HIPAA dilemma

Posted

Specializes in Critical care. Has 28 years experience.

Aloha

Ok something has been bothering me for quite awhile, and I need to get it off my chest. Some time ago we had a senior student do their rotation on our unit, let's call him Lord Voldemort (he who's name shall not be mentioned). So we had issues with Voldemort, unexplained mood swings, labile behaviors etc etc. Two weeks after Voldemort's rotation was done, they got admitted for an overdose, positive for meth/opiates/thc. I am sure you can now all see my HIPAA dilemma, how can we make sure Voldemort is never in a position to divert meds, practice nursing while impaired, and yet avoid violating HIPAA laws?

Cheers

vanilla bean

861 Posts

Did any of you document his behavior, speak with a clinical instructor, or inform the school while he was there as a student? As you know, you cannot now share anything you learned about him while he was a patient.

Let's just hope that Voldemort has a criminal history that will be a barrier to licensure or that he will be unable to pass a pre-employment drug screen.

As an aside, thank you for spelling both HIPAA and dilemma right, lol :yes:

KatieMI, BSN, MSN, RN

Specializes in ICU, LTACH, Internal Medicine. Has 9 years experience. 1 Article; 2,671 Posts

I always thought that HIPAA is about everyone, including colleagues, former or current... am I right?

If whoever is treating the Voldemort has well-grounded concerns about "his" direct and imminent danger to himself or others, then it is that whoever's duty to report. You have nothing to do with it, and your report very well might be qualified as libel.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 20 years experience. 2 Articles; 4,258 Posts

Aloha

Ok something has been bothering me for quite awhile, and I need to get it off my chest. Some time ago we had a senior student do their rotation on our unit, let's call him Lord Voldemort (he who's name shall not be mentioned). So we had issues with Voldemort, unexplained mood swings, labile behaviors etc etc. Two weeks after Voldemort's rotation was done, they got admitted for an overdose, positive for meth/opiates/thc. I am sure you can now all see my HIPAA dilemma, how can we make sure Voldemort is never in a position to divert meds, practice nursing while impaired, and yet avoid violating HIPAA laws?

Cheers

I find the whole notion of "making sure Voldemort is never in a position to divert meds, practice nursing while impaired" to be insulting. Especially since for whatever reason he is apparently now in treatment. No nurse should ever be allowed to work impaired but short of doing a UDS on every nurse every day there is no way to police this issue. It also completely discounts the many nurses who have been to treatment, successfully completed monitoring and/or probation and are now sober and working in the profession.

In my 2nd year of nursing while under tremendous emotional pressure that had nothing to do with my employment I stole (There I said It) two vials of Benadryl which I took with a whole lot of booze and Ambien in attempt to kill myself. I was never "Impaired" on the job but I was a falling down drunk when ever I wasn't working. It is truly a miracle that I am alive today. I did what I had to do to get better, returned to nursing and have been sober for just over 10 years. Statistics show that 13.1% of working nurses admit to having a substance abuse problem. Having a problem and diverting are two different things and there is no defense to putting patient safety at risk. However You might be surprised how many of your current co-workers have been through recovery and are working with you side by side, giving compassionate, competent care.

I am a firm believer in 2nd chances if - someone had not given me that chance I'd probably be dead or sucking off the welfare system instead of writing here.

Peace and Namaste

Hppy

  1. Substance abuse among nurses—Defining the issue, Dunn, Debra, AORN Journal , Volume 82 , Issue 4 , 572 - 575

ProgressiveActivist, BSN, RN

Specializes in ICU. Has 20 years experience. 670 Posts

We had a RN student, young lady, in ICU for an IV heroin od. I had to report one of our gossipy old CNAs for spreading it all over the hospital. Did anyone in management care about the pt? Hell no. They just didnt want to be sued. Some people suck.

Ranax

19 Posts

What a shame. Truly. HIPAA is our fallback for patient's rights. Common sense should have prevailed for all staff. Unfortunately for the staff, administrators, and hospital owners, heads roll uphill when HIPAA is violated. Hope the patient can keep her head above water, because she was the victim of a near-drowning. Seems like it's time to have an updated HIPAA in-service.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 20 years experience. 2 Articles; 4,258 Posts

And as a side note HIPAA does have a clause in it that permits certain healthcare professionals to report to law enforcement any patient who may currently be an immanent danger to themselves or others. Immanent is the key word here. The person in question is not a nurse but a student and they are in a hospital getting treatment - so no actual danger to patients at this time. There is a whole process for determining immanent danger - it can't be "Because I think so" on the part of the practitioner . There are very strict criteria that must be met to move forward. I worked in acute mental health for several years and did these assessments daily.

Hppy