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Discussion

HIPAA violation? Please help...

First TERM Nursing student. My clinical group and I were supposed to meet at the hospital where I work; no one showed. I was in civilian clothes at the time. Since I've worked there for over 3 years I felt comfortable approaching the nurses in the ER to ask what their techniques are for physical assessment since we had a test in a few days. They were more than happy to help me out. We went over some general stuff and then I was invited to watch a nurse in an ER room perform a physical assessment on a patient in the ER. I had verbal permission from the charge nurse, the attending nurse, the attending nurse received permission from the patient prior to me entering the room and I received permission from the patient directly before asking him any further questions. The nurse showed me her technique and handed me the pen light. I checked to see if pupils were equal and reactive to light, listened to heart and lungs, bowel tones before the floor supervisor nurse came in and said I was not allowed to do that without my clinical instructor present. I called my clinical instructor and told her the whole thing; that's the ONLY thing that saved me by being upfront and honest..... I almost got kicked out of the program. I see that it was against the program policy, though it states "shall not perform patient care" However, I was told I also violated HIPAA. I have searched DHS and cant find anything specific. Is there any HIPAA Gurus out there that can tell me where I can find info pertaining to this situation? I was only trying to be proactive in my education. i know it was stupid but I still can't pinpoint the HIPAA violation. I have to do two reports as restitution. Please help! Thank you....

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It is kind of weird that you did that without your clinical instructor there.

I can't find a HIPAA violation there either - you had permission from the patient who can give permission to whomever he wishes. If you weren't already in trouble I'd say go to your instructors and ask them specifically what makes this a HIPAA violation. My guess is that they are just expanding HIPAA to cover everything they don't want you doing.

Pat

When I was in school, we were not allowed to go near a patient unless our clinical instructor was on the floor. Sounds to me like it was a school policy you were violating.

If you acknowledge that you messed up and that you've learned a lesson, it may be best to let it go at that. Ideally, no one would accuse you of a HIPAA violation unless there were one, but I just don't think it's worth it to get bogged down in the semantics here. They may not be technically correct, but I don't see how arguing will improve your standing.

Yes, it was a HIPAA violation. The regs limit access to protected health information (PHI) to the professionals who are caring for the patient as part of their jobs. In addition, the organization is required to limit information on a 'need to know' basis, depending on the role of the professional.

In this case, you were by no means a 'professional' nor were you authorized by the facility to care for the patient. But - the real HIPAA culprits are the nurse who permitted you to participate without authorization and her(?) employing organization.

I know it can just become a tangle of regulations.. but the intent is to protect patient information from any unauthorized access.

Yes, it was a HIPAA violation. The regs limit access to protected health information (PHI) to the professionals who are caring for the patient as part of their jobs.

Or to anyone designated by the patient themselves. Otherwise we would never be able to tell family and friends what the status of the patient is.

According to the OP she had permission from the patient to watch an assessment. That permission takes away the HIPAA protection here.

Pat

  • Author

I'm just going to lay low and muddle thru this without an arguement. I called the state; they do not see a HIPAA violation either. Thank you for the input.

  • Expert

Yeah they don't want students doing anything when the instructors aren't around but I can see where you though it would be ok since you have worked there and had permission. You are smart to just let it go and move on. Take care.

If you acknowledge that you messed up and that you've learned a lesson, it may be best to let it go at that. Ideally, no one would accuse you of a HIPAA violation unless there were one, but I just don't think it's worth it to get bogged down in the semantics here. They may not be technically correct, but I don't see how arguing will improve your standing.

It didn't sound like she was arguing about it - she said she has to do two reports about the two violations and was looking to see what she did to violate HIPAA.

I know it's kind of been resolved for you, but I wonder why no one else showed up at the hospital that day. (even the instructor) Did you get the date or time wrong? Or did the others get in trouble for not showing up?

I'm really stuggling with the HIPAA violation. But I do understand the school policy regarding pt. care without an instructor - that is a big violation.

Like I tell others, learn from this experience and move on. Schools tend to be more likely to let it pass if the student has learned from their mistake. To fight the HIPAA violation...not sure if I would. Maybe its best to see what they write up first to see just what they think you violated. I have yet to see anyone successfully fight anything - either in LPN school or RN school. Good luck whatever you do.

But please let us know what happened to everyone else that day. That is just weird. I'm also suprised they let you have clinicals at a facility that you had worked at before??

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