I need some answers please!

Nurses General Nursing

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My friend is going before a Nursing Board next Thursday. She is being accused of a Hippa violation.

To make a long story short....she was fired for getting an ABG and chest x-ray because the pt. was in distress and the M.D. wouldn't return 3 pages. In the end, the pt.'s PO2 was 47 and PCO2 was 90. He coded and ended up on the vent. Ultimately, she was fired. That's not what I need an answer for because she knows she shouldn't have done it and she's not in trouble for that.

The next day a reporter shows up at her door (even the nursing board didn't have her address...she had just moved. The only people who knew the new address was the employer) with a paper in hand and this patient's name on it and starts questioning her from being woken up from a dead sleep (cried all night). She never said his name on the news, never confirmed it but on tv while just talking with her they showed the man's name. She is now being brought up on a Hippa violation. Does anyone know if she could lose her license for this? And what about the hospital releasing this man's name? Aren't they in violation??

She will be with an attorney next week and he says as far as he can see it WAS a HIPPA violation.

I just want to know if you can lose your license. Thanks so much! She has been a CCU RN for 28 years....I would hate to see her license taken. One outstanding nurse!

anything is possible.

Specializes in Trauma, Teaching.

Seems to me a reasonable board would realize SHE didn't call the TV news, and she didn't release the name.

Did she confirm it to them? Did she discuss a case in front of a camera? That to me would be borderline.

Let us know how it turns out.

Specializes in CVICU-ICU.

I am not sure I understand the reason she was fired in the first place. Sounds to me like she did what any prudent CCU nurse would do in that situation. Why was she fired for taking care of a critical patient in distress.

In any critical care unit or any unit for that matter there should be standing orders for ABG's, CXR, labs etc for any patient in distress. If she attempted to phone the MD 3 times without any return calls then it seems strange she lost her job for being a patient advocate. If we have a critical patient we cant just wait for the MD to call back before we treat them. A CXR and ABG is pretty basic and not unreasonable.

As far as the HIPPA violation goes I cant imagine the hospital gave out her name to the TV station however if that is true she needs to find out how they got her name and if she can prove it came from the hospital sounds to me like she would have a nice law suit against her employer for breech of confidently. If she didnt speak to the TV station then I cant see any HIPPA violation. I guess I just think there are pieces of this puzzle missing.

Sometimes families contact media outlets and report this stuff, especially after a particularly poor outcome for the patient. I wonder if that's how it went down. Sounds like there might be a couple of things that she could have done differently in an ideal situation, but I really hope this wouldn't lead to license revocation in someone who has practiced for almost three decades.

Specializes in pure and simple psych.

I'm not sure that a state board has any juristiction over HIPPA, unless the regs have been changed to include it. Get an attny that specializes in nursing issues. Call the state nurses assoc. They frequently have attnys that are on retainer, and will do a free eval of the case. Possibly there is a nurse who is an attny?? And if she did not say the patient's name, did not call the media, where is the violation. And, for sure, standing orders to be used in an emergency... Best wishes to her. Good for you for standing by her. That's champion.:bowingpur

As I see it, there are two separate issues here. One is that if she didn't have standing orders for the ABG and chest x-ray, then she practiced outside of the scope of her license. This will get her in trouble with a state board but probably only a suspension. The second issue is the HIPPA violation. The way I am reading your post, you seem to be saying that she did talk to the news media about the case. That is a definite no no. We never discuss particular patient cases with or without mentioning a name with the media unless an attorney advises us to do so. I would think though that given the patient's circumstances, the board would not strip her license. The way I understand HIPPA is that it is a finable offense. This fine generally applies to the employer and not the nurse if I understand it right. She needs to be sure she gets an attorney who specializes in nursing issues and keeps to herself from here with the media. Refuse to speak to them.

Thanks for the replies. There were no standing orders that's why she paged and paged and paged. This particular Dr. has had it in for her since day 1. Like I said, this nurse is good! She had been right on a few occasions and this made the doc quick to anger. She is a female M.D. from another country and definitely does not care for being shown up in front of colleagues and us "pee on" nurses (except if you're of her culture) Nothing against nurses from other countries. I've never had a problem but this doctor is just that way. But my friend didn't do that intentionally...she just knew that what she had ordered was wrong and made suggestions.

Also, like I said, she did practice outside her scope by getting the ABG and CXR but that's not what she's in trouble for. It's about the broadcast. The pt. originally came to our unit due to an overdose given on the floor. The family was considering a lawsuit (don't know what happened there, I resigned my position there) and was furious when the media was contacted so obviously they didn't call the media. She never confirmed anything on the broadcast (thank goodness I made a DVD of the broadcast because the media wouldn't give her a copy) but when they did it they showed the patient's name. She didn't even realize it until she saw the news report.

Anyway, she hired an extremely good health care atty. (very expensive, too) and he feels a little worried about the HIPAA violation. MY original thought still stands.....where did they get the name and her address? Only the hospital knew....can we say HIPAA violation?

Thanks for all your help and I'll keep you posted.

Specializes in Education, Acute, Med/Surg, Tele, etc.

WOW! Okay, sounds like she did her best, using her clinical judgement and skills to help the patient within her knowledge base. Considering she was the highest trained person in charge at the scene (?), then you are protected under certain guidelines and good samaritan clauses dependant on state...but many times that gets so complicated that someone still gets burned...usually the one doing the saving! Sorry, given that situation I would be applauding her not dissing her, especially if this was a case of overdose by the hospitals hands initially...a RN took up the reigns despite no MD present...good for her!!!

Anywhoooooo...I have heard when it comes to anyone from the media ever coming to your door, or someone asking you about a patient outside the facility, and who doesn't have direct rights to that info in facilty...you automatically say 'No comment, please refer to the facility...thank you'. Even if she admitted she worked with the patient, saw the patient, breathed near the patient....she is liable. However...I think a rational judgement would be on her side considering!!!

Heck..where in the HIPAA rules does it have instructions for media coming to your door specifically!?!?! I have never seen any, so there is no formalized statement or plan of action...that would be a HIPAA violation of HIPAA itself!!!! Any medical person should have reference to policies and procedures for all things involving pt care..this would be one...so HIPAA and the faciltily let her down!

This HIPAA crud makes me so mad at every turn...I find it is against the people it protects under a cloud of uncertainty, confusion, and beyond reason(always having that 'loose your license' looming is harrassment at every turn...not a good thing!).

Good luck to your friend Snow hon, and let us know what happens. If this was a violation against HIPAA for not instructing persons what to do if this occurs at their home...I am all in and would love to help!

I think it could look bad d/t media portrayal. I mean, if she said anything at all (even w/o names) and the news had her interview along with his name, it could be bad. I've been hassled by reporters too, and I just say, "I have no comment. Please contact the hospital media center for any information," and walk away.

I hope her atty settles all of this and she doesn't lose her license. Sounds like she did everything she could to save the pt. I hate HIPAA. Grrrr.....

Specializes in Community Health, Med-Surg, Home Health.

I am a three day old LPN (just received my license in the mail today), and some of this does not make any sense. Why wasn't she allowed to obtain the ABGs or Chest Xray? I have not been trained as an RN, so I don't know, but I would think that there should be some sort of intervention. And, someone appearing at her house out of the blue makes me think that her address was released by an employee. I hope that things work out for her.

Specializes in Day Surgery/Infusion/ED.

I think the OP could find herself in trouble for violating HIPAA; she's revealed so many details that it would be very easy to identify/recognize the pt.

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