patient privacy, arghh!!!!

  1. Could the nurses here help me understand this situation.

    On New Years eve, my sister, her best friend and the boyfriend to the best friend were involved in a horrible car wreck.

    When we got to the hospital after 2am, all 3 were in the ER. My sister was laid in a brace in terrible pain waiting for the doctor.

    We were very concerned about her close friends also. We kept asking about the condition but were told nothing. All that happened was that the nurse kept coming to ask us for phone numbers to get in touch with the family of her best friend.

    We gave all the information we had but they were not able to get anyone, we later found out they had gone for an all night church service and we did not have the mum's cell phone number.

    We did not get hold of them till Saturday morning.

    The whole night the hospital insisted that the girl's family were the only ones to get any info, one patient care rep let us know that her condition was not good and that is why they needed her family. I think she only said this because she realised how concerned we were.

    When we finally got the family to join us at the hospital around 10am we were informed she had passed away at night, some time after 2am.

    It is so sad that she had no one by her side when she passed. If this every happened to my family I would want someone there by their side if I could not be there. It is INHUMANE to let people die alone when they have a close friend nearby who could give them some comfort.

    Is this the procedure everywhere? THey kept saying it is privacy, privacy issues, maybe HIPAA.

    If that is the usual practice, it SUCKS and someone needs to change it.

    It is one thing asking to get someone's private hospital information and it is another just wanting to know the condition of a person so that you could be there for them.

    The boyfriend remained hospitalized with an injured lung, injured kidney, broken ribs, internal bleeding and could not walk.

    I could understand not letting another sick patient see a fellow sick patient because that could make them deteriorate, but we were there healthy and strong and kept answering their questions and kept asking for info......

    I really think this SUCKS!:stone
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  2. 18 Comments

  3. by   live4today
    I agree. It does suck in situations as you described.
  4. by   fallonrn
    congratulations you just experiencd government run health care.
  5. by   NurseFirst
    I agree, this sucks! I am truly sorry for your pain...

    HIPPA (or is it HIPAA) stuff is still being implemented--not all of it is about privacy. The last two initials stand for "portability act" -- and has provided a means for some people, including moi, to get better medical insurance than they might have otherwise...

    ...but I think the privacy pendulum has swung in one direction, too far, and within a few years there will be enough backlash (such as comes from instances such as yours) that things will change. Not back to where they were, but at least to something better than we have now.

    Truly, the privacy issues in medicine have needed to be addressed to some degree. But now, they've made the healthcare workers paranoid. Fortunately, in 2003, when I had an operation, and a friend had an operation--and our only local "family" was people from our church, the surgeons came out and talked with our friends--something, according to HIPAA, that they should not have done. (Maybe it was because they saw that the people who came in with us to pre-op weren't relatives? Don't know for sure.)

    When I think about the times I called the hospital 400 miles away about my father's condition in 2001, I wonder how much of that information I would have been able to get from the nurses--and would have had to get from my sister. Sheesh.

    There's got to be a better way than what is happening now, I think...but not sure what it is...maybe, at least, if someone is dying the rules could be different?

    NurseFirst
  6. by   Chaya
    The situation Renee described is inexcusable, but I can see how such a situation is possible with this cockamamie regulation. At my hospital we honor written requests (as well as verbal request from the pt to give info to whoever they request on the spot). Trouble is this only works when the pt is A +O, plus technically it could put us at risk if there's nothing to show on paper. This is the kind of situation I might let slip to the concerned party where the pt was specifically, and look the other way...Ironically we do not have the facilities to actually provide privacy when asking admission questions of the pt. Anyone w/in earshot would learn some very private info.
  7. by   madi_88
    some comfort....no, not all hospitals (policies) are like that - I'm sure she knows you did your best.....
  8. by   CarVsTree
    I am truly sorry for the pain this young girl, her family, you and everyone involved experienced. Sounds like the staff needed to learn some common sense. I always find it so hard to believe that this type of stupidity goes on.
  9. by   Tweety
    Obviously your friend was in critical condition. It's common practice to restrict visitors in a critical situation and especially with possibility of death.

    My condolences.
  10. by   Spidey's mom
    I'm very sorry about your loss.

    I was thinking that this wouldn't happen in my small little town - everyone knows everyone. We'd be more apt to let you in than keep you out. But don't tell the bigwigs.

    steph
  11. by   Antikigirl
    I am horrified and shocked, but not suprised sadly...and I am very sorry for your loss and the way you found out about it...finally.

    Here is what a hospial rep would say....

    It is standard in cases of death to only alert the closest family member, usually a spouse, parent, POA, brother or sister. Friends or life partners are not included in that role call (in some facilities) of responsible people able to make choices or know of a patient's case. However, it is up to the discression of the MD under advisement of the patient or whomever is chosen to speak for them.

    In cases of near death, the same applies...mainly because of conflict between friends and family present that have resulted in law suits. Sometimes friends approve or insist on live or non-life saving methods that may not have been wanted by the family! It is now also considered a breach of confidentiality to let anyone outside immediate family or poa know anything about the patient...again because there can be confusion that leads to heroic or non heroic implementations to the patient approved by non-family. Hospitals are no longer taking chances...so now they just keep all nonfamily out and uninformed out of fear of lawsuits by family.

    So like the other poster said...the pendulium has gone the total opposite, now it is almost impossible to even get information or even see patients unless you have an order in your hand signed by the patient, and a witness, and the MD saying you can.

