Relatives/friends/whoever call the operator and get transferred to the unit...what do I say?

Posted
by bella14b bella14b, BSN, RN (New) New Nurse

Specializes in med-surge nurse. Has 10 years experience.

I often times am aware of the patient's HCP or POA. Often times I will get a call through the operator and the person calling is some random person who's not a POA or HCP. I will lie and say something along the lines of "Can you hold while we have a patient by that name?", to which they'll reply, "sure", or "Well the operator transferred me here because he confirmed the patient was on this unit-can I talk to him?". I say, "Well let me check to confirm, like I said, I do not konw this patient, but I will check for you". So meanwhile, I ask the callers info (name/relationship), walk to the room and ask the patient if it's okay to talk to this person. They usually say 'yes'. But if they say 'no', should I ask the pt if they would rather make their name private? In other words, someone unwanted who is calling should be told that the patient isn't there? But then I run into the problem of the caller telling me that the operator transferred him/her for a reason, and theY know their patient is on the unit.

There needs to be a protocol or something, nurses and unit clerks are handling these situations differently, and there needs to be a universal way to handle this to avoid a breach in confidentiality.

Does anyone have a method of dealing with these people, or a protocol? Our protocol is vague, and it doesn't tell anyone anything abotu how to actually deal with the situation when these people are on the phone, waiting for answers. Usually I'm just very blunt and say that I cannot give out that information at this time. If you are on the primary contact list, the physician will call you with an update. Otherwise, Marie is doing well and has even eaten her breakfast". I don't divulge more than that. But I feel like whatever I'm doing, or whatever the operator/front desk/security is doing has lead to quite a few things to fall through the cracks, and god-forbid it comes back to haunt me, and you guys. I feel rude dismissing them off the phone, but it's either I do that or I lose my job.

Please advice.

Thank you

Rose_Queen, BSN, MSN, RN

Specializes in OR, Nursing Professional Development. Has 17 years experience. 5 Articles; 11,142 Posts

Patients have the opportunity to opt out of the hospital directory. It is not against HIPAA to acknowledge a patient’s presence in the facility unless they have opted out. A simple way to answer is “The patient has requested we not share information. I cannot provide you with an update.” I would expect that in the vast majority of facilities, the patient’s directory or opt out is displayed to the operator. It is in mine, and if the patient is private (opted out), the operator will tell them they have no one by that name listed.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 41 years experience. 4,292 Posts

If the patient has not opted out of the hospital directory then the call should be put through directly to the patient's room.

Delia37

Delia37, MSN

Specializes in Critical Care. Has 15 years experience. 138 Posts

At my facility, upon admission we provide patients/main contact with a code (the last 4 digits of the MR#) and explain only callers who are able to provide that code would be able to receive medical info over the phone.

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 16 years experience. 1,476 Posts

On 5/20/2020 at 1:19 PM, bella14b said:

...Usually I'm just very blunt and say that I cannot give out that information at this time. If you are on the primary contact list, the physician will call you with an update. Otherwise, Marie is doing well and has even eaten her breakfast".

You don't even owe them that much.

Hannahbanana, BSN, MSN

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB. Has 52 years experience. 1,187 Posts

It has been considered that even confirming that the person is in the hospital at all is a violation of their privacy. Might want to have the Risk Manager review this c the switchboard staff and put out an all-points to everybody else. 

amoLucia

amoLucia

Specializes in retired LTC. 7,735 Posts

Most esp true re psych hospitalizations!

On 3/8/2021 at 4:38 PM, Hannahbanana said:

It has been considered that even confirming that the person is in the hospital at all is a violation of their privacy. Might want to have the Risk Manager review this c the switchboard staff and put out an all-points to everybody else. 

I definitely agree. Having worked in domestic violence victim advocacy prior to nursing school, it’s staggering the number of people experiencing DV and IPV that you’d never expect and who’s never tell you. 

Hannahbanana, BSN, MSN

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB. Has 52 years experience. 1,187 Posts

People rarely remember that people need protection for all kinds of reasons. Thank you for reminding us of this. Abusers can be very devious and the slightest hint that their prey may be in your care can mean they’ll show up. 

Squidpdx, CNA, LPN

Specializes in Ambulatory Care, Community Health, HIV. Has 6 years experience. 70 Posts

I don't work in a hospital, but basically this comment section is an example of the myriad approaches and need for standardization of policies for this?

summertx

summertx

Has 7 years experience. 146 Posts

On 5/20/2020 at 1:19 PM, bella14b said:

I often times am aware of the patient's HCP or POA. Often times I will get a call through the operator and the person calling is some random person who's not a POA or HCP. I will lie and say something along the lines of "Can you hold while we have a patient by that name?", to which they'll reply, "sure", or "Well the operator transferred me here because he confirmed the patient was on this unit-can I talk to him?". I say, "Well let me check to confirm, like I said, I do not konw this patient, but I will check for you". So meanwhile, I ask the callers info (name/relationship), walk to the room and ask the patient if it's okay to talk to this person. They usually say 'yes'. But if they say 'no', should I ask the pt if they would rather make their name private? In other words, someone unwanted who is calling should be told that the patient isn't there? But then I run into the problem of the caller telling me that the operator transferred him/her for a reason, and theY know their patient is on the unit.

There needs to be a protocol or something, nurses and unit clerks are handling these situations differently, and there needs to be a universal way to handle this to avoid a breach in confidentiality.

Does anyone have a method of dealing with these people, or a protocol? Our protocol is vague, and it doesn't tell anyone anything abotu how to actually deal with the situation when these people are on the phone, waiting for answers. Usually I'm just very blunt and say that I cannot give out that information at this time. If you are on the primary contact list, the physician will call you with an update. Otherwise, Marie is doing well and has even eaten her breakfast". I don't divulge more than that. But I feel like whatever I'm doing, or whatever the operator/front desk/security is doing has lead to quite a few things to fall through the cracks, and god-forbid it comes back to haunt me, and you guys. I feel rude dismissing them off the phone, but it's either I do that or I lose my job.

Please advice.

Thank you

If the person is not on the contact list, I don't even like acknowledging that the patient is there. Sometimes the patient is not aware of their rights. If the person calling is not on the contact list, I say I cannot give any information on the patient and can't confirm if the patient is here.  I simply say call back at a later time and talk to administration.

Sweetheart2005

Sweetheart2005, ASN

Specializes in Med surg/tele. Has 11 years experience. 52 Posts

We have passcodes for our patients that are supposed to be given in the ER or at admission. Patients rarely know what to do with the passcode or understand.. our secretaries often will ask if we can talk or a common busy timeframe (8-10 am for am med pass) they take message. If they are in contact list I call back. Otherwise sorry.