Patient is a sex offender with a tracker on his ankle

[Alex_RN]

When I received shift report for my very ill, bed-bound patient, the RN giving report pointed out the tracker affixed to his anklet. She had admitted him a few hours earlier and did not know the details and there was nothing noted in his chart. Before she left, she looked online and he is a convicted sex offender (lewd and lascivious with a minor under the age of 14).

Is it appropriate to add this new information (pedophilia) to your shift report? To his chart?

[cyc0sys]

Safety and security of all patients, staff, and visitors is a primary concern. While the patient is entitled to the same care as another, it does warrant a properly individualized risk assessment and notification of the appropriate authorities in house or otherwise.

An investigation should never be undertaken by someone involved in a 'direct' care capacity. If the patients' health or care becomes 'compromised' it could result in an investigation of medical/criminal neglect. Avoiding investigations and civil rights lawsuits are a good thing.

That being said, I worked for a Pain Management Practice where a substantial number of our patients were convicted criminals. After a violent altercation with Doc and an assistant, I began screening the patients for violent offenses via government databases. As a private practice, we had the ability to deny care which doesn't fit into your scenario.

If the information is readily available via internet from a trusted source of public records, courts, or law enforcement agencies there is no right to privacy due or expected. This information is published for reasons which includes informing the public at large.

[Esme12, ASN, BSN, RN]

First...it is HIPAA not HIPPA...lol

This is one of those issues best brought to your manager and risk management/lawyers. When there is criminal activity/investigation HIPAA allows disclosure....but this person had served their time. The courts felt he was at risk for re-offending...hence, the ankle monitor. Googling your patient is probably not the best behavior. However, sex offenders history is available to the general public so "privacy" isn't exactly in play here.

What makes this important? If this patient was admitted to an adult floor that also has peds patients. A roommate that has young girls visiting. Most sex offenders have rules to follow about the presence of children to them. It can become a huge mess. In general I would suggest you go to your manager and ask her for the policy for patients with ankle devices, the care of these devices, and the removal for tests.

[Racer15, BSN, RN]

I have taken care of many patients with ankle monitors and pt's that are currently inmates. I do not google what they are in for and I do not want to know. I would prefer not to know and would not pass the information along in shift report.

[Wolf at the Door, BSN]

Yes, that is relevant information. I am glad she looked the person up. Not all the times are we informed of exactly what type of person we are dealing with. You need the information to keep YOURSELF/STAFF safe and visitors. Some nurses talk about their children and show pictures to patients. You don't want to set this person off on a sexual fantasy. I would document the tracker for sure.

[Emjay274]

Go ahead and put it in the cart, that way when he needs to request his medical records for something, he can see it and consult his attorney. He can then sue you, coworker and the hospital for violating his privacy.

You guys have NO right to look up his legal history. If he was a danger to other patients, he would have a sheriff by the door. Also, you should hope nothing goes wrong during his stay there, or they may also accuse you of treating him differently after you and the coworker violated his privacy. You discussed it, so it's going to be your burden to prove you weren't the one checking on it.

How in the world is this even something that's being questioned. He has a right to privacy from the people providing his medical care. His community control officer knows where he is, and if he was a risk, you would have been notified.

You may want to notify your supervisor what your coworker did, because it can come back on you. Either tell her up front, or drop an anonymous note.

[Wolf at the Door, BSN]

You guys have NO right to look up his legal history. If he was a danger to other patients, he would have a sheriff by the door. Also, you should hope nothing goes wrong during his stay there, or they may also accuse you of treating him differently after you and the coworker violated his privacy. You discussed it, so it's going to be your burden to prove you weren't the one checking on it.

How in the world is this even something that's being questioned. He has a right to privacy from the people providing his medical care. His community control officer knows where he is, and if he was a risk, you would have been notified.

You may want to notify your supervisor what your coworker did, because it can come back on you. Either tell her up front, or drop an anonymous note.

Its public knowledge just like your nursing license is public information that can be used against you.

You have no privacy once you are a convicted of a crime, you wear that wherever you go for life.

Please tell the supervisor so that nurse can be praised for keeping everyone on the lookout. The bracelet has to be documented in case it causes skin breakdown.

