Referral

[darren_callcareer18]

Nurses, Do you think, what appropriate situation when u need to keep your observations on your patient to yourself?

Thnks

[rn/writer, RN]

Not sure what you're asking. Could you phrase this another way or add more information, please?

[classicdame, MSN, EdD]

pretty much keep everything to yourself unless the listener has a "need to know".

[nurseprnRN, BSN, RN]

this is actually a hipaa question. the short answer is that if you find yourself with private health information (and depending on what you're talking about, an observation could count as that) that's unrelated to the care being given, you do not reveal it to anyone in any form.when i did workers compensation case management i would occasionally learn parts of the medical or social history which had no relation to the work injury or the comp claim, and i never, ever put that in my notes or report. and i reminded the md offices to redact it from the notes they sent in to the claims people to support their billing. if someone breaks a leg at work it doesn't matter if they are using birth control or had gynecological surgery or hiv testing before, and the insurance company specifically has no business knowing it either.

that's a pretty broad explanation, so i'd need a better idea of what you mean before i could say anything more intelligent.

[amoLucia]

Not sure if this fits here but --- if a pt swears you NOT to tell anyone. Something in confidence which otherwise would be a breach of trust???

[Meriwhen, ASN, BSN, MSN, RN]

Not sure if this fits here but --- if a pt swears you NOT to tell anyone. Something in confidence which otherwise would be a breach of trust???

OP: it would help us greatly if you could clarify your question.

This quoted suggestion wouldn't fly in psych nursing because that can lead to...you guessed it, staff splitting. Among a whole other host of legal and ethical issues.

Whenever patients want to tell me something that they don't want me to tell anyone else, I tell them that I can't promise that because their safety is my priority, and depending on what it is, I may have to tell their doctor or social worker or whatever. I can promise them that I won't trumpet it from the rooftops, and that I won't tell it to anyone that doesn't have a bona fide need to know it...but that's the limit.

[amoLucia]

Meriwhen - you made me think further. Your point is well explained. I've never had anything come up that I had to respond like a priest or a lawyer. Most pts just don't want me to pursue an incident report issue and I've explained it them along the lines as you post. It does go with the job to communicate information as nec with discretion. Thanks.