Admin/Clerical Staff in Scrubs, Observing Procedures

Nurses General Nursing

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Specializes in Tele, Interventional Pain Management, OR.

I'm an RN in a hospital-based surgery clinic. Other hospital-based surgical specialties share our suite and hold clinic as well. Across our outpatient organization, there is a black-and-white policy that only clinical staff wear scrubs. However, a surgery scheduler for another specialty has begun showing up to work in scrubs for the past couple of weeks. That in and of itself is not a major deal to me as surgery schedulers are not typically patient-facing--their patient contact tends to happen over the phone.

However, I have twice in the past week randomly overheard this scheduler asking to observe nurse visits with minor procedures, and the nurses allow it. These nurses and the scheduler have worked together for years and exhibit a very close-knit dynamic. To complicate matters, their manager works at another clinic site; the manager of my suite is not technically their manager.

My concern is that this admin/clerical staff represents herself to patients as clinical. I doubt she straight-up says she's clinical, but she's in the room during procedures and the scrubs give the impression that her presence is somehow relevant. I do not like the idea of patients being an exhibit for someone who has mentioned to me more than once that she wants to be a nurse but for whatever reason it hasn't happened. Patients do not exist to be our personal learning experiences--whether we're clinical staff or not. It's one thing if we're a teaching facility and/or the patient has signed a form indicating they're okay with observers. That's not the case here.

Should I do anything? I am the last person to be a tattletale in ANY situation, or contribute to selling the drama in our already drama-filled ambulatory setting. My philosophy is to fight the important battles (exceedingly few and far between) and to fly below management's radar while being the best nurse I can be the rest of the time.

Should I just let it lie?

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Specializes in Community health.

I agree that it's not appropriate. But it's probably not a battle I would choose to fight. Hopefully they are at least asking the pt's permission (even if they probably aren't explaining fully what her role is on the staff). I would get involved only if they are clearly deceiving the patients. Otherwise, I'd ignore it and keep my powder dry.

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Specializes in retired LTC.

Sounds like she's trying to 'shadow' like many others do for a learning experience. Maybe?

I never heard of 'shadowing until I joined AN. It just wasn't done way back in my pre-nsg dinosaur days. I am TRULY AMAZED how acceptable the practice is in today's practice settings.

Correct me if I'm wrong, but doesn't 'shadowing' have to be administratively approved by someone? Maybe this is occurring?

I would be more concerned re HIPAA acceptance. So maybe your HIPAA compliance officer could guide you.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
1 hour ago, amoLucia said:

Sounds like she's trying to 'shadow' like many others do for a learning experience. Maybe?

I never heard of 'shadowing until I joined AN. It just wasn't done way back in my pre-nsg dinosaur days. I am TRULY AMAZED how acceptable the practice is in today's practice settings.

Correct me if I'm wrong, but doesn't 'shadowing' have to be administratively approved by someone? Maybe this is occurring?

I would be more concerned re HIPAA acceptance. So maybe your HIPAA compliance officer could guide you.

That's what I was thinking. I'd probably make an anonymous call to the HIPAA hotline. Didn't you have to sign something agreeing to report possible violations?

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Specializes in Psych (25 years), Medical (15 years).

On another matter where a staff member sat in on shift report when they were not assigned to work that particular unit, I believed it to be a HIPAA violation. That staff member did not have a "legitimate need to know" PHI.

I used the quotation from two examples of HIPAA violations where the facilities were fined large amounts of money. However, I have received correspondence from Public Health that, if a person is employed by the facility, they can be privy to PHI.

I responded, stating that I begged to differ, but thanked them for their time and consideration.

I agree with TriciaJ's recommendation to "report possible violations". In the very least, I would objectively document the situation and send the report to administrative officials, for then you've done your duty, jena.

Good luck to you!

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Specializes in retired LTC.

As I remember, each facility was required to have an official HIPAA Compliance Officer. I would hope that an in-house Officer would be resistant to the common facility gossip-mongering mentality, so confidentiality of any inquiry would remain private/confidential. It was my hope back then but I still wonder about it now.

Kinda' like my concern about confidentiality and EAP Officers.

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Specializes in Tele, Interventional Pain Management, OR.

I really appreciate the responses and perspective here. I don't care about trying to get anyone into trouble, but I want to make sure rules around patient privacy are being followed. I hear what a couple of you said about shadowing being relatively commonplace these days. However, this situation stands out to me because I've worked in this setting for two years and I've never noticed clerical/admin staff observing procedures (not that I've ever gone out of my way to look, either...)

The best course of action is likely to place an anonymous call to the compliance line--something I've never done, but I guess this type of situation is one reason why such a line exists. I will probably just make the call and let the situation go.

Again, thanks to everyone who took the time to read and respond.

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10 hours ago, jena5111 said:

The best course of action is likely to place an anonymous call to the compliance line--something I've never done, but I guess this type of situation is one reason why such a line exists. I will probably just make the call and let the situation go.

If you patients are not aware of the fact that admin and clerical are being allowed in private areas, they would greatly appreciate it. Patients are not there to be put on display for nonprofessionals. They assume that whoever is in the room should be there and it should be their decision to allow the person to be there. Patients will assume that if someone is in scrubs they have the right to be there just because a staff member wants to see how something is done is not an excuse.

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Specializes in Clinical Research, Outpt Women's Health.

Maybe she just wants to understand the patient experience better in order to better do the job?

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Specializes in Oceanfront Living.
1 hour ago, CrunchRN said:

Maybe she just wants to understand the patient experience better in order to better do the job?

That was my first thought. However, I was very strict on who was allowed in "my OR".

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Specializes in Critical Care, ICU, Rehab.

Have you discussed used these issues with your boss? Going above their head without taking to him/her first seems a bit extreme. Maybe the woman had permission to wear scrubs. Maybe she is working on a project or is in school and that's why she's shadowing. How do you know the patient want asked if it was okay for her to shadow?

Also.. Not sure how you can be a nurse, or going through nursing school, without patients being exactly what you're trying to claim they are not; a learning experience.

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Specializes in Dialysis.
44 minutes ago, TheLastUnicorn said:

Have you discussed used these issues with your boss? Going above their head without taking to him/her first seems a bit extreme. Maybe the woman had permission to wear scrubs. Maybe she is working on a project or is in school and that's why she's shadowing. How do you know the patient want asked if it was okay for her to shadow?

Also.. Not sure how you can be a nurse, or going through nursing school, without patients being exactly what you're trying to claim they are not; a learning experience.

I was going to ask the same thing, but then re-read

The OPs boss isn't this person's boss, so probably wouldn't be able to do anything about it.

This clerk isn't in nursing school, so they shouldn't be observing as a learning experience.

OP: I would call the compliance line, anonymously, to express your concerns. It's up to them to investigate. If nothing is amiss, then someone will likely make the statement to all in the area of what's going on. If there is an issue, TPTB will make the nonsense stop. Either way, no harm no foul

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