How much patient information to give family members?

[RachelRN25]

I recently just transfered to evening shift from working night shift for on a busy med/surg floor in a hospital. There are many differences with evening shift, one of the primary being having a whole bunch more patient and family interaction and questioning. Having just come from nights, I'm still getting used to how to handle this.

An issue came up with a family yesterday having to do with why my patient was admitted and wanting to know the plan of care. I let them see the doctors orders and interpreted them for the family in explaining what sort of tests we were going to do and such. They still weren't satisfied and the patient being a direct admit from a doc's office, that doc had already gone home and I told them the on call would not be able to give them a good answer. I offered to let them read the doc's progress notes or interpret them for the family and they agreed. At that point I asked my charge and a few veteran nurses what they thought about me sharing all of this information with the family, and they were just aghast with how much information I had already shown to the family members! They suggested not sharing anything more and telling them to wait for the doctor in the morning to see the patient. It was not right according to HIPPA and stuff.

So, my question is how much information do you with patients and/or family members? The patient was willing to let the family see the orders, etc., but did I have a right to show them?? The veteran nurses told me to never share info with family members unless they are the POA, which they weren't. I just hate not being able to give them a little bit of piece of mind in this situation.

Any thoughts would be much appreciated! Thanks! :)

[Elvish, BSN, DNP, RN, NP]

If I ever have any doubt, I ask the patient privately if they mind my telling said family members anything. That is, assuming the patient is verbal, a & o. (I'm on a antepartum/postpartum floor, so the nonverbal bit is generally not an issue.) If they give me permission to talk to the family, I ask if there is anything they do NOT want me to share. And I document those conversations. If you have the patient's permission, you are okay. But always be sure to document that you have pt's permission.

If in doubt, though, err on the side of caution.

I don't know that I've ever gone so far as to actually show them the chart, but I have explained the orders to them. If the patient doesn't give permission, I gently tell the family, "Your relative has asked me not to share his/her information with anyone other than healthcare staff directly participating in his/her care. You are free to talk to your relative directly if you want more information than that."

[LiverpoolJane]

If a relative asks me for information the first thing I do is ask them what the patient has told them, if they say something like -he/she says she needs to have a scan. I will then give them information relating to the procedure but not particularly personal to that patient. If they are more pushy, I approach the patient with the relative and say - you daughter has asked me for an update on your condition, can you tell me what Dr ?? said when he saw you today. Them I let the patient do the talking and if they ask for clarification I will happily claify matters for the pt in front of the relative.

I know if I was ill in hospital and had capacity I would be furious at any relative of mine that approached staff without my knowledge.

If the pt is very unwell / lacks capacity I always ask for the family spokesperson - and explain that we cannot be expected to address all family members but will liase with that one and ask the others to then use them as a reference point.

It is difficult as relatives can be very demanding - you need to be firm - not rude and explain in a confident manner that you are not at liberty to answer their questions, or refer them to either the family spokesperson or ask the to make an appointment with the Dr.

[babynurselsa, RN]

If the patient is verbal I direct the family to ask the family member.

If they are not then I give them the basics. No facility that I have worked at allows staff to open the chart and let the family peruse it. This is something that must be arranged through the appropriate channels. Check your facilities P&P manual. Usually this is with the physician in attendance to answer questions, or a liason such as a house supervisor.

[GrumpyRN63, ADN, RN]

I will update the pt on what the POC is, they can update the family themselves,I will NOT open a chart to the pt or family members, that is up to the doc's to do. If it is a very involved case,a family meeting is called, family w/ md's, socialwork ,and the nurse all get together to address the POC. If its a test result,again I tell only the pt, if it's someone on the phone checking on the pt, ie husband/wife and the pt is stable, I tell them they are stable and I can't give out anymore info, and they are enc to call the pt themselves, or I have the pt call them. If someone goes south, the MD will let the family know the condition/turn of events.If the pt wants a copy of their medical records, I give them the phone number and they have to go thru med records to order it : takes2-3 weeks after discharge.

[Ms Kylee]

I tell them "You'll have to ask the nurse. I don't have access to his/her chart".

[madwife2002, BSN, RN]

You know the pt has to sign a release to allow family members to read their chart I do not believe you can actually allow members of the family to review it without the pts say so. If there is a MPOA then the relative who has this will be entitled to know information otherwise it is not a general free for all regarding the pts information.

[jmgrn65, RN]

you never let them read the chart without the doctors permission the doctor has the right to be there to answer questions and explain.

You just tell the family member what is planned and your plan of care. if that doesn't satisfy them, then they need to speak to the doctor. There is only so much you can say and do.

[loriangel14, RN]

The hospital I work at has a strict policy.NO info is given to anyone except the pt unless that person is the POA.This strictly enforced.