morphine sulfate given even though has an "allergy" listed in chart

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I work in LTC and a resident has an "allergy" listed in chart to morphine sulfate. The resident was on hospice, actively dying so the MD prescribed morphine. My question is would this be considered a med error or bad practice for the nurse to administer this drug? Will this be a redflag to the state? If I was this residents nurse I would have clarified this with the MD and family. Sometimes residents/patient lists allergies that are not real allergies but are expected side effects. Or maybe the MD discussed the risks and benefits of drug with family. My concern is that NO clarification is documented in the chart. So what do you all think?

By looking thru the chart it is no different than all those people who have been fired and sued while looking a the chart of a celebrity that they were not directly caring for. ABOLUTELY NO DIFFERENCE. It is a HIPAA violation and I take vilation of privacy very seriously.

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How many times have you not been able to read a doctors writing and need another nurse's opinion about what is written in the progress notes. This is not a HIPAA violation.

I wish they would separate out allergies from side effects on patient charts.

By deciphering doctors notes it falls under the catagory of consulting. The person only reads the pertinant part that pertains to the docotrs handwriting. By just reading the chart becasue you are interested it is a violation of HIPAA.

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Specializes in 1st year Critical Care RN, not CCRN cert.
Oh lord. It's not a HIPAA violation.

If it were then any time a nurse asks another nurse's opinion or asks a question of a nurse while caring for a patient, she's "violated" HIPAA.

Frankly, when I'm working, I have right to know about every patient in the ER. I don't go looking at charts willy nilly, but I help out my coworkers, often without being asked. If I'm not doing anything and someone else has something to be done, I grab the chart and go.

Are the HIPAA police going to come take me away because I wasn't "assigned" that patient? No.

If a new nurse (or an older one) asks me to look at something in the chart either for clarification or to ask an opinion, should I plug my ears and run away screaming so I don't hear anything about a patient I'm not assigned? No.

OP, you haven't violated HIPAA. Use you best judgement, and don't let the scare mongers frighten you.

Most of this stuff with HIPPA has to be coming from people with no experience in an actual medical setting. It is impossible not to be in violation at all hours of the day unless you work on a floor with only one patient and one nurse and only allow one doctor on the floor at a time.

How about the hospitals with 2 or more patients in a room? We should probably take the patients and their beds since most are on bed-rest and cannot be getting out of bed, out into the hall so they cannot hear the conversation with the nurse or doctors as they assess each patient.

Get over yourselves with the HIPPA! Most grown ups can understand that with EMRs you cannot open charts you have no business being into because you then violate hippa, with paper charting, the charts are all over the place and open on the nursing station or in the little wall cabinets while being used. Just don't take pictures of the pages or post names and/or identifying hospital information and you will be a-ok.

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Thanks and this is so true ! Once again I DID NOT TAKE CARE OF THIS PT. AT ALL. so when you say " you" that is incorrect. One of my coworkers took care of this pt. on her unit not me ! Just wanted to clarify this... but other then that I agree with you.

BE CAREFUL OF THIS..(bolding mine) You could get fired for going thru a chart of a patient that you have no involvement in her care. It really is a HIPAA vilation this time.

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Specializes in Trauma Surgery, Nursing Management.

I must agree; the nurse who was assigned to the pt and received the MSO4 order was not in violation of HIPAA by pointing out the pt's allergy to a nurse that had taken care of the pt previously. Both nurses knew the pt's hx and were working in collaboration with each other as we oftentimes do to better care for our pts.

If I am in the OR taking care of another pt, and the surgeon across the hall comes to ask me a question about a pt that I had taken care of the previous week, neither of us are in violation of HIPAA laws. We are part of an interdisciplinary team and we are discussing pt care in a holistic manner in order to deliver the safest, most effective care that we can.

OP, in response to your question, I think that there should have been some clarification regarding an allergy to MSO4.

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By looking thru the chart it is no different than all those people who have been fired and sued while looking a the chart of a celebrity that they were not directly caring for. ABOLUTELY NO DIFFERENCE. It is a HIPAA violation and I take vilation of privacy very seriously.

You must not work in the medical field.

The people who were looking at celebritie's charts weren't just not caring for them, they weren't even working on the same floor as the patient.

If I'm working on a floor, or the ER, I can have a legitimate need to know about the patients. Such as, a nurse needs assistance, a nurse needs a break and needs me to listen out for her people while she's eating, a nurse has a question and to answer it I need a little history, a doctor needs to know something and the patient's nurse isn't available, but a quick look through the chart can give the MD what he needs to know.

These are not HIPAA violations.

If I worked in the ER and was just perusing for ***** and giggles the charts of patients who are admitted on the 11th floor, that IS a HIPAA violation.

Looking at a chart for a patient whose room you may walk into to answer a call light IS NOT.

If we took your interpretation of HIPAA, then only the nurse caring for the patient and the MD assigned the patient would be allowed to code the patient because we couldn't have anyone else see the patient or know they were there! If that's how it worked, the morgue would be overflowing.

Use some common sense.

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Specializes in Trauma Surgery, Nursing Management.

Edit-I suppose I was writing while the OP was posting and did not see that the OP had NEVER taken care of the pt. I had assumed that the pt was under her care at some point.

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Edit-I suppose I was writing while the OP was posting and did not see that the OP had NEVER taken care of the pt. I had assumed that the pt was under her care at some point.

No, the OP had taken care of the patient earlier, just not while the patient was "actively dying."

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Specializes in Trauma Surgery, Nursing Management.

OK, now I am thoroughly confused. Post #18 states that the OP did NOT care for the pt...AT ALL. Post #20 states that the OP did take care of the pt previously.

Lord, help this old tired girl! (meaning me!)

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OK, now I am thoroughly confused. Post #18 states that the OP did NOT care for the pt...AT ALL. Post #20 states that the OP did take care of the pt previously.

Lord, help this old tired girl! (meaning me!)

I think the OP meant to say she didn't care for the patient "at all" during this phase and so the any administration of morphine was not her responsibility.

I dunno. The OP will clarify, I'm sure.

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Specializes in FNP.

anyone familiar with the Internet theory that all debates will resort to someone yelling Nazi before its over? I think in nursing websites we can sub hippo for Nazi, lol.

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Specializes in Home Health.

If I received orders to give a patient a drug that they were allergic to, I would make sure the MD knew this. And, if the MD still wanted me to give the drug, I would tell them they would have to give the drug themselves. In our state, the responsible party is the 'hand that delivers', not the one that orders.

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