I'm Being Disciplined for Looking Up My Own Labs

[daisybaby]

Two months ago, I went to the ER (I work in another unit at the same facility) with status migranosus for IV hydration and treatment. Two days later, I went back to the ER with a red streak running from my IV site up my biceps. Thrombophlebitis with possible MRSA infection, the attending said. Got IV/PO Clinda and had blood cultures drawn, with instructions not to return to work for 48 hours.

Once back at work, I looked up my labs for the final BC report (thought it might be a good idea to make certain I wasn't infected before handling babies). Since my PMD does not have admitting priviledges at my hospital, it could be several days before her office received the results by mail and who knows how long before her office called me. So, I looked it up myself, and was reassured by the negative result.

Today, I was notified that I am being disciplined for 'Violation of Confidential Medical Information'- aka a HIPAA violation. I have, apparently, VIOLATED MY OWN PRIVACY by looking up my own labs. What the ???

For the next three months, every sign-on with my password will be reviewed to make sure I am only accessing information for patients I am directly caring for. If I am in found to be violation of these terms (which I certainly am not going to do), I will be terminated.

Now, I wasn't snooping around to find out a coworker's Hep status, or prying into the file of a VIP patient on another unit- I was looking up my own information, for Pete's sake! "The organization takes privacy very seriously and views looking up your own information as serious a violation as if you had looked up someone else's medical information," I was told.

I know plenty of other RNs I work with who have looked up their own information. Or their kid's radiology reports. Or their husband's labs. I seem to be the only one, though, being disciplined. And to be put in the same penalty box as those who have snooped into the files of other patients or coworkers makes me upset. I think my hospital is taking HIPAA to a huge extreme here.

Anyone else here been taken to the woodshed for 'violating their own privacy'?

Sheesh.

[carolinapooh, BSN, RN]

OK. This is the point where HPPA regs. and policies should be examined, or re-examined, I should say In my opinion, anyway. That is XXXX ridiculous and I'd be so inflammed I'd quit on the spot. That is the most ludicrous, atrocious violations of YOUR rights I've ever heard of....what about one of the organizations that offer legal advice/support free of charge and even represent one when one's own legal rights have been violated?

Seriously.

You can't look at your own stuff, but an insurance company can see pharmacy records and see what drugs you've been prescribed? Can see surgery records? What in the world - I've always wondered why yoiu have to SIGN A RELEASE to see your own medical records??!!!

This is where HIPAA falls RIGHT OFF THE DEEP END into ridiculous.

I follow rules because I like to keep whatever job I have, but that does NOT mean I just say "Ok, that makes sense, and it makes sense because they say it does". This one is just moronic. Yes, I know HIPAA - and every time I hear this one, I just roll my eyes because it is the just about the stupidest thing ever written.

You can request records, but not look at them? Insane.

And as for the whole personal-at-work thing, don't chat to friends, don't mention anything outside of what you're supposed to be at work to do, don't go to the potty, and don't take a second to sit if you get the chance - these are all personal acts that have nothing to do with office time. You can really stretch that as literal as you'd like to go. Anything that has nothing to do with what you're doing at work is, strictly speaking, personal, and could easily fall into that arguement. And no one would ever agree to work in an environment like that anyway (no literal interpretations, no fingerpointing, and no comments about hospital floors, please - you all know what I mean).

Simply stated, this is ridiculous. I would be equally infuriated and would feel equally accused and incriminated. Ridiculous. HIPAA has loopholes in it big enough for an insurance company to drive a semi through, and they're all wadded up because someone LOOKED AT HER OWN RECORDS and, by their own admission, VIOLATED HER OWN PRIVACY? The quote from that (form!) letter she got is almost ludicrous - the one about them taking her violation of her own privacy as a serious offense, or whatever it said. I mean, how daft does that sound?

And I have to wonder: how much time and money is being wasted by the institution dealing with this, while someone who's REALLY blowing it gets by with whatever wrongdoing they're committing? (Diverting? Looking at their neighbor's records via a nurse who's actually caring for the pt? Stealing money from Petty Cash?) DUMB. No, I correct myself - SAD. Really and truly SAD.

In this day and age, I WISH I was the only one violating my own privacy. Until I get a logical, reasonable, and in-black-and-white verifiable explanation of why looking at my own records should continue to be some type of criminal offense (because violating HIPAA can be a criminal offense), I will continue to giggle at the insanity of such a rule and will sympathize greatly with those who get dinged by it. Especially in cases like the OPs - assuming everything there is spot on, and I have no reason to think it isn't.

(Bows) Now I step off my soapbox...sling mud at will.... :)

[Chaya, ASN, RN]

Yes, until HIPPA starts to be applied both with common sense and with consistancy my attitude in "iffy" situations is to use my own common sense and take whatever course of action provides the best patient care. If I felt I needed to look up my own labs in order to provide safe patient care AND obtaining them through approved channels would cause unjustifiable delay AND I was willing to act on the results (ie, notify my MD of the result if abnormal and remove myself from pt care), that is what I would do and I would take whatever measures I needed to to prevent consequences.

I've never had an issue with my own labs because I am more comfortable receiving care at a facility different from the one where I work. But so often we are supposed to follow these stupid regs and there is no accomodation made to enable us to do so. Example: a few weeks ago I was caring for a patient whom I did not know personally but who happened to be a hospital employee. Special access is required to access medical records of employees, and I was unable to access crucial lab results for several hours until I was able to reach one of her docs who could access them. Of course TPTB would say to have the Unit Coord or charge nurse access them-only it was a weekend, when we don't always have a UC-as was the case that day. Also not all the charge nurses have the enhanced access-and this one did not. TPTB would have all sorts of suggestions about all the options I had; only TPTB were all home enjoying their weekend and this turned out to be one of those frighteningly frequent times when an individual pt "falls through the cracks. Luckily no harm to this pt resulted from this delay but it could have turned out differently.

[canoehead, BSN, RN]

Pts. who aren't employees of a facilty would probably like such peace of mind.

I think they should be able to access their records online, absolutely. That would be a huge selling point for a hospital- patients results are available to patients just as soon as they are available to the health care providers. They would have to speak with their PCP for interpretation of the results, the hospital may decide to post just "positive" or "negative" online instead of detailed reports, but I think it's a great idea!

[outcomesfirst, BSN, RN]

My post was in reference to the "Those records are not yours. They belong to the hospital. You do have a right to request copies, but there is no law that says you will get them."

Computer access to your own records is a hospital policy issue, and is grounds for firing, if it is stated in the policy.

I stand by my information. Yes the records do belong to the hospital (or doctor or insurance company) and yes you may request a copy. There is still no law which specifys what you will get. The HIPPA public fact sheet does indeed state: "Providers and health insurers who are required to follow this law must comply with your right to: Ask to see and get a copy of your health records" Stop for a minute and think about the words in this statement.

It is naive, perhaps even dangerous, to believe that this public statement means you can just say to your hospital or doctor I want to see and get a copy of my health records and they will just quickly run off a set for you. Try it.

[Tweety, BSN, RN]

I looked up my own lab results after a needlestick. I didn't realiz I was violating HIPPA. When employee health called for me to meet with them and go over the results I told them "no need I looked them up and I'm fine with that."

They didn't get upset or write me up.