HIPAA and Advocate for competent patient - page 2

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... Read More

  1. Visit  Altra profile page
    1
    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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  3. Visit  applewhitern profile page
    0
    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.
  4. Visit  MunoRN profile page
    2
    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.
  5. Visit  applewhitern profile page
    0
    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?
  6. Visit  JustBeachyNurse profile page
    0
    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.
  7. Visit  MunoRN profile page
    0
    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?
  8. Visit  applewhitern profile page
    0
    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.
  9. Visit  ktwlpn profile page
    0
    Quote from LadyFree28
    I am a healthcare proxy for a few of my family members because I am the only nurse in my family-before your ask; I am a practicing, licensed nurse-I NEVER overstepped a nurses practice when it came to caring my family members, or demanded that they breach HIPAA.
    Then good for you for not sucking up various staff member's time for a ridiculous reason. You are one of the few in my experience.Nurses I have worked with for years have been some of the most unreasonable family members when their loved ones have been in the care of others. People who have no excuses-except that maybe they think the rules don't apply to them? And it's a sad comment on health care to think that the only safe patient is one with a nurse in the family to communicate for them. Isn't it our duty to give patients and their loved ones the information they need to heal and stay healthy in a dialogue that they can understand? We have to learn to speak to them on their level, we educate over and over and over.That's what we do.
  10. Visit  Esme12 profile page
    0
    Quote from applewhitern
    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.
    First it's HIPAA not HIPPA and there are not HIPAA requirements that say the POA has to be in person. Your facility has interpreted HIPAA their way and instituted policies accordingly which you must follow as an employee of that facility.

    There is NOTHING in HIPAA that states information cannot be released over the phone. Information can be released with the patients permission. This is an interpretation of HIPAA regulations and yes they are making up their own rules on how they feel HIPAA regulations are complied with at your facility.

    HIPAA states what must be done...how each facility does this is their interpretation and facility policy.
  11. Visit  Susie2310 profile page
    0
    My legally competent family member was recently hospitalized. I am the POA and in addition to the POA I have an authorized statement signed by my family member and witnessed and notarized by a lawyer according to the laws of my state that grants me the powers to advocate for my family member's health care needs even if they have not been determined to be incompetent. It authorizes release to me on my request all of my family member's medical records, pursuant to HIPAA. It specifies that my family member intends me to be dealt with by their health care providers, as required by law, as they would be dealt with themself regarding protected health care information.

    I telephoned the nurses station from home and told my family member's nurse who I was and why I was calling. I had been by my family member's bedside for most of the day and night and had previously spoken with the nurse. I am happy to say I didn't need to resort to saying I would scan and e-mail the POA and the other document (the former of which was on file) if that would suffice for them to identify me. If anyone, whether nurse or administrator had refused to talk to me or give me information I was entitled to receive about my family member, I would have called a lawyer as soon as I could.
  12. Visit  ktwlpn profile page
    0
    Quote from Esme12
    HIPAA states what must be done...how each facility does this is their interpretation and facility policy.
    I remember way back when in the LTC when the whole HIPAA thing started our former DON decreed that this meant the residents names could not longer be on the wall outside of their door.Thankfully some of the other staff talked her back off of the ledge.
  13. Visit  ktwlpn profile page
    3
    But anyone could have called and claimed they were you. That's why so many hospitals have a policy in place -code words or numbers,etc. How many of us have ever gotten a call of spoken to a visitor who turned out to be an ex- wife or some long estranged family member just looking for dirt? It happens all the time.
    And I just don't understand the willingness of competent adults to give this kind of control to a family member unless they are elderly or infirm or circling the drain.To me it reveals a lot about the patient-I tend to assume they don't want to take an active role in their careplan.
    GrnTea, applewhitern, and Altra like this.
  14. Visit  springchick1 profile page
    3
    Quote from "Susie2310;
    If anyone, whether nurse or administrator had refused to talk to me or give me information I was entitled to receive about my family member, I would have called a lawyer as soon as I could.
    I think this is one reason people are so careful about giving out information to someone,especially over the phone, because there is always someone great ending to go to an attorney.
    ktwlpn, applewhitern, and Altra like this.


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