Oboy..........I got a dilemma

  1. [font=book antiqua]what do you do when you find out information about a pt from a source outside of work that directly affects the pt's care?
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    [font=book antiqua]*edited to add more info*
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    [font=book antiqua]the information relates to possible fraud by the pt and wife. i am concerned about my liability if it's discovered that i knew and said nothing. i did not discuss the pt with anyone, the source coincidentally knows this person and had another reason to talk about him; i just happened to realize during the conversation that she was talking about my pt.
    Last edit by TazziRN on Sep 19, '07
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  2. 20 Comments

  3. by   Jolie
    Unless you can verify the information with the patient, you do nothing. How do you know that the information is accurate or reliable?
  4. by   TazziRN
    The pt's wife told me one thing and the someone else told me the opposite based on her own conversation with the wife. VERY reliable source.

    What I'm concerned about is that it could be fraud on the pt's part. If I knew and didn't say anything, how much liability do I hold?
  5. by   traumaRUs
    None - since you were privy to private info - no responsibility at all. Sleep easy.
  6. by   SaderNurse05
    IMHO you cannot use information from someone unless they are providing information on the patient's behalf and with the patient's consent. Therefore I do not see how you could have complicity...I would be very careful because if something is hinky the less information you get from outside the proper channels the better. Last but not least, people lie (who would have thunk it). There is the possibility it was misinterpreted or for whatever reason the wife may not be telling the truth. If you concerned about possible fraud I would look for something in my assessment and treatment to see if anything is suspicious. I would caution you not to EVER mention the source and try to avoid any more communication with them about this patient unless the patient has consented. Good Luck@@@
  7. by   Zookeeper3
    see, the word FRAUD, caught me with your post. Now if I had info that would tell me outcomes could be negatively affected without this information, I would get risk management involved, our office is fantastic and takes the worry about these things right out of my hands so I could care for patients.

    Fraud could involve regulatory agencies inwhich we are required to comply with, so supervision, then risk management would be my course of action. Its not for ME to decide, let the powers that be do so.
  8. by   TazziRN
    Quote from sadernurse05
    imho you cannot use information from someone unless they are providing information on the patient's behalf and with the patient's consent. therefore i do not see how you could have complicity...i would be very careful because if something is hinky the less information you get from outside the proper channels the better. last but not least, people lie (who would have thunk it). there is the possibility it was misinterpreted or for whatever reason the wife may not be telling the truth. if you concerned about possible fraud i would look for something in my assessment and treatment to see if anything is suspicious. i would caution you not to ever mention the source and try to avoid any more communication with them about this patient unless the patient has consented. good luck@@@
    [font=book antiqua]i know better than to reveal the source. and i did not communicate about this pt. the person who told me does not know the pt is mine, does not even know i know him. it's a whole sticky situation that honestly belongs in a soap opera, because if i weren't involved in this i would never believe it would actually happen!!!!
  9. by   SWEETIVY
    dont listen to the source at all your a nurse just do your job if its a family member take it up with the supervisor
  10. by   Zookeeper3
    Tazzi, without getting into too much detail, do the doctors NEED this to treat the patient? I would be VERY careful because word of mouth does spread and this person may very well know you were caring for the patient, despite your statement.

    If your patients care depends upon this info, again I say risk management.

    I don't see how fraud, unless someone is trying to fake something for a claim.... then it's a mess. Thats when being privy and knowing of fraud becomes two different things, but YOU are then safe, just get outta the drama and alert the risk management people. Maybe I'm not seeing this clearly enough, although trying to help you feel better.
  11. by   loricatus
    As far as what your source told you, it's just gossip & you are ethically not obligated to report the product of gossip. Just think about it this way: If you did report the act as possible fraud (based on what you heard through gossip,) how would you feel if you did find out that it wasn't completely factual and you put an innocent person through an investigation?
  12. by   mauxtav8r
    Tazzi, you said that the source is "reliable", but would that really stand up? I'm not a "sleep easy" kind of person . . . due diligence is always a good plan, so if there is any way to document the statements of the couple (this may have been done on admit).

    JUST AN EXAMPLE: So, for instance, if a pt is admitted for chronic pain, and seeks tx including marketable meds, you are already charting the pts report on pain levels, etc. That you suspect (strongly) that the hydrocodone is leaving the hospital and being sold on the street is not so verifiable and you are covered because you charted. The responsibility lies with them not you.

    Sorry you are in this situation. Keep us posted. If this was a newbie I'd discount the whole story, but it's Tazzi.
  13. by   TazziRN
    Quote from zookeeper3
    tazzi, without getting into too much detail, do the doctors need this to treat the patient? i would be very careful because word of mouth does spread and this person may very well know you were caring for the patient, despite your statement.

    i don't see how fraud, unless someone is trying to fake something for a claim.... then it's a mess. thats when being privy and knowing of fraud becomes two different things, but you are then safe, just get outta the drama and alert the risk management people. maybe i'm not seeing this clearly enough, although trying to help you feel better.
    [font=book antiqua]it would not affect his medical care from the doctors, but it might affect what care the agency can give him. and yes, it involves a claim.

    Quote from loricatus
    as far as what your source told you, it's just gossip & you are ethically not obligated to report the product of gossip. just think about it this way: if you did report the act as possible fraud (based on what you heard through gossip,) how would you feel if you did find out that it wasn't completely factual and you put an innocent person through an investigation?
    [font=book antiqua]no, it's not gossip.
  14. by   fgoff
    Tazzi, I agree with another poster. Get RM or legal department on it if you feel this affects the agency claims for care provided. The have ways to check on info to cover the company and protect the business IF they feel it is warrented.

    Good look!
    fgoff

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