HIPAA and Advocate for competent patient - page 2

by akn1563

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I have been an RN for about a year and a half now and I have recently started on days on a cardiovascular step down unit. I had a 29y.o patient who was completely alert oriented and competent. A patient's family member (aunt)... Read More


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    as a soon-to-be nurse, can I ask why not go into the pateitns room, ask him if you can talk to so-and-so and address it that way? I'm asking because that's probably what I'd do and want to see if that is an acceptable practice
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    Quote from krisiepoo
    as a soon-to-be nurse, can I ask why not go into the pateitns room, ask him if you can talk to so-and-so and address it that way? I'm asking because that's probably what I'd do and want to see if that is an acceptable practice
    The other big issue is how do you know for certain the person on the phone is who they claim to be? When my father was critically ill quite a few of over curious liars, I mean "acquaintances" would call seeking information about my father's diagnosis, condition, and prognosis. One trying-to-be-helpful staff member was a bit too forthcoming with info and was overheard by one of my siblings. It was someone claiming to be one of my father's siblings too bad both his siblings were there as were my mother and all his children. Administration was involved shortly thereafter.

    The better option, which the OP DID offer (assuming patient is awake. & alert) is to transfer call to the patient. The "aunt/nurse" in the OP refused this option.
    .
    applewhitern likes this.
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    I had a similar situation, face to face with a patients friend. She was at our facility visiting while the patient was being transferred. She immediately started asking questions and became very upset but I refused to put my license on the line to please her. The HIPPA rules are very clear. Its our job as nurses to ensure they are followed.
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    This is easy-peasy ... that info cannot be shared over the phone. If a patient is A & O, I always defer phone calls to the patient. If they have A&O family with them - that's my second choice. "So and so has called the nurses station - can one of you come take the call, please?"

    And please, PLEASE remember that patients are not always OK with family member discussing the fine details of their care. What young adult really wants his/her aunt to be discussing the color of his/her urine? But it's an easy out for them to just not answer questions, without damaging their relationships - and let the nurse, who they will likely never see again, take the heat.

    And ... WHERE do these nurse family members come from, who think that their licensure means they are entitled to a detailed shift-to-shift report? UGH.
    applewhitern likes this.
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    Even if you walk into the patient's room and ask "Is it OK if I talk to so-and-so on the phone" you have NO IDEA who is really on the other end of that phone! It could be the patient's attorney or a newspaper reporter for all you know. If someone wants access to information at my facility, they have to go through the medical records department. I would rather risk making someone mad at me, than be sued for violating the patient's privacy.
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    Quote from applewhitern
    Even if you walk into the patient's room and ask "Is it OK if I talk to so-and-so on the phone" you have NO IDEA who is really on the other end of that phone! It could be the patient's attorney or a newspaper reporter for all you know. If someone wants access to information at my facility, they have to go through the medical records department. I would rather risk making someone mad at me, than be sued for violating the patient's privacy.
    I'm confused how that works, lets say you have a patient where the POA is the decision maker, you refer them to medical records when they call?
    krisiepoo and Susie2310 like this.
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    We don't discuss the patient on the phone, period. They have to be there in person, unless they have a code to identify themselves with. Yes, if they want to see labs, physician progress notes, etc., they have to go thru medical records. Anyone can call and claim to be a relative or POA; how do you know who is really on the phone?
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    In my area specific identifiers (MR# , code word ) etc are required for phone updates on condition but full report is not given over the phone to callers.
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    Quote from applewhitern
    We don't discuss the patient on the phone, period. They have to be there in person, unless they have a code to identify themselves with. Yes, if they want to see labs, physician progress notes, etc., they have to go thru medical records. Anyone can call and claim to be a relative or POA; how do you know who is really on the phone?
    So if a patient's POA can't be there in person then they aren't the POA?
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    If the POA cannot be there in person, no, we cannot discuss the patient over the phone ~if THEY call US~ because we have no way of knowing who is actually on the phone. WE can call THEM, however, if the doctor requests it and/or we need a phone consent for something. Usually if a patient is incapacitated, they have a POA who is nearby. We are simply following HIPPA, and not just making up our own rules.


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