About patient confidentiality

Her actions were inappropriate and constitute a HIPAA violation.

I understand your loss of confidence in the office and don't blame you for wanting to change providers, but that in and of itself will do nothing to prevent her from divulging confidential information regarding your or others in the future, regardless of her good intentions.

Please consider requesting a meeting with the physician/office manager and nurse to air your concerns. They may be able to reassure you that this won't happen again. If not, you will have the peace of mind that you took the steps necessary to protect your privacy and that of other patients.

Thank you for finding a way to address this professionally.

She has violated Federal law, and there are v. serious consequences for this if you choose to make a complaint. Many hospitals would fire her on the spot for that behavior. I encourage you to at least bring this up with her employer (your physician), and consider making a complaint to the feds and/or your state agency that regulates healthcare (there are also state confidentiality rules which she has violated).

If she is truly a "nurse" (and I qualify that only because so many folks working in physician's offices aren't, but get referred to as "nurses" anyway), you could also complain to the state BON.

http://www.hhs.gov/ocr/privacy/index.html

Here is the main HIPAA site. It includes info about how to file a complaint.

I'm curious about why you want to change docs (presuming you were happy with your physician in the first place), but don't want to do anything to jeopardize the nurse's job. Hearing that the person in question is definitely an RN makes the situation even worse, IMHO. If if were some unlicensed person who sincerely didn't know any better, I would feel more charitable. But this RN has violated state, Federal, and state BON rules, and, if she doesn't know that she's doing so, that's evidence of incompetence in itself (IMHO). She either doesn't know or doesn't care about one of our most basic professional responsibilities. This is very serious business!

You have to "sign something" (a Release of Information form) in order to give permission for any information to be released from your record (and the form specifies what information is to be released, and to whom), NOT to keep your information private!! Your medical information is always to be kept private unless you give instructions otherwise.

I appreciate that you have a personal relationship with this nurse and information about her past that makes you reluctant to create problems for her, and that is certainly your choice to make, but I do hope you will at least make her employer aware that this happened -- if she did it to you (disclosed legally protected information), she can/will do it to others, and, again (not to beat a dead horse), that is a serious violation of Federal law, state law, state BON rules specific to nurses, and even (as you note ) the Nightingale pledge (!) The next person whose confidentiality she violates may well not feel so charitable and forgiving, and her actions can have legal repercussions for her employer, as well.

Just to throw my two cents in; if it were me I would probably opt to just tell the nurse that what she did was upsetting to me, and let her know that I was going to go ahead and change doctors because of it, and let the doctor know as well. Of course it was a serious legal violation. You'd be justified, certainly. But that would be a mighty painful way for the nurse to learn her lesson. If she's the kind and sensitive lady that you describes, it seems to me that she'd be horrified enough to know that her slip impacted you the way it did. You know how sometimes we have an awful experience and learn from it? If I had made that slip, and someone confronted me about it, that would be enough to make me never open my mouth again. But you're the only one who can decide.

Oops I meant you'd be justified to call the BON, but etc., etc.

She made a big mistake and yes, it was against the law. I know you don't want her to get in trouble or go that route - but you REALLY do need to address this. The law is there to protect you. Let her learn through this. Since she's a close family friend and the person she made the oops with was a relative of yours, perhaps she thought everyone was in the information loop as to what is going on with you and didn't think she was disclosing info. Or maybe it just slipped out - but either way, it was wrong.
You said she doesn't talk about other patients - which is good. Was this an innocent slip up?... or A 'can't hold it in' tidbit of info that she just had to tell? ....or..... Overstep of her bounds because she thought that relative needed to know in order for your welfare? ... No matter what the reason, it was wrong and I'm sorry to hear it happened to you.

Talk to her. If you feel that she could learn from this and not do it again, maybe you could stay with the practice.
If you feel that she really can't be trusted even after pointing out the magnitude of her error, then change practices, but her boss needs to know. Sometimes people are uncomfortable going to any practice where they know someone well; even if that person keeps a tight lip on everything, it's still someone you know well - knowing your private health issues. That alone can be enough reason for some folks to seek a different practice. Sometimes folks feel better knowing someone in the office - other times it just complicates things and makes things uncomfortable.

Good luck. (And I hope you are okay.)