Breach of Confidentiality?

[Double-Helix]

My class in nursing school was trying to figure out if this was a confidentiality breach:

You are working as a nurse on the floor of a hospital and see a person that you know from outside of the hospital. You make eye contact and say hello. Later you stop by the room to say hello to the patient and their hospitalized family member, who is also an old friend. You both talk a little bit about how you and your family are doing and how the patient and her family are. The patient shares some details about why they are hospitalized.

Was this a breach of confidentiality? No personal information was shared without the patient's consent, nor was anyone else- healthcare team or otherwise- told of the conversation. Our instructor says it was, stating that the nurse should not acknowledge anyone that she knows and the acknowledgement was a breach of confidentiality.

Opinions?

[gentlegiver, ASN, LPN, RN]

I have been in the situation twice where I took my assignment and found out that I knew a patient. I simply walked into the room said Hello and asked if they were comfortable with someone (me) they know taking care of them and that I would have full access to thier medical history if they said yes. I also made sure they understood that I would not be insulted or upset if they said no, and that I would not pass any information I learned about thier medical history to anyone outside the medical team currently taking care of them. This gave them the option of whether or not they wanted a "friend" to know about them. One said yes one said no, no problem for me and when we met outside the hospital I talked to them as any friend would, I did not ask about thier hospital stay.

[belgarion]

Run into this at least once or twice a week. I always say hi, hows it going, hows the family, etc. I try to remain professional but I will be totally dipped if I am going to ignore a friend or relative because some arrogant administrator has no idea of what HIPAA really says.

On the other hand we once ran into one of the nurses from the dialysis clinic where my wife is a patient. I believe it was at Wally World. We tried to say hello but she abruptly turned around and walked off. At the clinic a couple of days later she apologized and said the company policy was that if an employee runs into a patient in public they are to walk away without acknowledging that patient. She said if it was in a very small area like a convienence store they were supposed to leave the store immediately, even if they have to leave their purchases on the counter.

It's amazing how such a simple little law that was designed to simply protect patients from the unauthorized release of information has been twisted around into a thousand headed, out of control monster just because too many people try to read too much into it.

[BabyLady, BSN, RN]

When I was a student, at the beginning of my 4th semester, I was assigned to a ward where one of my friends lived. Her mother had a stroke and was admitted to the same hospital I was at. I was not certain if she was in the ward I was on. I noticed my friend's mom's last name was on the assignment board and had to make sure that it was not the same person I knew. I had to let my instructor know if I knew that patient so I can avoid getting assigned to her. I made sure I was on the other side of the hallway in case she was there......and she was. Her other family members had seen me and started a convo, I must say, as a student, I tried my best not to engage myself too much with the family as it may seem to breach confidentiality. though they did indulged me a few details of the situation, it seemed rude to say "no, I do not need to know the details".

I had to stop by and say hello because it seemed rude not to. They did request that I become the patient's nurse and I had explain why I could not.

I think in the end, it is okay to talk to the family IF they approached you first, a smile and nod of acknowledgment is good enough.

Why did you think it was a breech of confidentiality for THEM to volunteer their own experience to you?

I hope your instructor didn't tell you that it was, because it wasn't. You don't have any control over what someone else tells you...zero. In fact, it could be your duty to listen to a patient you are not even assigned to one day because another nurse may be giving less-than-adequate care and they may need to tell someone when you just walk into the room to drop off water.

You did the right thing by not going into the room and by not taking the assignment...however, if they saw you in the hallway and wanted to speak, there is NOTHING in HIPAA that says you have to ignore or minimally acknowledge people you know outside the hospital that acknowledge you first.

[BabyLady, BSN, RN]

Oh...sometimes you walk into a situation and you have no idea of what you are running into.

Co-worker: Can you run this acyclovir to Room 100 for me?

Me: Sure! No problem.

I walk into the room to drop of the medication and discover that it was a girl I went to high school with..not only that, we did not get along. I did not recognize the name because she had a very common first name and had got married and had a different last name.

Let's just say, it was a very uncomfortable moment.

[student29349]

I'm a nursing student who works in a health care office on campus. I see people I know all the time in the waiting room, make them appointments, etc. If they're there in person, I always say hi but treat them like a normal patient. Sometimes they'll come up and talk to me at my desk or ask how my day is going, or on the phone they will be like "oh hey! it's _______, can you get me an appointment?"

But that's where it stops. I NEVER acknowledge that I saw someone in the office outside the office unless they say something to me about it and start the conversation themselves.

I think it would be fine to stop in the room, if they seemed like they wanted to talk to you when they said hello in the hallway. I think it's a thing of what you think is right for the situation.

[TDCHIM]

Run into this at least once or twice a week. I always say hi, hows it going, hows the family, etc. I try to remain professional but I will be totally dipped if I am going to ignore a friend or relative because some arrogant administrator has no idea of what HIPAA really says.

On the other hand we once ran into one of the nurses from the dialysis clinic where my wife is a patient. I believe it was at Wally World. We tried to say hello but she abruptly turned around and walked off. At the clinic a couple of days later she apologized and said the company policy was that if an employee runs into a patient in public they are to walk away without acknowledging that patient. She said if it was in a very small area like a convienence store they were supposed to leave the store immediately, even if they have to leave their purchases on the counter.

It's amazing how such a simple little law that was designed to simply protect patients from the unauthorized release of information has been twisted around into a thousand headed, out of control monster just because too many people try to read too much into it.

Well said. As someone who has taken an ungodly number of classes on HIPAA, I'm often horrified by the way some people seem to misconstrue its tenets.