HIPAA and picking patients

[cathering, ADN, BSN, MSN, APRN, NP]

Hello all.

I am a nursing student and I have some questions regarding HIPAA and picking patients.

I was in the ICU one day and I saw a pt transferred to the unit from the ER after she had been found unconscious after a massive heart attack (she died shortly after being transferred). She was my RN's patient and at first, I had no idea why she was there or what was going on with her.

My RN was super busy because she and other staff were trying to do hypothermic therapy? And I was sooo tempted to go into her chart and see why she was there. But I stopped myself because she wasn't technically my patient.

But on the way home I was thinking... As a student RN I am encouraged to look through the units' patients and pick the patient who meets my objectives for the day. So can I look at other patient's charts to see what's going on especially since she was my nurse's patient? But what if she wasn't my nurse's patient but another nurses?

I am a little confused at my limits regarding HIPAA as a student. It seems like anytime I ask any RN on the floor "can I ask what is going on with this patient?" All the RN's I've asked seemed more than willing to share the info. Is this technically a violation for them?

I can't ask my instructor since I'm on break...

Thank you in advance!

[krisiepoo]

As a student, I never looked at any charts other than the people I was assigned. I even had one guy who I was assigned to one weekend and the next weekend I came he was still there but wasn't assigned to me and I wouldn't look in his file at that time.

I know you wanted answers now, but I would clarify this with your instructor as I assume you won't be in the hospital until break is over, right? I don't think the RN's on the floor are violating HIPAA but before you leave a digital footprint in a case, I'd make sure it's OK through your instructor, not the floor RN's

ps, hypothermic therapy is REALLY interesting (at least to me) so do some research on it to learn more. Our bodies are amazing machines

[cayenne06, MSN, CNM]

As a student, you may look at the charts of patients not assigned to you, as long as you are looking for educational purposes. That is a permitted use, covered under "health care operations."

Uses and Disclosures for Treatment, Payment, and Health Care Operations

[cathering, ADN, BSN, MSN, APRN, NP]

Thank you I appreciate the response! I feel it's a gray area as students. I'll definitely be asking my instructor once semester resumes.

Thank you again!

[bebbercorn]

I'd also add, don't be scared to say to said nurse or the charge nurse, "I know you're super busy, but do you mind me looking into this a little," also, ask questions of your assigned preceptor. When I have student nurses on the floor and I'm doing something you don't see everyday, I try to pull them into the room, even if they aren't my student. Some are eager and excited, some are just there to finish hours. You can tell which ones I like ;-)

[HouTx, BSN, MSN, EdD]

This is such a great question - this issue should be clarified for all students by their instructors prior to beginning clinical practicums.

[vintagemother, BSN, CNA, LVN, RN]

As a student you may look at the charts of patients not assigned to you, as long as you are looking for educational purposes. That is a permitted use, covered under "health care operations." Uses and Disclosures for Treatment, Payment, and Health Care Operations

This is what I was taught in school.

[elkpark]

I'm always a little shocked to hear that there are nursing programs that allow students to choose their clinical assignments ... That's not something I experienced as a student, or has been done in any of the programs in which I've taught (nor would I be willing to work in a system in which that was done).

[Esme12, ASN, BSN, RN]

I would clarify it with your school.....if they are sending you to a facility to pick a patient they expect you to look in the chart. You may look into the chart if it is for the purpose of educational purposes. but I would check with your school. You can also ask the charge nurse if there is any interesting patients you may take care of.

[kakamegamama]

I also taught for numerous years...both BSN and ADN. We only assigned the first patients, then afterward gave the students instructions as to what to look for, objectives they needed to meet, etc. and had them choose their own. THEN if we disapproved, they had to choose another. Some faculty had them choose again on that particular day, others (myself included) might or might not, depending on how the student was progressing, etc. The only exception was in L&D....assigned them there.

[cathering, ADN, BSN, MSN, APRN, NP]

I agree that this issue should be clarified from the instructors in the beginning. I am definitely going to ask my instructor once the program resumes.

I think I am pretty safe going into other patient's charts since it is for "educational purposes" but I can't help feel that it might be a violation. If I were the patient or their family member, I wouldn't feel 100% okay with random students looking into the chart. I was curious about how the patient was brought in and why she needed the hypothermic therapy. I wouldnt technically have gone through it to give any care to the patient... I feel it's such a gray area!

Thank you again for responding everyone.

[cathering, ADN, BSN, MSN, APRN, NP]

I'd also add don't be scared to say to said nurse or the charge nurse, "I know you're super busy, but do you mind me looking into this a little," also, ask questions of your assigned preceptor. When I have student nurses on the floor and I'm doing something you don't see everyday, I try to pull them into the room, even if they aren't my student. Some are eager and excited, some are just there to finish hours. You can tell which ones I like ;-)[/quote']

I love this! I have even fortunate to have met nurses like you. Thank you!!