Anyone else think HIPAA rules are getting out of hand? - page 2

My manager told me yesterday that I can't write the resident's last name on our bowel care sheet. For privacy I have to write a room number. Really? The clipboard we keep behind the nurses station... Read More

  1. by   NRSKarenRN
    Quote from Tankweti
    Fact is, none of these people has ever seen the HIPAA law. Why? Because it can' be bought anywhere nor is it online in its entirety.
    Regs are available online...

    HIPAA - U.S. Department of Health and Human Services

    The official central governmental hub for all HIPAA issues including rules, standards and implementation guides.
    Last edit by NRSKarenRN on Oct 14, '12
  2. by   wooh
    Quote from brownbook
    Yikes!!!! Sorry I don't have a very good imagination. I can understand not wanting family to know someone is in the hospital, I can understand not wanting, allowing, family to visit or see a newborn.

    However we of course had to pass through a security guard and check points just to inter the maternal infant unit. How could we have make it pass all these check points and gotten to be able to actually stand at the newborns bedside without a lot of permission already being given. We would not have gotten that far if the mother hadn't allowed it.

    So suddenly, somehow, my knowing EVERYTHING else about my grandchild, everything about the delivery, seeing what O2 and IV he was on.......but somehow knowing what antibiotic he is on would........well I can't imagine what? Sorry as I said I don't have a good imaginationl
    We regularly have issues with this. If baby has something possibly caused by birth mom's STD, often parents understandably don't want family knowing that, and the antibiotic can be a huge clue. So we keep the antibiotic names private from family members that aren't parents. That's not the only reason that people might want privacy, but it's a big one.

    It's no different than adults. Just because I might not mind someone visiting me in the hospital, it doesn't necessarily mean that I want them to know everything going on with me treatment wise.
    Last edit by wooh on Oct 14, '12
  3. by   david_thomaschefsky
    Yeah Hippa can be a pain, but it is necessary. In the hospital where I work, unfortunately there is a lot of talking in the hallways. The administration has stepped in to put a stop to it. I can not believe what some nurses will talk about in the open.
  4. by   babyNP.
    Quote from brownbook
    I have been wanting to vent about HIPAA.

    Having stupid run-ins over the phone when we, a free standing surgical center, request patient information from another hospital!!! I know HIPAA allows this but still we can and do get the run around from medical records or other departments which can be annoying to dangerous in urgent situations.

    In 2004 I was in the NICU, visiting my grandson. Grandson was, is, fine just a precaution after a stressful delivery.

    Purely out of ???? my nervousness ???? just not being sure at that time how we would be, etc. I asked his nurse what antibiotics he was on. She said because of HIPAA she couldn't tell me I would have to ask his mother!!!!!!
    What if we had the kid on acyclovir? then you would know that we suspected HSV or HIV, among others and then you go back to your daughter, "OMG you have HIV!!! you sluuuuuut!" stranger things have happened. This has not happened to me, obviously, but I heard of it happening at an agency hospital I used to work at (p.s. mom had neither and they were being precautionary b/c mom had no prenatal care)
  5. by   KelRN215
    I agree with not sharing information with just any family member. That was something I think my old facility was not very good at. Doctors seemed to assume that anyone at the child's bedside (nannies, grandparents, mother's cousin, grandmother's neighbor's son) should be privy to what was going on with the child.

    I'd be very not happy if I was in the hospital with visitors and the doctor (or nurse) came in and said "we're going to do xyz this afternoon" without asking the visitors to step out... or at least asking me if it was ok to talk about whatever in front of them. In fact, when I look back on my medical history, I can think of several doctors who did the wrong thing by not asking my parents to leave the room and/or not asking me if it was ok for them to be in the room. I was eighteen years old so, legally, my parents should not have had access to any of my medical information without my expressed permission. Heck, I had a neuro-psychiatrist who allowed both of my parents to remain in the room as he interviewed me! I don't think it should be up to an eighteen year old to tell the doctor he needs to do his job and ask the parents to leave. Actually, now that I think about it, the only people who I can recall ever asking my parents to step out of the room were my nurse practitioner and an inpatient nurse. Someone at my College's Health Center even gave information to my father over the phone (when I wasn't on speaking terms with him at the time and I was 19 years old!) I also once had a doctor call my mother behind my back (I was nineteen, nearly 20 at the time)... fortunately, I intercepted the message he left on the house answering machine. My mother also found out that my brother (who was 22) was having surgery because the surgeon's office called her house and left a message for him saying "we're calling to schedule your surgery". He was not intending to tell my mother that he was having this surgery and he didn't live with her at the time. I have had two surgeries and been diagnosed with two chronic medical conditions that my family doesn't know about and I'd be pretty peeved if anyone shared that information with them without my expressed consent.

