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 would have to agree with the majority here and inform the officer. If the pt were to be discharged and repeat the offense it might be my precious child or loved one who might be the victim of her illegal actions and be maimed for life or killed. If her BAL was 2x she needs an intervention in the consequences of her actions
So you would have no problem with a nurse not involved in your care disclosing your HIV status to a stranger? How about the results of your pregnancy test? How about your genetic markers for breast cancer?
We don't get to pick and choose the situations in which we follow HIPAA and those in which we flaunt it.
If you don't like the legislation (and a lot of people don't for valid reasons), then work to CHANGE it. If you stand up for what you believe to be morally right at the expense of another person's right to privacy, don't belly-ache when you lose your job and license.
Obviously, we shouldn't share info with everybody especially when it only affects our patients. The examples you gave are completely different in that they do not pose a direct threat to other people. I say we should pick and choose situations that can have ramifications on the public and innocent people. A person's right to privacy shouldn't translate into their right to kill or maim another human being or themselves. People like you perpetuate the idea that it is OK to drink and drive and get away with it. It is never acceptable... I did say I would defend what I believed to be right
"no matter what it cost me" so you won't hear any belly-aching from me if I did lose my job or my license. At least I will be getting a drunk driver off the street and potentially be saving lives. I couldn't just let someone leave the ER in that condition. I would be responsible just as much as the person who drank and drove.
My opinion of HIPAA is that it is over inflated bureaucracy at its best. It protects people who least need protecting ie... drunk drivers, drug users. These people cause harm to our society every day and the law actually helps them get away with it. I stand by my previous post saying that she did the right thing. You have to be willing to stand up for what you believe is morally right no matter what it costs you.
As long as you're willing to have your license suspended/revoked, I guess that'll work. You probably wouldn't fare too well in court if you were sued for breach of confidentiality, though.
The pt was still in the ED. At that time, she did not pose a danger to anyone else. Had she left AMA, then it would have been appropriate, and legal, to notify the police. In addition, the nurse who reported it was not the pt's nurse, so she had no business being involved. There's a second HIPAA violation.
Obviously, we shouldn't share info with everybody especially when it only affects our patients. The examples you gave are completely different in that they do not pose a direct threat to other people. I say we should pick and choose situations that can have ramifications on the public and innocent people. A person's right to privacy shouldn't translate into their right to kill or maim another human being or themselves. People like you perpetuate the idea that it is OK to drink and drive and get away with it. It is never acceptable... I did say I would defend what I believed to be right
"no matter what it cost me" so you won't hear any belly-aching from me if I did lose my job or my license. At least I will be getting a drunk driver off the street and potentially be saving lives. I couldn't just let someone leave the ER in that condition. I would be responsible just as much as the person who drank and drove.
You cannot pick and choose. Suppose someone working in the ED believed that HIV was the result of immoral conduct, so if a pt. tested + that nurse believed it was moral and legal to notify the spouse/SO.
There is a reason why we have laws. If everything were left up to individual interpretation, there would be chaos.
What really bothers me is that everyone keeps talking about the pt. getting back in her car and driving off. She was still in the ED, people. You're speculating about something that didn't even happen. Having worked in the ED, I can tell you we never let anyone leave who was impaired. They got to sleep it off in one of the cots. If they did leave AMA, we called 911. We certainly didn't call the police preemptively
Obviously, we shouldn't share info with everybody especially when it only affects our patients. The examples you gave are completely different in that they do not pose a direct threat to other people. I say we should pick and choose situations that can have ramifications on the public and innocent people. A person's right to privacy shouldn't translate into their right to kill or maim another human being or themselves. People like you perpetuate the idea that it is OK to drink and drive and get away with it. It is never acceptable... I did say I would defend what I believed to be right
"no matter what it cost me" so you won't hear any belly-aching from me if I did lose my job or my license. At least I will be getting a drunk driver off the street and potentially be saving lives. I couldn't just let someone leave the ER in that condition. I would be responsible just as much as the person who drank and drove.
Nowhere in Jolie's post did I see her say that it was OK to drink and drive. That's quite a leap to say that, and quite an insult to her.
People like you perpetuate the idea that it is OK to drink and drive and get away with it.
I absolutely will not allow you to put inaccurate words in my mouth! :angryfire :angryfire :angryfire
I have never, and will never "perpetuate the idea that it is OK to drink and drive and get away with it."
I clearly stated another option to stopping the impaired patient from driving away that DID NOT INVOLVE DISCLOSING CONFIDENTIAL PATIENT INFORMATION.
I also suggested working to change HIPAA, and would further suggest lobbying for mandatory reporting laws, so that it would be possible to provide information to law enforcement officials WITHOUT COMPROMISING ONE'S PROFESSIONALISM, and without fostering mistrust among our patients.
Many posters here have justified their desire to report by citing their concern for public safety. While that seems to be a noble stance, it will eventually serve to erode the trust that other patients have in us as individual nurses, as hospital staff members, and as a whole profession. If I know that the nurses at County Hospital are loose-lipped, why would I go there, even if I am in need of treatment? As another poster asked, where does it end? If you can justify violating HIPAA for what seems like a noble cause (reporting a possible drunk driver), then how can I have confidence that you won't likewise share my HIV results (also to protect the public)? What about my breast cancer gene status (to protect my future spouse and children)? What about my use of anti-depressants (out of fear that I may be mentally unstable and a danger to my co-workers)? It is a slippery slope that we have no business starting down.
I am not attempting to protect drunk drivers, for Goodness sake. I am trying to protect our professionalism.
