Corrections nurse asks "Am I breaching HIPAA?"

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

Published  

I work as an RN in NYS corrections. I have a past error with privacy and it's been years but I still ruminate on it. (This error was not in my current place of employment) . Anyway, I always worry about violating or breaching HIPAA. I try to be careful but there are some instances where I feel I haven't been vigilant. I have spoken openly with inmates about their conditions with other inmates and or officers present. When I feel I have done wrong, I report myself to my nurse supervisor. So in a way I feel I've done the right thing by doing that but I worry what if I should be reporting myself further so that I'm accountable. I lose sleep and stress myself to the max worrying about this. The NYS office of Professions doesn't want to answer these types of questions neither does the Board of Education.  I regret becoming a nurse due to the amount of stress it has caused me over the years. I'm very conscientious and honest. But I'm not perfect.  How do I handle this. I appreciate any feedback 

Share this post

+ Add A Comment
Specializes in Tele, ICU, Staff Development.

I believe your anxiety might be more about possibly violating HIPAA than actually violating it.

I'm really sorry it's causing you so much stress. HIPAA violations are stressful, especially when you are conscientious and committed to doing the right thing like yourself. 

Are you generally very hard on yourself? It's important to acknowledge that everyone makes mistakes—no one is perfect, especially in such a high-pressure field. You are measured by the standard of "What would a competent nurse do?" not "What would a perfect nurse do?"

That said, it's also essential to know that intention matters in healthcare. If your actions were not motivated by malicious intent and you self-reported them to correct them, you've done what you can within your control. Give yourself credit.

Actionable Steps

Here are a few things you might consider to help handle your stress:

  • Revisit policies and training. If you haven't already, revisit your facility's HIPAA guidelines. Correctional settings have unique challenges regarding privacy and confidentiality.
  • Clarify the reporting process. You may be over-reporting out of fear of under-reporting. Since you're already self-reporting to your supervisor, you could ask for feedback about your reporting process. 
  • Educate yourself. Take additional training sessions or take an online continuing education class. I challenge you to become an expert in HIPAA. This will help you gain confidence.
  • Consult with a mentor or peer for some reality testing. Discussing your worries with a trusted colleague, supervisor, or mentor (outside of your direct reporting chain if that makes you more comfortable) can be helpful. Often, understanding and reassurance from someone who's been through similar experiences can give you perspective.
  • Document your actions. If you are worried about breaches, consider keeping a personal log of actions where you feel you may have faltered or made a mistake, even if you've already reported them. This way, you have a record of your efforts to be vigilant and accountable, and you can look back on it to see how far you've come.
  • Reflect on your accomplishments. You've worked in corrections as an RN, which is not easy. You've helped people through incredibly tough situations, and despite these worries, you are doing your best to uphold the standards of your profession. Give yourself some grace. The fact that you care so much about patient privacy shows that you have integrity and are committed to your role.
  • Stress management: You are ruminating, losing sleep, and second-guessing yourself. Your anxiety level is excessive, and it's hard to function well and stay healthy when you're in a constant state of stress. I'd encourage you to try stress management techniques, like mindfulness, exercise, and breathing exercises, to help ease your rumination.
  • Consider speaking to a counselor, perhaps through EAP.  Having a professional guide you through this mental load can be helpful so it doesn't continue to drain you emotionally.

Lastly, remember that you're not alone in your worries about HIPAA breaches; many nurses experience these same fears and doubts at some point. 

Take care,

Nurse Beth

+ Add a Comment