I took care of a patient on Unit 1 and the patient had a terminal illness. The patient and family were trying to decide whether to implement Hospice care. I transferred the patient later in the day to Unit 2 on another floor of the hospital where I work. (105 bed hospital)
The next day I came to work and was walking thought the cafeteria with some fellow co-workers and saw this patients family. It reminded me to go upstairs and see what the patient had decided about Hospice. Later on in the day I had a few minutes and went upstairs to Unit 2. I could not find the chart easily. I asked who the nurse was and spoke with her and asked her if she knew whether the patient chose to go on hospice. She said she didn't know. I asked if I could go visit and the nurse sad she didn't care. I went into the patients room, she was asleep and no visitors where there. I went back into the nurses station and the bedside nurse was still there charting, I told her the patient was sleeping and I did not wake her up. I asked if I could look at her chart and again she said she didn't care. I asked where it was, because I couldn't find it. She said she didn't know. ( I knew this bedside nurse a little better than the charge nurse, because we had worked together when I floated up there and had lunch and chatted a little bit. I considered her a friend and liked her). I stood in the middle of the nurses station, looking around and the charge nurse saw me and asked if she could help me. Know, I know the charge nurse from working at the hospital, through transferring patients to her unit. I had worked there for 1 year and floated on several occasions to her unit. We weren't friends as if eating lunch together. We were definitely not enemies and had never had any issues. It was a cordial, working relationship. We knew each others names in the hallway and said Hi with a smile in passing and thats the extend of our relationship. So when she asked if she could help me, I said yes, I'm looking for ------------ chart. She immediately saw it on a lower rack where the unit secretary was sitting and pointed it out to me. I went to the chart, opened it up to the progress notes....(HIPAA VIOLATION) and was in the chart for maybe 30 seconds, finding the progress notes and reading that they had decided on hospice. I closed the chart, said thank you and put the chart back where I found it.
The next day I was informed of my HIPAA violation and placed on leave and terminated 1 week later.
Just curious what other nurses responses are. I did the crime, I have learned from it and it was a very costly lesson. Honestly think, how many times has that happened to you in your workday......really think about it before you reply, which I hope you do, because I am just flabbergasted that the nurse would lead me to the chart, and no one EVER said,"Are you sure you want to do that? It all happened so fast......... There was no public sharing of information, there was no gossip, no conversations ever about it. Just my eyes in a chart of a patient I wasn't assigned to that day.
I'm not even going to say what I think about it, except to say that this is probably one of numerous reasons that although I'm glad I've done nursing as a late second career, I'm simultaneously glad that I'm not doing it for 30-40 years.
I hate to be blunt about this but...you DID do the crime, now you have to do the time. You consciously went searching for this patient, asking for the chart, and relying on your "friendships" with coworkers as justification to violate a patient's privacy. And then, when you were in the same room as the patient you chose to seek out the chart for the information that YOU were curious about. To me this is a purely personal MO and I don't have much sympathy considering nurses have been terminated for much less. What you did was wrong, point blank. Would you want some random nurse who took care of you before you were transferred to another unit doing this to you? Please, whatever you do, refrain from doing this again.
Do you know that the charge nurse is the one who reported you?
Perhaps it was the secretary going to the NM saying "a nurse came from another floor and looked through a random chart." Sure, the charge nurse could have said something to the OP, but, at the same time, I can see certain nurses I work with saying "I went to XYZ unit, and the charge nurse felt the need to lecture me on HIPAA."
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
Perhaps it was the secretary going to the NM saying "a nurse came from another floor and looked through a random chart." Sure, the charge nurse could have said something to the OP, but, at the same time, I can see certain nurses I work with saying "I went to XYZ unit, and the charge nurse felt the need to lecture me on HIPAA."
This was my thoughts exactly. It very well could have been a handful of other people who reported it. Or perhaps for some reason the charge nurse didn't feel comfortable "reprimanding" a nurse who wasn't part of their staff. Or as another poster suggested maybe the charge nurse thought that you were adding something to the chart that was related to patient care, instead of just being nosey.
The fact that you not only went out of your way to go through this chart, but seriously went through trouble and out of your way to go through this chart is crazy to me - all other facts aside about whether you should have been reported or not, you are one million percent responsible and accountable for this. This was a blatant violation of HIPAA, basics 101, and you should know better. What a hard lesson to learn.
My old job was pretty casual and I regularly would glance at my former patient's notes if I had been off for a few days. When did they go home, did they get transferred, did that weird lab resolve?
In my current job, clearly people DO NOT TOUCH CHARTS NOT IN THEIR DIRECT CARE. I have seen obvious hesitancy even in situations where it is warranted. Plus, almost everything is electronic now so there will always be a trail. I have had to keep my curiosity and generalized nosiness in check.
It is no one's responsibility anymore to be a human being
I know the OP did not have any malicious intent when she sought out and looked at the chart, but it was so clearly a HIPAA/privacy violation, and she bears all of the responsibility for what happened. According to the first post, she did not say "would it be a HIPAA violation if I look in the chart?" She did not ask permission to look in the chart and then have charge nurse said "ok" (i.e., the charge nurse did not 'set her up' for a violation). How did the charge nurse know that the OP was coming just to 'snoop' in the chart and not coming for a legitimate purpose? I don't see how the charge nurse had any obligation to stop the OP and remind her it was a HIPAA violation. Also, anyone working in the hospital should not have any questions about the inappropriateness of looking into the chart for whom you are not providing direct care.
