A friend's Mother is a patient

[mauddib]

So I am about half way through RN school and tonight something interesting happened to me and I have questions that hopefully someone here can help me with.

For starters, this took place in NYS.

I was on the floor tonight when a friend spotted me and called me over. His mother was a patient on the floor where I was doing my rotation. He introduced me to her and his father and I never asked any medical questions, not even why she was in the hospital. She volunteered a few things on her own but for the most part we just engaged in some chit chat. She was concerned about her allergy to penicillin not being on her wrist band so I promised to ask her nurse for her about checking her record (not me but the attending nurse) and getting back to her about it.

I told them about using proper hand hygiene just to be safe and said I would stop in to see if she needed anything later on. I also explained that I couldn't look into her chart or do anything treatment oriented with her, but would be willing to help out in any other fashion I was legally able to. Fresh pillow, sheets, utensils, that sort of stuff. I even told my friend when he told me to send his regards to my wife that I couldn't because of privacy rights.

So the problem came later when I saw my friend leave the room with his coat while talking with another student and went over to say goodbye. My professor saw me and told me I couldn't go near any of them because of HIPAA regulations. Now she is more knowledgeable than I by far but I am pretty sure that I wasn't in violation of any laws.

Was I wrong? I mean, we're told to help with any and all patient's on the floor and not just the ones assigned to us so this really got under my skin and she didn't seem to have the time or desire to explain this to me. So hopefully someone here can!

Thanks in advance.

[tokmom, BSN, RN]

I don't think you are. I can't figure out what you have done wrong. How many times do we run into people we know at work?

If I'm incorrect, I need to be educated as well. Now if you had gone through the chart, etc.. then as you have already stated, you would have been in violation.

[loriangel14, RN]

I don't think you did anything wrong.How could it be a violation to speak to someone you know? I don't think we are required to pretend we don't know people.Goodness,I work in the town I grew up in,I always see people I know at work.

[mauddib]

Thanks. I kinda of thought I was following the rules so it was just confusing to basically be reprimanded for it. I think I'll try and formulate a very polite email asking for clarification from my professor. I mean, when I start working professionally this is gonna happen all the time (it's that kind of town). My wife encounters this regularly as a nurse and she just never tells me. I only find out later on when the friend brings it up that he or she was at her hospital and saw her there, which is the way it should be.

[ckh23, BSN, RN]

While it sounds like your professor may need to brush up on his/her knowledge of HIPAA, I wouldn't be sending emails questioning it as a student. Ultimately this is your professor and is in charge of whether you make it to the next level or not. I wouldn't be making waves as a student.

[Altra, BSN, RN]

Agree with ckh23 ... just let this go. You seem pretty clear about the non-negotiables of HIPAA, and that's all that's needed for now.

[MomRN0913]

You are not wrong. At all. Your professor is fearing for herself.

[loriangel14, RN]

Wait until you are working and follow the policies of your employer.

[llg, PhD, RN]

I don't think you did anything wrong either. Your instructor was probably being a little over-cautious, playing it safe because she is not 100% sure of your abilities to walk that fine line between appropriate and inappropriate. Wanting to avoid any appearance or hint of inappropriate behavior, she erred on the side of caution. That's understandable.

[bjaeram]

You did nothing wrong!

You could have given his reguards to your wife as well. It's not against HIPPA at all. The person gave you permission too. You can walk into any hospital and visit a friend and you are allowed to know anything they tell you. HIPPA protects their privacy and if they chose to tell you anything they certainly can.

Going through a chart, talking to a doctor, getting info from the persons wife is all a HIPPA violation but talking to the patient is not.

[Meriwhen, ASN, BSN, MSN, RN]

If it happened exactly as you wrote, you didn't violate HIPAA.

I would also let the issue drop with your professor.

[rn/writer, RN]

If the instructor was not aware of the earlier interaction, she wouldn't have known that the friend initiated the contact and that the family was apparently comfortable with your presence. It would have looked like you were the one striking up the conversation, and the instructor's caution would have been not only correct, but necessary.

Why didn't you just explain that the friend and family members (including the patient) had started the ball rolling earlier and you were simply saying goodbye?

Instructors are only human. If an important piece of the puzzle is missing, it might be good to supply it rather than get all bent our of shape because she didn't understand.

On the flip side, having had the earlier conversation with your friend, it probably wasn't necessary to interrupt a conversation to go say goodbye to him. You were there to attend clinical, not to socialize.

I would caution you further that, while what took place doesn't appear to have broken any rules, encouraging friendship or a social connection while at a clinical or on the job can predispose you to errors down the road. You can still be friendly in your demeanor, but I really wouldn't encourage a lot of interaction with people you know (who are not your patients). Even though you understand the boundaries, they don't. They might mention aspects of their treatment with you before you can stop them and put you on the spot. Without doing anything wrong, you might still end up knowing more than is good for you or for them. Also, people who feel vulnerable sometimes spill their guts and feel awkward about it after the fact. It's better for you to set the boundaries that will help avoid this.

Even if they say something about their treatment and you do nothing more than refer them back to their doc or their nurse, their confidences can create discomfort. And heaven help you if your expression or anything you say creates a question. It wouldn't take much for one of them to say, "When I told that other nurse what meds I'm taking, he made a funny face." You might have. You might not have. It doesn't matter. You just don't need that kind of hassle while you're still in school. Or after.

Bottom line--be friendly but not overly so. Extricate yourself from any and all confidences regarding someone else's patient. Don't go out of your way to recognize or say hello or goodbye to people you know from other areas of life. If they initiate contact, be cordial but brief. Keep a professional distance between you and other people you know. It may feel odd at first, but eventually, it will come naturally.