Did I Violate HIPPA?

[nursingj]

feb 15 by nursingj

i need your help.

the hospital where i worked said i violated hippa several times and even reported it to the state board of nursing. i was the rn on staff on the evening shift working with one other person (not a nurse) and 16 patients.

did i violate hippa? i worked in a rehab (drug) hospital/unit.

1. i had a patient say he/she was going to kill someone (named a specific person). this is a duty to warn. just to make sure i called the psych unit and discussed this with an rn there. she agreed it was a duty to warn. just to make sure i called the nursing supervisor (actually 2 of them as it was a change in shift) both said it was a duty to warn. so i did. i called the police station and reported it. my boss was so mad she said i violated hippa and wrote me up.

2. i had a new patient arrive who i had not admitted yet. he/she was wearing a trench coat and had a bag with him/her. i did not have a chance to search his/her belongings yet. she/he sat on the floor and was crying out loud, "someone please shoot me, i just want someone to shoot me in the head". still working with only one other person on the unit (not a nurse), i called the nursing supervisor for help, as he/she needed to go to the er. the hospital nursing supervisor sent two police officers to the unit and they took he/she to the er. my boss said i again violated hippa, because i allowed police officers on a locked unit.

3. i was admitting a patient, and wrote "jack" instead of "jill" (first name only) on a drug screen cup. i gave the cup to the new patient "jill" with "jack's" name on it. "jill" brings the urine cup back and gives it to the secretary and said "i don't know who "jack" is but i don't want "him" to get in trouble with my dirty urine". i was fired for that "violation".

the unit director and the secretary are very good friends . the secretary use to kick my door, throw charts at me and even threatened me while i worked there for two years.i reported this however nothing was ever done. i fretted when i walked into work, about what "i did wrong yesterday". i was dedicated and often worked past my shift until 2 or 3 in the morning, (was a salaried employee) because of the heavy workload, and no night shift nurse to report off to. i needed the job so i stayed.

unemployement was given because the charges were unfounded. the state board of nursing also said the charges would not be made public as it was unfounded, but in the future it would require disiplinary actions. meanwhile, i cannot get a job. no one wants me. i do not make it known i was fired when interviewing, nor do i lie, i just tell them "it was time for a change".

i am so discouraged with nursing, i am an "older nurse" and no one wants me. i am like a peice of trash thrown out of nursing. plenty of apps and interviews, without a job. i feel like giving up.

[Whispera, MSN, RN]

in this first scenario, you had the duty to warn the intended target, not to call the police. did someone tell you that you should call the police? now the patient has a report on record at the police department when he might have been blowing steam. i'd need more information about it all to make a more intelligent comment about it.

1. i had a patient say he/she was going to kill someone (named a specific person). this is a duty to warn. just to make sure i called the psych unit and discussed this with an rn there. she agreed it was a duty to warn. just to make sure i called the nursing supervisor (actually 2 of them as it was a change in shift) both said it was a duty to warn. so i did. i called the police station and reported it. my boss was so mad she said i violated hippa and wrote me up.

what's the policy where you work? do the police always take people from one floor to another? there isn't hospital security that can do this? again, now this person has had a report made about him. again, more information is needed. 2. i had a new patient arrive who i had not admitted yet. he/she was wearing a trench coat and had a bag with him/her. i did not have a chance to search his/her belongings yet. she/he sat on the floor and was crying out loud, "someone please shoot me, i just want someone to shoot me in the head". still working with only one other person on the unit (not a nurse), i called the nursing supervisor for help, as he/she needed to go to the er. the hospital nursing supervisor sent two police officers to the unit and they took he/she to the er. my boss said i again violated hippa, because i allowed police officers on a locked unit.

i'm confused about this. it's not a violation of privacy laws, though, since no information about anyone was shared with anyone else. 3. i was admitting a patient, and wrote "jack" instead of "jill" (first name only) on a drug screen cup. i gave the cup to the new patient "jill" with "jack's" name on it. "jill" brings the urine cup back and gives it to the secretary and said "i don't know who "jack" is but i don't want "him" to get in trouble with my dirty urine". i was fired for that "violation".

since unemployment was given because the charges were unfounded, there's no reason such things in the future, if unfounded, would require disciplinary action. unfounded accusations are just that--unfounded. they don't bring punishment. it could be you can't get a job because there just aren't any right now. if you're getting interviews, that's a good sign. keep trying and don't give up!unemployement was given because the charges were unfounded. the state board of nursing also said the charges would not be made public as it was unfounded, but in the future it would require disiplinary actions. meanwhile, i cannot get a job. no one wants me. i do not make it known i was fired when interviewing, nor do i lie, i just tell them "it was time for a change".

[Whispera, MSN, RN]

I understand the first two now. Those weren't your decisions. Being fired for the third incident makes no sense.

[MomRN0913]

I think these are not HIPPA violations and for the last one, that is ridiculous, it is a mistake which caused no one harm.

On the first, I would have called the police too. Who else is going to warn the guy? You don't know him personally this is something that the police have to do.

Be glad your not there anymore. They were clearly out to get you, and it is sad.

The BON I am sure will find this unfounded also. Good luck with the job search, don't give up!

[nurseprnRN, BSN, RN]

i suggest very strongly that you go to http://www.ocr.gov and read the hipaa faqs. they are in easy english and will give you a much better understanding of the issues. i'll bet your administration hasn't really read them, either.

i often have to obtain medical records and have always said that, "i can't give you that because of hipaa," really means, "i am too lazy to get up and read the manual on the other side of the nursing station," or, "i slept through that inservice," or, "i don't want to tell you anything and if i invoke 'hipaa' you'll back down without a murmur."

as fezzig says in the "the princess bride," "i don' think that word means what you think it means."

health insurance portability and accountability act... one p, 2 as. hipaa.