Non clinical boss wants to sit in on pre-op visit with patients

[erica2117]

Hey everyone,

my boss is non-clinical and doesn't know a single thing about anything remotely medical related. She even tells us we are "grossing her out" when she hears us talking about medical issues. I work in an outpatient gynecologic oncology office. One of my jobs is to do pre-op visits and sign the consents, go over pre surgical testing, how to prepare for the surgery and what recovery is like. I have been at my job for over a year and have done hundreds of these visits. Suddenly my boss has decided today she wants to sit in on my pre op visits so she can "learn more about the procedures". Honestly it made me VERY uncomfortable because not only is this a very personal topic to be discussing with patients, I don't think she has any right to watch pre ops to "learn" in fact I find it nosey. She interrupted my preop several times today, her phone was vibrating, she was flipping through my paperwork and just being a huge distraction. What made it the worst for me was that she introduced herself as the office manager and she was "observing" me today. I felt like it broke the trust between the patient and the nurse because to me it looked like I was in trouble and I had to be watched. Mind you I have never had any complaints, my physicians are happy with my visits and explanations. She asked to sit in on more with me this week. This doesn't feel right. Is someone who is administrative even allowed to do that??? Something just doesn't seem right.

[roser13, ASN, RN]

I don't know where people are getting that this is a potential HIPAA violation, from the description it's the nurses direct supervisor, so whether she's a nurse or not her involvement in observing would clearly be allowed under HIPAA.

It is my understanding that an RN's practice cannot be overseen by a non-medical manager. Non-medical managers may supervise the non-clinical aspects such as absenteeism, tardiness, collaboration with other members of the team, etc. Therefore, the non-clinical manager has no reason to be in a patient's chart, at least not the medical chart. Insurance or charging issues, probably.

This manager's performance is so wrong in so many ways.

[Ruas61, BSN, RN]

I don't know where people are getting that this is a potential HIPAA violation, from the description it's the nurses direct supervisor, so whether she's a nurse or not her involvement in observing would clearly be allowed under HIPAA.

Non-clinical is the key word. If she is the office manager why does she need to know about your lady parts?

[MunoRN, RN]

Non-clinical is the key word. If she is the office manager why does she need to know about your lady parts?

According to the description she's the OP's direct supervisor, HIPAA allows for her to directly observe her staff even when providing patient care under the quality assurance exception. Whether she's acting appropriately is another matter, but at least under the requirements of HIPAA it is not a violation.

[Ruas61, BSN, RN]

According to the description she's the OP's direct supervisor, HIPAA allows for her to directly observe her staff even when providing patient care under the quality assurance exception. Whether she's acting appropriately is another matter, but at least under the requirements of HIPAA it is not a violation.

This is not QA, this is nosey. I doubt it would stand the true test to the letter.

[VivaLasViejas, ASN, RN]

According to the description she's the OP's direct supervisor, HIPAA allows for her to directly observe her staff even when providing patient care under the quality assurance exception. Whether she's acting appropriately is another matter, but at least under the requirements of HIPAA it is not a violation.

Maybe not, but it IS tacky for the manager to be on her phone and flipping through papers during the visit. Also, the patient should be asked if it's OK for her to sit in while the nurse is working. Frankly, I don't know why she has made it her business to "observe" when she is clearly not in a clinical role.

[MunoRN, RN]

Maybe not, but it IS tacky for the manager to be on her phone and flipping through papers during the visit. Also, the patient should be asked if it's OK for her to sit in while the nurse is working. Frankly, I don't know why she has made it her business to "observe" when she is clearly not in a clinical role.

I completely agree her behavior is inappropriate and she seems to be completely lacking in basic healthcare etiquette, and that the bigger problem is that she has no clinical knowledge whatsoever.

[MunoRN, RN]

This is not QA, this is nosey. I doubt it would stand the true test to the letter.

The QA requirement is not all that strictly defined, it's pretty much up to the facility to determine what they define as QA.

[Here.I.Stand, BSN, RN]

According to the description she's the OP's direct supervisor, HIPAA allows for her to directly observe her staff even when providing patient care under the quality assurance exception. Whether she's acting appropriately is another matter, but at least under the requirements of HIPAA it is not a violation.

My thing with this is, she wasn't there to do a performance eval (although that would be odd to evaluate nursing practice too.) She told the OP she was there to learn about the procedures.

[Ruas61, BSN, RN]

The QA requirement is not all that strictly defined, it's pretty much up to the facility to determine what they define as QA.

Well, this situation as explained violates the spirit of the law.