Ethical/Personal Dilemma - What would you do?

[EMEddie]

Hello everyone- I need some insight on what to do on this event that occurred 3-4 weeks ago.Currently a RN student in my last semester; there is a friend ( X) in my program whom also works at one of the local hospitals which I do as well. During one of her shifts, X sent me a message stating that one of the patients in her floor was the husband of one of our past professors and whom we were supposed to have as a professor this last semester again. She told me in this message that the patient had been admitted a day before with X Diagnosis and also suffering from X and Y. I felt weird because even though she is a friend, I felt that its not right for her to be sharing that kind of information with me so I told her that she should be careful and respect patient confidentiality.1 week later school started and we find out that this professor will not be teaching our class for a personal issue.. While walking to class on campus, Y, another friend from the program tells me that this professor is probably not going to teach the class because her husband is sick, maybe pretty sick.. As not knowing, I asked Y how did she know, which she replied.. Oh, X told me... That made me feel even more uncomfortable because to be honest I really care for this professor, we have built a great relationship. A few hrs later I find out that X had not only told me, but also to Y and to Z.. Not sure if she mentioned it to more people or not..She violated HIPAA, Hospital Policy and Patient's rights... Should I mention this to my professor? That X told several of our class about her husband's condition? Should I contact the nurse manager of her floor and mention what X mentioned to me and several others? If I dont do it because she is a friend, I will be failing one of my duties as a healthcare provider and preventing this from happening in the future.. I would be very ****** off and upset if someone was leaking information from a family member..If I do say it and she gets fired from her work I will feel guilty, and what if she gets kicked off the program? She has done certain things in the program that I was not happy about in the past, like cheating while on an exam with another student and the professor had a serious talk with them..I just don't know what to do?? What would you do?Tell the professor? Tell her Nurse Manager? Thanks in advance.

[SuzieeQ]

You need to report to her employer. period. They may ask why you waited 3-4 weeks to report the incident.

[roser13, ASN, RN]

OP....I think you need to advise your friend to shut her mouth and tell her you no longer want to hear a word for if you do you will be going to her boss as well as the program head. Let her know this is a HIPAA violation and she is chucking her career away.Loose lips sink ships....I think your professor has enough to deal with right now and your unethical friend? Will hang herself when given enough rope.However.....if you say nothing there is a danger of being duplicitous as just as guilty as she.....it is clear in HIPAA regulations that a failure to report can lead to punishment as well.I would have a meeting with my manager and tell her what I know......let your manager advise you. Keep it at the workplace as that is when the violation occurred.

Esmeralda, ordinarily I agree with everything that you post. However, another poster originally stated something that resonated with me: Notifying the employer prior to notifying the school (thereby not giving the school a chance to take corrective action) may very well put the school's relationship/contract with the hospital in jeopardy. As has been said frequently, institutions frequently take quick, drastic action when HIPAA is involved. This is NOT isolated to the place of business. Students were discussing the private details in class. I still say tell school first, then step back and let them deal with the whole mess. OP, I hope that you will come back and give us an update.

[FDW630]

What a crappy situation to be in, OP. I think if it were me, I'd go to my manager at work (since that's where it happened), tell them what I know to be fact and let them handle it. If she heard it from the family, she can tell them that personally. I wouldn't want to risk my job or future as a nurse to protect someone with her background. It sounds kind of cold to say it like that, but if she has a history of cheating then this most likely isn't an innocent mistake. If you are at risk of being dragged into it and being disciplined, I would not even think twice about taking a fall for someone like that. No real friend is going to put you in that position.

[roser13, ASN, RN]

Esme12, please forgive my ipad's autocorrect to "Esmerelda!"

[BuckyBadgerRN, ASN, RN]

If it were me, I'd contact her employer. THEY will deal with her from there. She violated HIPAA while working in their facility, not while acting as a student of your school, so I'd leave your college out of it. If she's dismissed from the program, that'll be the fallout she'll have to deal with, but she wasn't "their problem" when she made such a STUPID decision....

