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...
I assume hubby stands ready to bake you a cake with a file in it, and bring it to you in your jail cell?
The law is the law. We don't have to like the laws. We just have to obey them, or suffer the consequences - which, in our case, are not worth the risk.
I had to have a LEEP procedure done for dysplasia about a year ago... I didn't tell my parents and most of my family about it... (I didn't feel like explaining it- it seemed routine enough to me. I could just see my mother telling everyone at her church that I had "cervical cancer", LOL, which was not the case)
The hospital called me several times in the weeks before the procedure, and I didn't know. (I had to talk to the nurse- maybe it was about the anesthesia?) We don't have an answering machine. and, BTW, if you can't get ahold of someone at 10 in the morning, why wouldn't you try again at 5pm instead of calling again the next day at 10am? (we do have caller ID and I remember seeing a strange number) anyway-
So they called the emergency number, provided by my OB/GYN- and it was my parents house.
They told my dad I was having "a procedure" done, and told them that I needed to get ahold of them. I was livid. I really don't mind that they called the emergency number for a non-emergency, but why would they divulge the info that I was getting a procedure done? the nurse was very "ho-hum" about it and said that they didn't give away the *details* of the procedure so I had nothing to be upset over. I thought it was really unprofessional and the nurse was quite a ***** instead of apologetic. (and I was visibly upset but *polite* about it, I swear!)
I guess my question is- they shouldn't have done that, right? I was feeling like "I can't keep nothin' secret in this small town!!! aahhhhh!" LOL
I'm lucky they talked to my dad (who is the same way about medical procedures- private) My mom would have hit the roof.
(sniff sniff) Me thinks I smell a HIPAA violation!
Seems pretty clear-cut to me. (but then, I'm not an attorney) They don't have to give out "the details" in order to have violated the law. I think Nurse Ratchet screwed up big-time when she called Daddy!
Sounds like there was enough time to send you a snail-mail request for you to contact them.
Most people off load on their spouse when days are hard and long. I would have thought that the ground rules would have been laid down a long time ago of what is allowed etc.
I will admit it is not a problem I have, my wife is a nurse and we have often transfered patients to each others area, so it is more a hand over that any thing else. We do not ever discuss patients with others however, be they church members or friends of our parents; any thing we know stays with us and we can be blissfully ignorent of any news if asked.
I can see the dilemma but he should sleep on the couch.
This aspect of confidentiality has been an issue at several points in my life. My father was the only physician in a small town, so I had to learn about confidentiality as a child.
Later as a nurse working in the regional perinatal center, I had an instance in which I was accused (mildly) of violating the confidatentiality of a baby's family in my care. In that case, the mother was from out of town and not used to a small-town culture. She was shocked that everyone knew what was going on with the baby in the hospital and assumed that I had talked about it. However, she later realized that her husband and his family were quite openly discussing it with all their friends in town.
Also as a NICU nurse, I have cared for the babies of a lot of hospital employees, friends of employees, and a few local celebrities.
My advice is to talk with your husband about the issue in general (when he is in a receptive mood, after he has calmed down) and figure out some phrases you can use in those situations to deflect the questions. For example, once it was known that your friend's parent was in the hospital, you could say something like "Yes, I have seen them in the hospital, but it is against the law for me to talk about them and I could be fired if I do." or "Yes, I know that ___ is in the hospital, but I am not directly involved with his/her care." Practice such phrases ahead of time so that they come to you easily when needed.
Also, I recommend trying to avoid those situations as much as possible by avoiding situations that might put you in an awkward situation. Sometimes, you can request not to be assigned to a patient that might cause a problem for you. By explaining your reasons to the management, they might be supportive of your request and actually appreciate your efforts to avoid an ugly lawsuit. Sometimes, you can avoid conversations with your friends and family by leaving the room, changing the topic, etc.
You did the right thing. HIPPA and patient confidentially are not to be taken lightly. Hubby and you need to discuss how easily you could have a problem if confidentially was broken. Stroke his ego, and tell him you know you can trust him, but the law is the law. Your sworn oath as a nurse is precious to you, tell him the future may bring other situations like this one, and you will do what is expected of you as a nurse. He may sulk but he should evidentually see that you are very trustworthy. In a marriage trust is priceless.
It would be ideal if we could avoid situations like the one described. I have found administrations to be helpful in one or two incidents, but after awhile, they take the "if you do your job, it will be fine" line. She was right is keeping silent. She had the best interest of her patient, patient's family and hubby at heart. I think she deserves a pat on the back for her integrity.
Thanks to everyone for responding. This was my first post as the OP, and that in itself was a big step for lil' ole me. It was so nice to get so many positive replies.
Anyway, it's still a bit smoggy around here today, he's as miffed as he was last night, but especially now that I see from everyone's responses there wasn't any other way I could have or should have dealt with the situation, I feel like it's his problem to deal with. I love him, but he just doesn't get this.
(sniff sniff) Me thinks I smell a HIPAA violation!
Seems pretty clear-cut to me. (but then, I'm not an attorney) They don't have to give out "the details" in order to have violated the law. I think Nurse Ratchet screwed up big-time when she called Daddy!
Sounds like there was enough time to send you a snail-mail request for you to contact them.
Thanks, I appereciate that! not that knowing it was wrong for sure makes a difference now except it makes me feel better for being so upset at the time...
Sorry to the OP, I didn't mean to make your thread about me, LOL
I wish I had some advice for you, I'm not a nurse yet but I've learned (from "big mouth" :chuckle problems in the past) that it's better to not say anything...
AndyLyn, you might show your husband this thread so he can be assured that it's not personal why you didn't share details with him. This is the way nurses deal with patient info around the country because HIPPA is a federal mandate with serious consequences. Hopefully he'll understand. I think 3rdshiftguy hit the nail on the head, maybe he is grieving over the death of the pt and this is how it is being projected. Talk to him about it. Hopefully you won't be on the couch too long =)
except it makes me feel better for being so upset at the time...
NICU_RNwantsFL
77 Posts
I assume hubby stands ready to bake you a cake with a file in it, and bring it to you in your jail cell?
The law is the law. We don't have to like the laws. We just have to obey them, or suffer the consequences - which, in our case, are not worth the risk.
You done good, girl!