I work alongside this nurse in a 2 RN ER and to my eyes, she is one of the worst gossips I have ever met. I tolerate her because I have to if I want to continue working here. (And all in all, I really like where I am working so it is usually no big deal.) But a few days ago, I think she really crossed a line and it has stuck in my craw since then. I really want to call her out on it to the point that I want to report her to the state for violation of confidentiality.
A woman came to our ER via EMS who was the sole person in a one car MVA. She had bumps and bruises and a minor head lac. The attending MD ordered his routine labs, among them, an ETOH level. Her ETOH level came back at roughly twice the legal limit.
A police officer was in the ER doing the accident paperwork. As he was leaving, my 'partner' asked him about what he was going to do about her blood alcohol level. His reply was, "What do you mean?" She told him that her B.A.L. was 0.15. His reply was, "Well I guess I am going to have to arrest her for D.U.I. " Upon hearing that, I was absolutely flabbergasted.
I have always felt that as a nurse, my prime role is to be a patient advocate. In NO WAY do I see my role as an agent of the state. Unless I have objective evidence that a patient intends harm, or is a potential threat to themselves or others, any circumstance that brings them to my care is irrelevant and nobody's business save for those directly involved in their care. In that light, I just can't believe what that nurse did to her. I am so upset about this. That nurse could very well have ruined that woman's life from a legal perspective. At the very least, it will cost her about $5,000. How is that being a patient advocate?
I wasn't saying that at all. I was saying I wouldn't report to the BON. That to me is vindictive because the op doesn't like the nurse and their history together. I would definately report any activity that puts a patient in danger, Even then, I would first follow the chain of command established at my facility and not call the BON directly unless the chain of command failed and patients are in danger.
Do the nurses here report every HIPPA violation they see to the BON? Is there any nurse here who can honestly say they haven't inadvertantly violated HIPPA? If every HIPPA violation got reported to the BON, what a mess that would be.
Why is it that so many people run behind someone's back first? I think first the nurse should confront the person and take it from there. Ideally this should have occurred at the time of the violation. If eventually it leads to a report to the BON it should be management doing the reporting not the coworker. As it stands now this coworker has no idea that what she did is being held in such disgust by the op.
I admit the coworker was wrong. I also admit I don't feel sorry for the poor patient whose confidentiality was broken and she was forced to deal with the crime she committed. Forgive me, that's my human side coming out. I'm not saying nurses should turn their patients in and violate HIPPA.
Am I making more sense now?
I agree with this. Except I'm still not sure about whether there is mandatory reporting in the state where this occurred. If there is, then the point here is moot.
We are, as nurses, mandatory reporters of abuse of children and/or adults.
Seems like drunk drivers fit into a category of potential "abusers" though.
The law needs to be ferreted out here. And I agree that going directly to the BON is not the right way to go - even if there was not a history between these two nurses and they got along well.
I admit to having NO sympathy for people who drive drunk even one time.
As nurses I feel that we have a duty to advocate for our patients for the betterment not for their detriment. How can this woman drinking problems not be delt with if they are Ignored. We also have a duty to protect the health of the public. Would you feel that this nurse was a gossip if a child were injured in this accident? Would you be upset if a nurse that had your respect prior to this incident reported this? These are some important ethical issues that you need to explore and make decisions on so that you can deal with this situation when it arrises again. Because I can guarantee it will. I my personal ethics would tell me that it needed to be reported and that it is not gossiping. Public endangerment in my mind is grounds alone. We have a duty to report child abuse or potential child abuse I feel we have a duty to report DD foe others and the opatients safety. Good luck in exploring your ethical issues, It never hurts to explore where you stand on important issues. And its good to know what is expected of you by the law in your area for the next time this happens.
It's common practice for the police to get a BAL, especially after a single MVI. If he didn't do the paperwork for arresting her then- it would have been later. In fact, the doctor would have (at least in some states) been REQUIRED to report her to the DMV. It was HER actions that will cost her money. It may not be ethical or moral in some people's eyes. Perhaps it isn't a specific law. Will she be fired or lose her license for sharing legally relavent info with an investigating officer? NO. Too bad. I guess that nurse has lost that patient's trust- or maybe she was too drunk to remember. Whatever the case, at least one life was saved that day and maybe more.
