My HIPAA mistake.

[somenurse]

I have done a HIPAA violation, and looking back on it, i can't believe i did this. As an older nurse, it has not been the easiest of things for me to reform my previously sloppy (by today's standards) ways of patient protection.

I will share this story, but, kinda doubt anyone can learn from it, as, most nurses today are so so so more HIPAA savvy, than i was.

I was working in outpatient surgery center (very fun work, btw)

My guys absolute best friend, "T", came in for minor removal of a fatty lipoma (benign lump on his shoulder of fat tissue). Weird thing is, my guy had exact same thing done the month before.

"T" is at our home most every day, it seems, i mean, this guy is super close to both of us, like family.

HERE'S WHERE I WENT STUPID (cuz i was so so casual and comfortable with this patient, i let my HIPAA guard down)

After my lunch hour, "T" is now dressed and ready to go home, and i told him that my guy said to tell "T" this or that (a joke) about how to recover from this 'surgery', and "T" and i laffed about some jokes about maybe something is in the lake we all swam in all the time, causing these lumps on both "T" and on my guy.

Somewhere in there, i had said to "T", that i had told my guy on my lunch break, via cell phone, that "T" is going to be going home soon, so my guy should go over and check on "T" in an hour or so.

We had only curtains between the patient recliners in this area of discharge area.

another nurse overheard me, discussing my guy's joke advice for "T", and for telling my guy to go over and check on "T" in an hour or so,

and wrote me up for HIPAA violation. I got in huge trouble, (for telling my guy that "T" is about to go home)

(as i should have)

and it was all rediscussed at my evaluation that year, too. Big ol file on it, in my employee file, came up every now and then, during evaluations forever after, that i had an actual HIPAA violation on file.

I felt about one inch tall. I did know better.

("T" , who came over for a dressing change that evening, had no complaint whatsoever, that i had told my guy he was being discharged,

and "T" was stunned i got in trouble, and wanted to call my boss, but, i told him that would only make it worse)

anyway, i guess the moral of the story here might be:

BE EXTRA CAREFUL, if you are dealing with super close pals as patients,

that you treat their privacy just as you would a total stranger's privacy. It's tempting to think of them the way you do OUTSIDE of the hospital, but, while they are IN the hospital, they ARE actual, official "patients" like anyone else.

[CrunchRN, ADN, RN]

I think that is sad. you had a personal relationship with this person.

If he had complained ok, but i actually think for that other nurse to do it sucks.

I would have just pulled you aside & warned you to be careful all the while understanding this was a special situation.

[psu_213, BSN, RN]

Why was the other nurse so interested in what was happening on the "other side" of the curtain from her pt? How did he/she know that you didn't have permission from T to tell your guy about T's impending discharge? I'm still not 100% sure a violation took place here. Anyway, move on from it and try and stay away from this other nurse.

[somenurse]

Why was the other nurse so interested in what was happening on the "other side" of the curtain from her pt? How did he/she know that you didn't have permission from T to tell your guy about T's impending discharge? I'm still not 100% sure a violation took place here. Anyway, move on from it and try and stay away from this other nurse.

It took me a lil while, too, to realize i actually HAD violated HIPAA, in telling my guy that "T" would be going home soon. This other nurse, was the unit charge nurse. I had told "T" that i called my guy on my lunch break and told my guy how "T" would be home soon, so go over and check on him.

She heard me telling "T" that i'd called my guy on my lunchhour.

If i hadn't opened up my big mouth and told "T" that i had called my guy, probably not a thing would have happened.

Having an actual HIPAA violation in your employee file, is huge huge deal. It does not go away. At a later point in time, years later,

i was having a tardiness problem, and my boss told warned me, this is now my second warning (cuz HIPAA was first, so now that's two)

[nursel56]

Did your guy already know that T was having the surgery and had agreed to check on him? I'm having a hard time seeing the HIPAA violation, too. I think the other nurse had an overly "gotcha" attitude under the circumstances.

It does bring home the point though, that we need to be hyper-vigilant at all times and not assume people will behave according to the rules of common sense. Sorry that happened to you!

[Ntheboat2]

That just sounds CRAZY to me!!! I have had the whole HIPAA thing pounded into my head through school...but people are still realistic about things like that.

You said you are an "older nurse." Are you sure they weren't trying to get rid of you because they were paying you more, or for some other reason?

I just can't imagine anyone with any sense writing you up for something that obviously the patient was okay with. I don't need anyone to explain HIPAA to me either because I know it and understand it, but what the heck....what if you had said, "T wanted me to let my husband know?"

I guess the best thing to do really is not to accept a patient that you know that well. That's pretty much the standard rule around here anyway...and thankfully so after reading that!

[CrunchRN, ADN, RN]

On the bright side........................... at least you spell HIPAA right!

[somenurse]

Did your guy already know that T was having the surgery and had agreed to check on him? I'm having a hard time seeing the HIPAA violation, too. I think the other nurse had an overly "gotcha" attitude under the circumstances.

It does bring home the point though, that we need to be hyper-vigilant at all times and not assume people will behave according to the rules of common sense. Sorry that happened to you!

My guy DID know that "T" was going to have the lump removed, but, did not know exactly which day "T" was going in for it. "T" had asked both me and my guy about what all was involved in having a lipoma removed, like, how much time he'd need off work, etc, so he could plan for it. "T" had not asked my guy to go check on "T" after the surgery, that was MY idea, since "T" lived all alone.

