"Was she one of your patients?" HIPAA, and other inconveniences

Nurses General Nursing

Published

Specializes in critical care.

When I was in nursing school, I got in this big old argument with my spouse. Apparently, HIPAA shouldn't apply when you're married. "People just assume that spouses will tell each other everything." Also, my very favorite, "if my mom/dad/sister/dog's cousin is in the hospital, you owe it to me to tell me about it."

Well, call me Puritan Patty, but no. I won't tell, and I owe nothing. I may share stories, but never identifiers. My personal feeling on this is my duty when I am working is to the patient, and when I clock out, that doesn't end. Maybe his mom has been admitted for end stage syphillus and doesn't want her son to know she's been sleeping with the milk man. I don't know! I just know there will already be an awkward moment there where I will need to make sure the patient knows I'm not telling our mutual relations what is going on. I'm not violating that.

Anyway, this became a huge argument. One that just went away as fast as it started and has since, not come up again. I figured he knew I was very adamant about this and it wasn't worth trying. Plus, I don't work at the "local hospital", so as of now, I've seen one total person there that I actually know in regular life. And no, I didn't tell anyone.

So today, he calls me and asks me, "did you have a ___ year old girl named ________ as your patient yesterday? She's the wife of a guy my dad knows."

"Mr. Ixchel, you know I can't tell you that."

"I'm not asking if she was there. I already know she was. Was she your patient?"

"I still can't tell you that!"

If you want to know the truth, I don't even know if I did. I'm absolute crap at names. The person was not a normal demographic for my unit, and I did have someone fitting her description, but I don't remember that patient's name. I'm HIPAA-fied when I leave that building. So even if I wanted to tell him, I couldn't. And I know, know, know, anything I tell him, he will tell other people. I mean look.... First time he actually asks, it's for his dad. *sigh*

Anyone else deal with this? I figured I'd have friends who don't know better ask stuff like this. Honestly, if they did, I'd just say I don't know and be done with it. Good grief, though..... He already knows I won't tell him. Guess he figured the worst I'd do is exactly what I did? (Not tell him, I mean.)

Specializes in Med/Surg, Academics.

Yes, I've had to deal with it, and I did just as you do--don't say a word. I've had as a patient my in-laws' good friend--like she was at my childrens' baptism and stuff. In nursing school during our psych rotation, I had to remove myself from an outpatient group for recovering substance abuse patients because one of them was my husband's young cousin! My husband's cousin eventually told his mom (who is in the same generation as my husband is), and she said at a family gathering, "Why didn't you tell me you knew he had a drug problem?" I said, "I couldn't!" Thankfully, she wasn't upset about the family/professional boundaries that I had to keep.

Specializes in Psych ICU, addictions.

Never had that problem because my other half knows I won't tell him any specifics. He understands why.

There was one time that came up where one of his staff members could have possibly been my patient because he knew the staff member was being sent to my hospital. I told him that if the staff member became my patient, he'd never know about it and I wouldn't tell him. He in turn said that he'd rather NOT know anything about the staff member if they were my patient :)

Specializes in Pedi.

My mother used to do this to me all the time with high profile cases. The news would say that the child who was hit by a car, a baby who was shaken by the nanny, the child who fell out of the window, etc was taken to my hospital and she'd be all "did you take care of that kid on the news?" or "was that kid on the news on your floor?" After a few years she stopped asking because she realized I wasn't going to tell her either way.

I did once care for my middle school gym teacher's child after surgery but, since it was 10+ years after middle school, no one that I was currently in touch with had any way of knowing that said child would have been undergoing surgery and therefore wouldn't have known to ask me about it.

Specializes in ICU, LTACH, Internal Medicine.

Normal situation in a small city where everyone "just cares" for everyone else.

No problems with my hubby after I gave him a couple of posts from this very forum to read and think of. He knows now that for me go above HIPPAA is the same as for him to try to circumvent the "Science" publishing guidelines - the rule might be pure PITA but it is just something not good even to consider, doesn't matter for what purpose.

Specializes in Healthcare risk management and liability.

I tell people that when I get deposed, and have to disclose whom I have discussed the case with, if I give their name, they will end up being deposed as well, and do they really want that?

But just like everyone else here, I don't disclose anything to family members. I tell them they would not want me to talk about their care with someone else.

Luckily, I'm dating someone who is also in the medical field. We have no arguments about adhering to HIPAA.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

I'm lucky. My husband and I worked in the same unit. HIPAA questions didn't come up . . . if he had the patient, chances are I helped turn at least once, watched his patient while he went to lunch, etc. And vice versa. We discussed our patients freely on the way home.

Recently, though, I've had a chance to re-think the whole thing after reading, of all things, a spy novel. The spy was telling is wife (who had at one time worked for the agency) details about situations she didn't need to know. She was sharing the information with her psychiatrist -- priviledged, right? Another spy agency bugged the psychiatrist's office and found out details of ongoing operations. One of the good guys was compromised or killed or some such because of this, and the spy's colleagues spent hours listening to tapes of his wife's sessions with her psychiatrist, trying to capture the agents who bugged the office and were trying to set off a dirty bomb in a major urban center. When the spy found out that his colleagues now knew all about his problems with impotence and intimacy, he was furious. But as his colleagues pointed out, "You should have thought about that before you started sharing state secrets with your wife. If she didn't know anything, she wouldn't have shared it with her psychiatrist and we wouldn't be listening to these tapes to find out who knew what when."