Let me give you another example. Are doctors agents of the state as you put it? I passed out last year- just once- just for a moment. Unfortunately it was at work. I was checked out and sent home- no biggie. Then came the letter from the DMV. The doctor was REQUIRED to report any syncope or seizure to the DMV and my license was revoked for at least 90 days and until a doctor verified I was okay. Thankfully I was. I thought it SUCKED. I had to take the stinking bus! But what if I passed out driving and killed someone? :uhoh21: She may not be a nice person, but in this case, she may have actually not have committed an unethical act according to law.
Perhaps this nurse should have let the police officer finish his job. The Etoh lab was ordered for a reason. Sure, I want the drunk driver to pay the price, but lets not turn the Er into a episode from greys anatomy. The oficer knows what he is doing, he does not need a nurse blabbing results in a hallway.
In our facility, it is policy that we do not do a BAL unless requested by law enforcement. The reason? Money. Apparently, it has something to do with not being reimbursed for medical care if the patient is found to be intoxicated. But if the police are involved, they request a sample and there is a kit we must use. So unless the officers specifically request an ETOH level, one will not be done.
That has to be the stupidest policy I have heard of in a long time. How on earth can the pt. be fully assessed if the only time a BAL can be ordered is if requested by police? Off the top of my head, I can think of dozens of reasons why you'd want a BAL.
First of all, I would like to thank everyone who has chimed in. Sorry I ignored my own thread. The past few days have been a living hell at work. (I hate this job sometimes. Also, I could really use a group hug but that is for another thread.)
To answer some of the points raised. The doc who ordered the B.A.L. will routinely order a B.A.L. and a drug screen on kids who come in for a scrapped knee and will order a pregnancy test on little old ladies who are getting x-rays for a hand injury. (Can you say, "bill inflation?")
The woman in question was not acting impaired at all. Hence, the reason why the police officer did not suspect her of D.U.I.. (Nor did I for that matter.)
The nurse that ratted on her did not do it out of a sense of civic duty to protect the public, she did it to be the smug little controlling old bitty that she is. Put it this way, if you come into that ER with your husband having a heart attack, and she is his nurse, she will make you wait in the waiting room till he is either admitted or he is dead. When I have asked her about this, she justifies this controlling behavior by citing HIPA!!!! And F.Y.I., if your husband is my patient, you and anyone else you want will be at his side from triage to disposition.
What really upset me about that incident was the patient that was arrested was MY patient! If she finds out that the nursing staff turned her in, she is going to blame me.
As far as those who agreed with my partner's decision for acting in the interest of the public good, I can see and respect your point. I really can. But where do you draw the line? But what if she had admitted to the nurse that she had been speeding? Should she have been turned in then? If your answer to that is 'yes', then, when you find yourself doing 37 in a 35, do you pull over, call the cops and await your speeding ticket? And then to extrapolate this line even further, if the average person is afraid of seeking emergency help for fear that they will be turned in to the police for a transgression, how will it be serving the overall public good by them staying at home and licking their wounds instead?
One of the things I respect about my job is that nursing is consistently viewed by the general public as the most trusted of professions. I would hate to see that perception tainted for ANY reason.
Also, I did call out my co-worker out on this. She just giggled and blew me off. As far as my professional relationship with her, I absolutely respect her for the great, technical nurse that she is. It's just that "I have a secret, I have the power" attitude that I despise. I grew up in a bad situation. I always kept my nose clean, but where I grew up, that woman would have been stabbed for what she did. It would not have happened, it would have been unheard of.
Bottom line, I don't agree with what she did. I am NOT an agent of the state. That is what the police are for. I am a patient advocate. I AM A NURSE!!! I still feel that what my partner did was COMPLETELY out of line. I just can't reconcile what she did. On a professional, legal, moral, medical level, anything, I just don't see it.
Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
bottom line, i don't agree with what she did. i am not an agent of the state. that is what the police are for. i am a patient advocate. i am a nurse!!! i still feel that what my partner did was completely out of line. i just can't reconcile what she did. on a professional, legal, moral, medical level, anything, i just don't see it.
imho if the patient was not assigned to that other nurse and if she was not asked to assist you in giving care for the patient, then the blood alcohol level and the patient was none of her buisness.
too often i have watched nurses access information on another patient that is in the hospital because they know the person, their family, a friend of a friend, or something along those lines.
i was taught that if you are not directly involved in actually giving the patient's care, then you have no buisness plundering through their chart information.
if your state required a blood alcohol test and the results, then the nurse or doctor assigned and actually giving the care would be the one to share this information...not nosy-nancy-nurse down the hall.
nurses are now greatly affected by state laws. there is a duty to protect, but there is also a duty to report, as in cases of suspected abuse. there are privacy and hippa issues, but there are also legal requirments to document other types of information. it can make being a nurse difficult at times, but i don't think that other nurses motivation was for the right reasons.
Bottom line, I don’t agree with what she did. I am NOT an agent of the state. That is what the police are for. I am a patient advocate. I AM A NURSE!!! I still feel that what my partner did was COMPLETELY out of line. I just can’t reconcile what she did. On a professional, legal, moral, medical level, anything, I just don’t see it.
I see what you're saying. While I don't support being vindictive in return by calling the BON, I don't support ratting on someone just for the sheer enjoyment of it, which is what she did, HIPPA violations aside.
I also agree, it's not our job to pay police. Let them do their job.
As far as feeling sorry for the drunk driver that her trust in nursing is potentially blown. Nope. Still not going there. I wouldn't worry about the public's image being blown by nursing reporting drunk drivers. I do think this nurse and some of her other behaviors ruin it for us though.
Specializes in med/surg, Icu/Ccu. ER, PACU, HHC, LTC.
Varies from state to state. In CA we cannot release that info because it is a part of the pt's chart. Can't be released without the pt's signed permission. If she had come into my ER by private vehicle after an MVA, I would have been legally obligated to call and report the accident itself so that an officer could take a report, but I could not have said "And she's drunk," no matter what my feelings were about the situation. By the same token, if I have a pt who is obviously under the influence, or whose tox screen came back positive, I cannot call the police about it.
As for the pt mentioned by the OP, if she was that intoxicated the officer should have been able to smell the alcohol and should have followed his procedures to obtain a legal BA.
That is the first thing that came to my mind,why wasn't he aware that she was intoxicated? and if the officer didn't persue the issue for whatever reason so be it....we are not the law in the ER....when i left ER 1.5 years ago, if it was ordered medically the police had to subpoena the results.....and the doc's had a relationship with the law enforcers by ordering it medically *wink*...i must look into the state law as to whether i would be responsible to relay that blood value to them or not, but i no longer work in the ER. But knowing that she probably drove drunk before and will again does get emotional as I have children driving the roads too.
that makes for a sticky situation........
also when working in er and i had medicated a patient after asking them if they have a ride and them saying yes and even producing someone from the waiting room......later to leave and let the patient there alone and to drive.....after discharging the patient i followed them outside and watched them get into a car and drive and i promptly called the police....and one time an intoxicated and very obnoxious *big man* ripped his iv out and walked out and i followed him and watched him drive away and called the police and they brought him back after picking him up for a bac.....tg he was too mad and drunk to think about why he got popped, but he was driving left of center they said......boy was he mad :uhoh21: but as i said there may have been someone i cared about on the road that night and for that matter i do not want to see anyone hurt.....
Whatever the case, at least one life was saved that day and maybe more. 
I was checked out and sent home- no biggie. Then came the letter from the DMV. The doctor was REQUIRED to report any syncope or seizure to the DMV and my license was revoked for at least 90 days and until a doctor verified I was okay. Thankfully I was. I thought it SUCKED. I had to take the stinking bus! 
But what if I passed out driving and killed someone? :uhoh21: She may not be a nice person, but in this case, she may have actually not have committed an unethical act according to law.
Spidey's mom, ADN, BSN, RN
11,305 Posts
I agree with this. Except I'm still not sure about whether there is mandatory reporting in the state where this occurred. If there is, then the point here is moot.
We are, as nurses, mandatory reporters of abuse of children and/or adults.
Seems like drunk drivers fit into a category of potential "abusers" though.
The law needs to be ferreted out here. And I agree that going directly to the BON is not the right way to go - even if there was not a history between these two nurses and they got along well.
I admit to having NO sympathy for people who drive drunk even one time.
steph