Hipaa violation-What happens to RN?

[xrayrn]

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!

[JKL33]

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?

[xrayrn]

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.

[xrayrn]

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."

[JKL33]

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, LPN]

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.

[Wuzzie]

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.

[RNKPCE]

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

.

This ten times over.

[xrayrn]

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.

[Wuzzie]

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]

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.

[dishes, BSN, RN]

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.