Personal Cell Phone Use

[NJ2010RN]

So I am new to LTC as this is my first job outside of the hospital setting. At my new facility it is commonplace for the nurses to text the doctors/NP's with questions and asking for orders USING THEIR PERSONAL CELL PHONES. Yes patient personal information is being shared in these texts, sometimes pictures of the wounds as well. When I was confronted with this situation, I refused. When I asked how I could reach these providers, I was ignored till hours later or told by supervisors that they would text the providers for me. This doesn't feel right to me. It seems as if a HIPPA violation is still occuring and I don't want to be apart of it, but so many nurses at this new facility do this, that I feel pressured to use my personal device as well. I'm affraid of security and theft, not to mention my own personal privacy. In the hospital we use phones and email provided by the hosptial. I see doctors in the hospital carrying two phones: one for business, and one for personal use. I brought the issue up to my DON, and she shrugged it off saying "No, we don't require you to use your cell phone" but said nothing of the practice by most of the nursing staff. I want to advocate for my patients, but I don't want to get myself in a sticky situation. Are the HIPPA laws different for LTC?

Here is an interesting article on the topic: Hospitalists Should Refrain from Texting Patient Information | The Hospitalist

[Libby1987]

Have you heard of the app HIPAA Bridge?

[NJ2010RN]

No. I have never heard of it. Do you use it?

[Ele_123]

I don't think it was HIPPA Bridge, but there is a large hospital system in the city that encouraged doctors & nurses to download this secure HIPPA approved app (if that makes any sense). There were three different types of doctors: the ones that really caught on and responded to messages in a timely manner, the ones that had the program installed on their phone but never set up notifications and only opened it once every few days, and the last type still used pagers.

I work at a couple different LTACs. At one of them the charge nurse calls/text the doctor from a company cell phone for all the nurses, so the floor nurses don't contact the doctors themselves. Texting at that LTAC was used for simple or small issues, for example patients who want OTC medications, diet changes, x-rays for line/tube verification, etc.

At the other LTAC I asked the charge nurse for a Dr.'s phone number, she gave it to me and told me that he prefers texting for small issues. I asked her for the phone & she gave me a strange look and told me that most nurses just use their personal cell phones. The LTAC had 20-30 patients split between 2-3 doctors. The nurses would either refer to the patient in the text message by room number or initials. A few years ago in nursing school we were taught that room number is not a patient identifier/PHI and is one of the safest ways to refer to a patient when talking with staff where information might be overheard. Also on all of our nursing care plans we used patient initials.

[CapeCodMermaid, RN]

LTC has to follow the same HIPPA regs as everyone else. I've only worked in two buildings where doctors were sent texts. In one, we texted the doc: Please call the unit ASAP. No HIPPA violation since no personal information was given out. In another facility it was common practice to text the docs and the NPs. It's not ideal since most phones are not secure.

[nurseburst, ASN, BSN]

I agree that it is a HIPPA violation and really wish that our facility would provide cell phones for each hall since we are 9 times out of 10 not at the nurses station to place a call or receive a call. And hearing the page over the intercom? You cannot hear squat in patient rooms!

However, one of our doctors at the facility utilizes something called YouCallMD where we can log in and send the doctor a message and it'll go to whoever the on-call is as well. I REALLY love this because I can send a secure message from the laptop on the cart and go about my business.

We've also had a nurse (prior to my time) who had been fired for calling either a family member or doctor using their cell instead of the facility. I don't see an issue using my own cell to call the physician since it is on me at all times but apparently our facility won't use our phone records and only the facility's (I've been told) if something comes up and they have to check records. (Like for example: a doctor says he wasn't called but you documented you did call in a lab.)

So, I try to call from the facility but often I am so slammed I use my cell. Oh well! I do text one of our ARNPs with questions however, without trying to disclose information, if I've already talked to her about the patient via phone. She loves teaching and has no problem texting me back as long as it isn't midnight or later, haha.

I say go with your gut. Do what is right. Don't follow suit. Make it clear to physicians you cannot use your personal cell and it is ridiculous you don't have numbers for them... We have numbers posted at all of the desks but I've saved them in my phone to quickly pull it as well.

Edit: Curious if survey was coming up if you guys would be suddenly given "the numbers."

Best of luck,

nurseburst

[Double-Helix, BSN, RN]

How to maintain HIPAA compliance with mobile devices | The Advisory Board Daily Briefing

Healthcare Providers May Violate HIPAA by Using Mobile Devices to Communicate with Patients

Healthcare Professionals Violate HIPAA with Personal Phones

If your facility has a Compliance Officer, I suggest taking this issue to them, or your administration, which would be on the hook should any lawsuit be filed against the facility for a HIPAA violation. While using your personal phone to page or call a provider would not be a violation, transmitting any PHI via your device puts that information at risk for being compromised. So I'd be comfortable using my phone to text a physician to request they call, but agree with your decision to not include any identifiers or photos in that communication.