Do you discuss lab results/x-ray or other test results with patients?

2shihtzus · May 31, 2008

Sometimes I do...it depends on what it is. If its something basic, like WBC, lytes, or H&H, I will let patients know if there is improvement. If its something serious though, like a hepatitis panel or HIV, I tell them they need to wait until the doctor looks at the results. I had one pt ask about the results of a bone scan (to rule out mets). The results were negative, but I called the doctor to find out if I could let the patient know, because they were worried sick about it.

I think alot of times it has to do with common sense, and also who the pts primary physician is.

nightmare, RN · May 31, 2008

On the other side of the blanket, it annoys me if I ask for blood results and they won't give them to me,saying the doctor/nurse will tell you.This means waiting a week for an appointment and worrying about the result for that week!

racing-mom4, BSN, RN · May 31, 2008

Here is what I do, if it is a result and I know the main course of tx I will tell. Ex 94 year old mild MI. Her trop was going up, not drastic, but up. I sat down with son and husband and had the lab that showed the norm and what hers was, I also explained that there can be an elevation due to other reasons etc etc etc, her level was not rising that quickly-but it was rising, i then showed them the ranges for suspected and possible MI. She was in no position to go to cath lab and that was not an option for her. They were very thankful and appreciative that I showed them.

Now on the flip side, the patient in the next rooms H-pylori test came back positive, and Dr was not in yet, and pt was asking, I did not know the course of tx for this, so I deferred that answer for Dr, as I did not want them saying to the Dr, "well the nurse said"...it a tx is involved that I dont know about, I dont tell, I let the pt and Dr decided that one. I simply respond when they ask if the tests came back "I am still waiting for that, " if they keep pressing and I just dont want to give it out, I may even say "I think they faxed it to Drs office and he will bring it during rounds"

If new admit comes onto the unit and has an elevated WBC and I know pt is getting IV antibiotics started and the family asks, I will show them those labs and educate them on normal values. I think the more they know the better they are as far as asking. I have been thanked by many pts for simply sitting down and showing them the lab slip, showing them the normal ranges and where they are and then telling them the goal of tx.

dianacs · May 31, 2008

This is a pet peeve of mine. I have no problem doing so if it's something routine, like a BMP that subsequently calls for electrolyte replacement. But many of the patients I work with require blood, sputum, etc. cultures as well as frequent x-rays. I feel like this is something above and beyond "normal" stuff--yes, it's normal to me, but the if patient needs these types of diagnostic tests, they are usually pretty sick and their management more complex. Often these patients are intubated and sedated, and visiting hours are after the physicians round, so I am often asked by the family about the results. If the resident is at hand I will grab him or her to discuss it with the patient/family. But that is not always possible. Sometimes I can stall--like if cultures are pending--or tell them that the physician will contact them. It's just frustrating to not be able to satisfy the patients' and families' need to know. I'd want to know too! I really do feel like the physicians should be communicating these things but often times they don't.

KyPinkRN · May 31, 2008

Myself, I am hesitant to tell results because often patients/family hear what they want to hear and that's it. For ex. I had a very elderly couple recently, she was admitted with a uti. Her husband was one of those people who asked a question and before you could even answer he would go off half cocked and spout off some other concern. He wound up thinking that his wife had a bleed simply because I could not complete a sentence. When I finally told him that he would have to discuss it with the doc he got even more upset thinking that we were keeping something from them. Eventually he got the charge nurse involved who told him the same thing I did.

robred · May 31, 2008

I do, but I also use comon sense in what results to reveal to a pt and/or family (if pt wants a family member to know).

FireStarterRN, BSN, RN · May 31, 2008

I do with my hospitalized patients, if they ask. In my opinion they have a right to know. Usually this involves h&h, white count, troponins, etc. I don't interpret for them, but I'll do explanations.

Patients need information and they like to be in the loop. They also are comforted by knowing their nurse is knowledgable and responsive to their questions.

Agnus · May 31, 2008

The biggest problem with this is any test must be view within the entire context of a situation.

As you know labs are very general and the same result can mean different things with different patients and at different times.

if someone asks specifics sometimes that can be answered. Pt with a infection has an elevated WBC. I would feel ok telling them, you have an elevated white cell count which indicates you probably have an infection. Or your wbc has come down that means the antibiotic is working.

Or it looks like you are a little anemic.

It depends on the level of knowledge they already have.

I tell them when a test must be explained in a much larger context and or you do not have all the information.

I do not act stupid.

I may say that I do not have access to particular test result or that I do not know how these particular results apply to their situation.

They generally understand only normal or not normal. Even saying normal can leave them with a wrong impression.

I play these case by case. Some people are well educated about their condition and you can give them information that you can not give Mrs Smith because she would have no clue.

You can say I see nothing life threatening and these results have to be discussed within the whole context and frankly the doctor has information that I do not have.

lpnstudentin2010, LPN · May 31, 2008

The NP in my geneticists office informs me of test results all the time. Most of the time I have a test ordered by them, she reviews it with me over the phone. The only time recently that the doctor reviewed it with me herself was when I had been seen in GI and my GI specialist and my geneticist decided together that I should have a rush head CT to rule out increase ICP, due to symptoms I was having. She informed me of the results of that and went more in detail into results her NP had given me previously. This NP is the one who told me that I had the (benign) tumor on my spine. She did it in a caring way and she always keeps me up to date on what is going on with my different tests.

The times that it annoys me are when it is someone who knows nothing who does it. I had my primary doctors MA call me and say an ultrasound I had was normal. I asked what we were going to do next to figure out what was going on. Well I need to talk to the doctor. She should have already known what would be next, even if she had asked the doctor before calling me, they left it up to me to ask.

Riseupandnurse · Jun 1, 2008

I don't think that legally it is in the RN's scope of practice to disclose test results. I never discuss them with patients or families unless I know that the doctor has already done so. With an NP, it's different.

FireStarterRN, BSN, RN · Jun 1, 2008

I don't think that legally it is in the RN's scope of practice to disclose test results. I never discuss them with patients or families unless I know that the doctor has already done so. With an NP, it's different.

Do you have a link to support that? I'd be interested in the legalities regarding this.