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Hipaa violation-What happens to RN?

Hello,

I have a friend ( and I really mean that - I am NOT asking for me ) who works prn in an E-ICU (Electronic ICU - for those who do not know.) and he called me two days ago pretty upset over something that happened at work.

So, here's the situation: He just started this prn job a few weeks ago and was supposed to work there the night before and had to call in because his son was sick and he wanted to take him to the ER. He called in early to let them know so they would have coverage because he didn't know how long it would take and he lives an hour away. However, the ER he took his son to is in his city and happens to be in the hospital he works full time for...and his boss THERE sees him, of course, and asks him to work. He is done in the ER by then and says...OK, why not?

So, this hospital he works full time for in the ICU is one of the remote hospitals controlled by the E-ICU he works for and one of the RNs in said E-ICU looks through a patient's chart that isn't assigned to her that night with the purpose of finding his name on the charting so she can find out if he is working there that night since he called in and she is mad she has to work short. She is so mad that he called in (inexplicably, as she isn't his boss) that she calls the hospital and he told me that like 6 other nurses in the background heard her yelling "I know he's there! I saw his name in a patient's chart!"

Ok, sorry the question/scenario is so long, but he here it is: He told me that he talked to his boss in this E-ICU and they are just...by the sound of it..sweeping it under the rug and that she will be "disciplined" or something to that effect. They also promised that she would be professional when they work together. I thought that sounded like a serious and fire-able offense...I still don't quite believe someone would DO that..He's upset and wrote a letter to HR. I told him that I thought that was the correct thing to do, but now I'm worried that HE will be the one fired somehow.

My questions: What should he do? He asked for my advice ... and what will happen to her? Isn't this a serious hipaa violation?

Thank you in advance!

So, this hospital he works full time for in the ICU is one of the remote hospitals controlled by the E-ICU he works for and one of the RNs in said E-ICU looks through a patient's chart that isn't assigned to her that night with the purpose of finding his name on the charting so she can find out if he is working there that night since he called in and she is mad she has to work short. She is so mad that he called in (inexplicably, as she isn't his boss) that she calls the hospital and he told me that like 6 other nurses in the background heard her yelling "I know he's there! I saw his name in a patient's chart!"

So your friend's contention is that these individuals were independently suspicious that he may have called in so that he could work at his other job, and because of their suspicion they randomly started going through patient charts to see if his name was on any of them?

That sounds like a far-fetched accusation that he is trying to make. Why would these people at the PRN job just automatically think he was lying about his reason for calling in? That makes no sense.

What DOES make sense is that, in the course of them being in a chart they had reason to access, someone happened to come across his name and noted that the time was during the shift that he was supposed to be working at their place. This is not that impossible in an integrated system. THEN he was found out.

I won't comment on HIPAA; it could be a technical violation, but it doesn't violate the spirit of the law at all, really, since the spirit of the law is about protecting patients, not employees who make bad decisions.

And yes, I do think it was pretty crappy to work at his FT job after he was done with his son in the ED. He had a previous commitment to the E-place, so, at least in my personal opinion, the upstanding thing to do when he found himself with time to work, would be to call the place where he actually had an obligation that day, and see if they could still use his help.

ETA: I'd forget about crying HIPAA-foul if I were him.

What is it about doing something bone-headed and then when it doesn't work out perfectly, trying to make someone else miserable?

No, you aren't understanding AT ALL. His boss at both jobs KNEW where he was and what happened. The chart that nurse accessed was NOT a patient assigned to the E-ICU so she was NOT to be in it.

Please respond to the question and stay on topic if you do. You are assuming a lot and you are wrong on all counts. It doesn't matter if you think, if I think, or if she was upset, that he called out. I'm asking about the HIPAA VIOLATION HERE.

So AGAIN: It is OBVIOUSLY a Hipaa violation, but what usually happens here? Will she be fired? They said she'd be disciplined, but is that enough? She was going through charts one by one looking for his name specifically. She was not assigned-nor was the E-ICU assigned-these patients. They had access to them because there is one patient on that floor that belongs to them. She was in clear violation. She has admitted it. I was just wondering if they mean she will be fired when they say "disciplined."

No, you aren't understanding AT ALL.

Please respond to the question and stay on topic if you do.

You are assuming a lot and you are wrong on all counts. It doesn't matter if you think, if I think, or if she was upset, that he called out. I'm asking about the HIPAA VIOLATION HERE.

So AGAIN: It is OBVIOUSLY a Hipaa violation

So noted!

I was just wondering if they mean she will be fired when they say "disciplined."

Hope not.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

He cannot file a HIPAA violation as he has no expectation of privacy as a staff member.

He has no right to know what if any disciplinary action occurred with the other nurse.

There is no standard personnel disciplinary action for any real of perceived HIPAA violation.

1. He cannot claim a HIPAA violation. If she accessed his son's chart, different story.

2. He has no right to know what if any disciplinary action was taken with the other staff member as that is a personnel issue.

