HIPPA and the Allnurses.com Forums

[Tait]

Lately I have been thinking about this issue.

How kosher is it that we chat about our patients on this public forum?

Being a recent grad I am so used to the educational environment of discussing patients amongst peers, and I think a lot of people feel that is the case here, however how much is too much?

I try very, very hard NOT to list patient stories, even though some of them I would love to tell. I reserve one special story about my first loss of a patient to cancer for sharing because I know he would want me to continue to learn and grow from his experience. (His life and advice caused me to pursue a few major goals, like moving six states from home to be with the one person in the world for me, my fiancee).

How do you personally deal with the need to explain stories, but not violate confidentiality?

Taitter

Addendum: Since a lot of people will read the initial post, and then comment (which is fine) I feel I need to clarify. This thread is about HIPPA and the forums, incited by a post which discussed in detail a patient and thier situation. I was attempting to point out how easy it is to ascertain information on a patient by knowing where the POSTER is posting from (ie city, state etc).

I used myself as an example, I previously posted my location, in my profile because I DO NOT discuss my patients in an open forum. Therefore the risk of a HIPPA violation for me is not something I feel I run the risk of. Therefore I do not feel is completely necessary to conceal my city, especially a large metropolitan area.

My post was misconstrued and became a conversation about my personal "anonymity" values.

I have removed my location now just because now I DO suddenly feel there might be more of a personal risk here than I previously thought. I guess we tend to think we, personally, are safe among our peers, but I have rethought this.

I don't often start posts, I prefer to stay in the First Year Nursing category and offer support there as I have just completed my first year and have some insight into newbie fears.

I am not sure if this clears things up, but if this thread continues to be about me personally I will have to ask for it to be removed.

[tnbutterfly - Mary, BSN]

Tait, I think you have brought up a great topic for discussion and something all members who post here need to be mindful of. Thanks for your insight into this potential problem for those who post too many details in their posts that could lead to possible identification of patients/healthcare providers.

If any member reads a thread/post that you feel has too many identifing details and might violate Allnurses TOS regarding personal details, is a HIPAA violation, or is any way inappropriate, please report it using the red triangle report "button" located in the top right-hand of each post.

[Brian, ASN, RN]

tait, yes, thanks for this great topic!

the best way to report objectionable post is to report is using the following method. this is the fastest way for all the staff to act on it.

from our terms of service

how to handle personal attacks or objectionable material

if you are ever in a position where you feel you have been personally attacked, do not respond to that attack. please report the post using red triangle at the top of each post, you can submit your comments of why you are reporting the post. the staff will be notified with your comments for that specific, this is the most efficient way to report post. let the staff deal with the problem, if you respond to that attack, you may find yourself removed as well, and we don't want to see that happen.

considering the real-time nature of this bulletin board, it is impossible for us to review all messages or confirm the validity of information posted. please remember that we do not actively monitor the contents of posted messages and are not responsible for any messages posted. we do not vouch for or warrant the accuracy, completeness or usefulness of any message, and are not responsible for the contents of any message. the messages express the views of the author of the message, not necessarily the views of this forum or any entity associated with this forum. any user who feels that a posted message is objectionable is encouraged to contact us immediately using the report button. we have the ability to remove objectionable messages and we will make every effort to do so, within a reasonable time frame, if we determine that removal is necessary. this is a manual process, however, so please realize that we may not be able to remove or edit particular messages immediately.

we are the largest nursing discussion forum on the internet. we are dealing with 250,000+ of members with and an average of 1600 posts per day. when you grow to a bulletin board of this size, it becomes more difficult to moderate it. presently, we have 20+ volunteer moderator and admin staff who monitor this board periodically throughout the day. they are here to help -- please feel free to contact them with any problems you may have. on the other hand, they have been instructed to enforce our zero-tolerance policy. our biggest concern here is the quality of membership not the quantity. we have no problem removing any individual who disrupts this bulletin board.

[Virgo_RN, BSN, RN]

I'm guilty of posting about a patient, but I'd like to think that I did so while protecting the identity of the patient. For me, it was an interesting case study and I felt pretty good about how I had anticipated and prepared for the potential change in the patient's condition. I'm at a point in my practice where I'm starting to be able to anticipate complications and be proactive, rather than simply being task oriented trying to get through my shift without making a mistake. It feels good to get to this point, and I was tooting my horn a little. I doubt that anyone will be able to identify the patient from the information I gave, and my hope is that it might even be a case study that others could learn from. I hope I didn't do anything wrong or contrary to the TOS.

[NJNursing, ASN, RN]

I kind of feel like this is personally attacking my post and I'm already upset about all that was said there. I didn't mention anything about who the person was, what hospital I work at, what floor. There are at least 10 hospitals within a 20 minute drive of my house and many of them bigger than mine. Even Philadelphia is about a half hour from my house (depending on traffic). So for people to jump the gun saying I posted too much. I don't believe I violated anything NEAR what HIPAA related and I stuck to what was true and honest in my post. To me the details (and I'm not going to sugar coat anything. If we did something wrong, we did something wrong) were relevant to the story and as most of my friends are newer nurses like me, NONE of them had this sort of experience so I felt like I could come here and not get overly judged on it.