It is no one's responsibility anymore to be a human being
I am all for nurses looking out for each other and having each others back. If I was the nurse or charge nurse who was asked where the chart was I would not necessarily know why that person wanted the chart. If I knew they were just being curious I would say something to stop them but in a busy hospital environment it may not register what they are doing when you have 100 other things on your mind. The only time I have ever said anything is if the person obviously doesn't work at the facility (no badge etc) because many people look at a chart for many reasons (even outside people for Hospice/SNF care etc). It is usually just not on the radar because there are more pressing matters and we all know that as adults we are responsible for ourselves. That being said, I would try to warn someone if I knew they were about to make a mistake.
I appreciate you sharing your experience. It is helpful and thought provoking, and I will be examining my practices more carefully. I just started working at a hospital again and can think of ways I definitely need to be more mindful of patient privacy.
I'd be curious to hear about other nurses experience and how to deal with nurses venting to you about their patient. This happens a lot on my unit. Generally, I do not speak about my patients unless I have a question and need a more experienced nurses thoughts on how to do something. However, I hear other nurses vent to other nurses about their patients quite often.
The other day I mistakenly walked into the wrong patient's room. I cared for this patient on a previous shift, so I didn't want to be rude and just walk out. So I said hello and asked how the patient was and then politely made an exit. Now I realize this could be construed as a HIPAA violation. While I certainly understand the importance of HIPAA, I hate that we have to cover our a** so much!
Specializes in Complex pedi to LTC/SA & now a manager.
I appreciate you sharing your experience. It is helpful and thought provoking, and I will be examining my practices more carefully. I just started working at a hospital again and can think of ways I definitely need to be more mindful of patient privacy.
I'd be curious to hear about other nurses experience and how to deal with nurses venting to you about their patient. This happens a lot on my unit. Generally, I do not speak about my patients unless I have a question and need a more experienced nurses thoughts on how to do something. However, I hear other nurses vent to other nurses about their patients quite often.
The other day I mistakenly walked into the wrong patient's room. I cared for this patient on a previous shift, so I didn't want to be rude and just walk out. So I said hello and asked how the patient was and then politely made an exit. Now I realize this could be construed as a HIPAA violation. While I certainly understand the importance of HIPAA, I hate that we have to cover our a** so much!
That's not a HIPAA violation and you wouldn't need to cover your ass for walking into the room saying hi how are you and politely exiting.
I took care of a patient on Unit 1 and the patient had a terminal illness. The patient and family were trying to decide whether to implement Hospice care. I transferred the patient later in the day to Unit 2 on another floor of the hospital where I work. (105 bed hospital)
The next day I came to work and was walking thought the cafeteria with some fellow co-workers and saw this patients family. It reminded me to go upstairs and see what the patient had decided about Hospice. Later on in the day I had a few minutes and went upstairs to Unit 2. I could not find the chart easily. I asked who the nurse was and spoke with her and asked her if she knew whether the patient chose to go on hospice. She said she didn't know. I asked if I could go visit and the nurse sad she didn't care. I went into the patients room, she was asleep and no visitors where there. I went back into the nurses station and the bedside nurse was still there charting, I told her the patient was sleeping and I did not wake her up. I asked if I could look at her chart and again she said she didn't care. I asked where it was, because I couldn't find it. She said she didn't know. ( I knew this bedside nurse a little better than the charge nurse, because we had worked together when I floated up there and had lunch and chatted a little bit. I considered her a friend and liked her). I stood in the middle of the nurses station, looking around and the charge nurse saw me and asked if she could help me. Know, I know the charge nurse from working at the hospital, through transferring patients to her unit. I had worked there for 1 year and floated on several occasions to her unit. We weren't friends as if eating lunch together. We were definitely not enemies and had never had any issues. It was a cordial, working relationship. We knew each others names in the hallway and said Hi with a smile in passing and thats the extend of our relationship. So when she asked if she could help me, I said yes, I'm looking for ------------ chart. She immediately saw it on a lower rack where the unit secretary was sitting and pointed it out to me. I went to the chart, opened it up to the progress notes....(HIPAA VIOLATION) and was in the chart for maybe 30 seconds, finding the progress notes and reading that they had decided on hospice. I closed the chart, said thank you and put the chart back where I found it.
The next day I was informed of my HIPAA violation and placed on leave and terminated 1 week later.
Just curious what other nurses responses are. I did the crime, I have learned from it and it was a very costly lesson. Honestly think, how many times has that happened to you in your workday......really think about it before you reply, which I hope you do, because I am just flabbergasted that the nurse would lead me to the chart, and no one EVER said,"Are you sure you want to do that? It all happened so fast......... There was no public sharing of information, there was no gossip, no conversations ever about it. Just my eyes in a chart of a patient I wasn't assigned to that day.
Thanks for any responses.....
The institution made it clear that it was adopting a zero tolerance for HIPAA violations,some did not pay attention and made up their own rules, they were suspended then fired.
If it not your current patient you have no business opening the chart,and since we are online ,they can tell and monitor anyone looking.At one point you could not look at your own but now there is a patient special access part.
you can not look up your friends,your neighbors,your co workers.
The next step will be all those FB posters,I keep reminding staff ,do not post on FB,but no one listens.
djh123
1,101 Posts
I'm not even going to say what I think about it, except to say that this is probably one of numerous reasons that although I'm glad I've done nursing as a late second career, I'm simultaneously glad that I'm not doing it for 30-40 years.