Would this be a HIPAA violation?

  1. I had the pleasure of taking care of the cutest little ole lady for 2 days in clinical. She was my only patient so I spent a lot of time in her room talking with her. This lady was in the hospital for pneumonia, plus she got a kidney transplant from a relative. She had to get a biospy yesterday after I left.

    Today, I was on my way out while the doctor was coming in. The patient wanted me to stay with her while the doctor delivered the news of her biospy, her transplanted kidney had a lot of scar tissue and it's a big possibility she will have to go back on diayalsis. She was devasted. She pleaded with the doctor to come up with another solution. This little ole lady was just so positive for the 2 days I cared for her, I started to tear up myself, but kept my composure and kept it professional.

    I told the patient I was so sorry to hear that and gave her a hug. She wanted me to come back and see her and meet some of her family members. She even invited me to a family picnic.

    I told her I couldnt come back to see her, as my clinical time was up (although I do attend school at the hospital I do clinicals). I told her I couldnt attend her picnic either, it was against policy.

    This lady really touched me. I find myself thinking about her and how she's coping. I was wondering would it be a HIPAA violation if I sent her a get well card? I just want her to know I'm still rooting for her and she's not easily forgotten.

    Your thoughts?
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  2. 12 Comments

  3. by   TazziRN
    no. hipaa violations occur when you share info or go snooping.

    do not use your own return address if you send a card, use the school's.
  4. by   Jolie
    Why not ask your instructor if this would be OK? Even though it is probably not a HIPAA issue, your school may have a policy about communicating with patients.
  5. by   Turd.Ferguson
    [CODE]She even invited me to a family picnic.
    [/CODE]

    Assuming from your writing that the lady is going to be discharged to home, it would be a violation to get the lady's home address from her chart in order to mail the get-well card.
  6. by   TazziRN
    Quote from Turd.Ferguson
    [code]She even invited me to a family picnic.
    [/code]

    Assuming from your writing that the lady is going to be discharged to home, it would be a violation to get the lady's home address from her chart in order to mail the get-well card.
    Why? HIPAA is about protected MEDICAL information. Since when is an address medical info?
  7. by   Turd.Ferguson
    [CODE]HIPAA is about protected MEDICAL information. Since when is an address medical info?[/CODE]

    There is a common misconception that HIPAA protects only medical information. In actuality, the HIPAA privacy regulations are about PHI (Protected Health Information). An address is certainly protected information (see section 164.514 of the Code of Federal Regulations). A good explanation of what is considered protected health information is at

    http://privacyruleandresearch.nih.gov/pr_07.asp
  8. by   shoegalRN
    Quote from Turd.Ferguson
    [code]She even invited me to a family picnic.
    [/code]

    Assuming from your writing that the lady is going to be discharged to home, it would be a violation to get the lady's home address from her chart in order to mail the get-well card.
    I wasnt gonna send her a good well card to her house. I was gonna send it to the hospital. I personally wanted to give it to the volunteers to take to her room. How is that a HIPAA violation?
  9. by   Altra
    Quote from nurse2be09
    I wasnt gonna send her a good well card to her house. I was gonna send it to the hospital. I personally wanted to give it to the volunteers to take to her room.
    A good idea. But do check with your instructor first. There are some seemingly weird policies out there, but they all have their roots in good intentions gone awry.
  10. by   Ms Kylee
    Quote from MLOS
    A good idea. But do check with your instructor first. There are some seemingly weird policies out there, but they all have their roots in good intentions gone awry.
    That's why I won't send sympathy cards to patient's family members that I have taken care of that have passed. I won't go to the funeral home or funerals either. I don't want to run the risk of jeopardizing something that I'm working so hard for.

    Your intentions are sweet though.
  11. by   Blee O'Myacin
    I'm not concerned so much about the HIPAA violation as I am with the inappropriate attachment to the patient, and that the patient has with you.

    We all have patients that we remember and have touched our lives in a personal way, but part of becoming a professional is learning how to separate ourselves and end our therapeutic relationship when it is time to do so. In this case, the end of your clinical weeks was the time to end your relationship with this patient. You did the right thing by saying no to the family picnic invite - but I know that it is still upsetting you, just by the tone of your post.

    It's impossible to let every patient we come in contact with become a part of our lives outside our assigned shift. The human psyche just isn't equipped to deal with that kind of information and emotional overload. That's why the rules are there.

    I urge you to discuss this with your instructor - or someone else who can provide better insight into helping you learn to separate clinical with your personal life. I promise that you won't lose yourself and all the things that will make you a competent, caring professional.

    Take care,

    Blee
    Last edit by Blee O'Myacin on Mar 29, '08 : Reason: getting the facts straight..
  12. by   shoegalRN
    Quote from Blee O'Myacin
    I'm not concerned so much about the HIPAA violation as I am with the inappropriate attachment to the patient, and that the patient has with you.

    We all have patients that we remember and have touched our lives in a personal way, but part of becoming a professional is learning how to separate ourselves and end our therapeutic relationship when it is time to do so. In this case, the end of your clinical weeks was the time to end your relationship with this patient. You did the right thing by saying no to the family picnic invite - but I know that it is still upsetting you, just by the tone of your post.

    It's impossible to let every patient we come in contact with become a part of our lives outside our assigned shift. The human psyche just isn't equipped to deal with that kind of information and emotional overload. That's why the rules are there.

    I urge you to discuss this with your instructor - or someone else who can provide better insight into helping you learn to separate clinical with your personal life. I promise that you won't lose yourself and all the things that will make you a competent, caring professional.

    Take care,

    Blee
    You are right, this patient has touched me more than other patients I have taken care of in the past, either in clinicals or at work.

    I've never had an issue with leaving issues at work, but this lady's diagnosis about her kidney biospy just pulled at my heart, after knowing everything else she's been through in her life (according to her stories).

    I admit, I brought this one home with me and hence, me writing this thread. But I prayed about it, and I think this lady will be just fine in the end.

    Thanks for your advice and I will consider speaking with my instructor about this.
  13. by   elkpark
    Like some of the others here, I'm not worried as much about it being a HIPAA violation as I am about it being a boundary violation. I have a lot of years in psychiatric nursing, where we are, generally, more conscious and persnickety about boundaries than the rest of the healthcare world, and maintaining a relationship with a client outside/beyond the boundaries of the professional relationship (in your case, continuing to communicate with her, even by sending a card, after you've completed your clinical rotation) would be considered a big no-no. Ditto for taking the initiative on something like communicating privately with a client, outside of clinical, without including your instructor in the decision to do that ...

    Please do talk to your instructor before taking any action on your own.
  14. by   aleena23
    is this a violation nurse practitioner called due to lab works bec the family is asking her, knowing the nurse practitioner , and after that she asked for the face sheet to fax to her . thanks

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