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HIPAA privacy question

HIPAA   (8,621 Views 34 Comments)
by nurseandre34 nurseandre34 (New Member) New Member

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nurse2033 is a MSN, RN and specializes in ER, ICU.

3 Articles; 2,122 Posts; 28,257 Profile Views

I don't think there is any gray zone here. The patient was an adult. If she wanted privacy from her mother she could have said so. Perhaps she isn't mature enough to realize that she can run her own life, but that is not the nurse's responsibility. The nurse could have anticipated this problem and asked the mother to wait outside, but the situation may not have allowed for that, and frankly the nurse may just have been too busy to think about it. It is not the nurse's responsibility to foresee every possible family dynamic.

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14,620 Posts; 103,246 Profile Views

Why on earth would a 19 year old, even one still in high school, have her "mommy" in the exam room with her? :uhoh21: Was that her choice or did everyone else involved (the mother and the office staff) just assume that's the way it's going to be??? In that case, I would consider it more coercion than her "choice" and her "consent" for info to be disclosed to her mother.

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navyguyhm3 has 10 years experience and specializes in med-surg, urgent care, emergency med.

51 Posts; 1,752 Profile Views

Our 19 year old daughter is still on my husband's insurance plan...we pay the premium, we pay the deductable, we pay the pharmacy bill...we have every "right" to know our daughter's medical history.

If an adult has another adult with them in the exam room, they should be able to reasonably anticipate that there may be disclosure of protected health information. The HIPAA law actually recognizes this fact. The HIPAA law also allows for minimum disclosure as long as it relates to the current problem. If I take my neighbor to the ER because she has a laceration and she asks me to stay with her, the staff can assume that she has no issue with me having knowledge relating to the current problem. As long as she says I can stay in the room, the staff can ask whatever questions and disclose whatever information relates to the current situation. They probably should not ask questions like, "How are things going since your overdose?" or "Have you been retested for syphillis since you finished the antibiotics?"

I usually ask everyone except the patient to step out while I do my assessment...if the patient says, "Please let them stay," I let them...if not, I direct them to the waiting room.

I know all about partial disclosures of medical info. But just because someone still pays for or is on the insurance plan really isn't a reason to have the "right" to know anything about the patients medical condition. It ultimately falls under the patients wishes..so long as he/she is an adult. It's like saying....he's my son...I am a nurse...i can look at his medical record anytime i wish..which is clearly a violation if you are not directly in charge of his care.

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ktwlpn is a LPN, RN and specializes in Med Surg, Homecare, Hospice.

3,844 Posts; 30,597 Profile Views

Why on earth would a 19 year old, even one still in high school, have her "mommy" in the exam room with her? :uhoh21: Was that her choice or did everyone else involved (the mother and the office staff) just assume that's the way it's going to be??? In that case, I would consider it more coercion than her "choice" and her "consent" for info to be disclosed to her mother.

My 21 year old son is having some health issues at this time and has asked me to go into the exam room at the PCP's office and in the exam rooms of all of his consults to date. I made it clear to all staff that it was his request-not mine. Sheesh-my husband dragged me to the PCP and the urologist when he had his first kidney stone. I am really NOT a helicopter parent (or wife)

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6,978 Posts; 32,317 Profile Views

being perverse, I wonder if this was Daughter's way of informing mom?

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jimkusters has 5 years experience and specializes in Psychiatric.

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Working in an adult psych setting, I may have to treat HIPPA even more carefully than some others here. We have patients ranging in age from 18 to 65. Sometimes, we have young patients (18-25) that tell us very clearly, DO NOT talk to mom, dad, or whoever. Being a father also, it breaks my heart to have to tell a worried mother/father that I can't tell them even if their son/daughter is even at our facility or not. BUT, the law is the law and I like keeping my license.

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tainted1972 has 3 years experience as a ASN, RN and specializes in MR/DD.

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I have to be honest and say that I would have done the same thing. I would have assumed that since the mother was in the room, the patient didnt mind her knowing about any medical issues or medications.

I appreciate the OP for posting, hopefully we can all learn from the story.

I will definitely make sure that I ask everyone who is not the patient to leave the room before I say or do anything.

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13 Posts; 940 Profile Views

While I agree with everything mentioned above, I tend to look at it as, the girl is 19....An "adult" but aren't they mostly still just kids? As an adult who currently works retail with a bunch of "kids", I wouldn't be surprised if it didn't occur to the girl to ask the nurse specifically not to discuss anything, or if she even knew the birth control would be brought up if she was there for a non-gyno issue. She maybe could have told the patient "we will be discussing some personal information, would you like to have your mom wait in the waiting room?"

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Scarlette Wings has 27 years experience and specializes in M/S, ICU, ICP.

358 Posts; 6,742 Profile Views

a co-worker of mine placed a patient with her mother into an exam room. the patient is 19 years old and the nurse turns to her and in front of the mother asks if she is on any other medication besides her birth control. the mother of the patient blows a fuse and causes a scene because she just found out her daughter isn't a what she said she is. is this a violation of the hipaa law? can there be any legal persuing if the nurse admits guilt?

i think that the patient as well as the mother were both old enough to say "stay" or "come with me". to me people need to own their own behavior and grow up. daughter is old enough to realize that "mommy' does not need to go into the doctors examination room with her. mommy should realize that her "little girl" is grown.

i get a bit frustrated with so many people looking to blame, sue, finger point, and belittle everyone else for some of the idiot decisions they make. imho.

"mommy" should be thankful she raised a daughter with enough maturity and common sense to be using a method of birth control, and in reality, there are medical reasons to take contraceptives besides actual "birth control" reasons.

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11,294 Posts; 76,422 Profile Views

This is a good subject to talk about so we can foresee similar events.

However I'm in agreement that the onus is on the patient and I would not blame the nurse.

I tend to agree with cotjockey - if my kids want to stay on my insurance policy, they too sign a waiver letting me know information. Heck, they do the same thing with their bank accounts as sometimes they need their parents to put in some money for food so while in college, they all had a local bank that had a branch where they went to school. I refuse to send them money Western Union . . . . $25 a pop?! No. :down:

As to adult kids having a parent come in for an appt - I don't think there is anything wrong with that as long as it is the child's choice. And because I'm a nurse, my kids want me there to wade through the medical mumbo jumbo. So far anyway.

steph

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