Small Town HIPPA

Nurses General Nursing

Published

Anyone here live in a small town? I do, and I find that knowing many of your pts and their families poses unique problems and temptations regarding confidentiality. Yesterday I cared for the mother of a woman who goes to my church. The mother recognized me from the church too. She was a very neurotic 87 old woman who was driving the staff crazy. Her daughter, who is almost 70, is one of those controlling churchladies who gives all churchladies a bad name.

Anyways, because I took care of this old lady and had to work through the details of her discharge, I now know the there has been a recent falling out in this dysfunctional family between obnoxious daughter and obnoxious mother. I also know many things about other people in town, like who's on antidepressants and many other details of people's lives. I also have to be super careful about what I say to people.

HIPPA is harder in a small town...:uhoh21:

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
I guess I'm more talking about the discomfort of knowing all this stuff. For instance, the mother of a girl my daughter plays with was my pt. I know that she is on 2 antidepressants and has a psyche history because I read it in her H&P. She loved me as a nurse, but I'm not as comfortable sending my daughter to play at her house now.

I'm small town too, and I know exactly what you mean.

We know a lot of stuff about a lot of people we'd just really rather not know.

It's almost a "loss of innocence" thing.

I rarely have any difficulty in keeping things to myself (my husband says I'm "secretive" anyway). Sometimes my husband has a hard time with it- we'll see someone somewhere and he'll ask "Where do you know that person from?" and when I say something like "Oh, I just do" he gets peeved with me. I've explained over and over that I cannot tell him even that someone is or has been a patient but he tends to take it personally. Then again, he's one of these people who can be characterized as a "babbling brook:" if it crosses the brain it comes out the mouth.

One of the difficult things for me is knowing how to react to people in public. I usually smile, nod, and keep going. I don't want them to think I'm unfriendly, but if I stopped to chat, then that person might get asked about me- and I don't want them to have to explain that to whoever they are with if they don't want to. If the patient approaches me and starts a conversation, that is fine. (Or, like my [former, not current] pastor's wife, announces to a kitchen full of people that I had just done her pap smear that week!! :D You'd have to know her, though.)

Specializes in ER, Teaching, HH, CM, QC, OB, LTC.

I agree with GardenDove. What you learn about your fellow towns people if often more than you bargin for.

I had to tell people up front that I cannot & will not even acknowlege them as a patient is asked by others. But before HIPAA this was not as easy.

I would run EMS , pick-up parents that had OD'd or are the victims of domestic violents and have to be in class the next morning with their kid! Plus everyone in town 'knew' what had happened, because they saw these unit at the house......

It is very uncomfortable! The law may protect me but it does little to ease my mind!

I had to laugh a bit when I saw "switch assignments". We have a very hard time with OB coverage and I was the ONLY OB nurse a couple of days ago. Who could I switch with?

steph

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