Can manager call nurse at home regarding patient information?

[Nise478]

Hi all -

I received a text message from the manager of a unit which I floated to work the previous night. She asked if I could answer a patient care question regarding a patient on the unit I was assigned to that night. I wasn’t sure what type of information she was looking for specifically and I felt I was put in an uncomfortable situation. My question is... Is it appropriate that a manager call a nurse, off shift at home, to discuss patient information? Is this potentially a violation of patient confidentiality? Also, I felt that if I answered a question without the ability to protect myself and document the conversation (if need be) I could be held liable for something. Has this ever happened to someone before? Should managers be doing this?

Thanks in advance

[klone, MSN, RN]

Well, as a manager, I absolutely try to avoid interrupting nurses at home during their down time, but if something crucial is missing/needed, then yes, it's appropriate. For example, I've had nurses who have missed important fields in an intra-op record. Until that field is completed, the record cannot be closed out and we cannot bill for it. So in that case, I've had to call nurses at home to ask for pertinent details that they forgot to chart. No, it's not a patient privacy violation - why would you think that it would be?

[nursex23, BSN, RN]

Legally speaking, I would imagine this would be a huge hippa violation. I'll admit I've discussed a patient with my manager via text. She was asking about an incident and I did feel comfortable discussing it via text because I trusted her. But you're right, that would potentially open you up to trouble if she reported those messages. Maybe you would feel more comfortable via phone? Or just telling her you don't feel comfortable discussing it outside of work and you will talk to her the next day you see her. You would definitely be in the right to not discuss anything outside of work.

6 minutes ago, klone said:

No, it's not a patient privacy violation - why would you think that it would be?

Are you sure? Wouldn't that leave text messages on a nurse's phone about patient information? What if the phone got stolen or a spouse or a friend were looking through the phone for some reason?

[klone, MSN, RN]

1 minute ago, nursex23 said:

Legally speaking, I would imagine this would be a huge hippa violation. I'll admit I've discussed a patient with my manager via text. She was asking about an incident and I did feel comfortable discussing it via text because I trusted her. But you're right, that would potentially open you up to trouble if she reported those messages. Maybe you would feel more comfortable via phone? Or just telling her you don't feel comfortable discussing it outside of work and you will talk to her the next day you see her. You would definitely be in the right to not discuss anything outside of work.

My understanding is that the manager texted the nurse, requesting a conversation (by phone) to ask a patient care question. Not that they were discussing the patient by text (the title of the OP is "Can a manager CALL a nurse at home..."

No, you should never discuss patient information by text unless it's a HIPAA-compliant phone system.

[nursex23, BSN, RN]

That makes sense. I ran with the first line that said she got a text but it would make sense that the manager texted requesting a phone call. In that case OP I would see what the manager wants to discuss and make sure you are somewhere private when you're on the phone.

[Closed Account 12345]

A private phone conversation between a manager and a nurse does not violate patient privacy as long as there is a legitimate reason to discuss care, not just casual conversation for kicks. Managers regularly follow up with nurses about former patients due to complaints, missing documentation, incident investigation, or needing clarification about something.

As an hourly employee, you are legally entitled to pay for all time worked, so you could write the start and end times of the phone call into the unit's time log so you can be compensated if you choose.

[Pepper The Cat, BSN, RN]

Depends what she needs to know.

Years ago when we did taped reports I said I would hang a new bag of IV fluids - and I forgot. The next nurse went into the room and found an almost empty bag. She did not know if I a) forgot to hang the new bag or b) did hang the new bag and the pt just got 1000cc in under an hour (this was in the old days of gravity infusions so was certainly possible). So they called me at home. Luckily, on my way home I remembered what I forgot so was about to call anyway. But it was important info so a call was warranted.

Could a pt be displaying an acute neuro change and they need to know what they were like with you? Could there be a critical result which may or may not have been reported?

I'd take the call before pushing the panic button.

[Horseshoe, BSN, RN]

On 1/29/2020 at 2:32 PM, Nise478 said:

Hi all -

I received a text message from the manager of a unit which I floated to work the previous night. She asked if I could answer a patient care question regarding a patient on the unit I was assigned to that night. I wasn’t sure what type of information she was looking for specifically and I felt I was put in an uncomfortable situation. My question is... Is it appropriate that a manager call a nurse, off shift at home, to discuss patient information? Is this potentially a violation of patient confidentiality? Also, I felt that if I answered a question without the ability to protect myself and document the conversation (if need be) I could be held liable for something. Has this ever happened to someone before? Should managers be doing this?

Thanks in advance

There is nothing wrong with this as long as you are taking appropriate measures to be sure your conversation is not overheard and that the questions you answer are relevant to the patient’s care. For example, if your manager asks you if you gave a scheduled Med that you didn’t sign off, then yes, this is an appropriate call. If she calls and asks you if you know who did your cardiac patient’s facelift last year because they are looking for a plastic surgeon, that is another thing altogether.

And yes, I have both made and received these types of calls, always for good reasons.

[Sour Lemon]

I think it's appropriate, and I encourage calls if I've neglected something significant. I also tell people that I will hang up on them if they call me for something stupid.

[Nise478]

Thank you for the responses! This was insightful as I haven’t had to talk to a manager regarding a patient outside work. I guess I was just paranoid that I could possibly be violating HIPPA since I wasn’t technically at work. But, my biggest concern was discussing something over the phone that would or should have required me to follow up with documentation and I couldn’t make it to the hospital to do that. I did end up calling and it was only something minor.