Protecting the patient already died does not make any sense!

  1. My patients was HIV+ and he died during a central line insertion...
    It is tragic...but that is another story.
    What upset me the most is....his future wife came to the unit and she is pregnant. We the nurses are not allowed to share that confidential information with his future wife.... It does not make any sense at all.
    What do you think about this....Does it make any sense to you at all?
    Shouldn't we let that girl know that her future husband was HIV+....
  2. Visit chuck1234 profile page

    About chuck1234

    Joined: Jan '07; Posts: 644; Likes: 14
    Taking care of dumb nurses
    Specialty: Nurses who are mentally sicked

    79 Comments

  3. by   CHATSDALE
    NO
    i agree with you i think she is entitled to know but the law will not allow you to do so..
    i have seen a nurse do so when the residents were both mental pts..family had a fit but your can't prevent them from having sex..that is another thing that is beyond your control
  4. by   chuck1234
    Then this law does not make any sense at all...
    We are seeing this girl suffering, sickening then dying...
    Don't tell me we went to school for this.
  5. by   twinmommy+2
    Yes, you did. There is a possibility that she already know's, or hopefully suspects that something was up. Hopefully he was able to come clean as they were going to get married right? So you would be breaking the law for something that is already known by her.

    Does the law apply to someone who is deceased though?
  6. by   chuck1234
    Only a possibility...what happen if she does not know at all...
    When you give a pill to a patient...are you assuming that your patient already know the medication?...this is the reason why you have to inform the patient...again and again...
    Assuming something...I don't recommend any nurses to do it.
    I know the law...and I have no intention to break it and this is the reason why I bring it out and discuss it....I hope no one assuming that I don't know it.
  7. by   justme1972
    I think that may possibly vary from state to state. Where I live, in our Psychology course, we had a lady that came into speak to us that was a BSN, MSN from the Health Department specifically about sexually transmitted diseases, teen pregnancy issues, and the high correlation to marriage and healthy babies.

    She specifically stated, that if they tested someone for a sexually transmitted disease, that by law, partners must be notified if there was a known exposure.

    This man was clearly at a risk to others, and now an innocent baby is going to be affected, and she may or may not elect to have her baby if she is HIV positive.

    I wonder if there is a way "around the law" if you can't tell her in your area...can you encourage her to get a copy of the death certificate? Death certificates are public knowledge. Funeral Homes, I believe, have to be legally notified if the deceased has a blood illness such as HIV. Surely if she is pregnant her OB checked her for HIV...unless her exposure was so recent it won't show up on a test.
    Last edit by justme1972 on May 10, '07
  8. by   herecomestrouble
    There is no reason not to have the baby even if she is HIV+,with proper care and meds she can still have a healthy HIV- baby.The problem is if she doesn't know and doesn't get the meds she needs.Even with no prenatal care a + women can give birth to a - baby if she gets IV AZT during labor and a C section.The baby will test + for the first 18-24 months but after 24 months as the baby's immune system takes over s/he should be negative.With proper care she would only have 2%chance of having an HIV+ baby.Which leads us right back to the privacy issue,she needs to know so she can get proper care......What a terrible and heartbreaking dilemma for all of you.
  9. by   sirI
    Fine line here.

    HIV status of the living patient should remain confidential except under certain circumstances (not a global application):

    1 - If a physician knows that a third-party is being endangered
    2 - The physician has failed to persuade the patient with HIV to disclose to said third-party
    3 - The physician has contacted the proper authorities and they have failed to contact said third party

    THEN, the physician may reveal to said third-party the HIV status.

    http://www.ama-assn.org/ama/pub/category/15549.html

    But, the physician has a duty to maintain confidentiality of the patient after death.

    Another but:

    Some state statutes mandate that the physician provide the contact's name to the state health agency; the state health agency then notifies the contact

    (2) Some states give the physician the choice of notifying either the state health agency or the third-party contacts directly

    (3) Other states make such disclosures to a state agency optional. The tremendous variation of these provisions indicates that physicians should always seek advice from public health departments and their own attorneys to understand their legal responsibilities.
    But, as previously pointed out, the physician has a duty to maintain confidentiality of the patient after death.
  10. by   chuck1234
    Don't you think the law makers should do something about it.
    Let's change the law...
    Write to your congressman and let them know this law does not make any basic common sense at all.
  11. by   suzanne4
    Sorry to disagree with you, but this law makes total sense.

    HIPAA laws also cover this. If the physician wishes to tell someone, that is one thing. But you as the nurse could get fired for it. Even when you think that they have the right to know. You cannot legally make that determination as you are not the provider of that patient for one thing.

    Once you have more experience under your belt, you will understand this.

    If the patient wanted his fiance to know, he would have shared the information with her, and you do not know that for a fact. For you to do it, could cost you your job on the spot, and with no ill effect to the facility. I am sure that you have signed documents about confidentiality when you started working there. It is written there in black and white.
  12. by   chuck1234
    I know the law...
    I know I can't say anything...
    This is the reason why I am upset...
    I feel sorry for the girl and her baby....they are totally innocent....
    History always repeat itself...I am sure sometimes in the future...I will see another case that is similar to this...
  13. by   RedERRN
    What about the coroner? Could he/she convey this information to the family without negative retribution?
  14. by   sirI
    Quote from RedERRN
    What about the coroner? Could he/she convey this information to the family without negative retribution?
    Not in all states.

    NYC is the only state that requires an HIV test at autopsy by the ME. Confidentiality applies here with one exception: notification of third-party who might be at risk of contracting HIV from the deceased.

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