    On the other hand, I think there are a large number of medical professionals who generally don't understand who HIPAA applies to and who it doesn't. Many of my former colleagues would refuse to talk to a child's pediatrician due to "HIPAA" but would have no problem talking to the child's step-father or aunt.
  6. by   brownbook
    Yeah, maybe kind of sort of that could happen.

    However it is still wholly stupid if you ask me. And honest!!! I am a nurse and because that is not really my area of nursing I don't know or remember that acyclovir may be used for HIV, and I doubt if a non-medical person would, so that makes it even more of a really far stretch.

    I hate it when one totally weird exception, a family finding out patient is on _______drug, patient sues the hospital, makes the rules for everybody else to follow. So families have to jump through all kinds of stupid hoops to know about or care for loved ones because of one stupid extremely rare (if indeed it ever has or would happen) incident.
  7. by   brownbook

    It makes no sense. If a patient is in a hospital, if a patient says yes my family may know I am here, may visit me, etc. then (I am not a lawyer) but that would give implied consent that family visitors are going to see the patient. See the some or part of the medical treatment going on with the patient.

    "Yeah my family can visit but they can't see my surgical dressing, can't met or know of my surgeon or internist, can't see I have an IV, can't see my right leg is in a cast, etc."

    Maybe we should have all visitors wear masks over their eyes..... every visitor could have a volunteer guide them around......yeah that's the ticket!
  8. by   EmmaZ06
    As long as hospitals have double occupancy rooms there really is no such thing as patient "privacy". Sometimes I wonder about hospital priorities, you have to use a room number and not a name on the bowel sheet, but trust me the roommate knows exactly how many BMs that patient has had, and most likely their diagnosis, and their meds.
  9. by   babyNP.
    Look, you also run the risk of the parents not knowing about their kid's condition first and how would you feel if your mother told you that your child is sick when the hospital didn't tell you first? Your mother might interpret the words wrong so that it sounds more negative or positive than it actually is and have you being inappropriately freaked out or too blase about the actual situation.

    If the information is benign and mom is present at the bedside, I talk directly to the mom, but I don't ask the visitors to step out.

    But just because a patient allows a person to visit them doesn't mean that they want absolutely everything shared with every single person. Obviously, if you have a broken leg and you let visitors come, they're gonna know that you have a broken leg. I'm not talking about that. I'm talking about the jerk doctor who comes in amongst all the family members and announces, "your test results have come back and you are positive for gonorrhea" (again, this DID happen while I was a nursing student years ago).

    Know that in peds, everything is a lot more hairy when it comes to relatives/visitors. It's better to stay cautious. I once had a patient acutely decompensated in <30 minutes requiring intubation and multiple interventions and then the grandparents walked in. I felt really bad that I couldn't tell them exactly what was going on, but it was the right thing to do to tell the parent's first. They did know it wasn't good what was going on and I enlisted their help in trying to contact the parents (we had tried a couple of numbers).
  10. by   wooh
    Quote from brownbook

    It makes no sense.
    It makes no sense why you couldn't just ask the parents the question. Just because this was a benign question in your family doesn't mean it's a benign question to the next family. Frankly, it truly was NONE OF YOUR BUSINESS. If the baby's parents wanted to make it your business, then they were free to do so.

    Just because I'm in the hospital, it doesn't give every person that walks in the room the right to know whatever they want to know. Even if it's my grandmother that wants to know.
  11. by   wooh
    Do some of the privacy rules get ridiculous? Sure. But forget HIPAA law and think about a person's right to privacy.

    People always talk about "My family member wanted me to know but they wouldn't tell me!"

    I'm going to err on the side of caution. I don't know that YOU are who you say you are. I don't know know that the family member really WOULD want you to know.

    If it was YOUR medical information, would you want me giving it to the woman at your job that hates you and is always looking for ways to get you fired just because she said she was your sister?

    Would you want me telling your neighbor that you're dying before you've had a chance to tell your husband and kids just because you let your neighbor visit?
  12. by   OnlybyHisgraceRN
    Quote from Sweet_Wild_Rose
    Interesting. Our preop area has two large bulletin boards listing patients' last names and preop room number. Apparently this was investigated before initiated and found to be okay as long as we don't list first and last names.
    Same where I work. We have patients last names posted on the white board where EVERYONE can see.
  13. by   NicuGal
    We don't even allow visitors without a family member in our NICU. Believe me, we run into some pretty funky family dynamics and is better to talk with the parents there. Like some one said, if I told you the baby was on acyclovir or AZT, then I would be giving you mom's diagnosis also, which, frankly, isn't anyone's business unless the parent wants you to know. We can give basic info, he's doing okay, he weighs this, his length is that, he is eating well. Just general things. It is the rules and you, as an RN, should know we have to comply by them, no
    Matter how stupid they may seem.