HIPPA and Parents of Minors - page 3

I'm a prenursing student and a mom. A friend of mine just was told that due to new HIPPA laws, she could not go into the physical exam room with her 12 year old son. Is this a new law? Or did the... Read More

  1. Visit  Altra profile page
    1
    Quote from morte
    I wouldn't think it all or nothing. I think an initial parent/child visit, then parent goes back to waiting room.
    The dentist did this in reverse ... exam first, then consultation with parent.

    The pediatrician group had the parent present while vital signs were obtained and height & weight checked, to identify any areas of concern and answer screening questions which required parental input.

    I didn't mean to imply that the parent had no interaction at all with the providers.
    r.dav likes this.
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  3. Visit  morte profile page
    0
    Thanks for the clarification. I went to doc so infrequently at that age that i can't remember when parent stopped going in with me!
    Quote from Altra
    The dentist did this in reverse ... exam first, then consultation with parent.

    The pediatrician group had the parent present while vital signs were obtained and height & weight checked, to identify any areas of concern and answer screening questions which required parental input.

    I didn't mean to imply that the parent had no interaction at all with the providers.
  4. Visit  nursel56 profile page
    0
    vintagemother-

    I spent some time reviewing the laws that relate to minor consent in California. The bulk of those guidelines were published in 2002. There is a law under consideration that Governor Brown has not signed yet, AB 499 that adds the ability for a minor to consent to treatment of STDs, the main purpose of which is to be able to get the Gardisil vaccinations for the prevention of cervical cancer without parent's consent.

    The purpose of the laws is to allow a minor to consent to treatment themselves, without the permission of the parents or legal guardians. It isn't meant to try to cut the parents out of the process, which is not standard practice in California nor does the law require that children be examined without the parent present.

    Parents and/or providers may prefer to speak with the child alone, but again there is no legal requirement that this occur, which makes sense when you consider how vastly different both provider's personalities are and the developmental stage an adolescent child is in. As someone who is a parent and worked for many years with kids, both inpatient and outpatient, I know such a blanket requirement could end up being as harmful as it can be helpful. That's why the power to choose who the provider is and when to discontinue seeing an individual provider is left to the parents or legal guardians.
    Last edit by nursel56 on Jun 10, '12
  5. Visit  vintagemother profile page
    0
    Thank you for the additional information, nursel56.

    Spidey's mom: Re: "my kids heard the details about puberty from good old mom (masturbations, wet dreams, STD's, etc.) I've always been very blunt with my kids. I definitely think I should go back for most things but there are times when a private chat with the doc is a good idea too" for the most part, this describes how I feel and what I've done, as well.

    Altra: RE: "...the lack of recognition that a patient will most likely provide accurate answers to questions and get the benefit of health care providers' answers to their questions if they are not accompanied by family."

    Respectfully, I'd like to explain that the problem I personally have is a child isn't always the best advocate for him or herself. Some adults have trouble advocating for themselves at a doctor. With a child, you have lots of other dynamics at play-age, social status, authority, etc.

    Another relevant issue is that every adult does not have the same moral and ethical lifestyle that I want my children exposed to. As an example, my health plan gives a handout to 12 year old children detailing and explaining alternative lifestyles. Parents are not provided with the same copy of the same document.

    For me, as a parent, I want my children to be given facts. I want their questions answered and I'm okay if they get a different perspective from another adult besides myself. However, sometimes different adults have different lifestyle choices and these personal feelings can impact the info a kid is given. One adult might think it's okay for kids to have sex with whomever as long as they use condoms and birth control. Another adult might tell a child to wait until they area emotionally ready. Another medical person might discuss "mutual monogamy".

    I give my kids facts, but I have a certain expectations for behavior. Some adults have a different expectation. I think most parents and professionals know that children often rise to meet our expectations. My expectation might be totally different than that of the physician treating the child. It's one thing when a child has a question to ask the doctor or health care worker; it is a different matter (in my opinion) when the medical professional tells the child their beliefs and provides medical care based on that.
    Last edit by vintagemother on Jun 16, '12
  6. Visit  nursel56 profile page
    0
    I think it would be very rare for a provider to proceed with a physical exam of a teenage boy if the boy tells them he is uncomfortable with his mother in the room.

    Since you are attaching your posts to old threads nobody has commented on in a year, and the threads aren't exactly what you experienced maybe you would get better responses if you start your own thread about your concerns.
  7. Visit  jadelpn profile page
    3
    There is both state laws and there should be facility policy on the treatment of teenagers. Most are age based and state that a teenager can be treated without a parent in the room. They have specific rights to privacy. But all of the treatment team need to be on the same page about it. Then that gives the nurse the support to say to parent "If you would excuse us, I will come and get you in a few minutes after your son has his exam, then you can speak to the doctor". If you have the support to set boundries, set them.
    If your facility has no such plan in place then do what you can to ensure privacy. Have the boy change into a gown in the bathroom. Insure that the young man is covered with a sheet so the doctor can use that to just expose what is needed away from the parent. Most parents are pretty savvy in the thought process of their teenagers will tell the nurse and the doctor the whole truth. If given the opportunity to filter the information the parent receives. And that the MD and nurse will educate the child and hopefully it will sink in better than if a parent lectures. We all want our kids to be safe and make good choices. If a parent feels that their teenager is engaging in unprotected sex, drugs, ETOH---we already know this even if we don't want to admit it, and need to rethink a parenting style that works. The goal would be to have the child be in a clinical setting and educated accordingly, not to get the scoop to fufill some ulterior motive.
    As a sexual abuse survivor, it sometimes makes one hyper aware and instinctive in the thought process that sexualize a great deal of things. It is important to remember that most parent's intentions are good ones.
    unclebda, Altra, and r.dav like this.
  8. Visit  T-Bird78 profile page
    1
    I worked in an office with pediatric and adult pts, and you'd be surprised how many times the parent would stay sitting in the waiting room until I told them to come on back, or would look at me and ask if they could go back with their child. I'd always say YES because the kid doesn't know their medication history, allergies, and most kids, especially teenagers, will just say "I've been okay" when the nurse is trying to get their H&P. I can understand asking parents to step out for certain questions, to get accurate answers and info. Our office did allergy testing so I'd have the parents step out if the child/teenager was taking their shirt off and putting the ugly gown on, but for the actual procedure I'd insist on mom or dad being in the room.

    I took my oldest to a pediatric dentist when he was 6 and they showed us both the office, then had me in the main waiting room with the other parents. Parents and kids are brought back to a small consultation room, where the dentist gets the H&P and explains what will happen. Parents go back to the main waiting room and kids are brought back to a different waiting room filled with games, TVs, toys, etc to relax them. Once the kid has relaxed then they're brought back for the dental exam. Parents are brought to the consultation room and updated periodically.
    unclebda likes this.
  9. Visit  grpman profile page
    0
    From a strict legal perspective, I'd be very curious to see how it would pan out in court if hospital staff physically kept a parent from a minor during an exam without probable cause that something is wrong. I'm thinking a crafty parent, a lawyer, and a fickle adolescent could trump up something close to kidnapping.

    I do see the benefits of seperating the two at certain times and for certain reasons, but I'd be darn sure that other prudent nurses and staff saw it the same way if there was a conflict with a parent. It seems like it should be more of a suggestion with obvious benefits than a law to adhere to.
  10. Visit  LVN Pam profile page
    0
    They can only be separated during visits for sexual problems and birth control. Other than that, parent must be present.
  11. Visit  LVN Pam profile page
    0
    Quote from LVN Pam
    They can only be separated during visits for sexual problems and birth control. Other than that, parent must be present.
    Must have a standby present.


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