[MunoRN, RN]

What you chart should be information relevant to his care and treatment, it would be worth communicating to the social worker or care manager for instance as it would affect discharge placement if necessary, but I wouldn't include it in other information. For instance, I wouldn't start my note with "Pt is a 58 year old pedophile admitted for urosepsis requiring 2 days of pressors and AKI requiring CRRT. If for some reason the patient pursued action against you and the hospital for inadequate care or treatment, that random mention of "pedophile" would be gold to an attorney. That would be all that would be necessary to make the claim that you had a negative bias against the patient.

[Kooky Korky, BSN, RN]

That would be totally inappropriate.

I'd advise your coworkers against "googling" patients in the future.

They should do their googling at home, not at work.

It is appropriate to inform the next nurse that a pt has an ankle bracelet and the reason for it, if known. For people who don't normally work with criminals, it can be shocking, so a "heads up" is not out of place. What's the big secret? Why should a nurse not be informed that she is caring for a pedophile or other criminal?

The information is public information and it is public for a reason. This knowledge should not change the care a nurse gives a patient. Killers, robbers, thieves, rapists, etc. all deserve courtesy and proper care. But staff deserve to know who they're caring for so they can exercise due caution, not get hypnotized by or sucked in to the patient's views and not do favors for the pt that a nurse would not ordinarily do.

A pedophile who is very ill bodily should receive correct care. He is also mentally ill, although some don't see it that way. What is it - The Man-Boy Love Association or something like that believes sex by adults with very young children is not only OK but correct and desirable and should not be criminal. Our public schools generally are pushing for young children to be aware of sexuality and gender issues, explore sexuality, embrace it, act upon it. So our society is quite different now than in the era in which some of us grew up. But this patient needs appropriate psychiatric care, too.

No reason a nurse should not be made aware of who he or she is caring for.

[Kooky Korky, BSN, RN]

Go ahead and put it in the chart, that way when he needs to request his medical records for something, he can see it and consult his attorney. He can then sue you, coworker and the hospital for violating his privacy.

You guys have NO right to look up his legal history. If he was a danger to other patients, he would have a sheriff by the door. Also, you should hope nothing goes wrong during his stay there, or they may also accuse you of treating him differently after you and the coworker violated his privacy. You discussed it, so it's going to be your burden to prove you weren't the one checking on it.

How in the world is this even something that's being questioned. He has a right to privacy from the people providing his medical care. His community control officer knows where he is, and if he was a risk, you would have been notified.

You may want to notify your supervisor what your coworker did, because it can come back on you. Either tell her up front, or drop an anonymous note.

You are so trusting. The system doesn't always work nearly as efficiently as you seem to think it does. Don't you ever watch Law and Order or Blue Bloods? The Parole and Probation officers have so many cases, they get overloaded, they lose track of people, they go on leave and no one covers for them, etc.

Legal history is public and they can look it up, but should not do it at work. Also, there is no need to write anything about crimes in the chart.

[Kooky Korky, BSN, RN]

When I worked acute care we had a contract with the local federal prison and the county jail. I never wanted to know what their charge was that way it wouldn't influence my care or how I treated the patient.

But you knew you were dealing with convicts, inmates, prisoners, and the accused who were awaiting trial.

That way you knew to take precautions - be courteous and give proper care, but don't share your personal biz with them, no favors (like mailing letters for them, making calls for them, shopping for them, running errands for them).

Apparently, no one gave any information or instruction to OP and her coworkers, so they are freaked out about it. Shame on their managers.

[Kooky Korky, BSN, RN]

As horrible as the information you have found out, no one should've google him (HIPPA). People get fired for things like that. Just do your best to treat him, the law will handle the rest.

How is it a violation of HIPAA to look up criminal records? I do think the googling should have been done other than on the job.

[Kooky Korky, BSN, RN]

Can he talk? I think it would have been appropriate to ask the patient "Do I need to know anything about your ankle bracelet?" and documenting anything he tells you. I would also assess for edema in the area.

Documenting pedophilia in the chart is not appropriate. But a sex offender search is legal for anyone to do. I don't think it's necessarily helpful, but it's legal.

Sex offenders are everywhere. You see them all the time and never know it. Why worry about the one who is bed bound?

He might become ambulatory. LOL