Phone calls & families <sigh>

wooh, BSN, RN · Jul 19, 2010

Everyone thinks they're a special snowflake. I've had people come in to the hospital that don't even know the patient's last name. Heck, some aren't even sure of the first name.

As for it being "lazy" and "poor care" to "not involve the family." It's not just family calling. It's neighbors, it's third cousins twice removed, it's ex-spouses, people that went to church with Bob three years ago and don't know his last name but how many Bobs could there be in the hospital, can't I just look him up under "Bob" or maybe it's actually Bill, or is it Rob, I'm not sure but surely you know who I'm talking about, actually they may have been discharged, can you give me their home phone number????

Now all of these people would have a giant fit if THEY were my patient and I even admitted they were in the hospital, but it should be perfectly ok for me to tell them what they want to know.

shiccy · Jul 19, 2010

Here's how my phone calls go for patients *I* am taking care of:

"Hi this is shiccy"

"Yes I was looking for an update on my mom/dad/uncle/aunt/etc"

"Sure! Did you have their MRN?"

If they say no, I tell them, "I'm sorry ... unless you have that number I can't give you any information on that patient."

When they press further, I tell them, "Due to federal privacy laws, if you do not have that MRN number, I cannot give out any information on that patient."

Sometimes you sound like a broken record, but it gets the job done.

If I have an abundance of time, and I KNOW the patient is awake (and coherent), I will ask the family their first name, and go into the room and ask if I can GIVE the family the MRN. I've never had a problem with this, and the family members appreciate this.

This being said, I never EVER wake someone for something like this.

We have sheets at the clerk desk with all the patient stickers on a sheet. This makes it easy to get the MRN quick, and then forward it on to the correct RN...

As always, this is a customer service industry ...

On a side note, however, someone that DOES erk me is people that DON'T know the difference between a NO INFORMATION patient and a STANDARD DISCLOSURE patient. People CONSTANTLY try to be placed as a no info patient but "with a password". If a person is NO INFO, then I can't tell you I have that patient. It doesn't matter if you give me the DOB, SSN, MRN, Visit #, etc. ... I can't even tell you a patient is in the HOSPITAL with no info. How's about a Standard disclosure of "Yeah he's in the hospital" but nothing else w/out the password? Some people are overly cautious with this stuff.

BabyLady, BSN, RN · Jul 19, 2010

It never ceases to amaze me how "families" call the nurses station and either 1. demand info or 2. politely request info on a patient (and then get mad when I refuse them).
Honestly, you wouldn't call up say, a hotel and say tell me about Mr X staying there...you'd probably get a dial tone.
Case in point, last night a family member calls and automatically assumes that whoever is answering the phone (me) knows about every single patient in the hospital, and wants an "update on her father's status" (someone didn't take their common sense pills this morning!)
She proceeds to go on about her day, her struggles (hey I got a lady trying to jump out of bed, but do you care?), until I politely stop her, and say, "I cannot give you any information, however, you can call your father directly" You can guess the rest...(sigh)

Let me give you some background.

I see you are 25 years old, the reason that matters is that it wasn't too long ago, that family members were TOLD to call the nurses station and usually one of the nurses would answer the phone and would be able to update the family member on the patient or knew who could.

I run into grandparents every day that have never heard of HIPAA and have to have it explained to them.

Also, don't assume that it's been explained to the family members...understand that some family members live out of state and can't come to the hospital directly, so they were not there upon admission.

I personally, don't experience much negative comments when I explain HIPAA to family members...when they ask for information that I can't give them or even worse, when they have drove to the hospital and ask to see the patient (I work in the NICU) and I have to refuse them entry, the key is to explain it to them.

I say, with a SMILE, "I am so sorry, but because of privacy laws, I unfortunately, cannot update you on this patient or allow you in...you'll have to contact the patient (if an adult) or parent (if a child)...I understand that it's inconvenient, but it's just to protect everyone privacy, I'm sure you understand."

I have only had maybe one throw a fit on me.

BabyLady, BSN, RN · Jul 19, 2010

If I have an abundance of time, and I KNOW the patient is awake (and coherent), I will ask the family their first name, and go into the room and ask if I can GIVE the family the MRN. I've never had a problem with this, and the family members appreciate this..

I personally, wouldn't do this.

Depending on the family dynamic, you have no way to verify the person on the phone is who they say they are.

Our hospital gives the number to the patient or the family member that shows up with the patient and we tell them it's theirs to give out. We explain to them that the number doesn't change, so if they give the number to someone and change their mind later, too bad. Treat it like you would an ATM pin.

But we never, ever give that number out over the phone.

CNL2B · Jul 19, 2010

I personally, wouldn't do this.
Depending on the family dynamic, you have no way to verify the person on the phone is who they say they are.
Our hospital gives the number to the patient or the family member that shows up with the patient and we tell them it's theirs to give out. We explain to them that the number doesn't change, so if they give the number to someone and change their mind later, too bad. Treat it like you would an ATM pin.
But we never, ever give that number out over the phone.

