HIPAA violations by commanders - your opinion?

[macanes, BSN, MSN, DNP, CRNA]

Ok, I've got to get this off my chest and I want to hear some thoughts from y'all.

BLUF: Hospital commander comes to preop and/or PACU for field-grades before or after surgery -- I say HIPAA violation certainly, but invasion of privacy at very least.

Background: My hospital commander (I'm now a civilian contract CRNA) comes to the preop are or the PACU to see so-called command interest patients. She's not the only one. I have seen others (i.e., section/head nurse types, senior NCOs) visit their troops before or after surgery.

I've also seen civilian sector executive types do the same when their management types have surgery. I've also seen folks go up the the L&D floor when a staffer is on the labor deck.

My premise is that in none of these cases is it anyone's business to be seeing these patients.

* These folks are in a potentially high-stress state of mind (awaiting the knife, in labor, etc.).

* Perhaps they don't want anyone to know they're having their hemorrhoids or uterus removed -- or even a ditzlectomy -- they shouldn't have to tell beyond "My doctor says I need to have surgery."

* They are in a flimsy hospital gown which might or might not fufill their sense of modesty.

* Some of them are a little quiver-lipped when we start their IVs (who wants their boss to see that?).

* I'm pretty sure that NO female wants non-family/non-staff walking into her labor room (correct me here, ladies, if you think I'm wrong).

* Finally, their _families_ are not allowed the same visiting priviliges.

* . . . ETC . . . etc . . . .

What really burned my tail about this morning's visit was that while the commander -- a non-clincal MSC type -- was chatting with the patient, she also felt the need to criticize the fact that the PACU nurse had had to stick the patient twice, unsuccessfully. Heck, I've had days when I couldn't hit the broadside of a barn with a 20g (OK, not lately, but I've had them). That REALLY chapped my hide on top of the main issue (so I started the IV).

Trust me, I am NOT some touchy feely type who wants to cuddle my patients to make the pain go away. I AM a total professional who believes that the rules (HIPAA training, the so-called patients' bill of rights, but mostly the common sense of privacy in our society) must apply to everyone. I am totally down with commanders keeping track of their troops (I would be more impressed if more commanders knew the names of their troops) for unit purposes. I submit that they should go through the surgeon -- that is, the surgeon recommends XX days convalescent leave, and the commander is free to take it or leave it and ask why, and to ask about the fighting effectiveness of Troop Smith or Jones in relation to their recovery for the job. Period.

Ok, any thoughts. I might add to this later -- pretty steamed right now.

CRNA in Georgia