I have a question and am not sure what the right answer will be considering situation.For example ,can a nurse give a test result of a 16 year to her mum over the phone provided she can state the social security and date of birth? Or will it be correct to tell the mother that she is sorry she cannot give such information out.To me I will feel not giving out the results will be the best.But to come to think of it,is the 16 year old not part of the mom`s health care insurance and she has a right to know.
Secondly,can a parent stay in the examination room with a 8 year old child or does she have to wait outside to give the child privacy?
I look at this type of sceneraios putting one in a tight situation.I want views and help on this situation as it reflects Hippa and confidentiality please.
In my line of work, lab results are given out over the phone every single day. Kids are having labs drawn at home to determine if they need blood transfusions, if they need to continue or can stop drugs like neupogen or if they can receive chemotherapy. There's nothing- absolutely nothing- wrong or amiss with a nurse calling a parent and saying 'Mrs. Smith, Timmy's ANC is zero. This means that he shouldn't go to school, needs to continue with his daily neupogen and will need another lab draw at home later in the week. Please call the clinic immediately if he develops a fever."
An 8 year old is a minor. The only reason I can think of that you would ever ask an 8 year old's parents to leave the room is if abuse was suspected and the child needed to be interviewed without the parents present. Even in that instance, convincing the parent to leave would probably be a production in and of itself. I know of very few 8 year olds who would want to be alone for exams or procedures and even fewer parents who would agree to leave their young child in such a situation.
Results about STDs or pregnancy are confidential for even minor teenagers. I recall a 16 yr old who we had to treat for gonorrhea without her mother's knowledge several years ago.
So to say it will just be polite to tell the mum ,that I cannot give you the required information regardless of whose insurance it is.My eight year old will not mind me staying in the room during an examination,but for some 9 year old kids who have started to develop breasts or pubic hair may be shy.This means even kids have a right to their privacy.I get it now.Thanks for the explanation.
Who are you going to give the results to if not the parent? Are you going to call a 3 yr old or a 6 yr old or a 9 yr old to explain the results of lab work or an MRI or a biopsy? Of course not, the idea is absurd. Parents of minor children can access their information with some exceptions- i.e. Mom doesn't have the right to hear the results of 17 year old Suzy's pregnancy test- but you can certainly give the results of a CBC to the mother of a 5 year old.
In the first case (16 year old), I would check your local laws and see what is allowed. As someone's already pointed out in this thread, many jurisdictions will consider a teenager competent to make their own decisions about their reproductive health. It doesn't matter whose insurance she is on or who is paying the bill. If this is the case in your area, then I suppose you could give the 16 year old her test results over the phone...
But then there's the problem of "how can you really be sure that this is the patient?" Sure, you could ask them their name and birthdate and SSN...but guess who else probably knows that information? Mom. Or sis. Perhaps even a close friend. That's the risk you take when you give out results over the phone.
Of course not.You know the rate that some adolescents contract std`s are alarming.When they go for testing ,they will not want their parents to know they are sexually active or maybe pregnant.To some parents,they may still think their little girl is a virgin.Therefore,if a nurse is not very careful in handling the situation.The nurse may also be facing the problem of letting out information. I know how this issue is.Thanks to you all for all the comments and feedback.I am so grateful.We nurses learn everyday.
For the 8 year old...the child is definitely a minor, so if parent wants to stay, parent has the right to stay. If the child wants a bit of privacy and I felt it was OK for the situation, then I'd encourage parent to maybe give us a couple of minutes, but I wouldn't press it if the parent said No. But I would also make it clear to the child that I wouldn't be keeping any secrets from the parent, especially if they're self-harming.
The only time I'd insist on privacy for the 8 year old is if I suspect child abuse from parent. Then I'm going to come up with whatever red herring I can to get that parent out of the room for a few minutes, so the child could be examined/questioned in private.
I just realized that I misread your post--you were asking about whether you could tell Mom about 16's test results. I thought you were asking if you could tell 16 about her own results :)
Though my answer is still the same: check your local laws. If the law says 16 can make her own decisions about reproductive health, and 16 did not authorize the release of that info to Mom, then you'll have to tell Mom "sorry, but I can't disclose that information." You may or may not agree with this, and Mom may get mad and start taking it out on you (and will likely play the "I'm paying the bill!" card), but that's life.
Specializes in Complex pedi to LTC/SA & now a manager.
In the first case (16 year old), I would check your local laws and see what is allowed. As someone's already pointed out in this thread, many jurisdictions will consider a teenager competent to make their own decisions about their reproductive health. It doesn't matter whose insurance she is on or who is paying the bill. If this is the case in your area, then I suppose you could give the 16 year old her test results over the phone...
But then there's the problem of "how can you really be sure that this is the patient?" Sure, you could ask them their name and birthdate and SSN...but guess who else probably knows that information? Mom. Or sis. Perhaps even a close friend. That's the risk you take when you give out results over the phone.
This is what I am referring to if someone calls in don't release confidential information without verification whether it's name DOB & SSN or a code word in the chart. Know the laws in reference to your area of practice. Working as a pediatric oncology nurse will have different guidelines than a GYN clinic that does pregnancy, contraceptive counseling and STD testing whereby certain ages are automatically considered emancipated depending on the scenario.
Know the rules as they apply to your state and specialty.
I categorically refuse to provide information over the telephone; I respond with a simple, "you'll have to contact medical records."
At one of the large, local health systems, I was able to obtain online access to the records of my kid up until the kiddo turned 13. Now I am locked out and must go through medical records.
It's not about being on a parent's insurance; it's about being under the parent's legal guardianship. Why WOULDN'T the parent have access to the minor child's health information? I can see in cases of pregnancy where a pregnant minor is emancipated, but otherwise? Who are you going to give results to...this 8 yr old? What is an 8 yr old going to do with the results? They are not developmentally or otherwise able to make any decisions based on the results.
You can certainly request for the parent to step out, but it's up to the parent if they do or not. Personally I turn my back if the dr. is examining any areas typically covered by a swimsuit...but NOBODY is having a medical conversation with my children outside of my presence. That child and his/her health is MY responsibility so long as they are underage and living under my roof, and the provider would require MY permission to have any conversation or do any exam on my child.
KelRN215, BSN, RN
1 Article; 7,349 Posts
In my line of work, lab results are given out over the phone every single day. Kids are having labs drawn at home to determine if they need blood transfusions, if they need to continue or can stop drugs like neupogen or if they can receive chemotherapy. There's nothing- absolutely nothing- wrong or amiss with a nurse calling a parent and saying 'Mrs. Smith, Timmy's ANC is zero. This means that he shouldn't go to school, needs to continue with his daily neupogen and will need another lab draw at home later in the week. Please call the clinic immediately if he develops a fever."
An 8 year old is a minor. The only reason I can think of that you would ever ask an 8 year old's parents to leave the room is if abuse was suspected and the child needed to be interviewed without the parents present. Even in that instance, convincing the parent to leave would probably be a production in and of itself. I know of very few 8 year olds who would want to be alone for exams or procedures and even fewer parents who would agree to leave their young child in such a situation.
Results about STDs or pregnancy are confidential for even minor teenagers. I recall a 16 yr old who we had to treat for gonorrhea without her mother's knowledge several years ago.