Hipaa & things they didn't teach me in school

[nurseby07]

Hi everyone. Does anyone else have these types of situations happen? I had a pt who had just been raped. She was followed onto our unit with her good friend (another woman) During report from the ER I was told that the pt did not want anyone to know, including the friend. So as I assessed her she told me the story of how her ex broke in and proceeded to rape her with a hammer (!) She also told me she didn't want anyone one to know. The rapist escaped, last seen leaving her house. The her friend came back in and the pt gave her her house keys and a list of things to go get for her, at 2 a.m.! I was absolutely torn between what to do/say. Call the cops? Tell friend anyway? Obviously I couldn't, so I talked to my CN who strongly adviced the woman not to go to the house alone, and not at night....

The there was the time that I was to get an admit who happened to be a friend of one of the nurses I work with. The girl had had a serious motorcycle crash with a lot of injuries. The friend-rn was working with me and was obviously concerned. So I get report and they had just found out that the girl was pregnant (6 wks) and didn't want ANYONE to know. Well, that's impossible information to hide from the staff. Once again, consulted charge nurse and handled it as best we could.

Has anything like this happened to any of you??

[mom2michael, MSN, RN, NP]

Tough situtations, I agree.

The pregnancy thing stinks but unfortunatly in order to properly care for her, some people are gonna have to know she is pregnant but it should be on a very need to know basis.

Rapes, at least where I live, are required to be reported to police. We WILL loose our license if we do not report rapes, child abuse, adult abuse, elder abuse, etc.....Again, not a fun situation to be in but we always very up front with the victim about involving the police. We also encourage a victim advocate to be by their side rather than friends or family when appropriate.

[nurseby07]

Tough situtations, I agree.

The pregnancy thing stinks but unfortunatly in order to properly care for her, some people are gonna have to know she is pregnant but it should be on a very need to know basis.

Rapes, at least where I live, are required to be reported to police. We WILL loose our license if we do not report rapes, child abuse, adult abuse, elder abuse, etc.....Again, not a fun situation to be in but we always very up front with the victim about involving the police. We also encourage a victim advocate to be by their side rather than friends or family when appropriate.

Thanks for your reply! The police were called in the ER but she refused to say who it was. Even though they were called I still couldn't tell her friend why she was there...We did end up calling them again once she confided in me that it was her ex husband. That was a tough situation.

[EmmaG, RN]

So as I assessed her she told me the story of how her ex broke in and proceeded to rape her with a hammer (!) She also told me she didn't want anyone one to know. The rapist escaped, last seen leaving her house. Then her friend came back in and the pt gave her her house keys and a list of things to go get for her, at 2 a.m.! I was absolutely torn between what to do/say. Call the cops? Tell friend anyway?

Wow.

What a horrible situation. Forgetting for a moment the ethical/moral dilemma, what would be your (and the hospital's) liability if you knew of the danger and something had happened to the "friend" (and I use the term loosely; I can't imagine putting a friend of mine in such danger...)

The only thing I could suggest, other than what was stated above, is to contact the hospital attorney. In fact, if I were you I'd do so even now, just to get an 'official' plan of action should anything like this ever come up again... how to protect not only the patient and their acquaintances, but you and your staff as well. Was security notified of the potential danger to you all? With the rapist on the loose, and the victim not willing to name him, security should have been made aware in case he showed up at the hospital.

I'd also approach the doc for a psych consult on this woman. Not only to help her deal with the trauma of the assault, but because of her refusal to name who did this to her--- she clearly has some serious issues going on.