Manager reporting confidential info to state board

[geoda]

I am a new grad (well technically now have been there a year but haven't worked in 3 months )nurse in the CVICU in a pretty big hospital. So I recently took time off for exhaustion and depression. I was off the schedule. On the second day off, I drank alcohol and got drunk. This scared me because I have a past history of alcohol abuse. I spoke to employee assistance and they told me if it happened again, I should seek outpatient treatment. That day, I drank again and blacked out. So 2 days later, I met with a counselor to seek treatment. She suggested a 4 week outpatient treatment program as a sort of reboot since I had long term sobriety prior to this, but had the potential to get much worse. I agreed, but told her I would have to get extended leave prior to doing this since it would not leave me time to fulfill my work schedule. I spoke with the manager of my unit (a nurse). She told me that our conversation would be private and confidential and would not go anywhere. I told her that I just needed medical leave for my time off and she kept prodding, specifically asking me if there was substance abuse involved. Since she said it would be confidential, I confided in her and told her yes. A week later she tries to fire me for accusations that weren't true. I immediately called her on it and told here I could prove they weren't true. She rehired me the next day. (This also would have cancelled my insurance and I would have been unable to finish treatment). The next day, I get a call from the state board saying someone filed a complaint saying that I was in treatment. Because of my manager's betrayal of our private conversation, I have to be in a 5 year monitoring program. Keep in mind that I did not work impaired, I put no patient's in harm's way, I sought recovery on my own after having drank only 2 times while on leave from work. I want to know if this is legal. I sought council from my employer's legal department and they have kept me employed there but I haven't worked in 3 months now. The lawyer was supposed to find me a position on another unit and he has stopped returning my calls and emails. Should I seek council outside of my employer? Is what she did in reporting our confidential conversation to the state board illegal?

[caliotter3]

Seek legal help: TAANA Executive Office - Home. can hook you up with a nurse attorney experienced in dealing with nursing boards. Or, see an employment attorney. We can't offer legal advice here per terms of service.

[~Mi Vida Loca~RN, ASN, RN]

There is something posted I think in the recovery forums here, I was actually shocked to see it. But someone liked information (that I went and verified) that stated health care providers have a duty to report other health care providers if there is known mental illness, substance abuse and some degenerative diseases. That they can get in trouble for not reporting and HIPAA apparently didn't come into play in these situations which completely blew my mind. I mean basically the way it read, you check into the ER for mental break or substance abuse or something and you think your patient privacy will be protected. Someone recognizes you and knows you're a nurse. They can report you and not violate HIPAA. Regardless if you were working at the time or even currently. Same with reporting Doctors.

I am about to leave so I don't have time to search it right now but I was shocked to see it and I didn't think it could be true. But then something else said since HIPAA is federal law it supersedes anything. (although your situation wouldn't be HIPAA violation). Anyway, I am not sure of her motives and why she reported you. She however might be protected if what I saw was true and still valid. (I honestly don't remember the ins and outs of it and I have tried to google things regarding it sense and have yet to pull up the exact thing they linked in the recovery forum) but might be worth searching those forums for.

It's a crappy situation to be in. I wish you the best in your recovery.

[MunoRN, RN]

Is what she did in reporting our confidential conversation to the state board illegal?

Only a lawyer can help you determine the legality of what occurred, but something to consider is that many states have laws requiring nurses to notify the board if they are aware of a substance abuse issue in another nurse. So it's possible that not reporting the conversation could have been illegal.

[MunoRN, RN]

I should add that these reporting requirements can also include some form of a self-reporting requirement, so I would avoid complaining to your nursing board that your manager told them something you intended to keep secret from them until you're sure that's not an automatic reason for them to revoke your license.

[Purple_roses]

This is what really sucks about our jobs. We're supposed to be there for patients, we're supposed to be understanding, we're supposed to give them support. But as soon as a nurse reveals he or she is human *gasp!* all of that supportive, understanding stuff gets literally thrown out the window, along with privacy apparently. What sucks is that you seem responsible in that you recognize that you have a problem, you get treatment, and you recognize when you need to pull yourself off of a shift. I'm sorry this is happening to you. Apparently violating your privacy is allowed, but I personally don't think it should be.

I wish you well your recovery and I hope whoever is making these ridiculous rules gets pink eye.

[~Mi Vida Loca~RN, ASN, RN]

Yikes, I need to stop posting stuff in a hurry when we can't go back and edit later. :|

OP please update us on the situation when you know more if you're willing.

