11.2 Privacy, Dignity, and Confidentiality at the Bedside
Key Takeaways
Privacy is protected with physical actions: closing doors, drawing curtains, draping the body, and knocking before entry.
Confidentiality means health information is shared only with the care team on a need-to-know basis, as required by HIPAA.
Dignity is preserved by promoting independence, using preferred names, and never discussing residents in hallways or elevators.
On Ohio's skill tasks, privacy steps are scored non-key steps: each miss counts against the 80% needed on that task.
11.2 Privacy, Dignity, and Confidentiality at the Bedside
Three closely related rights, privacy, dignity, and confidentiality, generate the largest share of Residents' Rights items, and their privacy steps are scored on most skill tasks. They are tested as observable actions, so learn them as a checklist of things your hands and mouth do.
Physical privacy: what graders watch for
On Ohio's personal care task sheets, pulling the privacy curtain and exposing only the area being cared for are scored non-key steps, so each miss counts against the 80% you need. Knocking and closing the door are good practice but are not listed steps.
| Privacy action | When you do it |
|---|---|
| Knock and wait, identify yourself | Before entering the room every time (good practice; not a listed skill step) |
| Close the room door | Before any care begins (good practice; not a listed skill step) |
| Pull the privacy curtain | Even in a private room; it is a habit graders score |
| Drape with a bath blanket or towel | Expose only the body part you are washing |
| Cover the resident when you leave | Before stepping out for supplies |
Dignity overlaps with privacy but adds how you treat the person. Call residents by the name they prefer ("Mrs. Carter," not "sweetie" or "honey"). Promote independence: let them do what they can, hand them the washcloth for their own face. Do not rush, scold, or talk over them.
Confidentiality and HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) makes a resident's health information protected health information (PHI). As an STNA you may share PHI only with the members of the care team who need it to provide care. You may not:
- Discuss a resident in the hallway, elevator, break room, or cafeteria.
- Post anything about a resident on social media, including photos.
- Show a chart or share a diagnosis with a visitor or another resident.
- Confirm to a phone caller that a person is even a resident, without authorization.
Worked scenario
A resident's adult daughter stops you in the hall and asks, "Is my mother's diabetes getting worse? What did her labs show?" The correct response is to be warm but to redirect to the nurse: "I can take you to the nurse, who can talk with you about your mother's care." You do not share the lab values yourself, because that is outside your role and a confidentiality risk, even though the daughter is family.
Common traps
- Assuming a private room means you can skip the curtain: the task sheets still score it.
- Believing family members are automatically entitled to clinical details. Authorization and the nurse's role govern that.
- Talking about a resident's condition where other people can overhear, even using only a first name.
Dignity in daily routines
Dignity is not a single skill; it lives in dozens of small choices across a shift. The exam tests these as the "respectful" option among distractors.
| Routine | Dignified practice |
|---|---|
| Feeding | Sit at eye level, go at the resident's pace, offer choices, never rush or force |
| Toileting | Answer the call light promptly, provide privacy, never scold for incontinence |
| Dressing | Offer clothing choices, allow the resident to do what they can |
| Grooming | Style hair the way the resident prefers, shave or apply makeup per their wish |
| Conversation | Speak to the resident, not over them to a coworker, even during care |
A powerful rule: do not do for residents what they can do for themselves. Overhelping erodes independence and dignity. If a resident can wash their own face, hand them the cloth. Promoting independence is both a dignity practice and a rehabilitation goal the care plan supports.
Privacy beyond the body
Privacy also covers mail, telephone, visitors, and personal space. You may not open or read a resident's mail, listen in on their phone calls, or refuse a chosen visitor without a documented reason. Residents may meet privately with family, friends, clergy, an attorney, or the ombudsman. When a resident has a visitor, give them space and a place to talk where they will not be overheard.
Confidentiality and modern risks
The single fastest way to lose a job and a certification today is social media. Never photograph a resident, never post about your shift in a way that identifies anyone, and never share screenshots of a chart. A photo of a resident, even a kind one, posted without consent is a HIPAA violation and can be entered as a finding against you.
Worked scenario two
You are giving a bed bath and a coworker walks in to grab a supply, leaving the door open. The dignified, privacy-correct response is to ask them to close the door and to make sure the curtain and draping still cover your resident. You protect the resident's body and information in every interruption, not just at the start of care. On the skills test, the privacy curtain and draping are scored steps, so privacy is a continuous habit, not a one-time setup step.
While giving perineal care in a private room, the STNA should:
Skip the privacy curtain since the room has only one bed
Close the door, pull the privacy curtain, and drape so only the area being cleaned is exposed
Leave the door open so the nurse can supervise from the hall
Fully uncover the resident to work faster
A resident's neighbor visits and asks the STNA what medications the resident takes. The best response is to:
List the medications since the visitor seems to care about the resident
Explain that this is private health information and offer to bring the nurse
Tell the visitor to read the chart at the nurses' station
Share only the medication names but not the doses
Sections you finish are checked off in the contents.