you. You got lucky he came to his senses. That shows he’s a bright young man and hopefully will change some of his habits before he really hurts himself.

    Please don’t take how I’m discussing this as being stand-offish myself, I just try to examine a situation and see how I would have dealt with it. In this case, perhaps you were just the right person, in the right place, at the right time, and him having someone more like me might not have helped. And perhaps, a good kick in the rear is just what the doctor ordered!

    Good luck to you!

  3. bryn hagan Says:

    he’s 16 and at high school (boarding school). In this case I thought a good kick in the rear was what he needed. He’s now a senior and he has managed to stay off the cigarettes.
    I did lash out, but it was a controlled lashing out (if that makes sense).
    I do get your point though.

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