HIPAA with other nurses

[jkclark]

I have always had a hard time finding a balance between wanting to know and find out questions about a patient's particular case from other co-workers and trying not to violate HIPAA. I know it is a fine line and would appreciate any input. Thanks.

[Lunah, MSN, RN]

If you don't have a need to know, it's best to not ask! It puts your coworkers in a bad spot, too. If you are curious about a presentation or diagnosis, that might be something your educator can address.

[Sour Lemon]

On my unit, we tend to work together and do quite a bit for each other patients. HIPAA is not much of a concern.

[JKL33]

[My comment is specifically with regard to inquiries or information-sharing for educational/professional growth, not inquiries that are of a merely curious nature]

I think it's a crying shame to have to worry about this, especially given how conveniently-selective places tend to be with adherence to their own supposedly hard and fast rules (i.e. their take/opinion) on what is meant by Need to Know.

I have read and skimmed large portions of the rules many times and can't find a reason why inquiry that is educationally-purposed is not acceptable under the umbrella of operations. Entities actually are tasked with tweaking their own privacy practices, but one of the specific examples given in the rules themselves is that hospitals may elect to allow nursing staff to access information on all patients on a unit the staff member is working. Kind of makes sense since we are expected to collectively be responsible for all of them.

Places that want to make trouble over this make it crystal clear that they don't consider RNs to be professionals of any caliber whatsoever.

[Nurse SMS, MSN, RN]

I think "education based" became a bit of an umbrella under which "curiosity" has hidden.

Two individuals have lost their jobs in my place of employment this month due to HIPAA violations. The "need to know" marker is a good one to remember. The reason this is so touchy/sticky is because of the enormity of the fines plus liability in a lawsuit should the patient who was violated choose to pursue it. This was a case in which the information was interesting enough to cause widespread laughter and incredulity throughout the department. The facility had no choice but to act on it given the situation. As far as it meaning they don't see nurses as professionals, I just don't see how that holds water. It was clearly unprofessional behavior.

[psu_213, BSN, RN]

Asking for a very brief, general update on a pt you cared for in the past? I'm not a legal expert, but I suppose this could technically be a violation, but I would not think (just my opinion) that anyone would get in trouble for such an inquiry/answer. For example, "I took care of Mrs. Jones 2 days ago. She's not here anymore. You were here yesterday, do you know what happened?" "Yes, she went home/to the ICU/to the OR/left AMA, etc." Again, I don't think anyone would make a big deal of this.

Anything thing even remotely gossipy or dealing with a particular condition....stay away. An example: "I drew an HIV test on Mr. Smith last week. Do you know how that came back?" Unless you were stuck with a dirty needle used on Mr. Smith, you have no right/need to know this.

If there is a legitimate education question, go through approved channels--nurse education, NM, etc. Don't take it upon yourself to look up patient information even if it is truly a learning experience.

[Have Nurse, ADN, RN]

On my unit, we tend to work together and do quite a bit for each other patients. HIPAA is not much of a concern.

As long as it has to do with you needing to know to perform direct care for them, that is acceptable.

[CBlover, BSN, RN]

There is a lot of truth to what others are saying regarding asking your coworkers regarding other pt's and how that can violate HIPAA, but anyone that has worked in a hospital-type environment knows that everyone asks everyone. And if they claim they've not seen that they're simply telling a fib. I'm not talking about going and gossiping, but pt care-wise, yes. If you work on a say, med-surg floor and you ask your coworker, "Hey why are they giving Lopressor to so-and-so?" and she goes and says you're violating HIPAA, you should quit that dang job. Like SourLemon said, you all work together. Now if you called another floor and inquired about a pt sure that's a big no-no. And HIPAA seems to be becoming an accessing-electronic-records-thing here lately. Never access a pt's electronic record that you aren't caring for in some way. I work in an ED. We may be in others charts on a daily basis because we work as a team. If you abide by the basic rules and respect others it becomes second nature and you don't have to fear violating it.

[SeasonedTech]

Exactly. We work as a team on my floor.

[JKL33]

I think "education based" became a bit of an umbrella under which "curiosity" has hidden.

Two individuals have lost their jobs in my place of employment this month due to HIPAA violations. The "need to know" marker is a good one to remember. The reason this is so touchy/sticky is because of the enormity of the fines plus liability in a lawsuit should the patient who was violated choose to pursue it. This was a case in which the information was interesting enough to cause widespread laughter and incredulity throughout the department. The facility had no choice but to act on it given the situation. As far as it meaning they don't see nurses as professionals, I just don't see how that holds water. It was clearly unprofessional behavior.

Didn't have occasion to notice this in regard to my previous comment until now.

I prefaced my comment specifically by stating I was not referring to inquiries of a "curious" nature - such as spreading what amounts to medical gossip for the purpose of entertaining others or being entertained, which is the situation you are talking about that was rightly disciplined. Not sure how much more clear I could have been that that's precisely what I was not talking about.

How my comment holds water is by the fact that "need to know" has been applied in absurd ways, specifically with regard to chart review for the purpose of education, such as reviewing previous care and trends in patient response to interventions. You know, orientee spends hours working to correct severe metabolic derangement. Next day: How is that patient now (or did they survive) or what happened next? Are things improving? What additional interventions were undertaken for them to finally turn around? I will stand my ground that this type of inquiry is not nosy curiosity; it is nearly crucial as far as knowledge synthesis for several types of learners. I've actually had it suggested that a better thing to do would be to ask the librarian for case studies. Right....instead of continuing to study the scenario we are already intimately familiar with, that actually means something to the learner because they have a picture of it in their mind. Come on. Might as well watch nursing videos on YT.

It's a perfect example of HIPAA gone awry. No covered entity is going to get fined for such activity because it is not a violation.