In my opinion, if we nurses have a patient whom we transfer to another unit or facility, we should be able to obtain information as to the subsequent course of events and treatments of the patient. This information would be valuable to nurses so we can better understand the disease process and thus strengthen our nursing practise.
For instance, let's say I have a patient whose case is too complicated for my small hospital, who has a certain set of signs, symptoms, lab values, etc. The patient then gets transfered to a larger, better equiped facility for further evaluation and treatment. I think finding out the outcome of events would be extremely valuable to me, not because of idle curiousity, but because it would make me a more astute practitioner. It would broaden my perspective and give me a better grasp of what signs and symptoms led to what outcomes.
Therefore, I think we nurses have a 'need to know' the eventual outcomes of patients, even when they are no longer under our direct care. Knowing outcomes will make us better nurses!
I personally do not feel it would be right to be able to check up on patients once they are outside of our care. They are to be cared for and once they are out of our care they are out of our care.
Specializes in Telemetry, Oncology, Progressive Care.
I would love to know how patients do once they leave. I had a CA pt who was in the hospital to get set up on TPN, had lost a ton of weight, and had horrible gastroparesis. The NP told me a couple weeks after I released her she was doing great on the TPN, getting her chemo, and had even gained some of her weight back. I was so happy that she had a semi good outcome. Hoping they would get the CA and she could go back to leading her life. It's not very often that I hear stories.
So, if I transfer a patient to the ICU and go over there it is wrong to check on them because really I'm just being nosy. I don't know maybe I am being nosy but I also want to know that the patient is doing well and whatever problem was causing them to be unstable has been fixed and they're doing better. I have stopped and talked with family as well as the patient. I don't know I think they appreciate it. I wish them luck and tell them I hope they continue to do well. I'm human and even though I express my wishes for them I hope they don't take it any other way. The families seem to enjoy being able to talk about how well their loved one is doing. Heck I'd like to think that after I leave they say that was so nice of her to come and see how I was doing. True I don't need to do this but I am always curious what medical management the patient received and I do learn a lot from checking in on them.
I just don't see how this would be violating someone's rights. It's not like you're out there broadcasting all their personal information. I always hope someone is doing better once they transfer. I have also been known to check the obituaries on patients I know who didn't do well and weren't expected to make it. When I do find someone who didn't make it I get very sad. But I've increased my knowledge from learning what was done to stabilize a patient and see them go home. It's a wonderful feeling to transfer a pt to the icu, see them get stabilized, get the patient back, and send them home.
Thanks for all the imput. I understand that HIPAA might contradict the commonsense concept of healthcare workers empowering their knowledge base by following outcomes of patients who have been under their care, but that wouldn't be the first time that governmental agencies fell short in this regard. I still believe that having access to outcomes is beneficial to us all.
We already know sensitive information by merely having access to the patient's chart. I seriously doubt that a simple call to another facility to find out how the case progressed clinically would violate the spirit of patient confidentiality.
If you want to improve your nursing, then read books and journals, go to school, listen to nursing audio CDs. If you have to get input from strangers as to the propriety of the "spirit" of a thing, knowing it to violate the law, and knowing it to be therefore a danger to your job and license, then you have to ask yourself if your motivations (to invade a pt's privacy and track them after the termination of the professional relationship) are solely to become a better nurse as claimed, because you worked so hard to get your license and you're aware you can't be much of a nurse without a license. You asked strangers for input. Well here's mine--don't make that call. Stay a nurse in spirit.
I never said that I planned to violate any law. What ellicited this post is that a fellow nurse at my facility asked how her son's grandma was doing, I let her know I had transfered her the day before to another facility. Later in the day my colleague let me know that her son's grandmas was unconcious and probably dying.
I was interested in the outcome of the case. She had been transfered to a heart center for further evaluation and exploration of treatment options after initially coming in A-fib, RVR, the day before I had her had been put on a cardiziem drip, she had not tolerated BP wise, had required fluid boluses, then had been digitalized.
When I came on she was beginning a stable tachy-brady syndrome, so was deemed either a candidate for cardioversion, although she had not been anticoagulated for long enough, or else they were considering pacemaker placement.
The patient was A & O on transfer and stable. The dr had DC'd the dig and I had given 150 mg amiodorone over one hour before transfer, which she had responded to very well.
I'm interested in what treatment option they chose and what the complications they encountered were. Since I had personally laid eyes on the patient and assessed her, this type of information about eventual outcomes would be illuminating.
I think you were reading something else into my post than was not there. I've transfered many people and never found out the clinical outcomes. Often when we transfer patients there are still unanswered questions.
Way I saw it, worst outcome if I post: I look stupid. If I don't, someone loses out. Easy pick, especially since I'm used to looking stupid (I always take the same such choice).
Just a Q, as a friend of family, I think I would've just gone over there and a friendly conversation with her nurse would've been productive. Any reason why not?
I didn't understand your last post anonymurse. My nurse colleague works in another dept, she had a son years ago, who is now an adult, from a non-married relationship. I don't know the inner workings of communication in that family.
I brought up the case because it made me aware of the fact that, once I transfer a patient, I am out of the professional loop and have no idea as to what eventually happened. This is not the case with MDs, they are able to follow the outcomes of patients whom that have transfered to the care of specialists. Nurses, however, are not trusted with this information. We are not deemed suitable to be included within the circle of professionals worthy to be trusted in finding out clinical outcomes of patients for whom we have cared.
I think as a matter of following up on what we could have done better 24h is enough time. We have a responsibility to learn as much as we can from very patient so we can help the next one.
Beyond that it becomes more about personal interest than about what we could have done better or worse. Personal interest is not a bad thing- but maybe the patient doesn't share or appreciate it. They deserve the right to refuse access at that point.
I think as a matter of following up on what we could have done better 24h is enough time. We have a responsibility to learn as much as we can from very patient so we can help the next one.
Beyond that it becomes more about personal interest than about what we could have done better or worse. Personal interest is not a bad thing- but maybe the patient doesn't share or appreciate it. They deserve the right to refuse access at that point.
Good imput canoehead. Some sort of time limit and protocol would be great. I'd like to see some sort of formal feedback system in place. This type of collaborative effort is sometimes lacking in nursing. We shouldn't be operating in vacuums.
pickledpepperRN
4,491 Posts
We are very fortunate that many of our patients or family come to tell us how they are doing.
Patients transferred to tele or med-surg sometimes ask for their nurse and we go visit on our break.
Other patients go home, to a SNF or rehab facility.
I appreciate being able to share the grief of a family whose loved one died.
And it is wonderful to see a former patient come in and let us nurses share their joy in being alive after a critical illness or accident.