Dealing with family members who are also employees.

[gentle_ben_RN, ASN]

I've dealt with family members before who were employees of the hospital where I work, but it has never been an issue until today. A patient's daughter, a RN at my hospital (with a high reputation I might add) just waltzed up into the PACU unannounced. Patient was a total hip with spinal and was very drowsy from fentanyl, versed, diprivan ect. that she had received during her case. Sats were low initially so a face shield was applied at 40%. Also BP was low from spinal, so Neo was being started too. Obviously not ready to be visited by family and I sure as heck hadn't called for them yet. :angryfire Daughter was already angry over other issues prior to surgery not related to PACU. She begins baggering me over orders, labs, ect right in the middle of PACU and proceeds to go to our nurses station and start making phone calls. I pretty much told her she "Knows the Rules" and I can't tell her the information she wants. Hello? HIPPA? Meanwhile, my charge nurse was totally letting it slide because the nurse has "worked here forever" and "she's just worried about her mom". I on the other hand am thinking it is very inappropriate. I understand she is worried and a I know it's hard when you're a nurse on the other side of care. But this was a little extreme. I won't go into detail, but other issues arose, and it didn't go well. I was just wondering if this has ever happened to anyone else and how they handled it? Am I the one who was out of line? I believe in professional courtesey, but I'm not putting my butt on the line with all the privacy issues involved with HIPPA. I've just been bothered about it all afternoon. What do you all think? Thanks.

[Marie_LPN, RN, LPN, RN]

That lady was WAY out of line. She had no right to waltz back there, and it's obvious she used her 'position' to her rule violating advantage. Not to mention that my badgering you, she was interfering with pt. care!

I'd file a complaint, in person and in writing.

[Ruby Vee, BSN]

i've dealt with family members before who were employees of the hospital where i work, but it has never been an issue until today. a patient's daughter, a rn at my hospital (with a high reputation i might add) just waltzed up into the pacu unannounced. patient was a total hip with spinal and was very drowsy from fentanyl, versed, diprivan ect. that she had received during her case. sats were low initially so a face shield was applied at 40%. also bp was low from spinal, so neo was being started too. obviously not ready to be visited by family and i sure as heck hadn't called for them yet. :angryfire daughter was already angry over other issues prior to surgery not related to pacu. she begins baggering me over orders, labs, ect right in the middle of pacu and proceeds to go to our nurses station and start making phone calls. i pretty much told her she "knows the rules" and i can't tell her the information she wants. hello? hippa? meanwhile, my charge nurse was totally letting it slide because the nurse has "worked here forever" and "she's just worried about her mom". i on the other hand am thinking it is very inappropriate. i understand she is worried and a i know it's hard when you're a nurse on the other side of care. but this was a little extreme. i won't go into detail, but other issues arose, and it didn't go well. i was just wondering if this has ever happened to anyone else and how they handled it? am i the one who was out of line? i believe in professional courtesey, but i'm not putting my butt on the line with all the privacy issues involved with hippa. i've just been bothered about it all afternoon. what do you all think? thanks.

clearly, you needed to do some limit setting from the moment you first met this woman! were you in any position to take the time to talk to her? if not, i'd ask her to leave until you were ready to talk. as far as hipaa goes, the patient's designated next of kin gets answers -- had she designated anyone? if she said the daughter could get information, then the daughter could. every time i've goine into the hospital (5x in the past 6 months due to my back injury and the subsequent surgery, complications, etc.) i've had to sign a form designating the person they should give information to. if your patient had signed such a form designating someone other than the daughter, then the daughter wasn't entitled to that information. as far as using your nursing station for phone calls, etc., that's just plain inappropriate and you should have set her straight as politely as possible. your charge nurse should have backed you up as well.

[Laurel RN]

Being allowed information and being allowed in a place where family members are not allowed are 2 different things. And being allowed information does not mean she can randomly go through the chart at will. When I was in the hospital I could not even go through my own chart, but I could request a copy of my medical records. And it does not mean we stop caring for a patient just b/c family is there. The patient is the number 1 priority, and it sounds like you had your hands full with just the patient.

The charge nurse should have realized that this person was obviously very stressed, anxious, worried, upset, whatever, and have taken her to a room with some privacy. She could then talk to her (if she had the time and was close to her) or found someone to be with her. And when you were able the charge could have breaked you so you could talk to her. We like to take care of our own, but that is over the line. Also, maybe someone should have told her before surgery "we would like to let you back in PACU, since you work here, but as you know we can't, but we will keep you updated as much as possible." It's always easier to set the rules up front than to try to do it midstream (even though she should know already).

BTW, what about HIPPA for the other patients in the PACU at that time?

Maybe your unit needs to come up with a specific policy for this and send it out to all personnel.