when your patient is a nurse

[aeauooo]

A couple of months ago a patient was admitted to my unit with a diagnosis of overdose. The patient's urine tox was positive for a number of drugs including at least one illicit substance.

The ED nurse made a big stink that this patient was a nurse and that she was going to notify the state board that the patient had been admitted with overdose and a positive tox screen.

Aside from the fact that I found the ED nurse's behavior to be self-righteous and extremely offensive, I also believed that by contacting the state board to 'narc' on this patient she would be violating the patient's right to confidentiality.

Let me add this caveat; I am a recovering alcoholic. I got sober after a colleague, who is also a recovering alcoholic, came to me and told me he thought I had a drinking problem.

How should we advocate for our colleagues who have substance abuse problems?

[oramar]

I sincerly doubt she is permitted to call the BON under HIPAA BUT I certainly am not an authority on the matter. I am very glad you posted this and am very interested in knowing what others that know more on the subject will say.

[sjt9721, BSN, RN]

Here in TX, reporting said nurse would be a violation of HIPAA regulations. You can read a more thorough explanation here:

http://www.bon.state.tx.us/practice/faq-nurseunderinfluence.html

[locolorenzo22, BSN, RN]

It depends....if on duty, that's a whole other issue....

However, I did a search online for this...and found a statement from the NY state nurses association...

In conclusion, the New York State Nurses Association affirms and emphasizes two issues:

any testing for alcohol and/or other drug use involving professional nurses should be done only when there is reasonable suspicion and/or objective documentation that job performance is or has been impaired by alcohol or drug usage; not, as a random procedure or general policy; and

the above recommendations for policies for testing for alcohol and/or other drugs are separate from the provisions of a reentry contract which may have been negotiated between a recovering nurse and an employer

As a patient, a nurse has the same HIPPA rights as anyone else....regardless of our personal feelings. If it is not affecting job performance, and no criminal case has been proven, I believe that the nurse has the same right to get treatment as anyone else.

I realize that this thread borders on the legality of said issue....and may be closed, but that's what I believe....right or wrong.

Would I want that nurse working on my loved one? Nope. But would I know unless job issues started showing up? probably not......

[pagandeva2000, LPN]

I agree...if this nurse was not on duty, especially if she is actively receiving treatment for her problem, it is not right to report her. Maybe this overdose was the experience she needed to turn her life around. If she has no career to look forward to, then, the next time, she may be dead and leave a family behind to pick up the pieces. Not only is this judgemental ED nurse hurting the nurse, she may be also hurting children that are counting on this nurse as a bread winner. The nerve of some people...

[Agnus]

You have a good point about HIPPA. I would not have been inclined to report her but I did not think about how HIPPA might be an issue either.

[Scrabbler]

If she's there as a patient, she's a patient, and should be treated the same as any other. If she were a teacher, would it make a difference? Hopefully this is a wake-up call for that woman to get the help she needs...knowing her colleagues want to help instead of feeling like they're out to get her might be a bonus.

[Elvish, BSN, DNP, RN, NP]

Scrabbler, you said exactly what I was thinking.

[aeauooo]

Not only is this judgemental ED nurse hurting the nurse, she may be also hurting children that are counting on this nurse as a bread winner. The nerve of some people...

This is not the first time I've overheard this particular nurse say really horrible things to patients with substance abuse problems.

[Penny8611]

This is not the first time I've overheard this particular nurse say really horrible things to patients with substance abuse problems.

My completely unscientific and unresearched opinion is that he who throws the most stones has the most latent (or not so) tendencies to cover up.

I hope she can find a way to get off her high horse.

[RNgirlie]

wow. i think i would have a heart to heart with the patient if she was my patient, as we sometimes do with any of our other patients--just as nurse to patient. and turning her in would be against hippa and may backfire. totally agree with pagandeva2000.

hope things turn out well. did you talk to the ED nurse to tell her that squeeling is against hippa?

[aeauooo]

i think i would have a heart to heart with the patient

That's probably the best course of action. As I said, I got sober after one of my colleagues talked to me, so my bias is in that direction too.

did you talk to the ED nurse to tell her that squeeling is against hippa?

It didn't occur to me at the time - I was so appalled by her behavior. "[This patient] a nurse, but won't be after I call the State Board!" Loud enough to be heard accross the entire unit.

Later, part of me hoped that she would call the State Board and get nailed for violating HIPPA!