3. He needs to drop the issue as he reported his concerns to management there is nothing more he can do nor is there any further explanation owed to him by his employers.

4. If he approaches the affected patient and alerts of a possible HIPAA breach he could lose his job as the issue is not his to share risk management has a protocol and documentation to follow.

I understand your concern regarding your friend but it appears he still has his job in the E-ICU so he isn't going to be fired for calling off and working his other job. Beyond that I'm mystified as to why you are so intensely concerned about what happens to the other nurse to the point of beginning to sound a little vindictive. Really none of us can tell you what the facility will do because we don't know what transpired and these types of issues are handled on a case by case basis. So, I'm afraid you aren't going to get the answer you want no matter how much internet yelling you do.

He has no right to know what if any disciplinary action occurred with the other nurse.

.

This ten times over.

Well, she was fired.

Vindictive? Nah, just asking, but it does seem like hipaa needs to be readdressed with a lot of nurses here.

She was fired for the exact reason I thought she would be: going through charts she had no reason to be in. My friend was never in any danger of losing his job. That was never an issue.

Nah, just asking, but it does seem like hipaa needs to be readdressed with a lot of nurses here.

Not really. We didn't have enough of the details to give you an absolute answer. For instance, I can pull up the ED census at my facility and see what nurses are working without going into any patient charts at all so it wouldn't be a HIPAA violation. The fact that somebody is in the hospital or what nurse is assigned to them is not protected information unless they are a psych admit. But what I do with that information makes all the difference.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

While it's quite possibly a violation of workplace policies regarding accessing a patient chart, what you're describing isn't necessarily a HIPAA violation since it's possible in most EMR's to see who's assigned to a patient or who has been writing notes on a patient without actually accessing any specific medical information.

Seems straight forward to me, the nurse was not in the circle of care for the patient and she had no business looking in the patient's e-chart, so yes she violated the patient's health privacy.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

No, you aren't understanding AT ALL. His boss at both jobs KNEW where he was and what happened. The chart that nurse accessed was NOT a patient assigned to the E-ICU so she was NOT to be in it.

Please respond to the question and stay on topic if you do. You are assuming a lot and you are wrong on all counts. It doesn't matter if you think, if I think, or if she was upset, that he called out. I'm asking about the HIPAA VIOLATION HERE.

If this is truly about a "friend" and not about you, why are you getting so nasty over a post that you don't like? The nastiness is uncalled for.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

Well, she was fired.

Vindictive? Nah, just asking, but it does seem like hipaa needs to be readdressed with a lot of nurses here.

You have no knowledge that someone was actually IN a patient's chart. As mentioned here already, most EMR systems have the ability to find out who is working on another unit in the same system without actually going into the patient's chart. It isn't a HIPAA violation to pull up the census and see who is assigned to a patient.

You seem to be irrationally concerned about what happens to another nurse . . . vindictive might be a very good word to use.

KRVRN, BSN, RN

Specializes in NICU.

It sounds like this nurse went a step or two beyone merely calling up a census list and seeing which nurse was assigned to which pt.

It's mentioned that she went through charts one by one. She didn't think she was violating HIPAA (I assume) since she wasn't really trying to snoop through pt info, but in reality she would be in violation for every pt chart she opened--assuming it wasn't just a census list. Though my employer would probably want to know why you called up a census list for a unit other than the one you were in, but I don't know if that's necessarily a violation or not. I've known HIPAA violations to lead to warnings or to termination.

Secret to a long life: Mind your own business.

Jory, MSN, APRN, CNM

Has 10 years experience.

I don't think it's a fireable offense but she sure as heck needs to be written up for it. That is a major invasion.

We had a unit secretary that told everyone that one of our nurses was in the ER at another hospital because she saw it on an electronic list. She was suspended for a week.

You guys arent understanding the post. YES it was Hipaa violation because the nurse went into a chart that she had no business in. And just because you are an employee of the facility it doesnt mean you have no privacy. An employees medical chart is considered a patient chart! Therefor he is entitled to the privacy of any other patient.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

You guys arent understanding the post. YES it was Hipaa violation because the nurse went into a chart that she had no business in. And just because you are an employee of the facility it doesnt mean you have no privacy. An employees medical chart is considered a patient chart! Therefor he is entitled to the privacy of any other patient.

Respectfully, I think you are the one who is misunderstanding the OP. The man in question was in the chart as the nurse, not as the patient. The employee of the E-ICU could tell he was in the chart without accessing any actual patient information. Therefore she knew he was working in another facility after calling in sick to his job in the E-ICU.

While you are correct that an employee's medical chart is privacy protected, it isn't privacy-protected information to look to see what nurse is taking care of a patient in an ICU which you are remotely monitoring as a legitimate part of your employment. All it requires is backing out one layer from the individual patient chart to the assignments for that ICU. I can look at any unit in my 1000 bed hospital and see which nurse is assigned to which patient -- all without breaking HIPAA.

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