Patients' privacy and HIPAA vs. staff's right to know

[TheOneWithGlasses]

This is something that I have wondered about ever since HIPAA has been implemented in our facility. Of course the nurses know the patients' diagnoses, medication side effects, etc, but the CNAs usually aren't privy to that information, in part because we're not allowed in the patients' charts and that sort of info is not on the ADL flow sheets we have.

While I realize it's the patient's right to not have everybody know what medications they're taking, etc, I for one as a CNA would definitely appreciate knowing certain things...for example, I don't need to know the exact medications and dosages Mrs. Smith is taking, but I'd appreciate knowing that one of the common side effects of one of her medications is dizziness or diarrhea or whatever so that I can be prepared. Similarly, if a patient has something that's highly infectious that will require me to take extra precautions, I want to know so that I can take those extra precautions and not find out hours or days later that Mr. Jones has MRSA in that sore on his hand, so I should probably wear gloves not just to touch him but to touch anything he might have touched.

The nurses are usually willing to tell us these things if we directly ask them ("Is Ms. Yoohoo on anything that would make her pee purple?...cuz, it is") but neither the CNAs or the nurses has the time to sit down and discuss every possible problem like the ones I've mentioned. I was just wondering what other CNAs and nurses do about this in their facilities.

[leslie :-D]

a nurse should absolutely be telling the aides if a pt is infectious.

i've always made it a habit to give a brief report at the beginning of a shift.

but i also hope that the aides will come to me with questions, observations, etc. on any of the pts....also, a need to know.

there's a good chance the nurse isn't aware of certain side effects until the aide reports a, b or c.

and then through further research, will become aware of these adverse events.

but i agree w/you: good communication is key.

leslie

[skipaway]

You are the patient's caregiver as well as the RN. You have the right to know about a patient's conditon just as the RN does. It would not be a HIPPA violation to share information with you.

[SlavicNurse]

You are the patient's caregiver as well as the RN. You have the right to know about a patient's conditon just as the RN does. It would not be a HIPPA violation to share information with you.

It would not be a HIPAA violation either

(sorry could not resist, no harm intended)

[RobCPhT]

I would have to agree with others on this. As a caregiver you are legally able to know anything on the patients chart. If someone has these restrictions as a policy you may want to let them know. It would pose a worse risk to have this info found out later on.

[ms_orion]

Interesting...you are a provider of care and do not have access to pt info, in the clinic where I am working the receptionist has access to the info. I dont get it. As far as knowing if a pt is infectious...TREAT ALL PTS AS IF THEY WERE INFECTIOUS STANDARD PRECAUTIONS! Sometimes the individual has no idea they have a disease that may put others at risk themselves.

[charebec65]

I just finished nursing school and passed the NCLEX so I've only just started looking for a job but in most of the places I had clinicals, the aides were involved in report, either while the nurses were reporting off to each other or at a separate time.

Also, in every place I was, as soon as there was a reason for extra precautions, everyone who worked with that pt was advised. The extra supplies were put outside the door (big clue) and a sign would be posted on the door. (for instance "See nurse before entering")

You can't always trust the records. People don't always admit to all of their dx's, they simply may forget, or they may not know they have the illness. Never forget standard precautions.

Good communication between the nurses and aides is essential. Even as a student I could see how important it was. The better the communication, the better the pt. care.