"T" did not mind my guy coming over, btw, and like i said, later that evening, "T" himself came over to our house, for a dressing change, since he couldn't reach his dressing himself.

i guess the other nurse, overhearing me say to "T" ------- "Yeah, i called __my guy's name___and told him you'd be home soon, so go check on you." -------hit her Hipaa alarm bell, and in fact, that was a hipaa violation, since my guy probably did NOT know THAT was the day "T" was having his lump removed,-------------- (but, i'm not sure, now, if my guy knew or not, it's been a while, if my guy knew that "T" was there on that day or if he'd forgotten, or if "T" had not mentioned it to my guy in the first place, by now, that point is now blurry to me to recall...)

BUT,

whether or not "T" had told my guy that he would be in my workplace on that particular day or not,----------my guy definitely did NOT know that "T" was about to be sent home in an hour.

yeah, we have to be extra vigilant about HIPAA when we care for ppl we know!!! Or even see ppl we know in our workplace.

[somenurse]

That just sounds CRAZY to me!!! I have had the whole HIPAA thing pounded into my head through school...but people are still realistic about things like that.

You said you are an "older nurse." Are you sure they weren't trying to get rid of you because they were paying you more, or for some other reason?

I just can't imagine anyone with any sense writing you up for something that obviously the patient was okay with. I don't need anyone to explain HIPAA to me either because I know it and understand it, but what the heck....what if you had said, "T wanted me to let my husband know?"

I guess the best thing to do really is not to accept a patient that you know that well. That's pretty much the standard rule around here anyway...and thankfully so after reading that!

Actually, "T" was not my patient, i was restocking, and as i was refilling all the drawers in his area, we chatted. He was the patient of the charge nurse who reported me.

It has crossed my mind, if i was sometimes seen as an unwanted as an employee, as i myself am not "likable" by everyone. Some yes, some no. You know how maybe the bulk of nurses, no one really notices or has a strong feeling about, one way or the other, well, i'm not one of those nurses, i don't think. I think ppl who like me, really like me, but those who don't like me, really don't like me! It's usually not a lot, just a few who i sense do not like me, but, they always seem to be among the most powerful or influential of the unit nurses. darn!

(worth noting, i DO try to be likable, i bet most of us do, but, i seem to fall short of being liked by All, despite my best efforts)

But, my age might be yet another factor that puts me in the less desirable employee list. Who wants to pay retirement pay? Older nurses also jack up the insurance rates for the whole place.

and yes, older nurses tend to be getting more weeks paid time off per year, more accrued benefits, more pay per hour, and are, generally, more expensive employees. It's not impossible, that my being older, is yet one more factor working against me.

The Commuter had an interesting blog (one can read it if you go to The Commuter's page, is link called "My Blogs")

that i read recently, about how a nurse's "likeability" factor, can sometimes impact how long the nurse is kept on as am employee. I think how "likable" a nurse is, also might influence how that nurse is treated, too, but, who knows.

[somenurse]

On the bright side........................... at least you spell HIPAA right!

LOL! only with extreme effort, do i spell HIPAA correctly!! It's one of those words, that i must have learned wrong right off the bat,

and then, tried to RElearn,

and now,

i'm always left confused, which of my recollections IS correct, the first (wrong) spelling,

or,

the second spelling? I can't sort if out, which IS the first or second way i spell HIPAA?

I have a handful of words, that i just can't spell without checking, every single time!! Every time! Especially if i haven't used the word recently, is very low chance i'll spell correctly!! My brain refuses to learn how to spell those particular words, and HIPAA is one of them!! ha ha!!

[somenurse]

I just can't imagine anyone with any sense writing you up for something that obviously the patient was okay with. I don't need anyone to explain HIPAA to me either because I know it and understand it, but what the heck....what if you had said, "T wanted me to let my husband know?"

YES, I SHOULD HAVE thought of that, THAT would have worked. I was not quick enough on my feet when confronted with this HIPAA violation. Lol, oh my, later, after i had gathered my thoughts,

oh yeah, several options came to me, that would have saved me.

but, i guess i was caught off guard, just admitted it straight out, cuz, it was true. but, with only a small tweak, i could dodged the whole gunfire.

btw, the paperwork was all formally written up, when i was presented with the complaint. It wasn't like, they pulled my aside, and questioned me prior to writing it all up, nope. It was a done deal. I had no idea it was coming. In my shock, I didn't think of anything clever to say.

btw, it might just be a trick of my memory, hee hee, but, it seems i recall, it was several pages of paperwork involved. My mind wants to remember a giant file of massive amounts of paperwork, but, i imagine, that is a trick of my memory being impacted by emotion,

and it was probably only a few pages, not a "catalog" sized file!!

[somenurse]

also,

my impression is,

once someone has filed a formal, written HIPAA complaint,

you respond to it,

but,

no matter what you say,

that complaint stays in your file.

NOw, i could be wrong on that,

perhaps,

if the nurse's response proves she did NOT commit a HIPAA violation (not the case with me, but, maybe for someone else)

then, the employer throws out and shreds up the complaint? it'd disappear, if the employer decided no HIPAA violation occured?

but, my impression is,

that even if the nurse's rebuttal or reply, proves she did not commit a HIPAA violation,

that complaint still stays on file, along with the nurse's reply, to be read and decided, and maybe re-decided, over and over,

and reviewed each time someone with that file wants to try to figure out, if this was,

or was not,

a hipaa violation. (i could be wrong on this, though, not sure)