I need your advise please

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Hello Everybody

I am an LPN working for a home health care company.

I'm taking care of a special needs child. I go to school with him.

My problem is the school nurse. She demands me to chart for the school or give a copy from my charting and MAR.

I feel that it would violate the HIPPA and could jeopardize my license because of the double charting.

My employer stated that it is ok to do it and it would be done for billing purposes.

The school nurse is not involved in direct patient care and I don't work for the school either.

I expressed my concern to my employer and I did not received any reliable response i.e. legal reference etc. other then saying it is ok.

I am hesitating to escalate this issue to the corporate compliance team fearing that my boss would just take me off this case.

We all work on PRN base and it is hard to get 40 hours as I have now with this case. Also they could just not giving me anything because of my "defiance"

So my question is that would you chart for a company who you don't work for or would you give a copy of your documentation including MAR out of your hand to the school?

Thank you for reading this long thread....

Has 33 years experience.

My employer encourages the use of the compliance committee. They are there to reviews policies and procedures specific to the organization. What makes you feel you are being "defiant"?

Specializes in ER. Has 36 years experience.

I don't feel that way but I feel that they could come up with this conclusion after multiple phone calls and I'm still resisting.

The nurse keep harassing me so I keep calling my boss then the answer is oh its ok...I found in our Code of contact that I need written permission from my boss to give a copy...not sure anymore

Has 33 years experience.

Why not just point out what you found in the code of conduct manual? I would be concerned about giving progress notes to anyone not involved in the patient's care. Permission from the employer would not protect you anyway. Fail to see what that has to do with billing purposes. Seems like all you would need you be a time slip from the school.

What did the school nurse say when you brought up your concern for a possible HIPAA breach?

Do you carry ?

Specializes in ER. Has 36 years experience.

Well the Code of Conduct says that I can not give out info or show documents unless I have the written permission from my boss or from our HIPPA Officer... I still think it is not right...

The school nurse treats me like I work for her and said that my boss said it is ok..She is actually works on a complain against me full with slander... she forgot her paper in my folder ... I got a copy from the secretary and the nurse came to me and ripoed out of my hand... I reported this as an incident... it happened yesterday... she also demanded to have access to the Diastat I carry with me... she seems power hungry to me...

Specializes in ER. Has 36 years experience.

I am not sure about the billing but that is my boss told me. I said to him that in that case they should provide the info such as what skills I do i.e. tube feeding, medicating.It is something about that the school get paid after those skills too.

My company has on us.I am seriously considering renew mine I had before because the insurance company could provide legal information as well.

Has 33 years experience.

What's a diastat? Your employer needs to be present with you during a discussion with the school nurse.

No job is worth being pushed around for.

Specializes in ER. Has 36 years experience.

Valium suppository with the set dose and waste amount i.e. 10 mg syringe with the set lower dose

Controlled substance I sign for and sealed by the pharmacy. She wanted to open the seal too...I do agree with you I feel that we need a meeting but my employer doesn't feel that way...

Specializes in ER. Has 36 years experience.

I have to medicate the pt. She wants access to the med I carry stated" if you are incapacitated or incompetent"...

toomuchbaloney

10,182 Posts

Specializes in NICU, PICU, Transport, L&D, Hospice. Has 44 years experience.

Your company should have a written policy which describes how you should interact with school employees and policy (including school nurses). You share some objectives with these people in the care of the child. It is important that you discover a collaborative pathway to provide the needed safe and effective care for the child while in the school building. They have requirements and regulations which you may not be familiar with, please ask them for clarification so that you can determine how or if you can assist in achieving.

It sounds to me like you are feeling uncertain and pushed and are therefore, sort of digging in your heels. That is a pretty normal reaction, but it will not (in the long run) be good for your career.

I recommend that you get as much information as possible, take the mystery out of the questions or requests, and find ways to work together.

OCNRN63, RN

5,978 Posts

Specializes in Oncology; medical specialty website.
Well the Code of Conduct says that I can not give out info or show documents unless I have the written permission from my boss or from our HIPPA Officer... I still think it is not right...

The school nurse treats me like I work for her and said that my boss said it is ok..She is actually works on a complain against me full with slander... she forgot her paper in my folder ... I got a copy from the secretary and the nurse came to me and ripoed out of my hand... I reported this as an incident... it happened yesterday... she also demanded to have access to the Diastat I carry with me... she seems power hungry to me...

Don't get into a power struggle with this nurse. You will lose, without question.

​FYI, it's HIPAA, not HIPPA.