    I had a friend who's 16 year old daughter go into the ER one time with pelvic pain, and my friend was DENIED any information about her case untill the daughter approved of her mother knowing (and her daughter was asleep for a while on heavy narcotics). My poor friend waited forever it seemed before her daughter heard her own mother couldn't come in and was waiting in the lobby freaking out!

    My friend told that administration..."I am responsible for her welfare technically till she is 18..how in the H*** do you get off banning me from being with my own daughter or keeping information from me!!!!". They only replyed that she is of legal age to make choices in confidentiality about her sexuality or sexual practices..and untill a woman of child bearing age authorizes a parent can know in cases of pelvic or abdominal pain..they couldn't tell her! Can you believe this!!!!!

    So we come to find out that they knew from the get go that she was starting the pain of kidney stones!!! Oh great...and this has to so with reproduction/sex HOW??? Oh she was furious, the daughter was furious and embarrest because she was not 'active' and now was scared her mother thought she was...it created a mess!!!!!! She was fine after 8 long hours of serious pain...and my friend is thinking of a law suit against the hospital!!!

    So not only do we have the horribly sad above situation...Now we have a situation where a parent of a 16 year old child can't even get involved if it has to do with abdominal/pelvic pain!!!!! I was instantly sick to my stomach when I heard about this!!

    Now I am listed, and vice versa for all of my closest friends to have medical information given to them concerning my case, but only my husband...father...then my in laws, have a say in my health care choices! The only thing is...according to some facilities, I have to sign this each and every time I go into a facility...not a general consent! UHGGGGGGGGGGG!!!!!!!!!!! This also applies to the folks listed for care of my own children if I am not available immediately or also injured and can not speak for them! I don't know what to do anymore!!!! AND I AM IN THE FIELD!!!!

    Really nice when even us nurses don't know what to do..they keep changing the rules because control with disorder (ie no one really knowing what to do) is better than being humaine or rational!!!!!!
  12. by   z's playa
    I feel bad when anyone passes without someone beside them. Rules and protocal should be revised at a time like that! :angryfire
  13. by   PJMommy
    Here's the thing with HIPAA....

    We are constantly told that we will be "investigated" or otherwise reprimanded for so-called "violations" of HIPAA law BUT....

    HIPAA is a Federal Government ACT. Meaning the Feds administer and enforce the Act...with something on the order of 50 administrators (for the entire U.S.). Each facility determines how HIPAA will be interpreted. For example, my facility may say we have to shred and burn anything with pt info...another may not.

    The thing with a HIPAA investigation is that they will look at what a "reasonable nurse" would have done. Most reasonable nurses (in pre-HIPAA days) will tell the mom the daughter's condition...or how your friends were doing.

    Actual violations of HIPAA are investigated by the U.S. Dept of Justice and are pretty much flagrant violations (i.e. selling pt soc security numbers). Anything less than that are facility-based rules and regs. Sorry...this is usually some hospital attorney or administration person justifying their job to come up with stupid interpretations and rules.

    At our facility, the newest thing is that we can't keep pt labels in the room (which we use to label tubes of blood, order sheets, etc.) because someone might come in the pt's room and see the pt's name, DOB, and med record #. The administration sees nothing wrong with this rule despite the fact that the pt has an armband with the same info, IVs are hanging with this same info labeled on them -- all within 2 feet of the horrible, privacy invading sheet of labels. See...it's just stupid stuff that someone at a desk is coming up with.

    I agree that the pendulum will eventually swing back...but it is a paranoia-inducing, difficult situation right now.
  14. by   UM Review RN
    Renee, please accept my sincere condolences on the loss of your friend's sister in this tragic accident. I hope that your sister and her friend's boyfriend will recover from their injuries quickly.

    I would like to address a couple of your quotes, if I may:

    Quote from renee2004
    When we got to the hospital after 2am, all 3 were in the ER.
    we were informed she had passed away at night, some time after 2am.
    Is it at all possible that she passed away before you got to the hospital?

    In any case, you asked for nurses to help you understand what happened, and I would like to try.

    The three were brought to the hospital. Your sister's best friend was placed in a trauma room and the doctor, several nurses, and other staff were frantically giving medications and doing treatments in an effort to keep her alive.

    We have expertise, education, and practice, but what drives us to be better, get faster, and try harder is not that we can brag about how good we are in a trauma. It's because we have sisters who have best friends. We have moms and dads and children of our own. It's because we have thoughts like, "My God, this could be my child here," or "She's just too young to die," that we hold the hand of the dying, that we keep doing CPR long after it's sensible. We don't do it out of professional pride. We save lives because we value life. A stranger's life is as our own. We give our patients what we would want our family to have.

    I might not express it very well here, but you need to know that when your sister's friend died in that trauma room, she was not alone at all, but the center of intense activity. Someone was giving medications, someone was giving oxygen, someone was searching for vital signs.

    I can assure you that someone was at that bedside who cared, someone was holding her hand, someone was urging her to live despite the great injury she sustained.

    But at some point, they knew that she was gone, and that she had been gone for awhile. At some point, they had to stop. They had to let go.

    They've had a very short, intense relationship with this person, yet it was hard, extremely hard, to let go.

    There were tears in the eyes of those nurses for a woman who was not their family, not their friend....but who might have been. There were prayers going up for you and your sister, her friend, boyfriend and family that you might not have heard--but they were said. There were people who were in that room who will never forget how hard they fought for her life.

    Because they cared.

    I hope you will accept this in the spirit in which it is offered. No, it's not the best system in the world. You're right, it still sucked that laws stood in the way of what would seem to be common human decency.

    But please know, she did not die alone in a crowd of uncaring people.
    Please know that.
    Last edit by UM Review RN on Jan 8, '05

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