Disclosing Hep C status to patient's husband?

[EllaBella1, BSN]

Basically the situation is this: Patient is intubated with a poor prognosis, is found to be Hep C positive on this admission, husband doesn't know it. She will never wake up to be told/tell him. He is never able to be present while the docs are doing morning rounds to speak with them himself (due to his work schedule, works a graveyard shift at a factory). In this situation, would you notify the husband of her Hep C status and educate him on getting himself tested? Or would you continue to pass it along to the providers, asking them to reach out to him and notify him, knowing that there is a good chance that they would never be able to reach him due to his work schedule/logistics?

[amoLucia]

Don't know about this but is new Hep C reportable to local health Depts? They would be able to contact contacts, yes? If it's reportable ...

[Asystole RN]

Is he the medical power of attorney while she is incapable of making decisions? I always treated the MPOA as the patient themself, as I would notify a patient of a diagnosis/finding/whatever so would I notify the MPOA.

I would not go as far as to recommend any kind of testing or medical treatment but I would notify him of the diagnosis and to seek the medical advice of his provider.

[Been there,done that, ASN, RN]

I would educate the spouse to discuss the patient's history with the physician.

[KatieMI, BSN, MSN, RN]

There is a thing named "family meeting" for such cases.I bet it is not only one, and probably even not the biggest issue on the plate.

[chare]

There is a thing named "family meeting" for such cases.I bet it is not only one, and probably even not the biggest issue on the plate.

Agree with calling a family meeting, at a time that is convenient for the patient's husband. It is not nursing's responsibility to disclose this information.

Basically the situation is this: Patient is intubated with a poor prognosis…Or would you continue to pass it along to the providers, asking them to reach out to him and notify him, knowing that there is a good chance that they would never be able to reach him due to his work schedule/logistics?

Are the physicians only available during morning rounds? None of the treatment team is available to meet with the husband at a time that is convenient for him? If this is what you are saying, I find it sad and very concerning that none of the physician treatment team will find the time to meet with this man and discuss his wife's plan of care and prognosis.

[EllaBella1, BSN]

Agree with calling a family meeting, at a time that is convenient for the patient's husband. It is not nursing's responsibility to disclose this information.

Are the physicians only available during morning rounds? None of the treatment team is available to meet with the husband at a time that is convenient for him? If this is what you are saying, I find it sad very concerning that none of the physician treatment team will find the time to meet with this man and discuss his wife's plan of care and prognosis.

No, they would be able to schedule a family meeting at a time that it works for him. The part that was limiting was his schedule/logistics on his end mostly. He was at her bedside very infrequently during her stay. Our unit does a very comprehensive multidisciplinary morning round with family included- of course this would be the best option if he were able to attend, and thats why I mentioned it. My moral dilemma here was that she did have many many other things going on, nearly all of which took precedence over the Hep C. My feeling was that it was going to be easy to have this information "slip through the cracks" so to speak, since we were dealing with so many more emergent conditions/more important things that needed to be discussed.

For what it's worth my end actions were that I asked the oncoming day shift nurse to mention to the doctor in rounds that the Hep C was a new finding and that her husband wasn't notified yet, but I don't know if it was ever done and I've been thinking of how I could have handled it differently.

[Jules A, MSN]

Isn't it possible that he already knows even if it wasn't mentioned on her intake? As a RN I definitely wouldn't discuss this their husband. As a provider unless there was signed consent or POA I also wouldn't discuss this with the husband. Remember also that HIPAA extends past death.