Patient confidentiality and husbands

[AndyLyn]

I have learned so much for all of you on this board, and need some words of wisdom tonight.

Last week, I helped care for the very ill parent of my husband's childhood best-friend. On my drive home, I decided that (for patient confidentiality sake) it would be best if I not share what I knew with my husband. For one thing, it goes against any privacy standards, and for another, I felt it would place too much of a burden on my husband, expecting him to keep the information to himself while I wasn't able to do so.

It turned out to be a good thing, because over the weekend several members of my husband's family told us that this patient was in the hospital, and what they knew of the person's condition. I kept quiet, and didn't say anything to them, or to my husband.

Tonight, we got a phone call that this patient had died. Afterwards, I told my husband (who it turned out had suspected that I might know more than I was saying) that I had seen the patient and his/her family (and not any more than that).

Now, my husband is very angry with me. He said that I never should have kept such a secret, and that he can't believe that I didn't think I could trust him.

I still think I did the right thing, and I'm wondering how all of you would have handled a similar situation. Do you think spouses may be exempt from any/all patient confidentiality issues?

And I think I'm voluntarily sleeping on the couch tonight...

Thanks for your words of wisdom.

[nursemaa]

I think you did the right thing. I never discuss patients with my family, it just wouldn't be right to do so. So far it hasn't caused any problems, but maybe I'm just lucky because I've always made it clear to my husband, mom, sister, etc. that I can't discuss patients with them. Don't know what to say to make you feel better or to help your hubby understand; hopefully in time he'll see that you really didn't have any choice. He needs to realize that it isn't a matter of whether or not you trust him, it's about the trust that patients put in you.

Sometimes I'll ask a patient (someone my family knows) if it's OK to let my family know they're in, then respect their wishes either way.

[Nurse Ratched, RN]

Tough one!

You did fine. You protected your patient's privacy. And it doesn't sound like there was enough of a personal relationship with the patient to recuse yourself from the care of her.

In the future, perhaps you could say something like, "Since I value your privacy above all other concerns, I of course would not discuss your case with anyone, including my husband. However, from a personal standpoint, I know that (Bob) would want to send his warm wishes, as do I." This might open the door for patient to say something like, "Please let Bob know we saw each other." Or something else along those lines. Or not. Either way, you have acknowledged the personal relationship and reaffirmed your professional role and obligations at the same time.

At the risk of being over simplistic, your hubby will get over it when he realizes you did the right thing. It's not about trust.

[Ruby Vee, BSN]

Even though I've never had the same dilemma (my husband works in the same ICU I do) I sthink you did the right thing! Stick to your guns!

[unknown99, BSN, RN]

You were 100% correct in handling the situation the way you did. I would have handled it the same way.

BTW, been there, similar situation, and my sofa is pretty comfy!!!

[IamRN]

Have actually had to deal w/similar situations, two of them. One of them was my dh's boss and the other the father of a neighbor.

My dh's boss called dh when he was out of the hospital (at which I had worked with him) and started the conversation along the lines of "I guess your wife already told you about me..." My dh had to laugh out loud because he knows how I feel about confidentiality. He answered, "Are you kidding? She would not even tell me if it were my parents as her patients!"

The other, my neighbor was very surprised to find out that I hadn't told my mom about her dad (which I had taken care of). I told my mother that it wasn't any of my business to have done so....and against the law.

You did what you were supposed to. Maybe you can show your husband a HIPPA handout.

[JBudd, MSN]

You did the right thing. My husband was a pastor, and I am an ER nurse, so we both had lots of confidential stuff that we didn;t tell each other. People would assume we each always knew what the other knew, which made for some really interesting conversations! Especially if I had taken care of a churchmember.

I usually just ask if they mind my mentioning they were in the hospital, and assured them if they didn't say yes it was no problem. Even then I wouldn't discuss what they were there for.

[Tweety, BSN, RN]

Hopefully your husband is just upset over the death. If he truly doesn't understand that it's not a matter of trust, that it's a matter of the law, then shame on him.

You did good. It's not easy keeping your mouth shut when you get home, but it's what we've got to do. I've had friends in the hospital that I was just dying to tell other friends or my spouse. Can't do it.

[Rapheal]

Sharing confidential information with even the purest intent can backfire. Say you told your husband, then he wanted to know details. Then he talks with the family and any one of them asks him questions about the condition or the info he knows and he tells them. If even one of them makes a fuss to the doctor or the hospital because they misinterpreted the info or expected a different outcome than you might find yourself in big trouble for violating HIPPA.

Not worth the risk. If your hubby is angry now, I wonder how angry he might be if you lost your job or faced disciplinary action from the BON for a HIPPA violation. "Ummm.... honey, I was fired today" may be more painful for your husband then not letting him in on confidential information.

[beckymcrn]

You did the absolute right thing.

I have a patient now whose family is a member of my church. I heard about it after she had her first surgery. :uhoh21: (I am a GYN Cancer nurse). I recognized her name when she was put on the prayer list. Since then she has been through treatment and a second surgery. From time to time the pastor will ask if anyone has updates on her condition. I do not and will not dilvulge confidential information.

You really can't if you love what you do. You never know what will happen/ or who maybe listening in the next booth at the restraunt, in the next room or around the corner. If your career is important to you in this world of sue you for everything it is important to follow confidentially rules.

You husband will understand in time.

[BadBird, BSN, RN]

You definately did the right thing, it is not a matter of trust, it is a matter of the law. Your husband should understand this and if he doesn't hand him a copy of the hippa regulations. Let him know how hard you worked for your license and you will continue to act like the professional you are.

[SmilingBluEyes]

Boy, talk about a rock and hard place! I really, really feel for you.

With HIPAA laws, you really are given no choice BUT to do what you did. You were respectful of the patient's right to privacy, and you followed the letter of the law.

I think your husband will see this and forgive you as the pain of this person's death eases a bit. He is grieving and angry. Give him a little time.

My best to you; you are an honorable person and having honor can be a real burden at times like this. I stand behind you 100% like the others. I admire you for this. It was NOT easy! ((hugs)):kiss