HIPPA for students

  1. 0
    Today was my last day of clinical for my third semester (one more to go!).

    Being a short day I only took one patient (my RN assigned him/her to me). Usually, I take 2 - 4 patients. Since we take so many patients it is not possible to come the day before and pick them out because then you would end up with patients that are with different nurses and that just does not work out.

    The patient I was assigned today turned out to be a nurse who thought it was a HIPPA violation for a student (me) to have a patient (her/him) because I am not an employee of the hospital! Later s/he accused me of violating HIPPA by discussing him/her with the PCA who was working as a 1 on 1 for the patient in the next bed. I did not, but apparently she inappropriately discussed things she overheard when I was completing my patient's assessment. (So, really she violated HIPPA, not me.)

    I have no idea how this patient thought that students are supposed to practice if s/he thinks their practicing violated HIPPA?!?

    Any thoughts or suggestions? I hate to end the semester this way but I just need to look forward to my last semester. Since, I am expected to take my nurses entire workload next semester, I need to plan in advance for dealing with similar people if they should happen to come my way.
  2. 8 Comments so far...

  3. 0
    I would discuss this with your Nursing Director or Instructor. As far as HIPPA is concerned, you are not emnployeed with the hospital but you are a student enrolled in a program that has an agreemetn the hospital and I am sure they have crossed all of the "T's" and dotted all of the "I's". I can't remember if I signed something regarding HIPPA or not when I signed all my other paperwork. I know that I was told about and had to learn about HIPPA.

    I wouldn't worry too much about it. But I do agree that it is odd that she would think it was a HIPPA violation. It is normal for students to be at the bedside.

    Congrats on getting this far in y our studies. I can't wait to get there.
  4. 2
    That's interesting. An RN should know that, while nursing students are not exempt from HIPAA, it is perfectly acceptable for nursing students to take care of patients, provided they have been granted permission by the hospital and have signed a confidentiality agreement.

    When you're taking care of a patient in a semi-private room, try to be as discrete and quiet as possible when caring for the patient and discussing their care, to avoid being overheard by listening ears. If your patient is hard of hearing, this will obviously be difficult.

    Refer to question 10 in this link. I've also copied a portion of it for you below: HIPAA FAQs

    Q10: Can health care providers have confidential conversations, even if they might be overheard?


    A: Yes. The HIPAA Privacy Rule is not intended to prohibit providers from talking to each other and to their patients. Provisions of this Rule requiring covered entities to implement reasonable safeguards that reflect their particular circumstances and exempting treatment disclosures from certain requirements are intended to ensure that providers' primary consideration is the appropriate treatment of their patients. The Privacy Rule recognizes that oral communications often must occur freely and quickly in treatment settings. Thus, covered entities are free to engage in communications as required for quick, effective, and high quality health care. The Privacy Rule also recognizes that overheard communications in these settings may be unavoidable and allows for these incidental disclosures. For example, the following practices are permissible under the Privacy Rule, if reasonable precautions are taken to minimize the chance of incidental disclosures to others who may be nearby: - Health care staff may orally coordinate services at hospital nursing stations. - Nurses or other health care professionals may discuss a patientâ¬"s condition over the phone with the patient, a provider, or a family member. - A health care professional may discuss lab test results with a patient or other provider in a joint treatment area. - A physician may discuss a patients' condition or treatment regimen in the patient's semi-private room. - Health care professionals may discuss a patient's condition during training rounds in an academic or training institution. - A pharmacist may discuss a prescription with a patient over the pharmacy counter, or with a physician or the patient over the phone. In these circumstances, reasonable precautions could include using lowered voices or talking apart from others when sharing protected health information. However, in an emergency situation, in a loud emergency room, or where a patient is hearing impaired, such precautions may not be practicable. Covered entities are free to engage in communications as required for quick, effective, and high quality health care.