[ItsThatJenGirl, CNA]

I am a new grad (well technically now have been there a year but haven't worked in 3 months )nurse in the CVICU in a pretty big hospital. So I recently took time off for exhaustion and depression. I was off the schedule. On the second day off, I drank alcohol and got drunk. This scared me because I have a past history of alcohol abuse. I spoke to employee assistance and they told me if it happened again, I should seek outpatient treatment. That day, I drank again and blacked out. So 2 days later, I met with a counselor to seek treatment. She suggested a 4 week outpatient treatment program as a sort of reboot since I had long term sobriety prior to this, but had the potential to get much worse. I agreed, but told her I would have to get extended leave prior to doing this since it would not leave me time to fulfill my work schedule. I spoke with the manager of my unit (a nurse). She told me that our conversation would be private and confidential and would not go anywhere. I told her that I just needed medical leave for my time off and she kept prodding, specifically asking me if there was substance abuse involved. Since she said it would be confidential, I confided in her and told her yes. A week later she tries to fire me for accusations that weren't true. I immediately called her on it and told here I could prove they weren't true. She rehired me the next day. (This also would have cancelled my insurance and I would have been unable to finish treatment). The next day, I get a call from the state board saying someone filed a complaint saying that I was in treatment. Because of my manager's betrayal of our private conversation, I have to be in a 5 year monitoring program. Keep in mind that I did not work impaired, I put no patient's in harm's way, I sought recovery on my own after having drank only 2 times while on leave from work. I want to know if this is legal. I sought council from my employer's legal department and they have kept me employed there but I haven't worked in 3 months now. The lawyer was supposed to find me a position on another unit and he has stopped returning my calls and emails. Should I seek council outside of my employer? Is what she did in reporting our confidential conversation to the state board illegal?

I'm no expert. Heck, I'm not even a nurse yet - but the bold is what stood out to me as something that would probably compel her to report you. This could mean so many different things, and many of them illegal.

I'm so sorry for your troubles. I wish you the very best. I'll be thinking of you.

[~Mi Vida Loca~RN, ASN, RN]

This is what really sucks about our jobs. We're supposed to be there for patients, we're supposed to be understanding, we're supposed to give them support. But as soon as a nurse reveals he or she is human *gasp!* all of that supportive, understanding stuff gets literally thrown out the window, along with privacy apparently. What sucks is that you seem responsible in that you recognize that you have a problem, you get treatment, and you recognize when you need to pull yourself off of a shift. I'm sorry this is happening to you. Apparently violating your privacy is allowed, but I personally don't think it should be.

I wish you well your recovery and I hope whoever is making these ridiculous rules gets pink eye.

I don't either. When I read that information and saw it was valid I was shocked. If something were to happen like mental exhaustion, I shouldn't have to drive an hour or two away to make sure I am far enough from anyone that might know me so that I can get tx without being reported to the BON. What a way to keep people from seeking help. I met a girl that still had an active license but hadn't worked in 2 years since having her baby. She got PP depression really bad and ended up in the ER with SI and tried to OD. Someone reported her to the board, she was on anxiety medication and some other mental health medication, I want to say Klonopin. Anyway, one of the nurses recognized her from when she worked in L&D and reported her to the BON. Now she has to do a 3-5 year monitoring program and be treated as a drug addict if she ever hopes to return to nursing, which she does because she is in an abusive relationship and wants to get out and this just made it all 100X harder.

That's when I really started looking into the legalities of it. It doesn't seem right at all.

[dirtyhippiegirl, BSN, RN]

I've run into other nurses who were not outright fired from their jobs when they were placed under monitoring but their employers effectively forced them out by impossibly dragging out the process of finding a monitoring friendly position within the hospital.

[Boomer MS, RN]

I don't either. When I read that information and saw it was valid I was shocked. If something were to happen like mental exhaustion, I shouldn't have to drive an hour or two away to make sure I am far enough from anyone that might know me so that I can get tx without being reported to the BON. What a way to keep people from seeking help. I met a girl that still had an active license but hadn't worked in 2 years since having her baby. She got PP really bad and ended up in the ER with SI and tried to OD. Someone reported her to the board, she was on anxiety medication and some other mental health medication, I want to say Klonopin. Anyway, one of the nurses recognized her from when she worked in L&D and reported her to the BON. Now she has to do a 3-5 year monitoring program and be treated as a drug addict if she ever hopes to return to nursing, which she does because she is in an abusive relationship and wants to get out and this just made it all 100X harder.

That's when I really started looking into the legalities of it. It doesn't seem right at all.

Oh geez...I agree. Where is the compassion?

[Anonymous865]

HIPAA has an exception -

"Covered entities may use and disclose protected health information without individual authorization as required by law (including by statute, regulation, or court orders)."

If the state has a law that health care providers are required to report a nurse who has a substance abuse problem or a mental health issue, then no HIPAA violation.

This is the same exception that allows health care providers to report everything about a cancer patient's history, diagnosis, and treatment to a cancer registry without the patient's knowledge or consent. It allows providers to report communicable diseases to the state's health department and suspected child abuse to authorities.