Is this a hipaa violation?

hawaiicarl, BSN, RN · Apr 29, 2016

In the back of my mind I was wondering if you worked prehospital ... like flight nursing or something, which like you said, is a whole different ball game. Yes CPR, and intubation is hurting a patient, and yes we need to stop if a family member tells us it is not in their best interest.

:-)

NotAllWhoWandeRN, ASN, RN · Apr 29, 2016

this is all hypothetical. my point is to see where hipaa starts and where it ends for the casual nurse. With social media, texts, pictures etc etc that never go away that can come back YEARS later we now live in a federal nightmare. If Jay Z comes to burger king I can tweet the world the he ordered a hot dog. But if I (THE NURSE) tweet Jay Z is at the hospital and I work there is that a violation? Is it a violation if someone tweeted that and they were in the waiting room at the time and saw him walk in?

Leaving aside that you're claiming you don't know if sharing a patient name is a HIPAA violation...

There are HIPAA violations and then there's bad behavior.

If you chat about a patient in an elevator, even without using patient identifiers, especially with visitors present, that's bad behavior. It is probably against company policy and is likely to get you disciplined.

If you post ANYTHING about work, coworkers, or patients to social media, employers may decide it's Bad Behavior and discipline or terminate you. My last several employers have been very emphatic about their right to regulate what you say about them.

It's why I have no social media accounts whatsoever under my real name, provide access only to "Friends" where possible, never "Friend" coworkers, and never affiliate my accounts with an employer by name. I even created a new account here last year because I had been casually active under a username that included part of my name in it, and I decided I no longer wanted to take that risk.

If the patient can be identified, it's a HIPAA violation. Just because it's not a HIPAA violation doesn't mean it's ok.

Kristiernbsn · Apr 30, 2016

you can assume it was your mom but it was really a patient from 10 years ago.

Why are you talking about it? Are you teaching a class? Are you telling your husband about your hard day at work? Are you in Grand Rounds? Are you sharing war stories at the nurse's station during a shift? Context is everything.

maddogatc · Apr 30, 2016

Technically, no. You have not released any type of information that would allow someone to identify the patient or his family. However, circumstances could turn that into a violation, if, for instance, that was the only patient you had and their identity was known. For instance, if you were a private care nurse for a wealthy family.

lkeasling · Apr 30, 2016

Like filing a cps or aps report, if you think it should be done do it. If you have a gut feeling, and I believe you do or you wouldn't have asked, if you think it is a hippa violation then it is. I am a firm believer in hippa as I have seen it broken and been a victim of a hippa violation. Just put yourself in the patients shoes, would YOU want to be talked about like you just talked about them? It's simple common sense and courtesy. As nurses we are SUPPOSED to leave the patient information where it belongs, with the patient. I would hope you learned that in your training.

Ruby Vee, BSN · Apr 30, 2016

HIPAA Is a law that came about because we (health care providers in general) didn't use common sense about disclosure. I think the law can go too far to the point of silliness sometimes, but maybe that's just me. I've been in trouble for HIPAA twice.

Once I was standing in an elevator in my scrubs, on my way to work talking to another employee in scrubs on his way home from work. We were married to each other. I was talking about a patient's lab values, cardiac cath, confusion and his wife's inability to cope. We were alone when the conversation started, but a gaggle of social workers entered the elevator and we continued our conversation because time was short -- I had to get to work, the topic was emotional for both of us and no patient identifiers were revealed. One of the social workers took it upon herself to follow me to the ICU and report the "HIPAA violation" to my manager. Fortunately, my manager knew (because I had called her before leaving my house) that the patient I was discussing with my husband on the elevator was my father who was hospitalized in another state and that I was leaving immediately from work at the end of my shift to fly to his side. I wouldn't have another opportunity to see my husband before leaving town. The social worker's reaction to this news was that "you shouldn't have been talking about it on the elevator." Possibly not, but we allow visitors to talk about their loved ones on the elevator, and everyone present was employed by the hospital. And it has always griped me that she never indicated any sympathy for my situation with my parents.

The other time was long, long ago when Robin Scorpio's HIV test came up positive on General Hospital. My assistant manager and I were discussing our favorite character and speculating whether she got HIV from her boyfriend whose previous lover was an IV drug abuser. We were standing outside a patient room, and the TV in the room was on to General Hospital and the angst onscreen was all about Robin and Stone. A patient's wife came boiling out of the room next door and started shouting at us that she was going to report us for openly discussing a patient's HIV status. The assistant manager disappeared before the visitor could read her name tag, but I foolishly stayed behind and attemtped to explain to her what we were discussing, even going so far as to point to the TV screen. It didn't matter. She went straight to the manager. What saved me was the assistant manager who was the next person into the manager's office.

I also got into trouble for NOT revealing information to "the patient's wife." John Doe went down on the golf course and was admitted to our unit. Woman shows up, says she's his wife and demands to start making his medical decisions. She has a ring. He has a ring. We put the name that she gave us on the chart and she started making decisions. I went into the room to check on an antibiotic that was hanging while I was providing lunch coverage for the patient's nurse. I found the woman sitting in the nurse's chair in the room, surfing through his chart on the computer that the nurse had left logged on. She pointed to a lab result on the screen and demanded that I explain it to her. Instead, I told her that it is part of our hospital policy that visitors not access the patient's chart, and when she refused to comply with my request that she get off the computer, I switched off the power strip the computer was plugged into. Instant dark screen. When the patient woke up, a couple of days later, he told us his name wasn't what she said it was and he had never seen her before in his life. Turns out the woman had recently lost her husband which had exacerbated her ongoing mental health issues.

