When patients want to know test results...

[vashtee]

I had a patient who had a HIDA Scan. Obviously, I knew the results, and the doctor knew them but didn't come in to the hospital to discuss with the patient the fact that he would need surgery because it was a Sunday night. Meanwhile, the patient wants to know what happened with the test. The patient knew what they were looking for, the diagnosis wasn't a surprise, but the patient still had no formal confirmation.

Do you tell the patient, knowing he is going for surgery the next day and won't be seeing the doctor? Or not? And if not, how do you tell the patient that the doctor is supposed to discuss test results? When I tried this, my patient assumed there must be a tumor that I didn't want to tell him about. haha

[TiffyRN, BSN, PhD]

The unit where I work, we are encouraged to tell parents (it's NICU) that whatever results they are awaiting are not "finalized" yet, until the MD reviews it with them. I also let them know that if there were any life-threatening results, the MD would be calling them immediately. The problem with many results is that parents/patients want to know a plan of care when they receive results and many times that is very dependent on MD's choice, and sometimes they choose to do nothing.

There are a few very routine things we do that I will share the results with the parents. Such as bilirubin results. In the unit I work, most MD's order to automatically start phototherapy for a bili > whatever. I will tell the parent that result because it's going to become "glaringly" apparent that something is off when I come and put eye shields on their child and turn on that bright light. More subtle findings like heart echo results with a possible PFO vs. ASD, I'm leaving to the MD to discuss with the parents (one is a most likely temporary condition vs. a permanent condition with possibly a surgical correction).

[TiffyRN, BSN, PhD]

I just saw the post above mine. I wanted to add that recently our hospital started a transition to electronic record. This has dramatically reduced the number or parents demanding to see the chart. They have the right to review the medical record after signing a release to acknowledge that they are reviewing an incomplete medical record. But since we no longer keep so many things on paper they don't seem compelled to rifle through the papers like they used to do. I'm sure that will change some day but for now it's nice.

Mostly we had parents wanting to find out what we were "hiding" from them (nothing). But sometimes we had parents wanting to see results of their child's (infant's) drug screens which we had already discussed with them. Once we had an aggressive father that wanted to get the contact information of a social worker who had been handling their Child Protective Services case. Of course there was only the employee's name on the forms he wanted, and he already had that information.

[ghillbert, MSN, NP]

In a critical care environment, I have no problem telling patients/spouses about results. They are usually hanging around wanting to know about, for example, the creatinine and whether it's going up or down in a patient who's been getting hemodialysis. I feel perfectly qualified with most labs to explain what the trend is. Exotic things, I'll say I don't know enough to tell them.

Things like echos, or today a patient wanted to know about their right heart cath, I will just say the doc needs to read the scan/etc and tell them about the results. Lord knows I have minimal idea about the various blobs on an echo...