This incident happened recently, and I would like to know what you all think.
It is unknown why this gentleman was in the ER at a Texas hospital other than he drove himself there one afternoon. One of the tests ordered was a BAC level. By the way, according to the ER nurse, he smelled of an unknown alcoholic beverage. A little over an hour had passed, and he decided to leave. The ER Nurse tries to convince him to stay, but he tells her that his fiancé will be meeting him in the parking lot. The Nurse follows him, and she sees him getting into the driver’s seat of his pickup. There happened to be a Sheriff’s Deputy in full uniform that was working extra as hospital security that day in the ER. The Nurse tells the Deputy that she believes the gentleman is intoxicated. The Deputy asked the Nurse what led her to believe he was drunk. The Nurse said, “he has a strong odor of an unknown alcoholic beverage, and his BAC is .367.
Do you think the Nurse breached patient confidentiality? I think it’s safe to assume the Nurse was trying to keep the patient and the community safe; however, how many of us believe she didn’t need to disclose his BAC level?
Nurse should not have disclosed actual lab values ( alcohol level). I believe that is a HIPAA violation. However telling the police officer said person smelled like alcohol and/or appeared intoxicated is fine. Especially considering said person was going to operate a motor vehicle.
This incident happened recently, and I would like to know what you all think.
It is unknown why this gentleman was in the ER at a Texas hospital other than he drove himself there one afternoon. One of the tests ordered was a BAC level. By the way, according to the ER nurse, he smelled of an unknown alcoholic beverage. A little over an hour had passed, and he decided to leave. The ER Nurse tries to convince him to stay, but he tells her that his fiancé will be meeting him in the parking lot. The Nurse follows him, and she sees him getting into the driver’s seat of his pickup. There happened to be a Sheriff’s Deputy in full uniform that was working extra as hospital security that day in the ER. The Nurse tells the Deputy that she believes the gentleman is intoxicated. The Deputy asked the Nurse what led her to believe he was drunk. The Nurse said, “he has a strong odor of an unknown alcoholic beverage, and his BAC is .367.
Do you think the Nurse breached patient confidentiality? I think it’s safe to assume the Nurse was trying to keep the patient and the community safe; however, how many of us believe she didn’t need to disclose his BAC level?
A BAC that high would constitute a medical emergency. I'm surprised he was able to make it to the ER driving himself there. I'm surprised she hadn't noted other signs of obvious impairment, rather than just an alcohol "beverage" like smell. I'm surprised he was able to get in and out of pick up truck and walk in without stumbling over.
He has alcohol poisoning by ingesting some type of alcohol.
There's a lot of missing details so it's hard to say what's what and what's not. What prompted him to go to the ER, first off...his S/S, etc. In my opinion, she could have and should have handled it at the bedside for safety and legal purposes.
If he was that intoxicated, call and have security come to him before he walks off. Give him a BA test as he is trying to leave (which I am assuming he is leaving AMA?) and explain that if he fails and leaves anyway she has a duty to alert (LE) because it's a safety issue... he's parked in their lot... it's also public intoxication. I believe she could have said that they legally need to see a designated driver pick him up and sign for him that she is his "care taker" while he isn't of sound mind with that BAC to actually sign himself out AMA legally, I don't think.
Otherwise, I'd assume the Deputy would see he'd be visibly impaired and smelling, so her stating the BAC test result wouldn't even be necessary.
I've never seen or heard of a nurse following a patient out to see if they are lying or not....and THEN tell security their concern (which I think would be a side gig for an off duty deputy). Usually handled before he'd even get to leave and get in car. By time he is in car it's kinda too late.
Long story short, imo, she didn't need to disclose it....as there should/would have been other proofs, as seen by the deputy himself, or security.
I would say that what the patient smells like is irrelevant if the nurse has the BAC result. Go by facts, not subjective observations.
That's true but it usually takes an hour at least to be admitted and seen, let alone anything else. So that number probably would have changed by the time he was leaving anyway. Could he come back with some kind of lawsuit....that's the real question.
Specializes in Med/surg,orthopedics,emergency room,.
Whether she did violate HIPPA is suspect. There are some medical conditions that will appear to be alcohol intoxication. I think she should have just told the sherif about the odor of alcohol and let the sheriff take it from there.
The patient leaving the ER and getting in his vehicle with the intention to drive makes disclosing the the BAC to officers before the inebriated patient drives away allowable as preventing him from driving impaired is a potential matter of public safety. In that situation there is likely not enough time to obtain a warrant before this patient drives the vehicle and the potential for harm to the patient or the public that could be caused by him driving with an elevated BAC outweighs the patient's right to not having that lab value revealed to the police.
ppfd, BSN, EMT-P
86 Posts
LOL
I "might" know some ED nurses that "might" share this information and more on a daily basis.
I've been in some big and busy ED's and "maybe" everybody talks about "everything".