Legal Nursing Question

nurse2033, MSN, RN · Mar 3, 2011

Sister Theresa: Your compassion makes me smile. The others are right, you may not get her address from the system. Doing this with multiple patients will kill you over time. Sometimes a patient triggers you to go the extra mile, this is sometimes asked in interviews. "When have you gone out of your way for a patient"? This is a fine line and problem area. One option might be, before discharge you should have told the patient you would like to help her and ask for her contact information. But, if she feels uncomfortable you could lose your job. And then think of all those calls at 3:00 AM for medical advice. Think of it as asking a coworker out on a date. Ask the wrong person and your job is done. You would be much better to find support services for her prior to discharge that would accomplish the same ends. Once you develop a relationship with this patient outside of work, there are many potential complications that could threaten your license or your free time and sanity. Sometimes a close personal relationship might be worth the risk, but you had better be careful. If you are new to the business you should tread carefully and learn to separate professional compassion and personal compassion. Although we deal with people's live in our work, you must know how to protect yourself so you may continue to do this work long term. A certain amount of distance is required. Part of our job is to keep our personal life in order so we can be balanced and focused at work. Giving too much will throw out the balance and make us crazy. :)

backatit2 · Mar 3, 2011

my very first "heart ripping experience" was with a young 20-something guy who was in a coma. i saw pictures of what he "used to look like" and it broke my heart. i found out that he had a long-time girlfriend (who was also beautiful and very much in love) but the man's mother wouldn't let his girlfriend have any contact with him. he would move facilities and she would not tell the girlfriend where he had moved to. one time she drove for hours only to find he had moved again.

after caring for him and knowing he was there alone all the time (his mother hardly even visited) and that he had someone (his GF) who so badly wanted to be there for him - it made me want to reach out to her and let her know, "i know where he is!" but i couldn't. it wasn't my place.

fast forward - the guy is still in a coma. the young girl is trying to move on with her life even though she still speaks of him often. even though at the time reaching out to her felt like "the right thing to do" and "what i would want," it may be just as well that she didn't have his info. and is able to move on.

it's in our nature to want to help others - but in situations like these, you have to take care of yourself, too. once again, it will get better and you'll figure out how to deal with it. just re-reading what i just wrote, i can't believe a thought like that ever crossed my mind - but i do know where you're coming from.

Woodenpug, BSN · Mar 3, 2011

Pre-nursing student here. Regardless of whether or not it is recomended or even appropriate, if you were to ask the patient if you could have their contact info and thoroughly explain to them that it is not for anything professional, but strictly for personal reasons, to be used for personal contact outside of the facility and outside the realm of a nurse, could they give it to you and you be able to use it for her original intentions? Again, throw out for a moment if its recomended or not or in good taste or not, but if the information were acquired with the patient knowing WHY and consentingly gives it to you, would that be LEGAL (not recommended, but LEGAL)?
Obviously pulling it from their medical records would be a def violation of HIPPA, but since its their information, I would think that they would have the right to share it with whomever they want assuming they are fully informed as to why one would want it.......though I could be wrong!:)

We nurses often love to give legal advise, the problem is that as lawyers, most of us are better nurses. It would probably be legal, but difficult to document. I think to be safe you would need signed informed consent.

You have read many reasons why it is likely not a good idea. If you would like to continue the relationship, in spite of its inadvisability, you could give the patient your contact information. Just in case the other posters are right, you may want to use an email address or P.O. Box.

BabyLady, BSN, RN · Mar 3, 2011

I am a nursing student, first semester, and during clinicals today I grew a huge heart for my patient!
She was a close-to 60 year old patient who has had a lot of previous medical conditions/procedures such as; CAD, CABG (2), MI (3), Stents (6). She was recently diagnosed with breast cancer, last September I believe.
She has no psychosocial support whatsoever! Her husband died 9 years ago, both parents are deceased, dog has passed away, brother is in Australia and maybe calls once a month, and a sister who lives fairly close to her, but yet since her diagnosis of cancer she has never came around to see her.
You can very much tell she is depressed, and for obvious reasons; no one to support her through this hard time, mastectomy, no hair, etc. And she seemed to use sarcasm as a coping mechanism for her depression..
After trying my hardest to get a social worker in to see her before her discharge, and before I left clinicals, I went in and just sat and talked to her that it would be very healthy for her to join some support group in the community, even going to church and joining a life/small group.
I have been around a few family friends that have been diagnosed with cancer, and a team of people would join together and create a support group for whomever and would do charitable stuff for them.
The question I had about legal issues is, am I able to find her phone number and/or address in the phone book and ask when or if I could bring her dinners some nights? Or just going over to clean the house, mow the lawn, etc..? And if this is possible, would I be able to just grab it off of our computer-based system?
My heart grew a lot for her and I feel so bad
Thank you so much!
(And please do not mention to me that I cannot let my heart get in the way of caring for patients, because if that day ever comes I will be retired or deceased! And also don't act like my parents and tell me that I cannot do this for every patient I grow a heart for. I put my heart and soul into my job now (PCT) and will continue to do the same as a nurse.) Thank you!

Why are we encouraging the OP to "let it go" rather than figuring out a creative way she can help this woman?

The OP is a nursing student, she is not a nurse at the facility that may be in charge of taking care of her later.

My advice: Talk to the hospital social worker and your nursing instructor that you would like to volunteer to do some things for this woman after she is discharged. Give the hospital social worker your information.

The hospital social worker will most likely approach the patient to ask if she may be receptive to the assistance...then things will progress/or not progress, from there.

That is the proper channel to go through.

It would not be appropriate, however, once you become an RN, to do this with patients when they are in the hospital, because let's say you took care of Mrs. Smith on Thursday in the hospital, she was dischaged and then went to Mrs. Smith's house on Friday and something happened to her..the hospital has to know WHERE the incident occurred and who is to blame...can you imagine how complicated that would be if you worked with her inside/outside the facility? it is a legal/liability issue.

BabyLady, BSN, RN · Mar 3, 2011

Pre-nursing student here. Regardless of whether or not it is recomended or even appropriate, if you were to ask the patient if you could have their contact info and thoroughly explain to them that it is not for anything professional, but strictly for personal reasons, to be used for personal contact outside of the facility and outside the realm of a nurse, could they give it to you and you be able to use it for her original intentions? Again, throw out for a moment if its recomended or not or in good taste or not, but if the information were acquired with the patient knowing WHY and consentingly gives it to you, would that be LEGAL (not recommended, but LEGAL)?
Obviously pulling it from their medical records would be a def violation of HIPPA, but since its their information, I would think that they would have the right to share it with whomever they want assuming they are fully informed as to why one would want it.......though I could be wrong!:)

It is not professional, NOR appropriate, to ever ask a patient for their personal contact information unless you are asking for the sole purpose of putting it in the chart.

Ever.

ammonthenephite · Mar 4, 2011

"It is not professional, NOR appropriate, to ever ask a patient for their personal contact information unless you are asking for the sole purpose of putting it in the chart."

But what if she's cute? JUST KIDDING, lol. No, I know its not professional nor appropriate, thats why I excluded those from my question. I was just looking strictly for legal ramifications. Thanx though!