Did my friend violate hipaa?

Nurses HIPAA

Published

Hello all new poster here, I have a quick question.

Last week my classmates and I were talking about our day. We were all in different sections of the hospital.

anyway another classmate asked my friend how was her day because she wasn't speaking. My friend said; "my day is going fine, the unit isn't what I expected though. I thought it would be like T.V with people running around panicking." Lol...

anyway my friend then said "most of the patients there are for neuro problems, my patients had strokes."

thats all my friend said, a minute or so later she noticed that a hospital employee seemed to be listening into the conversation. She said the woman he "devious eyes" lol

my friend is paranoid, so I'm trying to get advice to calm her down. Did she violate hipaa? Can she get in trouble for saying something as vague as she did because she said it in the cafeteria? She's normally very quiet and hardly says a word but she had a slip. She thinks that woman is going to report her.

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No responses? Lol,This was a scenario I actually made up because I was debating this scenario with my friend.

She believes you could speak vaguely as long as you leave out identifiers and I thought you weren't suppose to mention anything at all ever, unless it's with the patients team.

Am I right or her? Is a diagnosis like copd, stroke or heart disease a identifier? Would a location like elevator or cafeteria change the scenario

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There's HIPAA and then there are an employer's privacy practices. There's also professionalism and common human decency.

Discussing any clinical thing in an elevator is not appropriate whether it officially violates HIPAA or not. It's not what we want to portray to others sharing the elevator (or overhearing the conversation in the cafeteria). We are professionals who are caring for those who are very sick and vulnerable.

That's why we don't do it. Most times it wouldn't be a HIPAA violation, but that doesn't make it right.

Imagine your loved one being in very critical condition and when you allow yourself 10 measly minutes away from the bedside, you take the elevator to the cafeteria and somewhere in that process you overhear two professionals discussing someone (a patient, a human being) who's a "trach-peg" or who "bled out" or "stroked" or any number of other things. Not cool. How devastating to think that the people you are relying on are so....well, callous.

We do have to discuss things amongst ourselves and for the most part I don't believe we are calloused in the way the general public might misundertand us to be. But I think this is pretty serious. There is a time and a place. We don't ever "have" to make small talk about clinical things in public spaces.

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No responses? Lol,This was a scenario I actually made up because I was debating this scenario with my friend.

Why didn't you just present this as a scenario you and a friend were debating? We like to help students but we don't particularly "LOL" at being lied to. Going forward you might find the members here disinclined to answer your questions not trusting that you are being genuine.

That being said, you should not discuss anything about any patient in public areas...ever.

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I'm so sorry, wasn't my intention please forgive me. I was just trying to teach my friend about proper etiquette when she starts clinical. She has this idea that as long as it's vague it's fine even in the cafeteria or elevator.

I apologize again, I'm new here so I'll learn better forum etiquette along with my friend learning about professional etiquette

only reason why I did this was to paint a scenario as it actually happens because this kind of thing is very common among nursing students

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I'm so sorry, wasn't my intention please forgive me. I was just trying to teach my friend about proper etiquette when she starts clinical. She has this idea that as long as it's vague it's fine even in the cafeteria or elevator.

I apologize again, I'm new here so I'll learn better forum etiquette along with my friend learning about professional etiquette

Completely forgiven and thank you for taking constructive criticism like a champ. You'll be fine. Just don't talk about patients in the cafe!

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I guess we're both wrong because I swore cafe talk was a hipaa violation. Even if it's just something like "my patients had copd or a stroke."

I do see it now as more of a professional issue now though.

Her reasoning for her stance was that a stroke or copd wasn't in the patient identifiers outlined by hipaa but it still crosses professional boundaries as you said.

edit: in response to jkl33, I forgot to quote

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Specializes in Varied.

HIPPA is about information that give away information that can identify a patient specifically.

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Specializes in Critical care, Trauma.

When I was in nursing school, all of the students would come back from clinical to go to lunch together. We'd sit at a big table with our instructors and talk about our day. If someone had questions about the paperwork for the day (i.e. figuring out nursing diagnoses for their patient's care plan) then that would be discussed. Obviously we weren't yelling information over the loudspeaker, we were discrete, but we also made it a point to not say any patient identifiers.

I think another way to phrase what others have said above is that, HIPPA is important but so is the idea of not appearing like you're gossiping about patients. And some people can be very sensitive about that and have different thresholds for what they consider to be gossiping. When I worked in Primary Care, the physician I worked for had a large office with 3 client rooms off to one side and a reception area where followup appointments were made. Behind the reception desk was also where her nurses would sit, so the doctor would put her computer on the reception desk and talk to the nurse, i.e. "Please send a script to Walgreens North for Mrs Smith, she needs ___ medication, blah blah blah". Well one patient got offended because she heard the doctor use her name and apparently not much else of the sentence, because she assumed we were gossiping rather than communicating the required information in order to complete her care. Or even I heard of a situation from my nursing school where the clinical *instructor* got in trouble because, of all things, they had two Jenny's in the class. And apparently in pre-conference when she was assigning the Jenny's to patients for the day "Jenny G is in room 104, Jenny S is in 106" -- something like that -- apparently a higher up happened to walk by and assumed that the Jennys were patients and made a big-enough stink about it that it got back to the school. Silly, right? Some people are just incredibly sensitive.

That being said, understanding what does and doesn't constitute a HIPAA violation is important. I have physicians now that refuse to call patients by their room numbers, so every time I call them I have to say the patient's first and last name -- and that's okay, as long as I'm in an appropriate place when they return my page. And I know some nurses that are so extreme about not wanting to get in trouble that they refuse to give out any patient information over the phone because "you can't prove who you're talking to". That gets pretty silly when we're talking about patients who cannot update the family themselves because they're intubated and sedated. There has to be some common-sense, common ground.

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Ok, Ill be the one to give the real world advice and not the "by the book" BS here. Nursing can be stressful, fun and interesting. It is completely okay to say vague comments regarding pt care ect. Saying, "we have a lot of stroke patients today." is perfectly okay. Here is how a colleague explains it to his students, "Imagine your patients family member sitting nearby; you don't want them to know you are speaking about their son/daughter." Patient identifiers aren't just MRNs, names and DOB....saying things like, my patient is on ecmo and 20 drips after a lung transplant is pretty detailed and could be easily identified by the wrong person. Be discreet, be professional and you will be fine. No one expects you to never say a word about your day at work. If any nurse on this site says they don't go home and rant or vent to their spouse about a patient or family, is LYING!

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Specializes in PACU, pre/postoperative, ortho.

It's great that you are considering the seriousness of adhering to HIPAA. Avoiding talking about pts in detail outside of those involved in care doesn't really take any effort. However, it can be more tricky when family or visitors are present at the bedside. We have to be aware that the pt may not want everything laid out for other ears to hear when we do bedside report or assess pts.

This week, I took care of a pt in pre-op which was added onto the schedule. As I reviewed the health history & it was revealed that the pt had a recent dx for an infectious disease, pt requested that it not be revealed to the significant other who had not yet been informed. I assured pt that I would say nothing & I would pass that along to other members of the surgical team to allow pt to address that issue. The SO arrived soon after.

Unfortunately, the surgeon stopped in to see the pt with the SO there before I could warn her; and promptly made reference to the infectious disease. So the significant other not only had to deal with having their loved one going thru surgery for a traumatic event, but also found out that they are at risk for having a health crisis as well; and the pt was likely overwhelmed with feeling helpless, embarrassed & horrified how the information came out.

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