Communication over phones

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

In the past when family members call to check on their family who happens to be my patient, my usual response is They're fine, they ate well, they slept well: Why don't you talk to them yourself, I transfer you now.

Well, with the new HIPPA regulations apparently you can't say anything to anyone. Which I technically already knew but it is being more enforced now. So think about it, when a family member calls saying "I'm Sue, the patients grandaughter". How do you know for sure who this person is over the telephone. If family members stopped calling me all day long, think of how much time I would have to care for the patients!!!

But my general question to my fellow posters would be: How do you handle phone calls. I am trying to make a personal stand for myself so I can tell the "family" , sorry I can't tell you anything over the phone. I just don't want to make it look like I am trying to make care harder for families.

[fergus51]

We get our patients to sign a form when they are admitted which either says they will allow us to disclose general information about their condition to callers, or they do not want any information disclosed. That way it is up to the patient and you don't have to take the crap from upset callers.

[canoehead, BSN, RN]

I have no problem transferring into the room if the patient is able to take calls. Anyone have a solution for family members calling in the middle of the night, or patients too ill to talk. Sometime family has to be able to call and check on them or they cannot sleep- some will not leave the bedside otherwise. I think we can understand this- but how do we deal with it?

[BeeStrong]

I don't know for sure about other states but in Virginia if a patient is listed on the main log and phone calls can be put thru by the hospital operator, then their name and room number are a matter of public record. If the patient or family specifically requests that a patient name not be listed, then their name is not on the patient log and the hospital operator cannot put any calls through without specific written permission. Otherwise, this is a public record and therefore anyone can find out who is in the hospital and call. I usually will say only that the patient is stable, sleeping, unchanged. Keep it brief and minimal since it is true we cannot verify who it is actually on the other end. When we get telephone consents from POA or next of kin, we have to have another nurse on the line and two witness signatures but technically we have no way of verifying that the person on the other end is actually the POA or relative. Psych units have much more stringent rules/regulations and on some psych units, phone calls re patients are routed only to the patient's doctor since a pt might be in the hospital in order to get away from some family members. We once had a patient who died from liver disease on our unit and he had specfically asked that no one from his family be told anything. His mother called a week after he died and we couldn't even tell her he had been a patient !! We did refer her to his doctor however.

[P_RN, ADN, RN]

I'd be interested in the best solution. Once we had a cop who was shot by his own gun. "Relatives" came to see him.....sure they were and just happened to have a CBS affilliateTV camera with them.

Our hospital rooms each had a direct line from the outside. If someone called the switchboard the operator would send the call to the nurse's station!! Then a nurse would have to stop what they were doing to come answer the phone.

Best thing I guess was to tell them to call a family member and/or forward the call to the room.

Plan B was to ask "well how were they ween you last saw/talked to them?" That's when it would come out it was a "neighbor/friend" who didnt want to *bother* the patient or the family.

[puzzler]

Believe me--you can not know who is on that phone. I have had many people lie about who they are. Working in L&D I can not tell you how many times someone would say they were so and so's mother and ask for detailed info when all the time the patient's mother was in the room with the patient.

I like the idea about the signed form. We do not give out info on the phone and some people get really angry. If a patient says we can give out info--we will do it. But, it is everybody that calls or nobody-- no in between.

[deespoohbear]

Our hospital is also enforcing the new privacy rules. I have said all along, how do we know that it is Jane Doe's Mom calling from 3 states away to check on the patient. I am afraid this is going to be a big headache before it is all said and done. At our hospital patients sign a form stating whether they want their name on the patient's list that is released to the information desk. We mark the patients chart with a little red dot sticker which means do not release any info on this patient. That way if a nurse who is not familar with a patient and someone inquires about that person, she can just look at the board which is behind the nurses station. Red dot, no information. Period. I believe in privacy and patient confidentiality and all but I wonder how far this will go. Someone told me that ED patients will have to sign a paper stating that is okay to put their ED record in their doctors' boxes. What a crock. I think maybe some announcements for the general public explaining the new guidelines would be a good thing. I just know I am going to have to basically say: "I can't release any information over the telephone" and stand my ground about the no information thing. Fun days ahead. And they wonder why so many people are leaving nursing. Duh!!

[nilepoc]

If the person on the line says they are a relative, I ask when was the last time you were in to see the patient? If they have been in recently, I give them a vague answer relating the patients condition at that time to the patients currnet condition. The one exception being when we set up a code word for the family to use over the phone. This word is usually reserved for the closest relative who becomes the spokesperson for the pateint.

such as

"I was there three hours ago."

"Well Mrs XXX there has been no change in your brothes condition." or "The procedure that you left for went fine." I don't say much else.

If the family member has not been in or is from out of state, I tell them they have to contact XXX family member who has been designated as the family spokes person.

Works pretty well for me. I should mention that I am in an ICU with no phones in the rooms. We deal with a great deal of trauma, and the news frequently calls pretending to be family. This method seems to be able to frustrate them.

"

[Scarlette]

The hospital where I did my clinical rotations assigned the patients an "access code". If the caller couldn't give us the access code then we would have to say "Sorry, I'm not allowed to give out information without the access code." It seemed to work out pretty well, even though I felt evil at times for not giving out info to a relative that lived hours away. I figure they could call a relative that would know how the patient was doing and get info from them.