[Tait, MSN, RN]

I apologize if you feel this was "attacking" your post. It was in no way meant to. It was however initiated after I got a sick feeling in my stomach for you when someone suggested you violated HIPPA in your post. I felt BAD for you because you already seemed stressed out as it was, and then on top of it someone threw that in there. I will voice no opinion on wether or not I feel you violated HIPPA as the post has already, apparently, been edited for patient content.

But in the end this IS something we all need to be aware of, and even though your situation happened to be the situation that made me think about writing a post about it, hopefully it will save someone in the future that sinking feeling of "have I said too much" which I am sure is what you felt.

Best intentions,

Tait

[cmo421]

HIPPA is actually a joke. Pt confidentiality and respect is more the answer. Hospitals and such are throwing HIPPA at us all the time ,when actually they,and insurance companies are the greatest rule breakers. One chart and all its information is seen in detail by so many people ,it should just be published. If one researches pt privacy and all that is published and sold out there in the info world, u would be astonded.

As medical professionals, it is our duty to protect our pts rights and privacy,the best we can. In speaking of them in the third person,or using them as an example in discussion,just be smart and use very limited info.

I have never seen anyone step over the boundaries here myself. This forum is a wonderful site for learning from others. Do not take rules to the extreame.Utilize them in your practice and encourage them in others.

If you really have an issue with HIPPA and such. Advocate for a change in pt privacy laws.Think about this.Pharmacies sell your information all the time. Your social security number is actually public information. If only once, you have put that number on a public document,it is considered fair game.

[Tait, MSN, RN]

HIPPA is actually a joke. Pt confidentiality and respect is more the answer. Hospitals and such are throwing HIPPA at us all the time ,when actually they,and insurance companies are the greatest rule breakers. One chart and all its information is seen in detail by so many people ,it should just be published. If one researches pt privacy and all that is published and sold out there in the info world, u would be astonded.

As medical professionals, it is our duty to protect our pts rights and privacy,the best we can. In speaking of them in the third person,or using them as an example in discussion,just be smart and use very limited info.

I have never seen anyone step over the boundaries here myself. This forum is a wonderful site for learning from others. Do not take rules to the extreame.Utilize them in your practice and encourage them in others.

If you really have an issue with HIPPA and such. Advocate for a change in pt privacy laws.Think about this.Pharmacies sell your information all the time. Your social security number is actually public information. If only once, you have put that number on a public document,it is considered fair game.

You have made a point. I used the term HIPPA because generally it will alert nurses to issues of privacy and information protection. Maybe I will retitle my thread "Patient Privacy and the Allnurses.com Forums"?

[cmo421]

Just stating what I have learnt in recent months from personnal experience. I am also a huge advocate for pt privacy,and have been way before it became vogue. I think it is mostly common sence and ethical values that will encourage the profession to maintain our pt's rights. The powers that be in hospital certification have made this a vogue issue and now it is all the thing. Funny thing is,hospitals and such pay these organizations to certfiy them ,and pay them well. It is all a public image thing basically.

[nghtfltguy, BSN, RN]

you started quite the thread tait.....

bravo~~~

[Ruby Vee, BSN]

I would just advise to make the post as annonymous as possible. Many times the fine details are not relevant to the discussion.

For example, do not mention location, floor, hospital, names, sex of pt, unless relevant to story, date or anything that could identify the specific situation.

Keeping these and other tips already mentioned above, I don't think there would be a problem. I'm sure others could offer more suggestions or examples of "do's and don'ts".

As for not having your location in your profile, I don't think that is necessary. But each of you can decide that.

Over the years, I've accumulated many stories, and most of the stories I tell are old enough that if anyone DID recognize anyone, they'd have to be ancient. (Or omniscent.) Even then, I usually alter significant details or preface the story by stating "Many years ago and in another state . . . "

I have had threads closed or edited because of "too many personal details," which struck me as funny because those details (name, location, gender) were all made up. I guess there might really be a nursing unit somewhere populated by nurses named Hortense, Hildegarde, Agatha and Olga but probably not in this country or this century!

Most stories can stand to have significant details altered without changing the point of the story.

[NJNursing, ASN, RN]

I apologize if you feel this was "attacking" your post. It was in no way meant to. It was however initiated after I got a sick feeling in my stomach for you when someone suggested you violated HIPPA in your post. I felt BAD for you because you already seemed stressed out as it was, and then on top of it someone threw that in there. I will voice no opinion on wether or not I feel you violated HIPPA as the post has already, apparently, been edited for patient content.

But in the end this IS something we all need to be aware of, and even though your situation happened to be the situation that made me think about writing a post about it, hopefully it will save someone in the future that sinking feeling of "have I said too much" which I am sure is what you felt.

Best intentions,

Tait

Thanks for the clarification. I feel better about it. I'm just glad that the pt is gone and all is done with, but it leaves me a little bitter.

[Tait, MSN, RN]

Thanks for the clarification. I feel better about it. I'm just glad that the pt is gone and all is done with, but it leaves me a little bitter.

I don't blame you. There is nothing quite like thinking you have done something helpful and suddenly getting chastised for it.

:icon_hug:

Tait