Curious about how to handle this situation..

[MilliePieRN]

I'm a student nurse and this is just a "what would you do" question.

My husband went to a church camp this weekend and was a cabin leader for 15 ten year olds. There is no formal med policy at this camp, it's pretty casual.

A kid (who he didn't know) handed him a bag of meds with instructions from his mom and said "mom said to give this to the cabin leader". So dh took the meds and put them in his bag. He ended up coming home the second night and accidently brought the kid's meds home with him, before he left to take them back I looked and noticed what they were.

2x zyrtec

2x benadryl

2x ibuprofen

to be given each night. I told dh those were double the dose for a 10yo and I wouldn't give that kid those meds at those doses if I were him. I didn't attend the camp, but it got me wondering what would I do if I did? He just gave the meds to the cabin leader that replaced him.

What are a "real nurse's" responsibilities at a casual event like this? Would you intervene or do you feel it's none of your business if you weren't the one supposed to give him his pills? Am I just a jumpy nursing student and there isn't anything wrong with the doses she sent? I'm very curious how you seasoned nurses would handle it. :)

[KelRN215, BSN, RN]

So if a kid hands you a bag of meds that his mom said to give you, you would not look at them? How would you give the kid his medicine? I only looked at the meds in the first place to see if I knew the kid or the mom, because if I had, I would have seen if a friend at camp (45 min away) had the same med that could be given to keep my husband from having to drive back up there at 11:00 at night. I didn't know the mom, so he made the drive... If I had known her, I'd have called her and asked if it was ok to give her kid my dd's meds she had with her.

I don't believe my "looking at" the med was wrong. When I saw them, I immediately thought about my husband's responsibility... Not unreasonable at all.

No, I did not say that. You were not in a position to administer the medications. If you are going to administer medications as a nurse, of course you need to verify them and you need an order for administration. If your spouse accidentally brings meds home in a bag that belong to someone else, I see no need to concern yourself with what they are.

[MilliePieRN]

Ok, I understand what you are saying. I just know 70% of the people at this camp, and was hoping I knew this person. In practicality, under these circumstances, I still don't believe there was anything wrong with me looking at the name. Like I said, the situation just made me curious about the responsibilities of people in my husband's position and any medical people on the grounds, not so much this specific kid and his meds.

No, I did not say that. You were not in a position to administer the medications. If you are going to administer medications as a nurse, of course you need to verify them and you need an order for administration. If your spouse accidentally brings meds home in a bag that belong to someone else, I see no need to concern yourself with what they are.

[ArtClassRN, ADN, RN]

So if a kid hands you a bag of meds that his mom said to give you, you would not look at them? How would you give the kid his medicine? I only looked at the meds in the first place to see if I knew the kid or the mom, because if I had, I would have seen if a friend at camp (45 min away) had the same med that could be given to keep my husband from having to drive back up there at 11:00 at night. I didn't know the mom, so he made the drive... If I had known her, I'd have called her and asked if it was ok to give her kid my dd's meds she had with her.

I don't believe my "looking at" the med was wrong. When I saw them, I immediately thought about my husband's responsibility... Not unreasonable at all.

Let's be clear about the situation: No kid or no mom handed you none of anything and you were not responsible for giving this kid a single thing.

The meds, the kid, the mom the dosages - none of it - had anything to do with you. Your husband accidentally brought home a kid's medications, which was his honest mistake and his to correct. Those meds were absolutely none of your concern.

Your "looking at" the meds was definitely wrong and a violation of the kid's privacy. Since you are not a nurse, it was not a professional violation, merely a personal one. No camper's personal property your husband accidentally brings home in his duties as a counselor are any of your darn beeswax.

[ArtClassRN, ADN, RN]

So in a non-healthcare setting, with non-medical personnel, hipaa laws apply?

Of course not. Your situation covers personal, not professional misconduct.

However, you posted your story in a nursing forum, representing yourself as a "To be RN." So you received some replies based on those contexts. It did not appear that you learned anything from those replies, so I only wish you the best of luck in your future endeavors.

[EaglesWings21, ASN, RN]

It is possible that she looked at the meds to be sure it wasn't like something serious that her husband needed to return right then and there. I would be cautious in telling you husband whether or not to hold the meds because you don't know this kids weight/ height/ or anything personal about him, really. If it was that concerning I would just ask your husband to call the kid's mom and speak with her about the dosage and reasoning...May the kids has really bad allergies. I know my son does.

[cardiacfreak, ADN]

I'm confused were the meds in bottles with administering directions from a pharmacy if so then that is what the md prescribed and not giving the correct dosage could have potential harm against the child. If it was otc medications then I would call the mother if I was administering the medication.

[MilliePieRN]

I'm confused were the meds in bottles with administering directions from a pharmacy if so then that is what the md prescribed and not giving the correct dosage could have potential harm against the child. If it was otc medications then I would call the mother if I was administering the medication.

