Is it wrong if I....

xtxrn, ASN, RN · Sep 10, 2011

is it wrong and a HIPPA violation if I were to call the hospital's ICU and inquire about a patient I transferred down there earlier today? I am very concerned for this little lady and really want to know how she's doing and took care of her for three days. I really want to call the ICU and inquire, but I don't want to violate HIPPA or an ethical issue either. Any suggestions? I know I cannot look into her chart since she isn't assigned to me because that is for sure a HIPPA violation, but is calling the unit she's on after I transferred her down there? Thanks in advance

It's not a violation to call (though inappropriate since you KNOW about HIPAA) - it would be a violation for them to answer..... but bottom line, if you're not actively taking care of her on your shift, you're not entitled to any info about her. It's nice you care, but that's it.... You can ask the next time you work if you can call and get some vague info about her, but calling from home (it sounds like you're not at work, for some reason)- don't do it. :)

jesskidding, LPN · Sep 10, 2011

I'm not sure if that's a HIPAA violation or not, but I would think so.

arabstarRN · Sep 10, 2011

I am not at work, I am home since I am currently on first shift and I transferred her down there after she went into respiratory distress this morning before noon. I do care, and I haven't called yet because obviously I am finding myself in an ethical/legal dliemma that I wasn't sure about, and I realize there are going to be many many more patients that I am going to want to follow up because I care so much, just going to fight the urge...

Now, another question, if I happened to run into her son in the hallway and ask how she's doing, is that considered a violation and wrong as well? I know HIPPA can be picky and vague, which is why I am asking since I am not at work and cannot get a correct answer (although the answer I did get when I told my preceptor I wanted to call last night and check on her but I didnt because I thought it would be a violation, she told me "it wouldnt be because you took care of her and she has done it before" which kind of blew my mind when I was told that today... then I really started to wonder about the quality of my training period, well that isnt the first time I have questioned that to myself... anyway... whole other story.

bottom line - even though I really want to know if she's doing ok, I am not going to call, I am not going to question and going to do my best to consider it a part of work to leave at the hospital, just like I leave home at home... as hard as that is when you do care and want to see your patients pull through...

Guess a person can care too much - in a way...

xtxrn, ASN, RN · Sep 10, 2011

I think if you ask her son, that's ok- it's not the hospital giving out the info- and you did have a professional relationship with the woman; asking the son is an appropriate way to show you care.

Typically, w/HIPAA, the one doing the asking is not in violation- it's the one who doles out the info that is legally at fault.

If you call at work, since you did take care of her, you can call if hospital policy doesn't prohibit it- they have to be careful how much they tell you since you're not involved in her care now, but I've asked about patients before, after they go to another floor- that part isn't a problem :) Generally, I could find out if someone was still there, if they'd gone to another floor (which you can find on the hospital census list if you have access), and general info ... "she's resting well today" = that kind of stuff. :)

JustBeachyNurse, LPN · Sep 10, 2011

I wouldn't recommend asking the son if you ran into him in the hallway, however if he volunteers the information without prompting that is another matter. (In one HIPAA training during clinical rotations, we were taught that in the facility's/risk management's interpretation of HIPAA and privacy laws asking a family member about a patient that we no longer care for is a violation, whether the conversation occurs in the facility or in public.)

It's tough when you make a connection with a patient and they need a transfer to ICU. Since you care, you want to know how they fared. It's just part of human nature, however as nurses & healthcare professionals we just have to hope for the best. Perhaps the son will seek you out and let you know how she is doing, if not know that you rendered the best care possible to give her the potential for a good outcome.

arabstarRN · Sep 10, 2011

Now here's another question: Say I am at work, but for whatever reason, am not scheduled to that set where a patient I had taken care of for several days was still in the hospital. Is it wrong to go into the room and just say hi to the patient and ask how they are feeling? Not to get information from a nursing standpoint, but just to ask a way to show concern and maybe encouragement, if that makes any sense at all the way I worded it.... I always wondered that as a student and there was one time that a patient I had for two days was still there the next week but I wasnt assigned to him - no student was - and his wife saw me in the hall, stopped me and told me how he was doing (I did not ask her, she never gave me the chance to even say hello before she started rattling stuff off) and then she told me, "go see him if you get a chance, he would love to see you and say hi!" however, I was super busy that day and when I passed the room I just called in a quick hello to him and told him I was just passing by but had to get back to the patient I was getting supplies for. So, from the experienced nurses out there, is it ok to stop by their room on the floor you work if you are not assigned those sets and just generally say hello and ask if how they are doing as if you saw them on the street?

evolvingrn, BSN, RN · Sep 10, 2011

I think its completely appropriate if you see her son to say "hey 'bob' how is your mom doing " how much he shares is up to him. The fact you care enough to ask means something to families. We are the most trusted profession because people perceive us to be sincere and caring on top of our skill and knowledge base. That being said if you are at home and she is all you can think of ....then there may be some boundary issues and you may want to take a step back for your own sake. ((((hugs))))

xtxrn, ASN, RN · Sep 10, 2011

If you took care of the patient, and he/she is still on your floor for the same condition, I don't see anything wrong with saying hi- you're not asking for information; if they volunteer it- that's up to them. I've had numerous nurses stop in to say hi when I've been in the hospital. No big deal :)

As far as seeing them on the street- some facilities do have policies about contact with patients after discharge.

arabstarRN · Sep 10, 2011

I wouldn't recommend asking the son if you ran into him in the hallway, however if he volunteers the information without prompting that is another matter. (In one HIPAA training during clinical rotations, we were taught that in the facility's/risk management's interpretation of HIPAA and privacy laws asking a family member about a patient that we no longer care for is a violation, whether the conversation occurs in the facility or in public.)
This was my understanding too, but I have seen so many different instances and heard so many different things that I wasn't sure if it would be considered a violation and couldn't find any specifics regarding that in the policies.
It's tough when you make a connection with a patient and they need a transfer to ICU. Since you care, you want to know how they fared. It's just part of human nature, however as nurses & healthcare professionals we just have to hope for the best. Perhaps the son will seek you out and let you know how she is doing, if not know that you rendered the best care possible to give her the potential for a good outcome.

The son was very grateful to me the three days I cared for her and kept thanking me for giving his mom such good care and keeping them up to date on her condition each day he called or physically came in and asked about her. He thanked me more than once each day, and to me, I thought, "well this is what I am here for" but we all know there are some nurses who just don't appear to care as much as others, especially to a family member going through a tough time...

arabstarRN · Sep 10, 2011

As far as seeing them on the street- some facilities do have policies about contact with patients after discharge.

This just brought a somewhat funny picture to my mind. I can just picture seeing a patient on the street and trying to avoid them because of the facilities policies. Talk about looking like you don't care LOL not sure why it struck me as kinda funny, but can you imagine being in the grocery store and seeing a patient in an aisle, and if they try to follow you and you just try to get away so that you don't break policy lol seems like something for a comic strip...

xtxrn, ASN, RN · Sep 10, 2011

This just brought a somewhat funny picture to my mind. I can just picture seeing a patient on the street and trying to avoid them because of the facilities policies. Talk about looking like you don't care LOL not sure why it struck me as kinda funny, but can you imagine being in the grocery store and seeing a patient in an aisle, and if they try to follow you and you just try to get away so that you don't break policy lol seems like something for a comic strip...

My understanding at places I worked who had issues about this was intentional communication/contact :) You can say hi :up: