Possible termination for HIPAA violations

BuckyBadgerRN, ASN, RN · Sep 23, 2011

Who determines who has a "right" to look at your chart? I believe all patients sign a consent stating they agree to allow their information to be shared with appropriate personnel - insurance companies, nurse managers, etc. The charge nurse knows about all the patients, but does she take care of all of them? The same goes for the NM, etc. I think your situation was blown way put of proportion, and until you seek advise from an expert in HIPPA violations (which you should do so immediately, and independent of your hospital), you shouldn't get worked up about it. I agree that you should be familiar with all the patients on your unit - which makes you a team player, and if you needed to cover any other patient for another nurse, you need to know about that patient. I've never worked in a unit where I didn't get at least a brief summary of all the patients in case a nurse went home sick, or a critical admission took precedent, or I answered a call light for someone else's patient (gasp!) - we all pitched in to cover other nurses assignments.
Sounds like newer nurses are getting the fear of The HIPPA God put in them.....

APPROPRIATE personnel, yes. Those directly caring for them. The OP has stated that she was not their nurse and she was browsing during slow time. Violating federal law is not something to be taken lightly, as is evidenced by facilities heavy-handed approach to dealing with those who do so. HIPAA (not HIPPA) is in place for a reason, and the "HIPAA police" take it very seriously.

Clearly the OP's facility doesn't believe in briefing each nurse on each clients status. That means (right or wrong) that other nurses are out of the loop regarding the care of other clients on the floor.

We can stomp our feet, voice our displeasure, poo-poo the rigidity of the law all we want. The fact remains that she had no business in those charts (something she herself will tell you) and the facility could face HUGE fines over her error in judgement.

BuckyBadgerRN, ASN, RN · Sep 23, 2011

From her posts, I think it's clear that the OP realizes that what she did, was wrong and a very serious offense. So what good is making her feel worse and throwing it in her face going to do? She already knows she messed up.
To Magnolia- I do think you should prepare for termination or suspension, just in case you are faced with it. But like others have said, what's done is done. You learned from it, now all you can do is plan for whatever lies ahead.
Do some research on what your facility and state typically do for such an offense, call the board of nursing and ask questions, consult an attorney, start looking at other job options...get as much information as you can, so you can better deal with your situation.
And try to remain positive and have faith. I am in no way trying to make light of what has occurred. But you can't keep harping on the "what ifs" and "I should have" this or that. Bad things happen to people everyday, but you just have to keep going and not give up. Good luck to you!

At this point, I don't think people are "throwing it in her face". The posters that keep telling her that it's not that big of a deal and no harm was done are a little concerning though. It IS a big deal and that's why the fines associated with it reflect the level of severity that the federal government feels about it. :twocents:

BuckyBadgerRN, ASN, RN · Sep 23, 2011

I have no idea if the hospital will give you another chance. It's certainly not mandated that they have to fire you. It's not as if you did this with malicious intent.
You might have a partial defense if the hospital really did not explain their policies and applicable laws to you. That almost certainly is their responsibility under JCAHO.

Ignorance of the law isn't much of a defense.

JS343 · Sep 23, 2011

Ignorance of the law isn't much of a defense.

No, it's not a full defense, but it is a mitigating factor in assessing the degree of culpability and severity of punishment. Beyond that though, if the hospital did not instruct the OP in privacy, they are likely to be more lenient and not terminate her if they thought there was any chance of a JCAHO or similar complaint.