Perhaps there is some food for thought in the above, and maybe something to discuss in your class.

iShaybie, ADN · Apr 30, 2016

this is all hypothetical. my point is to see where hipaa starts and where it ends for the casual nurse. With social media, texts, pictures etc etc that never go away that can come back YEARS later we now live in a federal nightmare. If Jay Z comes to burger king I can tweet the world the he ordered a hot dog. But if I (THE NURSE) tweet Jay Z is at the hospital and I work there is that a violation? Is it a violation if someone tweeted that and they were in the waiting room at the time and saw him walk in?

Did he sign a HIPAA form yet?

iShaybie, ADN · Apr 30, 2016

HIPAA Is a law that came about because we (health care providers in general) didn't use common sense about disclosure. I think the law can go too far to the point of silliness sometimes, but maybe that's just me. I've been in trouble for HIPAA twice.
Once I was standing in an elevator in my scrubs, on my way to work talking to another employee in scrubs on his way home from work. We were married to each other. I was talking about a patient's lab values, cardiac cath, confusion and his wife's inability to cope. We were alone when the conversation started, but a gaggle of social workers entered the elevator and we continued our conversation because time was short -- I had to get to work, the topic was emotional for both of us and no patient identifiers were revealed. One of the social workers took it upon herself to follow me to the ICU and report the "HIPAA violation" to my manager. Fortunately, my manager knew (because I had called her before leaving my house) that the patient I was discussing with my husband on the elevator was my father who was hospitalized in another state and that I was leaving immediately from work at the end of my shift to fly to his side. I wouldn't have another opportunity to see my husband before leaving town. The social worker's reaction to this news was that "you shouldn't have been talking about it on the elevator." Possibly not, but we allow visitors to talk about their loved ones on the elevator, and everyone present was employed by the hospital. And it has always griped me that she never indicated any sympathy for my situation with my parents.
The other time was long, long ago when Robin Scorpio's HIV test came up positive on General Hospital. My assistant manager and I were discussing our favorite character and speculating whether she got HIV from her boyfriend whose previous lover was an IV drug abuser. We were standing outside a patient room, and the TV in the room was on to General Hospital and the angst onscreen was all about Robin and Stone. A patient's wife came boiling out of the room next door and started shouting at us that she was going to report us for openly discussing a patient's HIV status. The assistant manager disappeared before the visitor could read her name tag, but I foolishly stayed behind and attemtped to explain to her what we were discussing, even going so far as to point to the TV screen. It didn't matter. She went straight to the manager. What saved me was the assistant manager who was the next person into the manager's office.
I also got into trouble for NOT revealing information to "the patient's wife." John Doe went down on the golf course and was admitted to our unit. Woman shows up, says she's his wife and demands to start making his medical decisions. She has a ring. He has a ring. We put the name that she gave us on the chart and she started making decisions. I went into the room to check on an antibiotic that was hanging while I was providing lunch coverage for the patient's nurse. I found the woman sitting in the nurse's chair in the room, surfing through his chart on the computer that the nurse had left logged on. She pointed to a lab result on the screen and demanded that I explain it to her. Instead, I told her that it is part of our hospital policy that visitors not access the patient's chart, and when she refused to comply with my request that she get off the computer, I switched off the power strip the computer was plugged into. Instant dark screen. When the patient woke up, a couple of days later, he told us his name wasn't what she said it was and he had never seen her before in his life. Turns out the woman had recently lost her husband which had exacerbated her ongoing mental health issues.
Perhaps there is some food for thought in the above, and maybe something to discuss in your class.

I really hope you didn't actually get in trouble for these situations.. That's so ridiculous!

njpawarn · May 1, 2016

No. How can a person identify a specific patient?

Betty52 · May 1, 2016

I have a question. I work in home care and became comfortable with the mother of a patient because she talks and talks about her personal life and problems for 2 hours every time I arrive. So I mentioned another case I have with the company, no name but that it's a baby trach, vent, gtube, in so-so city...now I am being called in to talk to human resource...how will this effect my nursing license?

BuckyBadgerRN, ASN, RN · May 1, 2016

Sigh. You gave some pretty specific details. SN parents tend to know of each other, so chances are your momma figured out whom you were blabbing about even though you didn't give a name. Frankly, I'd be worried if I were you.

I have a question. I work in home care and became comfortable with the mother of a patient because she talks and talks about her personal life and problems for 2 hours every time I arrive. So I mentioned another case I have with the company, no name but that it's a baby trach, vent, gtube, in so-so city...now I am being called in to talk to human resource...how will this effect my nursing license?

Lisa.fnp · May 2, 2016

When saying; I have a case. That very well can be a problem. Sounds like you were worn down and befriended this person. That's when it can bite you. Hope things work out well for you. You might not of crossed the line but you don't need to walk on the tightrope.