I agree with you on this one. If this hospital has a system set up where a PIN is used, I bet it's against policy to give the PIN out over the phone. Good pick up.

mappers · Jul 19, 2010

Does anyone ever get this?

I've had people call me and want information about the patient. I give them the can't give out info speil and if the person is A&O or has family present offer to transfer them to the pt's room. I get the response of, "Well, he won't tell me anything and I know he's hiding something. I'm his {son, daughter, nephew, etc} and deserve to know. Can you tell me what's going on?"

Ummm...no. Your dad might be older and ill, but he is still and adult who can still make his own decisions. If he doesn't want to tell you what his cancer dx is, that's his right. It might irk you and it might not even be best for him...but it is still his right.

We actually had someone come up to the desk demanding to be told what was going on with a patient because the patient refused to tell him. "I grew up with him! I deserve to know!!!" Well if the patient won't tell you, you're not as close to him as you think. MYOB!

happy2learn · Jul 19, 2010

Wow, our families have to go through me, my fellow volunteers, or the workers at the emergency visitor services first. They never get to just speak to the nurses or doctors, unless of course they are back there in person. But in order to go back in person they have to go through me.

Ruby Vee, BSN · Jul 19, 2010

i have a feeling you are gonna be preaching to the choir on this one. the only thing i haven't figured out is if the general public really is that totally unaware of hippa (even though it has been in place for quite some time) or they genuinely think that they are special and that we are going to make exceptions for them.

i think you got it the second time. people truly think they are so special we're going to break the rules just for them. how else do you explain some of the calls we get?

"can you tell me how my mother is doing?"

"what's your mother's name?"

"mary."

"what's mary's last name?"

"i dunno, she just got married again."

huh? if you don't know your mother's last name (if she even is your mother), you're obviously not close enough to be entitled to the intimate details of her medical condition.

"i wanna know how earl duke is doing."

"can you tell me who's calling?"

"this is his cousin twice removed on his father's side."

"i'm sorry, sir, we are only allowed to give information to immediate family."

"i am immediate family. i'm the only family he's got, except for those bozos he sired. i'm his closest friend, too. and whatsa matter with you? all the other nurses tell me anything i want to know."

Ruby Vee, BSN · Jul 19, 2010

there have been numerous threads on this issue and in general it seems to be nurses that are totally unaware of hippa. hippa does not prohibit us from providing information to family and friends, it only places requirements on how that information is given. use a pin, password, or just pass the phone to the patient for a second to confirm that you can provide information to that person.
involving family and friends (with permission) in the overall care of a patient is an important part of nursing care. too often, we seem to use hippa to excuse lazy, poor care.

excuse me? what is "hippa?"

i'm familiar with hipaa. but our facility teaches that we cannot even aknowledge that we know someone unless the caller is on the list of patient contacts.

we're supposed to say, and i quote: "i'm sorry, sir (or madam). i have no information on a party by that name."

BabyLady, BSN, RN · Jul 19, 2010

There have been numerous threads on this issue and in general it seems to be nurses that are totally unaware of HIPPA. HIPPA does not prohibit us from providing information to family and friends, it only places requirements on how that information is given. Use a PIN, password, or just pass the phone to the patient for a second to confirm that you can provide information to that person.
Involving family and friends (with permission) in the overall care of a patient is an important part of nursing care. Too often, we seem to use HIPPA to excuse lazy, poor care.

That is 190% not true.

ALL nurses are fully aware of HIPAA (not HIPPA), because I don't know of a hospital that didn't put all of their staff through HIPAA training when the new law came out, considering you can be fined up to $50K PER VIOLATION and go to prison (yes, prison) if the violation was bad enough, up to a maximum of one year.

HIPAA is asked about on State Boards, taught in nursing school and every patient is given a copy of the privacy policy upon admission.

If someone is working in healthcare and have never heard of HIPAA and don't know how it works, they need to be working in another profession.

Where do you get that you can update the family and friends on anything? By what authority do you pick and choose who gets information and who doesn't without the patient's permission, or do you just give it to anyone who is sober enough to pick up the phone and call and ask?

Seriously...I am very, very surprised that you haven't landed in hot water at your job, because I have personally known of two nurses on my unit that have been fired for HIPAA violations.

We have even been told that we cannot even go and visit neighbors, etc that are admitted to the hospital unless we have been personally notified by them, not because we just happen to come across their information and know they are admitted.

It's a REALLY big deal.

livinthedreamRN · Jul 19, 2010

When my mother was hospitalized for complications from chemo, we designated one family member to receive info from doctors, nurses, etc. That contact person gave information to the rest of the family. That makes it so much easier all around.

I give the same advice to patients when they are admitted, then if someone other that person calls I refer them to the contact person.

livinthedreamRN · Jul 19, 2010

When my mother was hospitalized for complications from chemo, we designated one family member to receive info from doctors, nurses, etc. That contact person gave information to the rest of the family. That makes it so much easier all around.
I give the same advice to patients when they are admitted, then if someone other that person calls I refer them to the contact person.

oops. didn't mean to post this again!! :uhoh3: