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

[KyPinkRN]

it seems like everyday i have at least one patient ask me the results of their (fill in the blank here with test/lab). i usually tell them that the doc will discuss any and all test results with them. most of the time this doesn't satisfy them and they keep pressing me for the results... i am curious how other people handle this situation.

thanks in advance for your replies.

[hypocaffeinemia, BSN, RN]

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.

As far as I'm aware, the Texas NPA doesn't say anything either way about disclosing test results. As I student, I'm not allowed to anyway, but according to the nurses I work with (who will be my peers and mentors upon graduation), it's a necessity with most patients and families. However, they state it's a fine line to walk because while there is technically nothing preventing us from disclosing results, providing any sort of interpretation for the results crosses over into the "practicing medicine" territory. They say that they can explain in generalities what the lab means, and what the potential courses of treatment may be, but of course leave actual interpretation and implementation up to the doctor.

I can only guess that it is difficult to walk this line between interpretation and explanation.

I'd love to hear from some physicians to see what they think is appropriate as well.

Edit to add: I work in an ICU, and I realize that nurses here are often extended liberties by physicians nurses in less acute areas may not be granted. This, of course, doesn't avoid the scope of practice question. Also, my facility is a private facility without residents or interns.

[lpnstudentin2010, LPN]

I wonder where TiredMD is. It would be nice to hear from him on this.

[angel337, MSN, RN]

you just have to use your judgement. it depends on how sick the patient is, how well they comprehend what is going on with them and so forth. doctors sometimes interpret tests to the patient a different way than a nurse would, so be careful giving to much information. i try to stick to the basics without getting to detailed and then have the doctor do the rest. all you need is for the patient to say "...well the NURSE told me everything was fine". don't want to go there.

[xigris79]

just the other day i took my pt for a ct of the head bc she became unresponsive (already vented). i got the ct results very shortly after the scan and it showed she had multiple new infarcts in her brain. the family was in the room with her when we got back and they kept pressing me for the results. No doctors were around of course (non-teaching hospital at night) and i felt like this is something the doc should be telling them. i told the family the results were pending till the doc finally called me back and i could put him on the phone with them. they had many many other questions for the doc that i could not have answered for them. On the other hand, if the scan was negative I would have told them just that.

[lpnstudentin2010, LPN]

I have always appreciated this np for keeping me informed. She has been amazing through a time that I have been having a hard time. She always told me carefully, but kept me informed.

I do though understand though, how it could be a worry to a nurse to give a patient test results, not knowing how they will respond and other things.

[texas2007, BSN, RN]

In my nicu, we usually disclose things that nurses can interpret like routine labs, blood gasses etc. However if it's something a specialist usually reports on like head ultrasounds, echos, chromosomes, we will just say the results are pending, even tho we might have some preliminary info. The doctors usually follow up by the next day.

[wooh, BSN, RN]

Like others, it depends. If it's something I can put off without much question, "Results usually don't come back until..." and give a time that the doc can give results. Then I talk about the bureaucracy, "This person has to do this, then this person that, and it goes here and there." But if I can get away with something reassuring (and the results really are reassuring), then a "Oh, everything seems to be going in the right direction for now." It's a judgement call, and a tough one sometimes. And if called for, I'm perfectly comfortable saying, "That's one of those labs I'm not really familiar with, and I could give you numbers, but I don't understand those numbers very well, so I'm going to have to put this off until the doctor comes through because I don't want to mislead you."

[TazziRN, RN]

The NP in my geneticists office informs me of test results all the time.

But this is different. NPs are treating providers and are allowed, in their scope, to interpret results and treat accordingly.

Staff RNs, however, are not supposed to interpret. We have to know the norms and what direction of treatment to anticipate going in, but we're not supposed to interpret.

What I say to the pt depends on the pt and the situation. If it's someone who panics easily or who may only "hear what he wants to hear" and run with it, I say nothing. I'll even lie if I have to and tell them I don't have any results yet.

I have an example of my best-case scenario: I had a home health pt who had twice daily vanco for 6 weeks, and I was scheduled to take his PICC line out last week. He was nervous about his labs, afraid that something would show up to delay the pull. When I got the results I called him and told him they looked great, that we were on schedule to pull the PICC the next day. I have also called HH pts and told them that a result came back abnormal and that I was putting in a call to the doc, for them to anticipate having to pick up a prescription.