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Did I break Confidentiality

Nurses   (855 Views | 10 Replies)

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I have a question...I was working in drug and alcohol rehab...a patient decided he was leaving treatment and the doctor had to do a last minute discharge...long story short the guy was discharged with too many suboxone pills( Dr wanted him to only take 10)....when I realized the discrepancy I tried to call the patient and didn't reach him...in the meantime the treatment team leader had reached out to the guts probation officer to get in touch with him..  I am acquaintances with the probation officer outside of work and being g desperate to reach the discharged patient I private messaged the probation officer after I got home and asked him to call the treatment team leader as soon as he could...we discussed the situation in messaging but I dont believe I wrote the patients name...the PO may have ..  anyway the guy brought the extra meds back so that was good but I feel terrible now to think I may have breached confidentiality by reaching out to the probation officer on my own time...Any advice would be appreciated

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JadedCPN has 13 years experience as a BSN, RN and specializes in Pediatrics, Pediatric Float, PICU, NICU.

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Long story short, yes you did break confidentiality. Learn from this and move on.

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6 hours ago, OneRN50 said:

I am acquaintances with the probation officer outside of work

These are the kind of rationales that get people in trouble, yes.

Did you dispense/release to the patient more pills than you were supposed to? If so all the more reason to follow correct steps (I.e. if  you didn't give him the # that the order said and so now there are controlled substances unaccounted for officially). Is this the reason you took alternate measures to contact him?

If we make a mistake (and we all do at some point) then follow the proper procedure for rectifying to the extent you can, and let your superior know in the proper way (whether that involves incident report or some other notification process, etc) so that your actions are accounted for and so that continued follow-up on the issue can occur if you aren't able to fully resolve it.

What are you supposed to do if you have a need or duty to get in touch with a patient for some reason? Whatever it is, do that in a situation like this.

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Thank you for your kind words....yes I felt a need to immediately reach the patient. The doctor normally would send remainder of pills and had asked that morning what he had left I told her and she never called back to say she wanted less sent and did not bring us the chart....I felt like I did everything I could to resolve the situation.    The PO did find him and he did bring back the extra

I take full accountability for my actions...I feel so guilty like if I dont tell on myself I'm not being honest

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JadedCPN you sound as if you're mocking me

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JadedCPN has 13 years experience as a BSN, RN and specializes in Pediatrics, Pediatric Float, PICU, NICU.

1 Follower; 887 Posts; 8,278 Profile Views

33 minutes ago, OneRN50 said:

JadedCPN you sound as if you're mocking me

Not at all. I directly answered your question.

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4 hours ago, OneRN50 said:

The doctor normally would send remainder of pills and had asked that morning what he had left I told her and she never called back to say she wanted less sent and did not bring us the chart....I felt like I did everything I could to resolve the situation.    The PO did find him and he did bring back the extra

I take full accountability for my actions...I feel so guilty like if I dont tell on myself I'm not being honest

This is an opportunity also to advocate that your facility's procedure be cleaned up a little bit. A patient should not be leaving with remainders of prescribed controlled substances when there is no (confirmed/verified) order for them to do so. You should see the order and follow an established procedure which takes into account your state's regulations related to dispensing medications. If you don't have an established policy/procedure related to this, you should. Then make sure you check the order and treat it like any other occasion of administering medication (5Rs, etc.).

You don't need to be wracked with guilt. That's why @JadedCPN wrote the answer that way; s/he isn't mocking you at all. You learned something here and so just move on. But do so remembering to uphold the spirit of the rules you know, and apply them appropriately as situations arise. Next time don't panic and make a situation worse by trying to handle it your own way. 👍🏽

PS- maybe this incident will also sharpen your eye for things/procedures in which what you're doing ("the way we do it here") is not really the way it should be done and bases aren't being covered.

All is well ~

Edited by JKL33

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Another point is we should never text about patients on our personal cell phones.  Even if you didn't mention the pt's name, it is way too easy to give identifying information in this unsecured environment.

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I guess what I'm really asking is should I self report that I contacted the officer....I no longer work there but this issue is killing me I feel so guilty...it wasnt done maliciously I would never do that . But after I thought shoot I shouldnt have talked to him .  What do I do

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Don't over think it.... just learn for the future. 

Edited by sam619

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Thank you....your comment eases my mind some..I appreciate it

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