HIPPA and family members

[blackIrish]

I will try to shorten this long story.

Pt. in hospital has many family members that are physicians. Family member A. (MD)is raising holy hell every time he comes around. Is back *in* the nurses station demanding pt.'s chart be handed to him. He is a family member, not a doc on the case. Treating everyone in his path with disrespect and talking down to all of us. He threatened another MD "I'll fry your ass if anything happens" to said family member.

Management seems to side with this family member.

I am not comfortable with handing over a pt.'s chart to anyone.

I was very professional and accomodating when I told A. that I would try and help him, but I would need to go through the proper channels to make sure I could give him the chart.

Next thing I know, he has MY house officer on HIS cell phone pushing it in my face. I get on and H.O. tells me to hand over the chart.

Day 2-

I requested not to have this pt. because I didn't want to deal with the tornado again. (BTW, the pt. is absolutely lovely)

A. comes in and recognizes me and said "How's he doing?" I explained that I wasn't his nurse tonight, but I will go get the nurse for him. I was up and on my way to help when he said"Give me the chart" I said "I can't give you anything because I was not involved in his care last night, I'll get his nurse" He's mad now. He says "I don't need you, I'll get it myself" (in a very ugly tone)

I get the nurse and he's on his way out to help.

As I go back to what I was doing, A. steps up on me, like he was confronting me "Thank you SO much, you've been SO helpful, really I mean it, Thanks for everything" In a much louder and forceful uglier tone this time.

What is the law? My manager said I am the first one to not hand it over, that is why I'm making them so mad.

I say, regardless of the rights and wrongs, I am allowed to question it, and I should NOT be subjected to that.

I should be able to go to work and expect to not be bullied or harrassed by anyone. And if I am, I think my managers should back me up.

Just needed to vent. What is the rule?

[BlueRidgeHomeRN]

1. you are right.

2. the md-family member is an ass.

3. your management team are spineless wimps.

...but you knew all this already, right?:angryfire

[blackIrish]

Well, I thought I was right.

I talked to my manager this morning and she was reiterating that a pt. has a right to his chart. Period.

And I said "Uh, a PATIENT, maybe, but not a family member"

And even that doesn't sound right. They told us if we look up our OWN lab results or records, we'd be fired. She went off and told some obscure stories of what could happen if we see our lab results and attempt to diagnose ourselves and the MD goes along, and prescribes something and we have a bad reaction, and yada, yada, yada.

WTH???

So, anyway she said the patient could have the chart and decide who got to see it. Fine, but even then, we didn't get that far. He was too busy throwing his weight around.

I don't think I'm seeing clearly. I think I'm gonna wake up a lot more upset than I am now.:icon_roll

[lorilou22RN]

you poor thing...these types of situations chap my ass. He as an MD understands hospital policies etc. and should know rules! not to mention just courtesy. Some of these type of families just like to throw their weight around and use scare tactics, intimidation to get their way. You are right it is abusive to us the health care team, your management are wimps and should back you for doing the right thing. I am sorry you have to deal with this, next time instead of trying to deal with it yourself, direct the whole mess to your manager. Let him/her deal with the ass.:angryfire:angryfire:angryfire:angryfire

[justme1972]

First, there was no excuse of the family member speaking to you that way...that was uncalled for, especially since he was a physician.

Was the patient conscious and alert?

To me, (assumign that he was) it would have been simple...(keep in mind, I'm a student) but why couldn't you just walk into the patient's room and get them to sign a consent form (or asking the attending physician to...I don't know what the procedure is) allowing whoever in the family that the patient wanted to review the charts?

I recently changed physicians, and there was a form I signed where they said, "If you want anyone else to have access to your medical information such as a spouse, parent, relative, etc...just list their names here."

I don't think it's a HIPAA violation if the patient can give consent.

Then again, I am assuming that the patient could give consent....of course, none of this would apply if he couldn't.

Am I incorrect in my thinking?

[EmmaG, RN]

It's a bunch of crap that your management is caving to this ass.

Your hospital has a corporate compliance department that investigates and enforces these regulations. And there is a toll-free number for anonymous reports. Most will give you a numbered ID or case number so that you can call back and check on the decision made.

I'd also contact the hospital's legal department. Find out under what circumstances a family member can legally access a patient's chart, and what hoops they have to jump through to do it.

Finally, I'd consult an outside attorney who specializes in employment law, especially one who has experience in health care. Find out what the laws are in your state regarding harassment of health care workers, and failure of your employer to protect you against such harassment. Armed with this, you can then approach management regarding this situation.

Good luck.

[EmmaG, RN]

Well, I thought I was right.

I talked to my manager this morning and she was reiterating that a pt. has a right to his chart. Period.

In every place I've ever worked, that requires the patient going through the proper channels in HIM, signing consents, etc.

[leslie :-D]

realistically?

i would politely and firmly tell him it is against hipaa violations:

and would thank him not to verbally berate me.

then i would defer him to next in charge.

i don't get paid for this crap.

leslie

[EmmaG, RN]

"He threatened another MD "I'll fry your ass if anything happens" to said family member."

"As I go back to what I was doing, A. steps up on me, like he was confronting me "Thank you SO much, you've been SO helpful, really I mean it, Thanks for everything" In a much louder and forceful uglier tone this time."

His behaviour is bordering on, if it isn't outright, assault. Hospital management best consider this and tread carefully before allowing this to continue.

[blackIrish]

I was right. I am more upset by this as the hours go on.

I was supposed to work tonight, then a unit meeting in the morning. I still had a lot to say and was going to bring it up.

Woke up this morning sick, went to my doc, I have strep. I called in sick tonight.

I am not done with this. I got the vibe from my manager that *I* was being the troublemaker for not just doing whatever he wanted.

[justme1972]

I've been thinking about your post too.

The hospital is setting themselves for a major lawsuit if the patient didn't want anyone else to view their medical records.

To me that "trumps" some physician family member.