    Finally, if your patient reported that the PCA was discussing her personal information with another patient, then this should be reported to your supervisors- such as the charge nurse on the unit. This is not acceptable behavior for a hospital employee and she should be counseled.
    GrnTea and Esme12 like this.
  5. 1
    FIrst it's HIPAA not HIPPA...like Ashley said.....nursing students are bound by HIPAA and it is not a violation for a student to care for anyone........Are you sure you didn't say ANYTHING to the PCA? Because if you did.......theses questions will be asked. Did you need to share the information with the PCA? PHI may be shared if it is pertinent to the direct care of the patient. The big question here is........ Did the PCA need to know any information about the patient in question, when the CNA's job was to watch the patient next door. Did that information NEED to be shared. If not....it might be a violation of HIPAA. Did you share any information with the PCA about a patient you were caring for?

    If there wasn't a valid reason to share PHI with the PCA, it just may be a violation.
    Last edit by Esme12 on Apr 12, '12 : Reason: for clarification
    CrazierThanYou likes this.
  6. 1
    My understanding was that the OP didn't say anything to the PCA, but rather the PCA (who was working with the patient in the next bed) overheard conversations that took place between the patient and the OP. Then the PCA was discussing that information with her patient.
    Esme12 likes this.
  7. 1
    Thanks Ashley, Just playing devils advocate.......by the Patient/nurse report "Later s/he accused me of violating HIPPA by discussing him/her with the PCA who was working as a 1 on 1 for the patient in the next bed". Even though the OP states "I did not, but apparently she inappropriately discussed things she overheard when I was completing my patient's assessment". I just like presenting the other side just in case she did discuss that patient.

    The problem....this nurse/patient seems to have an axe to grind. Who will be judged correct?
    Ashley, PICU RN likes this.
  8. 0
    I will let others debate whether there was a HIPAA violation between the student and the PCA.

    What I find the more interesting/disturbing issue is that this 'nurse' seems to think that is a HIPAA violation merely for a student to take care of her. If she has a problem with having a student, she needs to tell her RN and be done with it, but to pull the HIPAA trump card is kinda BS. Was she just trying to test you on the issue and see you response? (equally BS in my mind) Was she actually a nurse or was she an MA, unit clerk, etc? Either way, this part of things is clearly not a HIPAA violation, and this nurse needs to give it up and let students learn.
  9. 0
    it may be that the alleged nurse in the bed may be upset that anybody knows anything about her phi, or she may be remembering her own student days before hipaa and be concerned that her student may be doing what she used to do, i.e., discussing details of her patient care in class. or she might be like many of the nurses i encounter in hospitals, clinics, and md offices who will not give me patient information i am entitled to have "because of hippa (sic)," which i take to mean "i slept through that inservice / i am too lazy to get up and read the booklet on the other side of the nurses' station / i skipped the refresher / i'm on break and don't want to talk to you anyway."

    never attribute to malice what could be due to simple ignorance.
    :d the hipaa faqs are clear and easily accessible. i hope all students will have the link on their desktops and refer to it whenever any alleged hipaa violation occurs or is threatened.
    hipaa - frequently asked questions
  10. 0
    Well, excuse me for putting in an extra P! (I am thinking of both portability and privacy!)

    No, I did not talk to the PCA about the patient, but since then I completed an inservice/CEU at work on HIPAA. I paid very close attention, looking for anything that might apply to students or my particular situation.

    1) Students are allowed access to to PHI because it can be used for training. (But I know from hospital orientation before clinical that they will remove you from the hospital if they catch you looking up someone that you should not be looking up, ie famous person, friend, coworker, someone with whom you have not been involved in their care).

    2) I could have spoken softer.

    I have been debating inwardly about the need in the future to remind a PCA in the room that they should not repeat anything that they have overheard, that it violates the patients rights. I do not have a problem asking people to leave the room when someone needs to use a bed pan and wants privacy, but what to do with a PCA assigned to 1-1 observation for a neighboring patients seems a little more touchy. I don't want to come off as a B* because I am being anal about HIPAA, but if I have to ... I guess I may to learn.


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