As I could have expected, when I do finally get some kind of critical feedback on my blog, it comes filtered through a couple of people first and takes on a highly confrontational tone. Ah, the joys of being male and a gender minority. Just like work, you see. Don't bring it up directly, make sure you talk some shit first and build up a good sense of righteous indignation! Anyway, since this person lives near me, has been to my facility, and most likely knows someone who works there, I've made my most identifiable mirror of this blog (my myspace) private again. I'm loathe to do this, since the myspace mirror gets a couple hundred hits a week and this blog only gets 30 or so, but in light of what some of the gripes were, I figured it would be a good idea temporarily.
Something I hadn't really considered before is that, due to the volume of writing, someone reading only one or two entries might get an extremely polarized opinion that would have been balanced out 2000-3000 words ago or so. I've been accused of being arrogant and looking down on the aides, even though I've written that I get a lot of support from them and give a lot of support back. I vent once in a while when things go sour, but a lot of people use their blogs to vent, and many people do it much more frequently than I do. Is there a perceptible bias here towards venting about things that go wrong as opposed to writing about what's going right? What I might need to consider is that people are only going to read a post or two instead of the last couple of months worth of posts, so perhaps I should make each post itself more balanced.
If I wrote a month ago about how much I'm learning from one of the CNAs and how humbling it was to see her care for a dying patient, and then a month later write about how I think one of the bad-apples is displaying a lot of mal-adaptive behavior, someone can easily get the wrong impression if they only have the time or patience to read one or two posts.
Making each post balanced in this way, though, would get repetitive and time consuming. Ideally people would get more information before making judgments, but I suppose this is not always the case.
It's obvious when someone is complaining about something because they're already defensive or insecure about something, but the other part that I thought would benefit from some open discussion is the whole privacy thing.
I've read the full text of "the act" several times, including a handy list of what is considered "private" information. People I've asked to double-check have indicated that none of that private information is posted here. Ages over 90, specific dates of events, geographic subdivisions smaller than a state, all that stuff. I'm careful, but there's always the possibility I've made a mistake. The complainer, of course, hasn't yet supplied information as to exactly how I've violated the Act.
This person believes that because she has been in my facility and was able to piece together the information, that somehow constitutes a violation. Violations are clearly defined in the act:
`SEC. 1177. (a) OFFENSE- A person who knowingly and in violation of this part--
`(1) uses or causes to be used a unique health identifier;
`(2) obtains individually identifiable health information relating to an individual; or
`(3) discloses individually identifiable health information to another person
Have I done this somewhere? Does the fact that someone else already -knows- the private information magically make something infringe that otherwise wouldn't? A couple of lawyers have told me "no", but it would be interesting to get input from the blogosphere. I've read plenty of blogs of nurses, paramedics and MDs, and if I worked in their facility I would know who they were talking about, but that doesn't make their postings an infringement.
The main reason for keeping my identity obfuscated, besides privacy concerns, is that it would be more difficult to write about work if people FROM work were reading it. If these people are my friends already, and they find it through google or something, that's fine, but there's always the possibility that it could be used against me somehow.
So why continue?
Well, I still think this is important. I'm inspired by the other health care bloggers and want to try to follow their example, whether I agree with what they have to say or not. I'm confident that my blogs comply with the law (feel free to contradict me here, please cite references), however I'm -not- confident that my superiors would be a big fan. It's a tight rope, razor-thin. Thanks for reading so far.