[daisey_may]

Hi,
I have a question about HIPAA violations because I am not familiar with procedures. I know that each case may be a little different, so anyone who has experience, let me tell you what happened.

I have a co-worker who was fired recently because of a HIPAA violation. This co-worker of mine is a secretary. A friend in another part of the hospital emailed my co-worker and asked how a patient was doing who just transferred upstairs. The secretary said the patient is fine. No names, no room-numbers, nothing else was involved in the discussion about the patient that I know of.

This email happened a little more than 6 months ago yet was first addressed within the last few days. I assume this was an isolated occurrance and as far as anyone knows, the person in bed control has had no repercussions from the incident either.

I do not know how the process works, but my co-worker was terminated without suspension or any sort of discussion about what had happened.

I guess I'm curious about how the process works and what happens. It was more than a surprise to many people on my floor.

[daisey_may]

I have only been a nurse for a month or two. The more I'm reading about HIPAA, the more I am finding that this is a gray area. The fact that this has happened so close to me makes me concerned--rightfully so with a brand new license in my hands.

[gonzo1]

a couple of years ago a nurse I worked with on med/surg was asked to resign because she mentioned to another nurse that an agency nurse that worked with us sometimes was in L & D having a baby.
I am paaarrraaannnooiiid about HIPAA.
Lots of the nurses I work with will look up lab results for family members and stuff and I am amazed they haven't been caught ever, but that is a true violation and I would never chance my job over it.
You can never be to careful.
I do think that the act has been over interpreted to the point where I would be afraid to mention a neighbor being in the hospital to another neighbor etc because you just don't know who is listening or who it might get back too and cost you your job.

[classicdame]

I would think that the person who asked the question was also culpable.

In short, we just keep it to ourselves. Can't even be too friendly any more.

[jmgrn65]

it was a violation because it is a need to know and neither one of those persons had a need to know. but if the secretary was fired, so should the person who asked.
On the ohter hand, you are allowed to say the condition of the patient. so yes it is a gray area.

[leslymill]

I visited a home health client where the client was hiding she wasn't home bound, she was driving all over the place for this and that. Dress like she was going out on the town. She took her own bath and had the aide massage lotion on her back so she could use her to clean the house. After the interview I found she had three doctors prescribing sedatives and hypnotics without the others knowing about them. She was taking 150mg of Visteril per day along with Benadryl , pain killers,...gosh the list and doses where long and I personally was concerned even if she seemed alert at the time. I noticed the pill bottles overflowing from her purse she had not zipped and was nervous when I addressed what they were since I needed a complete drug list. I did not force her to give them to me. I asked her firmly about them as I wrote all her meds down. She didn't really have a choice but to show me what they were and who had ordered them. She reported me for violating her rights because I had to inform all the doctors what the other doctors were ordering and include them in her care. The agency sided with her. I was reprimanded, forced to read the Pt Bill of Rights, sign forms on pt confidentiality and watched. Home health agencies are required to stay in Medicare/Medicaid guidelines for pay. Some stray to grey areas and this particular agency sent me to MARS and VENUS more than once. I won't, but I could write a book.

[daisey_may]

There is a lot of gray area. It surprises me that you breached pt confidentiality, leslymill, because I thought that discussing the patient within the healthcare team was not considered breaching pt confidentiality. Wouldn't knowing the other doctor's plan of care for the patient be on an need-to-know basis for the client, especially in home health care?

As for the situation i had discussed in the original post, as I thought about it, because a HIPAA violation was not legally made, I'm beginning to wonder if it was an excuse the hospital used for termination. I believe there is more to the story than what we were told, and I'm not going to go probing. It is my understanding that giving a reason for termination is more of a courtesy than a requirement. I do not believe that this occurance will help the morale within my unit because none of us see the fairness, and many of us are worried about how HIPAA can be interpreted. Just can't be too careful.

[leslymill]

Originally Posted by classicdame

I would think that the person who asked the question was also culpable.
In short, we just keep it to ourselves. Can't even be too friendly any more.

I agree if the one who instigated the email isn't also terminated< I would wonder if she wasn't SET UP. Call me paranod, but that just ain't right. If it wasn't the patient doing the complainting then I would think someone is abusing authority.