HIPAA and state secrets aren't really the same thing -- except they kind of are. But it made me think twice about what I needed to share with my husband and why. If he knew about it anyway because he took care of the patient last week, or because he's covering for me today while I travel to CT with my other patient, it's one thing. If we were discussing a better way to handle this or that situation, or sharing something that really worked well with this particular crazy family. Or if we were reporting off to one another when we worked opposite shifts . . . But maybe sharing details just to vent wasn't so smart. At least, not in the hospital cafeteria, a crowded elevator or the local Outback Steakhouse. (Another long story.)

Specializes in Critical Care, Med-Surg.

Yep, been there. My wife had a co-worker that was a patient on the unit I previously worked on. She wanted me to to find out how he was doing.

Me: "Sorry, no can do."

Her: "You can't even ask anyone how he is and what's been happening."

Me: "Nope, I won't ask, and even if I did - I hope they wouldn't tell me anyway."

Specializes in dealing w/code browns and blues.
I'm lucky. My husband and I worked in the same unit. HIPAA questions didn't come up . . . if he had the patient, chances are I helped turn at least once, watched his patient while he went to lunch, etc. And vice versa. We discussed our patients freely on the way home.

Recently, though, I've had a chance to re-think the whole thing after reading, of all things, a spy novel. The spy was telling is wife (who had at one time worked for the agency) details about situations she didn't need to know. She was sharing the information with her psychiatrist -- priviledged, right? Another spy agency bugged the psychiatrist's office and found out details of ongoing operations. One of the good guys was compromised or killed or some such because of this, and the spy's colleagues spent hours listening to tapes of his wife's sessions with her psychiatrist, trying to capture the agents who bugged the office and were trying to set off a dirty bomb in a major urban center. When the spy found out that his colleagues now knew all about his problems with impotence and intimacy, he was furious. But as his colleagues pointed out, "You should have thought about that before you started sharing state secrets with your wife. If she didn't know anything, she wouldn't have shared it with her psychiatrist and we wouldn't be listening to these tapes to find out who knew what when."

HIPAA and state secrets aren't really the same thing -- except they kind of are. But it made me think twice about what I needed to share with my husband and why. If he knew about it anyway because he took care of the patient last week, or because he's covering for me today while I travel to CT with my other patient, it's one thing. If we were discussing a better way to handle this or that situation, or sharing something that really worked well with this particular crazy family. Or if we were reporting off to one another when we worked opposite shifts . . . But maybe sharing details just to vent wasn't so smart. At least, not in the hospital cafeteria, a crowded elevator or the local Outback Steakhouse. (Another long story.)

Soooo...what's the name of the book? Sounds interesting.

I worked in a high profile area that got news coverage from time to time. I would have staff from other departments ask me if I had "that guy they saw on the news on my unit". Uh, I'm not discussing it. Usually they would pout and say something along the line of, "well, we all work for the same team". Yes, we do. But until you are actually responsible for the care of Mr X I will play dumb and act as though I have no idea as to whom you are referring.

I'm lucky. My husband and I worked in the same unit. HIPAA questions didn't come up . . . if he had the patient, chances are I helped turn at least once, watched his patient while he went to lunch, etc. And vice versa. We discussed our patients freely on the way home.

Recently, though, I've had a chance to re-think the whole thing after reading, of all things, a spy novel. The spy was telling is wife (who had at one time worked for the agency) details about situations she didn't need to know. She was sharing the information with her psychiatrist -- priviledged, right? Another spy agency bugged the psychiatrist's office and found out details of ongoing operations. One of the good guys was compromised or killed or some such because of this, and the spy's colleagues spent hours listening to tapes of his wife's sessions with her psychiatrist, trying to capture the agents who bugged the office and were trying to set off a dirty bomb in a major urban center. When the spy found out that his colleagues now knew all about his problems with impotence and intimacy, he was furious. But as his colleagues pointed out, "You should have thought about that before you started sharing state secrets with your wife. If she didn't know anything, she wouldn't have shared it with her psychiatrist and we wouldn't be listening to these tapes to find out who knew what when."

HIPAA and state secrets aren't really the same thing -- except they kind of are. But it made me think twice about what I needed to share with my husband and why. If he knew about it anyway because he took care of the patient last week, or because he's covering for me today while I travel to CT with my other patient, it's one thing. If we were discussing a better way to handle this or that situation, or sharing something that really worked well with this particular crazy family. Or if we were reporting off to one another when we worked opposite shifts . . . But maybe sharing details just to vent wasn't so smart. At least, not in the hospital cafeteria, a crowded elevator or the local Outback Steakhouse. (Another long story.)

I actually kind of think that all nurses should try and know as much about all the patients on the ward as they can in case an emergency comes up or even something as simple as taking someone to the bathroom. Really while you are an inpatient on a ward you are under the care of all the nursing staff on that ward.

Specializes in critical care.
I actually kind of think that all nurses should try and know as much about all the patients on the ward as they can in case an emergency comes up or even something as simple as taking someone to the bathroom. Really while you are an inpatient on a ward you are under the care of all the nursing staff on that ward.

I just post stalked to see what your background is. I see you're from NZ? Here in the states, you are only allowed to disclose or access information on a patient that is DIRECTLY NECESSARY to give care. So even if there is a frequent call bell ringer on the unit who I've helped lay back down 15 times, I'm not allowed to ask, and her nurse is not allowed to tell, why she is here, and what we are doing for her care. Now, if she wants to ambulate and something in her history is pertinent regarding that, that's allowed to be asked/shared. But otherwise, sharing of other information is against the law.

Thank you for all of your responses, everyone. I'm glad to know I'm not alone. I haven't seen hubs since he asked for info, so there hasn't been any opportunity to bring it up again. Let's hope the subject has passed. I don't doubt for a second my father in law will ask. But I did look and no, I didn't have her as a patient, so I can tell him I don't know her and mean it. ☺️

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