pt. confidentiality between you and your fellow RNs

  1. does the law protect your patient's confidentiality from other staff rns in the emergency department?

    i was under the impression that the only staff that are privy to my patient's information (i.e. chief complaint, pmh, etc.) are me, clinical coordinator, the attending md, unit secretary, registration clerk, and those performing ancillary services (radiology and ecg).

    i simply have a peeve when i find other rns flipping through my patient's chart asking, "hey, what's going on with this patient?"

    thanks in advance,

    carotid

    supplying oxygen-rich blood to millions of brains globally
    Last edit by Carotid on Apr 24, '05
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    About Carotid

    Joined: Feb '04; Posts: 80; Likes: 4
    ER RN

    20 Comments

  3. by   UM Review RN
    Because if that patient has a huge problem, the other nurses will be better prepared to jump in and help.

    At least, that's how it works on our unit. We all have an idea of which patients are more fragile because we all help one another.
  4. by   MrsWampthang
    If your coworkers are flipping through charts that do not belong to their own patients, then they have too much time on thier hands. You could do one of three things: tell them politely that you would like them to keep thier cotton pickin hands off your charts! :chuckle Ask your charge nurse to remind everyone working that night to keep their eyes on their own papers :chuckle Or have a talk with your manager and have her bring it up at a staff meeting to everyone in general as a reminder about HIPPA and need to know basis type nosyness. Anyway, like I said, your coworkers need to stay away from charts that they have no need to know anything about. They are going to end up being seen doing that by the wrong person and then could face disciplinary action.

    Pam
  5. by   UM Review RN

    i simply have a peeve when i find other rns flipping through my patient's chart asking, "hey, what's going on with this patient?"




    allow me to amend my answer. we give a brief verbal report to one another; we don't flip through each other's charts unless we're asked to or unless we're orienting/precepting the nurse whose patient has the problem.


    [that's weird. i've tried three times to get rid of the bold-face but it keeps coming back..... ]
    Last edit by UM Review RN on Apr 24, '05
  6. by   LPN1974
    Where I work, all the nurses know what's going on with all of the patients.
    A co-worker and I discussed something last night on one of my patients.
    I needed some advice from her so I told her what was going on.
    As nurses in the same facility, I would say yes, they need to know. But we don't take this information outside of the facility. Our assignment changes often, so the other nurse might take of the patients I took care of last night, so all the nurses have a need to know.
    And there are other staff, also, where I work, who are not nurses, who come in and look at our charts, but they "have a need to know", so it's ok.
  7. by   Tweety
    Where I work the Charge Nurse gets a report on all the patients. The rest of us have a need to know only about our own patients and we are told not to discuss our patients with other nurses unless there is a need to know. (The reality is entirely different sometimes, just talking policy here.)

    Collaborating with a coworker, sharing information so you can better care for the patient is acceptable. It "using your resources" or somethingspeak like that.

    Picking up a patient's chart that isn't your patient and flipping through it to be nosy is a HIPPA violation where I work.

    p.s. I work in med-surg and just realized I posted to the ER board, but I'm sure as it's the same facility our ER follows the same "need to know" policy. Obviously in the ER you need help and people need to know besides yourself. But what you describe is wrong.
    Last edit by Tweety on Apr 24, '05
  8. by   traumaRUs
    I work in an ER as a case manager. I look through many patient's charts a shift. As someone else stated, "it is a necessary part of my job." Many times in the ER, we might have two nurses (or more) caring for a patient and yes, they might discuss the care of the patient outside the room (at the desk or breakroom - somewhere private), but again this is a learning environment. However, we are also very careful of one another's privacy. We do not "flip through charts" of our fellow employees or someone that we are not caring for.
  9. by   mercyteapot
    Quote from Traumamama59
    If your coworkers are flipping through charts that do not belong to their own patients, then they have too much time on thier hands. You could do one of three things: tell them politely that you would like them to keep thier cotton pickin hands off your charts! :chuckle Ask your charge nurse to remind everyone working that night to keep their eyes on their own papers :chuckle Or have a talk with your manager and have her bring it up at a staff meeting to everyone in general as a reminder about HIPPA and need to know basis type nosyness. Anyway, like I said, your coworkers need to stay away from charts that they have no need to know anything about. They are going to end up being seen doing that by the wrong person and then could face disciplinary action.

    Pam
    HIPAA protects the patient from the institution or anyone in it disclosing their medical information outside of the institution. Given that anyone to whom the information is disclosed within the institution (even in so casual a way as flipping through a chart and making an offhand remark) is bound by confidentiality, I don't think a HIPAA violation has occured. I'm not saying that I understand why the nurse felt the need to be looking through another patient's chart in the first place (or where she found time to do so), but I doubt it rises to the level of a HIPAA violation.
  10. by   mommatrauma
    I think as a department we are all part of the health care "team" taking care of the patient. While I'll have to admit I rarely have enough time to flip through my own patients whole chart I don't see any problem with other nurses doing so. I often look at nurses notes to see how nurses chart things, I like to learn from their notes...I often have my orientees read nurses notes so they can see the different styles of documenting and how things probably should be done and maybe even how they shouldn't be...The ER is a learning experience, if my coworkers think there is something to be learned from looking at my patients chart, then I'm all for it. The simple fact that if I should be off the unit and the other nurse may end up potentially being responsible for my patient, I think removes them from HIPAA violation.
  11. by   hollyster
    In our unit we give a generalized report. Our nurses also act as the code team. So if we have to leave the unit for a code or a road trip the other nurses need to know what is going on for the pt's safety.
    My BIGGEST BEEFis that nurses are not given the same amount of courteousy as our pts. I had some tests run and there were messages on my answering machine by the time I arrived home expressing concern over the test results. I had not even been informed of the results myself. It seems HIPPA only concerns pts and not staff.
  12. by   ERNURSE4MS
    Where I work, we work as a team. I might have pt A,B,&C but we look out for one another and if I am stuck in room A my coworkers will check for orders on my other pts and cover the gap and same for me. We are there to help each other any way we can. This is not a HIPPA violation, it is putting pt care first. But I work at a small ER, the same might not be true in the large hospitals.Also, in ERs the tendancy for pts to show up repeatedly for the same treatment for different problems( Ineed demerol for my back, my head , my foot) or the same complaint day after day. If I know that a pt has shown up frequently and the other nurse doesn't I can give her the heads up. We have to be there for each other.
  13. by   mommatrauma
    Quote from ERNURSE4MS
    Where I work, we work as a team. I might have pt A,B,&C but we look out for one another and if I am stuck in room A my coworkers will check for orders on my other pts and cover the gap and same for me. We are there to help each other any way we can. This is not a HIPPA violation, it is putting pt care first. But I work at a small ER, the same might not be true in the large hospitals.Also, in ERs the tendancy for pts to show up repeatedly for the same treatment for different problems( Ineed demerol for my back, my head , my foot) or the same complaint day after day. If I know that a pt has shown up frequently and the other nurse doesn't I can give her the heads up. We have to be there for each other.

    I work in a 48 bed level 1 trauma center...we work the same way
  14. by   LPN1974
    Quote from hollyster
    My BIGGEST BEEFis that nurses are not given the same amount of courteousy as our pts. I had some tests run and there were messages on my answering machine by the time I arrived home expressing concern over the test results. I had not even been informed of the results myself. It seems HIPPA only concerns pts and not staff.

    If you had tests run that puts you in a patient category, and someone in trouble.

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