Published May 23, 2009
vashtee, RN
1,065 Posts
A friend of mine from nursing school is friends with a patient on my floor of the hospital. He (the patient) is apparently not doing well.
I cared for him two days ago, and at that time he was improving, but apparently after my shift, he took a turn for the worse. (He has hepatitis and pancreatitis due to taking some OTC body-building medications, and developed some additional issues while in the hospital.) Incidentally, I took a telephone order for some additional narcotics for pain at the end of my shift (I didn't give them myself), and at the time I took the order, I was worried about his liver function, and now I wonder if that was a contributing factor to his worsening condition. Of course, being a relatively new grad, I admit that I worry about this every time I give narcotics to a liver patient.
My friend (also a new-grad nurse) called me yesterday knowing I work on that floor, wondering if I knew the patient, and pressing me for information, and other than confirming I took care of him, I danced around her inquiries as best I could. Then she railed against the doctors on staff. The guy was supposed to be transferred to a prestigious hospital, but didn't want to go. To be honest, this guy's primary doctor isn't well-respected by the hospital staff (most think it is long past time for him to retire), but I was afraid to tell her this for fear that might be a HIPPA violation.
How do you guys handle these situations? Do you tell people when you think they should find another doctor?
Also, my friend wants me to try to arrange to care for this patient myself (he felt I was good at bedside, but didn't care for his nurses yesterday). I really don't want to care for him again because of our mutual friend and his worsening condition. Do you all care for people when they are friends of friends?
Penelope_Pitstop, BSN, RN
2,368 Posts
Your friend needs to chill out, I think.
She should know that you can't reveal too much about a patient.
It sounds like she's setting you up to be in the middle of a touchy situation. Usually, I'd say it's no big deal to care for a friend of a friend. However, in this case, I'd probably inform those who make the assignments about the situation, because it's best to avoid taking care of this patient if at all possible.
Wish you the best with this one.
Fish Feng
6 Posts
it makes no difference , i think !
taking care of the patient is one thing,the relationship is another thing!
being a nurse , u should do ur best no matter what the result is !
To ur friend, what u need to say is " i will do my best "
she will understand it !
according to the doctor, in my opinion , u could tell her ur idea
then ask her to get more information about him from others !
cause different guys stand in different sides !
Your friend needs to chill out, I think. She should know that you can't reveal too much about a patient. It sounds like she's setting you up to be in the middle of a touchy situation. Usually, I'd say it's no big deal to care for a friend of a friend. However, in this case, I'd probably inform those who make the assignments about the situation, because it's best to avoid taking care of this patient if at all possible. Wish you the best with this one.
Thanks. I agree I need to avoid caring for this guy. Do you think it is appropriate to tell my friend (if asked) that I would get another primary physician? FWIW, I think the consults on the case are fine.
Virgo_RN, BSN, RN
3,543 Posts
Your friend's behavior is inappropriate. I understand she wants to advocate for her friend, but she is going about it entirely the wrong way. If I were in your situation, I would not accept an assignment to care for this patient.
As far as asking for another doctor, I would suggest to your friend that if the patient is not happy with his medical care, he can ask for a different doctor. I would take it no further than that.
madwife2002, BSN, RN
26 Articles; 4,777 Posts
I am sure she knows that it is against HIPPA to even ask you those questions and put you in a position which makes you feel uncomfortable.
My suggestion is you ask her if she has heard of HIPPA and when she says of course then you can say to her well then you know I cannot possibly divulge any information on any of my patients.
RNKel, ASN, RN
205 Posts
We can't tell someone we took care of so-and-so. That's a HIPAA violation. We can't even confirm they are a patient.
Whispera, MSN, RN
3,458 Posts
It is a confidentiality violation to tell someone you took care of someone, and it's a violation to even say the person is on your floor. If your friend said, "I know he's on your floor, how's he doing?" all you can say is that you can't talk about any patients. Your friend knows that, but is trying to use the friend-loophole (which doesn't make it legal to talk).
As for finding a new doctor, it's the patient's decision, not your friends' decision. Would you tell a patient that he should get a new doctor if you knew the doctor wasn't the best? Would doing such a thing be potentially a problem for you if the boss or the doctor found out? If the patient has confidence in the doctor, it's not a good thing to undermine that.
Anyway, please use care with confidentiality issues.
justiceforjoy
172 Posts
I would tell the patient that so-and-so was asking about them, but I couldn't tell them anything due to confidentiality and then ask the patient if and what I would be allowed to tell the friend -- if anything at all. Assure him that the conversation you are having can be kept mum completely from the friend if need be.
Your school colleague is concerned for her friend. Even though she is putting you in a difficult position, I don't think we should be judging her. I'm sure I would find it very hard not to ask questions if I were in that same position. It might be awkward for her to go in and see him. I would definitely encourage her to go in and see the patient herself and remind her I can't say anything.
For the doctor thing, well... It depends on how close this old classmate is to their friend, what the situation really is (why is this doctor bad? Has he done anything wrong?) And how close you are to the classmate...
2BSure
267 Posts
This person is not treating you like a friend by trying to get you to discuss this. You also do not have a leg to stand on should you get busted for this.
Do not discuss the physician with her... do not discuss anything with her. You are the ONLY one who will get in trouble here.
She should come see this person for herself. End of story.
HelenofOz
84 Posts
Good points have been made.
I would just say to her "you know that I can't say anything, and you also know that if I did it would be sure to come back and bite us both in the ____" . Sometimes subtlety is wasted and it's just better to be honest with your answers.
As to commenting on the physician, I don't make negative comments, tho' sometimes I've been known to 'damn them with faint praise'