Paramedics Calling for Pt Info

Nurses General Nursing

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Last night I got a phone call at work from a person saying they were the paramedic who picked up my pt (last week, stable, schedule to go home today) and wanted to know how he was doing and what his clinical diagnosis was. I have never received that kind of a call before but I instantly thought that it didn't sound very hipaa friendly. I put him on hold and asked the charge nurse. She said that no, I couldn't give out pt info as his care for the pt ended at our ER, just as I thought. She said, get his number and tell him you'll give it to the pt and he can tell him himself, if he wants to.

So I did just that but the paramedic got a little agitated with me. I said, "Hey, your in this field too, you understand hipaa and I can't violate it. I'm sorry"

So, I gave the pt the number and told him who it was. He said he didn't want to call the guy. Okay fine. Fast forward to midnight and the paramedic is standing at the nurse's station, again requesting the info. I told him that I had given the pt the note but that he chose not to call. The charge nurse backed me up and said that we cannot give out that info on the pt and please just get on with your job so we can get on with ours.

So as I was giving report this morning to the dayshift RN and another RN who is sometimes charge raked me over the coals. She said that they probably wanted the clinical diagnosis to find out if their care on the field was appropriate for the patient and I should have given him the info. She also pointed out that they were probably making a run to the ER when they stopped by the unit at midnight. (duh)

So my question is obvious, what would any of you do?

Thanks!

Been thinking about this thread the last 30 minutes, and I'm getting more and more irritated about this story.

Both on this board and in my real life, I hear nurses in the hospital talking about how they'd like to followup on patients they've cared for, but can't due to HIPAA requirements ("need to know"). I don't know that this is necessarily true, but in an era where people are getting fired for relatively minor privacy violations, I understand why you would avoid any appearance of impropriety. It's tragic though, because obviously any RN would benefit from following up on what happened to a patient who, for example, got transfered from their care on the floor to the ICU.

I am not convinced that paramedics would benefit similarly. Prehospital care tends to be much more algorithmic than in-house nursing care. Usually when I've seen paramedics try to followup on patients, it's not for any true professional development or educational reasons, it's because they tried to guess the diagnosis and were just curious to see if they were right. Whether or not the guy had flash pulmonary edema or CHF exacerbation is beside the point outside the hospital; you still had to tube him when he developed respiratory distress.

I will fill in the paramedics when I see a trauma and they hang out for a few minutes to see how things go. I will toss up the xrays for them and show them the CT scan, in the ER. But to come back after several days, and then try to use his professional status to extract information in the middle of the night, is completely inappropriate. Even if this is a gray area in HIPAA, it is totally wrong to come back with the same question when you were already told that it was inappropriate to give out the information.

I respect paramedics for what they do. But I dislike the cowboy attitude some of the younger guys have. Yes, they have a sexy job. But they are not hospital employees, and their right to patient information (at least in my eyes) ends in the ER. This paramedic was very unprofessional, and this story is going to annoy me all night.

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Specializes in ICU/Critical Care.

Yes, he was very unprofessional. For that matter, I hate when people throw around their title just to get patient info or just to get their way.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.
No, I would not have given out the information over the phone. This is one of the lessons you can learn from management. ALWAYS PASS THE BUCK. Say something like, "Our privacy officer will not permit me to give this information but here is their number 222-2222."

Speaking as a paramedic I will ay we are curious, but not stupid! So please dont "pass the buck" and lie to us, we wont fall for the privacy officer thing. Be honest, most of us are professional enough to leave it alone. Also understand that we do like to know what happened to the patietn and if are dx was on the money... thats all, we mean no harm or trouble.

Sweetooth

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Specializes in oncology, trauma, home health.
No, I would not have given out the information over the phone. This is one of the lessons you can learn from management. ALWAYS PASS THE BUCK. Say something like, "Our privacy officer will not permit me to give this information but here is their number 222-2222."

Speaking as a paramedic I will ay we are curious, but not stupid! So please dont "pass the buck" and lie to us, we wont fall for the privacy officer thing. Be honest, most of us are professional enough to leave it alone. Also understand that we do like to know what happened to the patietn and if are dx was on the money... thats all, we mean no harm or trouble.

Sweetooth

I agree we are all curious. Just like the staff who took care of Britney Spears was just curious. Curiousity is what feeds People magazine. Curiousity is fine. My patient's wishes (and my license) are what is at stake here. The problem presented wasn't about whether or not the paramedic was "nice" "kind" or "curious" just if it was legal or ethical.

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Specializes in Respiratory, Hospice, Med-Surg, MICU,.

This EMT was Totally out of line, and as the doc says, I would have called and reported this. His behaviour was completely inappropriate!

These guys (gals) are Fully aware of what the regs are and are trying to sweet talk someone into letting it slide "this time" for their own curious gain. Geesh! For what? I worked closely with EMS, was an EMT and have seen my share of "nosey" folks. Smells like that to me.

I came upon a woman on the street once who was in sudden death. I truly didn't expect her to make it......this was some years ago. Imagine my delight to know she survived without any neurological deficit-AND! She was the mother in law of one of the nurses I worked with on MICU. In that situation, all I had was my hands, breath and my ears to her chest until EMS arrived over 5 minutes later. I labored over her, anguished for her husband watching hopelessly and plucked pieces of gravel out of my knees from working on the asphalt in summer. Yes, I had a deep need to realize the final outcome. Nothing more.

