Is this inappropriate?

[2shihtzus]

My nurse manager is best friends with one of the LVN's on our unit.

The LVN ended up being admitted, and the manager made sure that this LVN was placed in the hospital room adjacent to her office. She also would frequent the front desk to look at the LVN's medical chart.

Is it just me, or is this a little inappropriate???

[EmmaG, RN]

Emmanuel

Excellent point about the corporate compliance hotline. I had forgotten about that. One of my former employers actually gave us a little card with the number on it when we got hired. Makes it easier to deal with situations that are swept under the rug locally. If anyone is going to take action, it is corporate hq.

When it comes to a possible HIPAA offense, they must take action. These lines were set up for just this kind of scenario.

[CyndieRN2007]

Which part are you asking that is inappropriate? The placing in the room or looking at the chart?

At my hospital any time an employee is admitted we try to get them a good room - usually at the end of the hall where it is quieter than near the desk, a private room versus a double (we only have a few doubles). So your manager getting her a good room I don't really feel is inappropriate unless they don't attempt to do so if other employees are admitted.

As for going through the chart - it depends. In my hospital, I peruse charts all the time to determine if we are charting correctly, if the charge indicates a patient is deteriorating I look to see what might be causing it, etc. Our managers also audit charts everyday and review any of patients that are 1) deteriorating 2) troublesome.

Do you know if the LVN asked her for input on what was going on with her chart? We would like to see that everyone gets the best possible care at all times, but unfortunately the real world is not like that and you have to decide who you are going to concentrate on. Choosing a best friend to make sure the hospital stay is the best it can be is not a problem with me.

Hope this helps,

Pat

I agree.

[patwil73]

I keep seeing a lot of replies indicating that this is a HIPPA violation. I think you will have a really hard time proving that. As the NM she can always look at any chart on her unit to determine if the care and charting is correct. Unfortunately since most hospital protocols tend to be above reality, it is easy to say that the nurses are not keeping up with the protocols and they need to concentrate more on this patient. It gets the patient better service and care.

Even if the patient doesn't want the NM to go through her chart, she might not get that option. Ultimately she is the NM responsibility to take care of. Will this result in "favored" treatment. It can easily be argued that no, it only results in the treatment our protocols says she is to receive.

I would be much more concerned if she was doing this to people she didn't like and advocating bad care.

Now one thing I missed that someone before pointed out - is that it is probably innapropriate to be best friends with someone you are managing. If they spend time together outside of work, the patient should be transferred to another department (if possible) when she returns to work. That can lead to bad "favoritism".

So overall, the NM behavior may stem from innapropriate impulses (ie. favoring one patient over another), but I doubt you will ever prove it and pushing it or being too vocal about it could lead to a focusing of the NM on you, which might not have as favorable an outcome.

Hope this helps,

Pat

[wooh, BSN, RN]

She can definitely get away with it. But it's still inappropriate. I've seen charge nurses get family members assigned to their floor so they'll be able to get away with looking in the chart. Just because it's technically legal doesn't make it right.

[Kunzieo]

It's NOT a HIPPA violation. HIPPA has nothing in that states that a nurse manager cannot look in the chart of one of the patients under her unit's care. HIPPA also says nothing about a nurse not being able to care for a family member/friend and reading their chart. HIPPA laws have been completely distorted by corporate/healthcare lawyers who have taken privacy laws to the extreme with rules and regulations that have nothing to do with the original intent of the HIPPA laws. HIPPA was originally designed to protect health information storage...to make sure that hospital/pharmacy/md office computors and faxes were secure. Most of HIPPA deals only with electronicly shared information.

Sorry. One of my pet peeves. HIPPA distortion.

[wooh, BSN, RN]

If the NM was looking in this chart because as the NM she'd look in this chart no matter who the patient was, then no problem. But then HIPPA or not, if she's looking in the chart because it's a friend, it's inappropriate.