Confidentiality vs 20 questions?!?!

Tweety, BSN, RN · Oct 22, 2004

I have to shake my head too. Like when a family member wants information "sorry we can't give you any information." Family member: "Funny how you just called me to get a consent for brain surgery tomorrow."

Sounds like a crazy day.

apaisRN, RN, CRNA · Oct 23, 2004

I was at the dentist's yesterday and the dental assistant came to the waiting room and said my first name. I stood up and so did someone else who apparently had the same name. The assistant then said my first name followed by my last initial, so I knew it was me. She told me afterward that it's a HIPPA violation to say first and last names, or even just "Mrs. Smith." That is so weird - what if the other person with my name had a last name that started with the same letter? As well, I think it's disrespectful to call a mature adult by their first name only. I always call my patients Mr and Mrs if they're older than 50 or so. They're a different generation and were raised that way.

KRVRN, BSN, RN · Oct 23, 2004

I've noticed that they only call first names too. But I've then been called Mrs. by the same person after going back with the person. I figured it was a HIPPA thing. It seems a very minor one to me, since most people coming to the doctor's office assume their last name will be used in the waiting room.

I sure it would be totally excusable to say a last name if there are 2 people in the waiting room with the same first name and last initial. What else would you do? Maybe say Jane X., the Jane X. with the blah blah blah problem and the medicial record #123456. No last names though!

apaisRN, RN, CRNA · Oct 23, 2004

I sure it would be totally excusable to say a last name if there are 2 people in the waiting room with the same first name and last initial. What else would you do? Maybe say Jane X., the Jane X. with the blah blah blah problem and the medicial record #123456. No last names though!

Yeah, I'd rather they publicize my problem to the entire waiting room than use my last name! :rotfl:

ADS RN · Oct 23, 2004

OMG I never thought I'd be in that category. I found that a lot of people want to be called by their 1st names, because that's how they see themselves. I had a Dr. that didn't want to be called Dr. so and so....he said so many people just saw him as Dr. so and so but he was really ( his 1st name). Made me stop and think, Mrs. was my mother in law not me. So many of us are tied to who we are as ourselves. I think generations way back Mr. and Mrs. was the expected address, but most of my participants would be insulted if I called them by Mr. or Mrs.

TracyB,RN, RN · Oct 24, 2004

Funny that when you sign in at the doc or dentist, you use first & last name on a list, that every other pt signs in on. Good grief, this HIPPA stuff is getting waaaay out of hand. I guess now we should all wear paper bags over our heads when we seek medical attention.

Antikigirl, ASN, RN · Oct 24, 2004

Well, over two years working where I do, I have gotten to know who likes to be called by their first name, and those that like Mr. or Mrs., so I use a combo of both when addressing them. It helped that when I first started I realized, like most, that different generations do have a preference...and I asked right away what they would like me to address them as :).

Oh but wow, I have 160 patients...and the care givers go by room numbers...two years and yeah right, I don't know them by room numbers. I have tried, but no can do! SO when I get a call on the walkie, and I need more specifics before arriving, I do have to break hippa a bit and ask the name...but I am getting better about only using initials (this is a major probelm for us nurses...even the ones that have been here over 5 years...residents switch rooms constantly...like loss of a loved one and they move to a studio, or cost factors that have them moving to another smaller apt. or fall risks moving closer to our main hubs so we can hear them better...etc). I am currently trying to find a middle ground here, and have been carrying a recent resident room list...but the print out is 5 pages..uhgggggg! Oh well I will come up with something!

Speaking of confidentiality...I have wondered something that maybe I can get some other nursing feelings about. The practice of using baby monitors in resident rooms r/t fall risks is becoming quite the deal at my facility. However...the monitors are located in the main service areas (we have 10) on the med carts so the staff can here them (any staff so they can hear a fall or alarm and rush in...even housekeeping). Okay great idea...but you can here EVERYTHING that resident is doing...and lets say there have been moments that were best left unheard!

Anything from bodily functions, to gossip, to folks talking to themselves (heck I do it!), to other...ummmmmm...'releaving tension' ...you name it! I think that yes, the monitors are a good thing, but really an invasion of privacy! And some areas have 3 per section...so the caregivers can't just put those on their bodies and walk around or anything. Even the consultant nurse we have to check over charting feels the way I do...and we are wondering how to overcome this very good functioning idea, yet perserve our residents rights to basic privacy!

Any thoughts or feelings?

apaisRN, RN, CRNA · Oct 24, 2004

Well, over two years working where I do, I have gotten to know who likes to be called by their first name, and those that like Mr. or Mrs., so I use a combo of both when addressing them. It helped that when I first started I realized, like most, that different generations do have a preference...and I asked right away what they would like me to address them as :).

I work in MICU, and probably 75% of my patients are vented when I first meet them. So I have to make a guess, unless they're awake enough to nod at me.

apparati · Mar 27, 2005

Interesting. That leads me to wonder if you serve a more metropolitan clientele, because calling my conservative, rural elders by their first names just doesn't seem appropriate at all. -tb

KRVRN, BSN, RN · Mar 28, 2005

Unfortuneately it's not a matter of whether it's appropriate or not. It would be a HIPPA violation to announce a person's last name in the waiting room in front of other pts since your last name is a pt identifier. The only alternative is to call the person by first name to get them to the back. Then it is appropriate and respectful to switch over to a Mr. or Ms. title. I agree that some medical personnel are quite flip about calling an older person by their first name, though.

Antikigirl, ASN, RN · Mar 28, 2005

Save all the hassle and have one of those number ticket things..LOL! Yep, lets make it like the DMV...'now serving 905'. Uhgggggggg!

I know that most of my residents would be very outraged at being called by their first names! Even working closely with residents for over 2 years at my facility I still have some that wish to be addressed by their last name out of respect (which I don't mind, I think of it as a nice respectful thing to do and keeps the nurse/patient border clear..they also call me "Nurse [my last name].).

Yep, I think HIPPA has gone wayyyyyyy over the deep end and is actually hurting patients vs helping them. Or from a customer service end...we are to treat each person as an individual right...well it is rather hard when you can't address them correctly, can't speak to them if they are within ear shot of someone else (delaying Hx gathering and treatments in some cases), and having to bounce around trying to qualify relatives as being next of kin or in the "need to know' catagory! Uhhhggggg! Yeah, nice personal customer service huh? LOL!

"I shall call you number 15...now 15, what brings you into our ER today? Opps hold on, someone just walked pass....okay now..." LOL!