This, could be possibly the ONLY type of circumstance I believe a paramedic/EMT should have their desire to know the prognosis fulfilled. Diagnosis? No, absolutely not.

Or me as a nurse who was the unfortunate one to do compressions on a 90 yr old non responsive woman in a fetal position for over 5 yrs with no next of kin and broke every rib in her frail body and ambued her for over an hour until transport arrived to take her to the city (years ago when I lived in Mayberry USA with a little bity hospital and no vent besides in the OR used for appys and sections etc with a CRNA). I was happy, relieved to learn later that the woman I lost sleep and anguished over finally made it to the other side....and prayed for God to forgive me for the horrible thing I did to her (of course required to do by law!).

I don't think it is breaking HIPPA in these instances to let those intimately involved in life saving measures to learn the final outcome. Other details are unnecessary.

IMHO........

To the OP, you did well! I hope you Know that in your being now :yeah:

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As a paramedic I can tell you that what this paramedic did is completely out of line. To ask for any information over the phone in my opinion is a serious privacy violation and a company violation where I work. Even showing up on the floor, you have no way to know if he really did treat this pt or not.

I routinely transport pts to 6-8 different hospitals and we have set pt follow up procedures with all of them. I find it hard to believe that he didn't have a better option.

Our followup procedure is a form with pt name, date of trans, and our run number, this is given either to our Q.A. officer or directly to the EMS coordinator at the receiving hospital. We will then get a reply in writing with pt's admission diagnosis or injuries (if a trauma) and current pt condition (critical, stable, discharged, or deceased) as well as a review of our treatment. We do not get any specific information about pt treatment other than surgery, cath lab, med/surg, or bypass. This is all information that would be generated on a standard call review as well.

A lot of generalizations and very few specifics.

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No, I would not have given out the information over the phone. This is one of the lessons you can learn from management. ALWAYS PASS THE BUCK. Say something like, "Our privacy officer will not permit me to give this information but here is their number 222-2222."

Speaking as a paramedic I will ay we are curious, but not stupid! So please dont "pass the buck" and lie to us, we wont fall for the privacy officer thing. Be honest, most of us are professional enough to leave it alone. Also understand that we do like to know what happened to the patietn and if are dx was on the money... thats all, we mean no harm or trouble.

Sweetooth

I didnt say you were stupid but you wouldnt "fall" for asking the privacy officer if you can obtain protected medical information? That is their job and they are the ones who formulate policy. The staff nurse is there to take care of the patient. It is not their responsibility to provide this information to paramedics, if the paramedic wants to develop some program to determine competency or evaluation then again come up with a program or policy with the privacy officer, not the bedside nurse.

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Specializes in ER.

In the ER when I want to know about the outcome of a patient we transferred out I go to my boss and he calls/researches and gets back to me. Usually it's because I want to know what happened clinically, but once or twice it was because the patient was extremely young, or had an unusual presentation. I assume that for EMS (like nursing) the information would be available through proper channels, but not instantly, and probably not with all the juicy details you'd get from a coworker. Force him to go through channels, avoid future inquiries like this, and protect yourself.

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Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

Many facilities offer a follow up number through their pre-hospital office for paramedics to receive information on how the patient is doing. If your facility does not have that availiable maybe it could be implemented.

As a critical care nurse I would not have given out any information either.

As a paramedic yes I would like some feedback to help me do a better job.

With both Rn and paramedic after my name I do understand both sides and no I don't give out info to medics on patients I have as a nurse.

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Specializes in OR, Robotics, Telemetry.

Hey All,

I have to agree, very unprofessional to ask over the phone or show up in person days later. You did just the right thing IMHO.

Not that I don't respect what the medics do, I have the highest regard for what they do, its a tough job. I have several family members who are EMT's and paramedics and I was a first responder prior to becoming a nurse, so I have an idea of what they do.

As a side note, about 13 years ago now, I was transported by squad to the ED from my doc's office. I was 6 mos preggers and experiencing severe stomach pain. The medics came to my room the next day and asked how the baby (fetus) and I were doing. I had just had emergency surgery and my husband and I were VERY impressed that they cared enough to check on us. It let us know that they cared about their patients beyond dropping them off at the back door.

My point being that there are ways to find out through proper channels, in this case asking the patient directly. As I gave the hospital permission to release my room number, they had easy and legal access to my room number even IF HIPPA had been around then.

Just my take on the matter,

Always Learning

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Specializes in LTC, Nursing Management, WCC.

If the paramedic had the truest of intentions and really wanted to know if the patient is doing fine...that was quite noble to care enough. However, he shouldn't show up on the floor to try to get a different answer. The patient was given the info and the patient declined. I really think HIPAA can be left out of this situation because the patient had stated that he didn't want to call. Leaving HIPAA out, the patient still has the right to privacy. The right to privacy was not granted by HIPAA but reinforced.

The nurse, as the advocate, is to protect patient's rights while the patient is in his/her care. The nurse's duty is to the patient and not the paramedic.

:twocents:

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Yes, you did the right thing.

HIPPA regulations have really made a big change in the culture of healthcare.

I remember,not long ago when info was more readily given out to family members. Psych units had a higher level of privacy. I think we are all still adjusting to the change.

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