is this a HIPAA violation

[nurse2289]

I currently work in a hospital on night shift. I have a coworker who was fired for a HIPPA violation. I don't know that I think it was justified and I'm curious if it was a true HIPPA violation. Earlier in the day the patient was in the room with a family member. The doctor and day shift RN both obtained verbal consent from the patient to discuss the patients medical treatments. On night shift the patient was in the room with the family member and the night shift RN came in to the room. The PATIENT asked the NURSE the results of a test taken. The nurse answered the patient and the patient reported this as a HIPPA violation. The family member was in the room but I was under the impression since the patient asked the nurse with the mother in the room this was implied or inferred consent. What are your thoughts?

[meanmaryjean, DNP, RN]

It would be implied consent only if the patient was a minor. Was this a different visitor, or the same one that was permitted info earlier in the day?

[nurse2289]

Same visitor. The Dr and day shift RN vouched patient gave consent for her to be in the room while discussing her test results.

[nurse2289]

Same visitor. Dr and day shift RN vouched for the verbal consent they obtained. I was just wondering if it was considered consent since the patient asked about it with visit in the room.

[Studentnurse365]

Don't know or have experience, but just my opinion... the night nurse should have asked if it was ok to give results in front of another person. I always hear doctors saying, may i speak freely? The patient doesn't know if the night nurse was told in report who the visitors were and if they were allowed to hear patient info. Maybe the patient thought they'd get money by claiming hipaa violation.

[CrunchRN, ADN, RN]

I think it is total BS. The patient should have asked the visitor to leave if they didn't wanting them hearing the answer. Smells like a set-up to me. Ridiculous.

[Anonymous865]

Firing the person seems excessive.

I don't agree that it was a set-up. It's possible that the patient might not have intended for the nurse to provide the extent of the information they did and was embarassed by what was revealed.

For example, a patient might ask about how their surgery went. They are expecting the surgeon to say something along the lines of, "The surgery went very smoothly. Your appendix was inflamed as expected, but was removed without any difficulty." They are OK with their visitor hearing about the appendix. If the surgeon said this and also went on to discuss that they would be restarting the patient's meds for bi-polar or Hep-C or HIV, the patient might get upset. They didn't want their visitor to know they had this embarassing illness and hadn't expected the surgeon to discuss that when asked about the appendectomy.

Expecting the patient to ask the visitor to leave isn't a smart approach.

Your patient might be battered. They might think that asking the person to leave would cause them problems when they are released.

The person might be extremely polite and would feel rude asking a person to leave. The visitor might be obtuse and not think to offer to leave.

The patient will be more likely to confide in you if there isn't an audience. If a visitor is present the patient might be uncomfortable mentioning to you that when they had a bowel movement there was a lot of bright red blood in the toilet, yet you would probably like to know this. Yes the patient should know that it's important to be open with their caregivers and that their health is more important than any embarassment, but that is not that easy for non-medical people.

It would be much more considerate of your patient and would protect you from accusations of violating a patient's privacy, if you just automatically asked visitors to step out while you provide patient care. Then if the patient says the visitor can stay, you are covered.

[nurse2289]

I don't disagree with you on that but this situation was very specific. Patient asked for results of a test, they were given to the patient, cut and dry. I'm not saying one way or another if it was wrong or right but just asking for my own knowledge later on in my career.

[Anonymous865]

If you are looking for information to guide your behavior in the future, your wisest course would be to ask your risk management a hypothetical question. What matters is how your hospital's management/lawyers interpret the law. Your state may have laws that are more restrictive than HIPAA. Your hospital may have chosen to interpret HIPAA very conservatively to avoid any possible fine.

Alternatively you may not have the full story. You know the saying that there are 3 sides to every story - the nurse's, the patients, and what actually happened.

[PacoUSA, BSN, RN]

HIPAA HIPAA HIPAA HIPAA HIPAA HIPAA ... !!!

When are people going to learn how to spell that right??

Sent from my iPad using allnurses

[psu_213, BSN, RN]

My first guess is that there is more to the firing that you know, and more than what your former coworker is telling you. I just can't imagine someone being fired over this incident and just this incident.

For your practice, in the future, I would say "is it ok if I take this private information in front of this person?" if the pt has a visitor in the room.

[nurseprnRN, BSN, RN]

All of the above are possible, including the possibility of a set-up, as somebody might just have heard that there's big fines involved in a bona fide breach. Too bad they aren't paid to the patient but hey, you can't blame 'em for trying.

I agree there was probably something else going on, including something you don't know about that particular nurse.