In addition, by disclosing that info you jeopardize the prosecution of a legally drunk driver. It would be inadmissable in court since it's illegally obtained. The ramifications to the general public are more harmful. She was transported by EMS, therefore her car is not there for her to drive home drunk.
Further back in the posts someone said "It's illegal to drink and drive." It is not illegal to drink and drive. It's illegal to drive over whatever BAL your state decides.
Preventing drunk driving is desirable. However, it has to be attacked in an intelligent and legal way. This woman just may get off DUE to a violation of law. If the officer does a competent accident report, BAL will be subpoenaed and used as evidence. If he doesn't then he needs to be retrained or disciplined. By disclosing that info, the nurse may have actually put that woman back on the road in the long run, technically not guilty.
I absolutely will not allow you to put inaccurate words in my mouth! :angryfire :angryfire :angryfire
I have never, and will never "perpetuate the idea that it is OK to drink and drive and get away with it."
I clearly stated another option to stopping the impaired patient from driving away that DID NOT INVOLVE DISCLOSING CONFIDENTIAL PATIENT INFORMATION.
I also suggested working to change HIPAA, and would further suggest lobbying for mandatory reporting laws, so that it would be possible to provide information to law enforcement officials WITHOUT COMPROMISING ONE'S PROFESSIONALISM, and without fostering mistrust among our patients.
Many posters here have justified their desire to report by citing their concern for public safety. While that seems to be a noble stance, it will eventually serve to erode the trust that other patients have in us as individual nurses, as hospital staff members, and as a whole profession. If I know that the nurses at County Hospital are loose-lipped, why would I go there, even if I am in need of treatment? As another poster asked, where does it end? If you can justify violating HIPAA for what seems like a noble cause (reporting a possible drunk driver), then how can I have confidence that you won't likewise share my HIV results (also to protect the public)? What about my breast cancer gene status (to protect my future spouse and children)? What about my use of anti-depressants (out of fear that I may be mentally unstable and a danger to my co-workers)? It is a slippery slope that we have no business starting down.
I am not attempting to protect drunk drivers, for Goodness sake. I am trying to protect our professionalism.
You are owed an apology, Jolie. Sorry if I jumped in, but that really infuriated me. :angryfire
I absolutely will not allow you to put inaccurate words in my mouth! :angryfire :angryfire :angryfire
I have never, and will never "perpetuate the idea that it is OK to drink and drive and get away with it."
I clearly stated another option to stopping the impaired patient from driving away that DID NOT INVOLVE DISCLOSING CONFIDENTIAL PATIENT INFORMATION.
I also suggested working to change HIPAA, and would further suggest lobbying for mandatory reporting laws, so that it would be possible to provide information to law enforcement officials WITHOUT COMPROMISING ONE'S PROFESSIONALISM, and without fostering mistrust among our patients.
Many posters here have justified their desire to report by citing their concern for public safety. While that seems to be a noble stance, it will eventually serve to erode the trust that other patients have in us as individual nurses, as hospital staff members, and as a whole profession. If I know that the nurses at County Hospital are loose-lipped, why would I go there, even if I am in need of treatment? As another poster asked, where does it end? If you can justify violating HIPAA for what seems like a noble cause (reporting a possible drunk driver), then how can I have confidence that you won't likewise share my HIV results (also to protect the public)? What about my breast cancer gene status (to protect my future spouse and children)? What about my use of anti-depressants (out of fear that I may be mentally unstable and a danger to my co-workers)? It is a slippery slope that we have no business starting down.
I am not attempting to protect drunk drivers, for Goodness sake. I am trying to protect our professionalism.
I will not be bantering back and forth with you like this... we aren't going to agree let's just leave it at that.
Furthermore the point I am trying to bring home is that people who drink and drive are more likely to do so on a regular basis if they think they can get away with it. We need to make it harder for these people to slip through the cracks!
Do you even work in an ED? I mean, have you actually had to deal with this sort of situation? Do you understand that doing what you propose would completely ruin the chance of a DUI being prosecuted? Have you ever been subponaed regarding a DUI you treated?
You really should have some working knowledge of this before you start telling people what they should or should not do/how wrong they are. If you were a staff nurse in the ED I worked in, you'd be fired for acting on what you suggest...and that would be the least of your worries. You would have probably been reported to the BON, because the hospital would want a lot of distance between you.
I don't see doing what this nurse did as noble...I see it as shortsighted and foolish.
I will not be bantering back and forth with you like this... we aren't going to agree let's just leave it at that.
Furthermore the point I am trying to bring home is that people who drink and drive are more likely to do so on a regular basis if they think they can get away with it. We need to make it harder for these people to slip through the cracks!
That's fine, we can agree to disagree, as long as we accurately state each other's positions in the process.
I have no problem with making it harder for impaired drivers to slip thru the cracks. I just believe that it needs to be done in accordance with the law, not by disregarding it.
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.
Thoughts? Opinions?
IMHO, anyone that has an ETOH that high and willingly gets behind the wheel of a vehicle intends harm and is a potential threat to themselves and others!!
Laura
PS I realize that this person's gossiping annoys you, but wait for a violation to get something in your "craw".
I will not be bantering back and forth with you like this... we aren't going to agree let's just leave it at that.
Daye
339 Posts
I would have to agree with the majority here and inform the officer. If the pt were to be discharged and repeat the offense it might be my precious child or loved one who might be the victim of her illegal actions and be maimed for life or killed. If her BAL was 2x she needs an intervention in the consequences of her actions