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?
I'm not a nurse, but I have been a pt on the floor where I work as an aide.
When I'm there (or in ER) I am not an aide. I'm a patient. Forget that she's a nurse. Remember she's a pt. If you feel that she has a problem, talk to her like she's a pt and not a nurse.
Once again, not a nurse, but if she's in the ER she's not endangering anyone but herself - she's not treating patients. Now, if she was treating pt's while under the influence then you could report her.
Specializes in vascular, med surg, home health , rehab,.
Had several staff admitted to my floor recently, I wasnt assisgned to them therefore did not have a clue about diagnosis etc. None of my business, but was amazed at the nosiness of others, discussing them at the station, accessing their info on the computer. I saw a part time secretary, gleefully reporting what a "sick puppy" one of our nurses was, after reading her records, then adding it was really none of his business, but she was a "friend". Insurance makes it hard to go elsewhere, but I think I drive a good ways to have my privacy respected by people who wouldn't be so interested.
Specializes in icu, er, transplant, case management, ps.
I have a question. What would anyone do if a police officer showed up, in your ER, out of uniform, drunk or high? Would you report him to your local law enforcement agency? I understand the concern of HIPPA but it is either blamed for not doing something or used as an excuse for not doing something. I really don't know if reporting a nurse for a drug over dose or illict drugs, even when she is not working, is a violation of HIPPA. I would think that protecting potential patient trumps her right to privacy. But I don't know. But I do know where to find out the answer.
What would anyone do if a police officer showed up, in your ER, out of uniform, drunk or high? Would you report him to your local law enforcement agency? I understand the concern of HIPPA but it is either blamed for not doing something or used as an excuse for not doing something. I really don't know if reporting a nurse for a drug over dose or illict drugs, even when she is not working, is a violation of HIPPA. I would think that protecting potential patient trumps her right to privacy.
My question is: is it really the nurse's responsibility to report substance abuse to a governing body?
I don't know of any regulation or policy that makes it my business to report that, but the right to confidentiality is pretty clear.
The nurse has no clear evidence that the person's behavior is placing anyone other than her/himself in immediate danger - as would be the case with a patient telling the nurse the she/he was going to commit suicide, kill someone else, or in cases of suspected abuse.
Would you call the police if your patient had been involved in a motor vehicile accident and you knew that person was legally drunk?
Generally, being drunk is not a crime (there are exceptions, of course). Using illicit substances is a crime, but are we obliged to report the crimes our patients divulge to us if we ourselves did not witness the crime?
To my knowledge, having a positive urine tox screen is not a crime and really isn't clear evidence that the person has committed a crime. I went to a party one time and ate a brownie that had marijuana in it - did I commit a crime? I didn't know the brownie had weed in it before I ate it, but all the same, my urine tox screen would have been positive, had I been tested.
So, in answer to your question, 'what would I do if a police officer showed up on my unit drunk or high?' I would treat her/him like any other patient.
Sometimes the best thing we can do is to take our collegue aside and talk with them. Many hospitals have help available for ppl with emotional and substance abuse issues, EAP.
With the nurse in question, she should have had a psych consult written by her primary physcian and treatment offered per their reqs. The patient care nurse hopefully was an advocate for this individual.
Shame on that ER nurse!!!!!!!!!!! HIPPA violation bigtime!!!!
Sometimes the best thing we can do is to take our collegue aside and talk with them. Many hospitals have help available for ppl with emotional and substance abuse issues, EAP.
Specializes in icu, er, transplant, case management, ps.
What I do not understand is everyone's lack of concern about potential patients who would be under her care. Granted you do not know if she does drugs on the job but it is pretty safe to assume if she does them outside of work, she could just as easily do them on the job. I would prefer not to have a nurse who may or may not be doing drugs on the job, taking care of me, if she had done them off the job. I would not trust her.
And in response to my question, concerning the police officer. If he showed up drunk in my ER, I would report him to his boss. He is violating his own agency's code of conduct. Just as any nurse who shows up high, at work or in public, or her home, is violating her NPA. Or has everyone forgotten the line about having good moral conduct? A North Port police officer was just suspended, without pay, for six weeks. His offense, he got into a fight, while drunk, with another patron in a local bar. He was not in uniform when it happened either. But his bosses were informed and his police chief took appropriate action.
I am surprised at all of you taking up for someone who is violating the law. I wonder if you would feel the same way if it was your child's teacher, or bus driver, or anyone else. Would you be so bound by HIPPA? Yes, she needs treatment and she deserves a chance to get it. And just how do you suppose one is suppose to approach getting her help or to face her problems, since you all claim to be bound by HIPPA? Or does your attitude change when it is one of your love ones who might be put in danger by someone using drugs?
What I do not understand is everyone's lack of concern about potential patients who would be under her care. Granted you do not know if she does drugs on the job but it is pretty safe to assume if she does them outside of work, she could just as easily do them on the job. I would prefer not to have a nurse who may or may not be doing drugs on the job, taking care of me, if she had done them off the job. I would not trust her.
And in response to my question, concerning the police officer. If he showed up drunk in my ER, I would report him to his boss. He is violating his own agency's code of conduct. Just as any nurse who shows up high, at work or in public, or her home, is violating her NPA. Or has everyone forgotten the line about having good moral conduct? A North Port police officer was just suspended, without pay, for six weeks. His offense, he got into a fight, while drunk, with another patron in a local bar. He was not in uniform when it happened either. But his bosses were informed and his police chief took appropriate action.
I am surprised at all of you taking up for someone who is violating the law. I wonder if you would feel the same way if it was your child's teacher, or bus driver, or anyone else. Would you be so bound by HIPPA? Yes, she needs treatment and she deserves a chance to get it. And just how do you suppose one is suppose to approach getting her help or to face her problems, since you all claim to be bound by HIPPA? Or does your attitude change when it is one of your love ones who might be put in danger by someone using drugs?
Woody:twocents:
So, using your logic, if I saw a co-worker drinking with friends in a bar on the weekend (off duty), I should assume that that person is drinking on the job and endangering clients, and report her/him to the BON?? After all, if s/he drinks outside of work, s/he probably also drinks at work ...
There is no "conscientious objector" exception to the HIPAA rules (all healthcare providers are required to protect the client's confidentiality unless they object to the behavior that led to the client being admitted?? )
BTW, you piqued my curiosity with your comment about the "good moral conduct" clause in (a) NPA -- I just checked, and my state NPA does not contain any language about "good moral conduct" or anything to that effect. Even if it did, I believe that it would be the responsibility of the BON to interpret and enforce that provision, not me.
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bethin
1,927 Posts
I'm not a nurse, but I have been a pt on the floor where I work as an aide.
When I'm there (or in ER) I am not an aide. I'm a patient. Forget that she's a nurse. Remember she's a pt. If you feel that she has a problem, talk to her like she's a pt and not a nurse.
Once again, not a nurse, but if she's in the ER she's not endangering anyone but herself - she's not treating patients. Now, if she was treating pt's while under the influence then you could report her.