My father's health information

[Catcar1963]

My estranged father is in a health care facility after a stroke, and has no contact with me or my siblings (his choice). My brother's friend is a nurse at a facility my dad was at previously. Yesterday the nurse found my dad's psych eval, and gave it to my brother. Now my brother wants me to read it and tell him what it all means. At first I wanted to see it. Thankfully I came to my senses quickly, and told my brother I could lose my license if I got involved, and that what he and the nurse are doing is illegal and unethical. I want to report the nurse but I don't know who she is, and I'm in a different state. Should I do anything, or just forget about it?

[NotAllWhoWandeRN, ASN, RN]

You are mistaken. I carefully considered everyone's thoughts. That's why I posted in the first place. Even if I didn't agree with everyone's ideas, I respect all opinions. I'm not the one who labeled your thoughts as reprehensible or terrifying. I think there is something to be learned from everyone's perspective, even those in the minority. I'm sorry you feel you were not taken seriously.

I said "The kind of nurse who thinks bad people (or people who did bad things) don't deserve the same protection under the law is a terrifying nurse to have in the field," and "[The] assertion is that unsympathetic patients don't deserve to have the same rights as other patients, and I find that a reprehensible way to govern your patient care." My understanding was that some posters, including Libby, didn't think it was a big deal for that nurse to disclose patient information because the patient was not sympathetic. If I misunderstood that and no one who has posted here believes that behavior is defensible, then my comments are general.

If you don't think that whether a patient's right to privacy only applies if they are a good person, I do not find you or your standards terrifying or reprehensible.

I will not apologize for being passionate about professional integrity, but Catcar, it's not my goal to derail your post or make personal insults. It's best if I step out of this conversation.

[Libby1987]

I said "The kind of nurse who thinks bad people (or people who did bad things) don't deserve the same protection under the law is a terrifying nurse to have in the field," and "[The] assertion is that unsympathetic patients don't deserve to have the same rights as other patients, and I find that a reprehensible way to govern your patient care." My understanding was that some posters, including Libby, didn't think it was a big deal for that nurse to disclose patient information because the patient was not sympathetic. If I misunderstood that and no one who has posted here believes that behavior is defensible, then my comments are general.

If you don't think that whether a patient's right to privacy only applies if they are a good person, I do not find you or your standards terrifying or reprehensible.

I will not apologize for being passionate about professional integrity, but Catcar, it's not my goal to derail your post or make personal insults. It's best if I step out of this conversation.

As his nurse I would have protected his rights and I would have reported the nurse.

Like all of us, we all take care of cruel people, we would be deeply naive to think we aren't. What are the stats? 1 in 4 are molested? That's a lot of patients that have abused. I don't need to know for a fact whether they did or not to know that a significant percentage have caused pain and suffering. Knowing it for fact has no bearing on my practice. Working in home health for decades patients histories and family dynamics can be very transparent and there many wounded people out there. But no one compromises my integrity as a nurse, they get my best and most ethical service whether they deserve it or not, try to undermine it, or are just plain jackasses. That's how I'm defined as a nurse.

As a daughter and sister, I'm not obligated to report a HIPAA violation within my own intimate circle. Especially when I didn't witness it nor have tangible proof.

I'm about as black and white as you can get, to a fault, but even I know there are extenuating circumstances out there that don't necessarily warrant going 100% to the letter. This may very well not be one of them but coming from my experience, which is much different than OP's, as a family member in this situation I wouldn't have reported it.

[TriciaJ, RN]

Are you and your siblings listed in his contacts? In a nursing home I used to work at, there was a sheet in the front with a list of contacts and saying that they could receive medical information regarding the patient. We were told to always check before releasing and pt information. Make sure you guys aren't listed. You don't want to unnecessarily get the nurse in trouble, especially if she isnt at fault. Get all the facts before you act. Thats how I see it.

If an investigation finds that the nurse in question did nothing wrong, then she won't be in trouble. From what I've read here so far, she is in BIG trouble.

[TriciaJ, RN]

Well then in that case do whatever you feel is best. I'm not trying to side with the nurse but what if she didn't know? What if your brother said hi I'm so and sos son, I would like to know about my father, etc? She might have assumed that it was okay for him to receive information. Again not siding with the nurse, but I don't think anyone would intentionally tell someone information that they know they're not supposed to give. Its nursing 101 so I figured the nurse would know not to do that, but then again don't know the full story. Good luck :)

The full story is: you don't release records to anyone, ever. If records need to be released appropriately, the patient signs a release of information form, and the medical records department takes it from there.

This is Nursing 101. This is not even a little bit of a grey area. No point speculating on the nurse's motives. What she did was 100% illegal. Period.

[jdub6]

This thread has become very complicated. Since the OP and others have stated that the main issue is whether she has a duty, AS A NURSE, to respond, I will just give my opinion on that:

It seems that OP is somewhat on the outside of this situation (meaning wasn't there to see it, learned of the nurses actions not by directly witnessing them). Personally, I would not get involved because there are so many confounding variables (normally a child would be next of kin and in some circumstances could have access to some info. The fact the the nurse is the brothers friend. The fact that dad has a health care rep but we don't know if he told the facility. )

This does not mean I think privacy violations are okay or that there is no duty to report, it just means I think the OP is in no position to look at this situation only as a professional since there are so many personal issues. Combine that with the fact that it seems the OP was not directly involved and I personally would not feel I had enough professional, unbiased info to be obligated to report.

That said, I'm sure privacy officers get complaints all the time from pts and familes who likely don't even understand what HIPAA is. Calling the privacy officer as the pts daughter with a concern for his privacy is no problem for me, they will investigate as they see fit. I personally would not feel comfortable bringing my profession into such a complicated personal situation when I was not a direct witness.