[RX.Coffee]

Have a sincere but absolutely firm conversation where you clearly relay your disappointment and disgust related to her behavior. She must also understand that she needs to stop all discussions pertaining to the said patient's condition; or you will have no choice but to turn her in. ( First lesson in advocating for your patient) In the real world, she would not pass go or collect $200. She would be terminated and rightfully so. I am curious about your institution??? To be caught cheating in most schools would entail automatic expulsion or at a minimum, failing the class. Best of Luck and remember Nursing is always an adventure.

[BlueDevil,DNP, DNP, RN]

head down, mouth shut, MYOB. best way to stay out of trouble!

[psu_213, BSN, RN]

Here's another issue with notifying the school, not the hospital. The OP goes to the school and says, "Sally Smith violated HIPAA." Now anyone could go to the school and say someone they did not like, who is a student at the school, "violated HIPPA." Now in the school's quest for more info, the OP (and I am not saying the OP in this case would do this) would say "Sally Smith told me Dr. H's husband is in the hospital." This may be something Dr. H did not want want spread around the school. So now, in addition to Sally Smith violating HIPPA, Dr. H's privacy has been violated.

Something to think about before the OP tells the school what happened.

[BrandonLPN, LPN]

head down, mouth shut, MYOB. best way to stay out of trouble!

Exactly, MYOB is advice that never goes out of style.

[Been there,done that, ASN, RN]

If it is required of you... per hospital policy... to report the privacy violation, then that is your answer.

If not, butt out, she will hang herself eventually.

[snuggles49]

If it were me, I'd contact her employer. THEY will deal with her from there. She violated HIPAA while working in their facility, not while acting as a student of your school, so I'd leave your college out of it. If she's dismissed from the program, that'll be the fallout she'll have to deal with, but she wasn't "their problem" when she made such a STUPID decision....

Correct....the school is not the one to notify unless the individual violating Hippa did so in the capacity as a student while doing Clinicals. Report the incident to your Hippa Officer and let them do the investigation and follow thru.

[ArrowRN, BSN, RN]

man-nurse2b: This person is not only a nursing student but also works in a hospital. She has had plenty of training regarding protecting privacy and HIPAA violations. If she had only spoken to her friend about it, maybe you have a point. But she texted the information, which is the same as broadcasting it in today's technology.

This is not OK at all. We are not condoning backstabbing at all, we are all concerned that this person's actions are in such clear violation of ethical and legal rules that we actually fear for her future as a nurse.

Also, to address you accusation that we are all liars, let me say this. There is a big difference between getting home and talking to your spouse about the hard day you had because "my patient was really hard to deal with" or whatever and saying, "Hi honey, you know who was my patient today? Mrs. XYZ! Can you believe it? She overdosed on cocaine!". That is a HIPAA violation. Sharing general information about your patient load without any identifying information is not. So, no, we are not lying when we say that we actually abide by HIPAA rules and regulations.

I don't think this girl was uncomfortable or whatever scenario you've dreamed up. I think she has no regards for the rules of the profession she is wanting to enter (and the fact that she cheated on an exam speaks to her character well).

To address you second paragraph. I have actually been assigned to care for patients at times that I realize I know from outside the hospital. When faced with this situation, I have acknowledged to the patient that I understand it may be uncomfortable to be cared for by me and could switch assignments if they wanted me to. No one has asked me to not care for them and I reassured them that nothing I learned about them during their hospital stay would ever leave the hospital and their privacy was the most important thing to me. Not a big deal. HIPAA always respected.

Thanks for the info. People can get mad if they want to at my post, I got several nurses in my family so don't take it personally, but noone really knows what is going on in that girls head. If I see someone I know I'd probably ask to be reassigned as you suggested. Texting it was a really bad idea I agree with that also. I agree with the other poster..she will eventually "hang" herself as people who don't follow rules often do and lastly poster who said...

"head down, mouth shut, MYOB. best way to stay out of trouble! "

To the main poster, just ignore all our opinions and do whatever it takes to clear your conscience and by ready for the consequences, good and bad.