cherrybreeze, ADN, RN · Sep 23, 2011

i don't agree...it's not the same as talking about pts in the lunch room. honestly, i don't see the big criminal offense in this. this is a new nurse, who was bored, trying to stay awake, perusing medical records. there was no ill intent, no maliciousness, she wasn't looking for anyone specific, and probably couldn't recall the names now anyhow!...and isn't this just another way of continuing her education? no, it is not. i mean, you see a pt has disease xxx and that leads to the following s/s and change in lab values. how is it different than when in nursing school and you make care plans? you're technically not the nurse responsible for care, yet you read every crumb the chart gives up. if you are doing a care plan on the patient assigned to you, then yes, you are participating in their care, and therefore have the right to look at the medical record. and, if you care for a patient and they're transferred to another unit, don't you ever want to check up on that patient? see what their outcome was? you might want to, but that doesn't legally give you the right to. did your efforts to save their life pay off? of course, but under this way of thinking, that's a hipaa violation. "under this way of thinking?" this way of thinking is the law, and it is a hipaa violation.
now, if she were perusing the local std reports and looking for her ex-boyfriends new girlfriend, i can see the outrage, but this? not so much. lesson learned, move on. just my 2 cents...
sorry, just read you're a nursing student...trust me, your views will change as you begin practicing. if you care now, you will learn you don't stop caring just because they left your unit. no, you don't stop caring once they leave your unit. what does stop is your legal right to access their medical record.

looks like the need for more education about hipaa is pretty widespread.

Rob72, ASN, RN · Sep 23, 2011

Ooookaaayyy. If you haven't had some resolution yet, here's a few suggestions:

1) Someplace, somewhere, I'm sure the Employee handbook states something to the effect of, "...you are responsible to only access the PHI relating to your care-assignment(s)." If not, you can take them to court, but that's a pretty standard statement, anymore. So. Pleading ignorance, as noted, is not a full defence.

2) I would suggest (also as noted) talking to Employees' Assistence (EAP), as soon as you can. I would also consider requesting an appointment with your facility's DON, and carefully, calmly, pleading your case. The DON may be a better source for appeal than the vacuously stupid rectum-breathers in HR. Sit down, and write out a short statement, and most respectfully ask, "if it is in any way possible, to receive a suspension and/or probationary period, with an opportunity to re-establish and validate the trust of the position for which I was hired."

God be with you, and best of luck!:hug:

sweetnurse63, BSN, RN · Sep 23, 2011

OP you seem like a nurse of honesty, compassion and integrity. You made a mistake as you are human like everyone else. You did not kill anyone or give the wrong medication, it could be worse!!!. Pray and think positive because no one knows what the outcome will be but God. Sometimes it looks a lot worse than what it seems, do not make your self sick over this. Waiting is one of the hardest things to do in life, but you must wait and see. If you are terminated as many of us have been in the past, you will find another job again and this will just be a lesson learned in which you know never to do it again. Hope all works out for you. :nurse:

sweetnurse63, BSN, RN · Sep 23, 2011

I am just hypothetically wondering, would it still be an offence if it was a doctor looking at patients charts that are not under his or her care? :rolleyes:

JustBeachyNurse, LPN · Sep 23, 2011

I am just hypothetically wondering, would it still be an offence if it was a doctor looking at patients charts that are not under his or her care?

Yes it would be. In fact a physician reviewing charts of patients that were not under his care (or referred to him) was listed as a validated HIPAA claim.

healthstar, BSN, RN · Sep 23, 2011

In my hospital, we only have permission to access our assigned pt charts. It is a Hipaa violation to view other charts. We follow the same policy for clinicals. They can also see how long you were viewing the chart. Some hospitals can call the pt and ask if they know you or not to find out if it was an accident or not ( rarely).Our hospital informs the pt about violation of hipaa so they can be aware. I don't know what to say, good luck.

BuckyBadgerRN, ASN, RN · Sep 23, 2011

I am just hypothetically wondering, would it still be an offence if it was a doctor looking at patients charts that are not under his or her care?

If he is an EMPLOYEE of the facility, then yes. I work in a small clinic, a partnership, not corportate affiliated. Both of the Dr's are owner/partners, not employees. THEY can look at any chart they please

eagle78 · Sep 23, 2011

Best to just be completely up front with your manager and HR. You are a new nurse and still in high learning and interest mode. Your curiosity could be seen as a desire to want to know more about different disease processes, not necessarily about the patient who is ill.
I will pray for you. I hope things work out. Please keep us posted. Bless you.

I agree with this poster, as I could see myself making the same huge mistake you just did for that very reason, tying to educate myself. I really hope this works out for you, and I hope you realize that this is coming from a similar spirit who would unwittingly make the same mistake.

You are in my prayers and I hope all goes well. Be blessed...