No, they were in a zip lock bag, OTC bottles, and an index card with instructions. It had a lot of writing on the card, but I only read the name and the name of meds that were bright and bolded (just to see if we had the same meds back at camp). Dh just passed it along to another cabin leader. He did give the kid the meds the first night. (He actually placed the pills in the kid's hand, that's what concerned me). Just glanced at the bottles; they didn't look pediatric.

It's over and I'm not worrying about it any more. I would have called the mother if I was responsible, too. Dh said he thought it didn't seem right, but handed over the med anyway (hence the concern and my responsibility question). :)

[Kooky Korky, BSN, RN]

What you did, looking to see if you knew the child, or the child's mother, would actually be a HIPAA violation. Even though it seemed like you had good enough intentions, it really is none of your business.

Now, if you we're the camp nurse, you would look to see what the medications are and follow your nursing judgement and camp protocols, and confirm with the parent. At least, that is what I would do, but I'm not a camp nurse, so I really don't know what others would do in this situation.

Her husband could have called the parent (once he had gotten home, in an effort to avoid the long drive back to camp). I do not believe the nursing student who posted here did anything wrong by looking at the bottles. Sometimes, the HIPAA stuff is carried just too far. I do not think the poster here violated HIPAA by looking at the bottles of meds. I could be wrong, but I'd like to hear that from a HIPAA expert if one happens to be reading this. Actually, my answer is too logical, therefore I must be wrong. Sadness felt, no sarcasm intended.

To OP: You say your husband gave on the first night the doses Mom wrote to give. The camper did well. So I think you can breathe easy, right, with regard to the dosages anyway?

[BuckyBadgerRN, ASN, RN]

What you did, looking to see if you knew the child, or the child's mother, would actually be a HIPAA violation. Even though it seemed like you had good enough intentions, it really is none of your business.

Now, if you we're the camp nurse, you would look to see what the medications are and follow your nursing judgement and camp protocols, and confirm with the parent. At least, that is what I would do, but I'm not a camp nurse, so I really don't know what others would do in this situation.

Where's the HIPAA violation? OP is not providing care for this child (the way I've read it).

[ClearBlueOctoberSky]

The OP identifies herself as a student nurse. While this didn't happen in a "professional" setting, it would behoove her to realize that this could indeed be a HIPAA violation. The child and mother's name are on a need to know basis, and she didn't have a need to know.

Furthermore, looking to see what the meds are so that you could see if someone else at the camp has the same thing that the child could take just so her husband doesn't have to drive back is wrong. In a professional setting, it would be diversion, if not dispensing a medication.

If the OP doesn't recognize why this would be wrong now, how is she going to recognize it in clinicals or in her job once she is licensed.

[jadelpn, LPN, EMT-B]

The camp should have (or should from now on) have a policy regarding medications, over the counter or otherwise. Whomever was in charge of the overall camp would have been given the medication to follow their policy on medication administration.

IF and only IF you are a licensed nurse, you could--in some states--and check with BON if you ever find yourself in that situation, bear responsiblity of dispensing meds, purely because you are licensed. One has no way of verifying that the meds in the bottles are what they appear to be, etc.etc. And I wouldn't want that responsibility, nurse or not.

From now on, this camp needs to have a policy/procedure in place. A permission slip, something other than a card with "give this much of this" stuff.

Or Mom can come back at bedtime and dispense the meds to her child herself.

[RNfaster]

What was the kid's weight? Per my drug guide, the children's (age above 6 years) dosage for cetirizine (Zyrtec) is the same for adults. Benadryl for children PO is from 12.5 mg to 50 mg per day (1mg/kg for sedative/hypnotic before bedtime)... At the higher levels, the doses are similar to those for adults... As for ibuprofen, an anti-inflammatory dose in a child might be 30-50mg/kg/day in 3-4 divided doses....and at the higher ranges, such a dose would be similar for an adult.

I think you might be asking about mandatory reporting.

https://www.childwelfare.gov/pubs/usermanuals/childcare/chapterthree.cfm

Your husband's company probably has some policies and procedures related to mandatory reporting of suspected abuse (it doesn't sound like there's anything going on in this case, to me...) If you are working at an institution, then you would follow the policies for reporting per your institution. If wou were a nurse and witnessed abuse of a child outside an employer, then you would be obligated to report on your own. --I'd also refer to your husband's company policies regarding medication administration and storing related to campers. --I would bet they have some rules/guidelines.

One other thing... I am not so certain that this issue has anything to do with HIPAA. Check out: Understanding Health Information Privacy --the camp is not a covered entity, nor is the student. --If the student were a student nurse at a hospital and the child was a patient at that hospital, (not one the student was caring for), that would be another story. --Hospitals are "covered entities" who must abide by HIPAA. --That's how I understand it.

Per the site above, Covered Entities include:

1) healthcare providers, such as: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, pharmacies --BUT ONLY if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard.

2) Health insurance companies, HMOs, company health plans, government programs that pay for health care, such as Medicare, Medicaid, and the military and veterans health care programs.

3) Healthcare clearinghouses - includes entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.