Socially needy coworkers

[Emergent]

We have a newer coworker at one of my jobs. She seems to be universally annoying everyone there. She seems to want to intrude in every conversation with over sharing about her own life. She will show photo after photo of her cat in different poses and other really boring things. She has some shopping fetishes that she goes into great detail about.

She is a physically very large woman both in height and girth. She has a poor sense of personal space and gets into peoples bubbles. Not only that, she butts into patient care with grandstanding and trying to direct the person to do things her way right in front of the patient. She is extremely bossy and obtuse regarding how she's coming across. And any little fault she comes across she writes up. She's also poked into other people's charts for no reason.

I get the feeling that she is socially starved. How do you all deal with somebody like this? I think people are being nice enough to her face, but there is a lot of backbiting going on about how she is driving them crazy.

[KatieMI, BSN, MSN, RN]

I'm not the most savvy person re: HIPAA. But it seems to me that I do need to know at least the basics about patients on my ward even if I'm not assigned to them. And if an emergency comes up, I think it is helpful to have the basics in mind. Name, Room #, Diagnoses, any bad labs, POD 1 appy or whatever. I don't need all of their intimate personal face sheet info - address, next of kin, insurance.

Is what I have stated appropriate and lawful with regard to HIPAA for all workers to know? If I'm going to cover for someone's break I will need some info about the patients, or if I am walking by and the call light goes on, I am going to go into the room and see what they need if at all possible, (not rushing to a known emergency, for example).

Thanks.

That really depends on policies of your agency. If you are covering, you are supposed to get report from the nurse you relieving with all necessary information for this (presumably) short period of time. If you need to take a look in the chart because you need to know something else, it is sure ok for the period of time you provide care for this patient. But if you just peruse this chart randomly, it may be not seen as benign action.

Since HIPAA, as many other laws, presents quite unspecified definitions, it is interpreted quite widely and in accordance to tastes and feelings of management, although usually within some (more or less) reasonable guidelines. I was in a unit one time where, to prevent spreading of PHI, no one but assigned personnel could ever enter the room for any reason, call light or not, unless it was a code (while residents were sitting there freely exchanging charts and making screenshots of EMRs), and in another one where everybody was supposed to know enough about each patient in unit to immediately get up and going with care if needed. Nevertheless, routinely looking through paper or electronic chart of a random patient just out of nothing else to do won't be seen positively pretty much anywhere nowadays - at least for a nurse. And HIPAA violations are from that short list of things which really can lead to endangering license. One may like it or hate it, but that's how things are right now.

[KatieMI, BSN, MSN, RN]

I wouldn't confide in anyone at work. Lesson about that learned long ago. People don't keep secrets well. Old saying - 2 people can keep a secret if one of them is dead. LOL

I heard that in hospitals walls got ears, and there's a pair of them on every step and in every elevator, too.

[TriciaJ, RN]

I'm not the most savvy person re: HIPAA. But it seems to me that I do need to know at least the basics about patients on my ward even if I'm not assigned to them. And if an emergency comes up, I think it is helpful to have the basics in mind. Name, Room #, Diagnoses, any bad labs, POD 1 appy or whatever. I don't need all of their intimate personal face sheet info - address, next of kin, insurance.

Is what I have stated appropriate and lawful with regard to HIPAA for all workers to know? If I'm going to cover for someone's break I will need some info about the patients, or if I am walking by and the call light goes on, I am going to go into the room and see what they need if at all possible, (not rushing to a known emergency, for example).

Thanks.

Some hospitals have become really picky about not accessing charts of patients to which you have not been assigned. I'm not sure if this is strictly HIPAA or agency interpretation. Best to check with agency policy. They probably made it clear on hire.

[Becareful]

Don't be mean. Lead by example. Stay busy so there is no time for extended conversations in patient care areas. Sounds like she is just lonely.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I actually love animals...particularly those awesome moments caught on video! But when it comes to looking at photo after photo after photo of them, especially at work, my response is "Sorry, I don't do the animal-thing".

[SpankedInPittsburgh, DNP, RN]

Repetitive pictures of a cat?!?!?! Honestly, tell cat-lady you have no interest and to find other cat-ladies to bore. I know many of you think this is rude but I think it's rude when people invade your personal space and try to bore you to death with things you could care less about. I've worked with people like this before and I believe that bring all of this non-sense with them to work because nobody on the outside cares. Tell her to look for a cat lady support group and get on with life.

[JKL33]

I'm not the most savvy person re: HIPAA. But it seems to me that I do need to know at least the basics about patients on my ward even if I'm not assigned to them. And if an emergency comes up, I think it is helpful to have the basics in mind. Name, Room #, Diagnoses, any bad labs, POD 1 appy or whatever. I don't need all of their intimate personal face sheet info - address, next of kin, insurance.

Is what I have stated appropriate and lawful with regard to HIPAA for all workers to know? If I'm going to cover for someone's break I will need some info about the patients, or if I am walking by and the call light goes on, I am going to go into the room and see what they need if at all possible, (not rushing to a known emergency, for example).

Thanks.

Hi Kooky -

Just wanted to echo Katie and others regarding what employers might say we need to know. Within the law, they are allowed to make policies that are more stringent than the general "Minimum Necessary" guidelines of HIPAA. There is wide variation - - but the crucial thing for you to know is your own employer's guidlelines, in which they likely conflate (and even confuse) their "Privacy Practices" with HIPAA. I would add that your own specific manager's interpretation plays a part. They are the ones who either educate the privacy people or conversely make a big issue out of whatever the alleged violation is. For example, let's say on a given unit, orientees and preceptors frequently review the charts of a patients they cared for yesterday or last week, for the explicit purpose of allowing the orientee to "follow through," review care previously given, and see how it fits in with the patient's subsequent course of care. There is nothing wrong with this and it is explicitly allowed by HIPAA last I digged around and checked. So if the "privacy people" make an issue, the manager says, "you're wrong and please don't bother us any more with this. HIPAA allows us to access information for educational purposes." So there...the problem goes away. But if you have a manager who is one of those types of people who feel better by getting others in trouble, there will be issues where there really are none.

The best "unofficial" rule of thumb I go by personally is that you/we/I should never find ourselves perusing a chart "merely for the sake of curiosity," nor should we be in any chart for reasoning that we know good and well we can't "defend." Next, we don't talk about information or give it to others who don't have the reason to know it that we have and don't have their own legitimate reason to know it. These things are the spirit of HIPAA.

Until you know the minute details of what your employer expects, be careful with the idea that every nurse can look at whatever we want because a patient is on our unit. I'm not saying it's wrong, I'm saying it's a frequent situation where the employer's idea of 'need to know' may be more strict than what we believe is necessary. And they can kind of defend it: We actually *need* to know less about that particular patient than we think we do, to intervene in basic/common situations. If I go in a room and silence/troubleshoot an IV pump, I really don't need to know much from that chart. I can see what's hanging, I can see what the IV site looks like, I can look for obvious pump issues. I can put the infusion on hold and call the RN responsible. Or if I happen by a room and see someone in distress - lets say a respiratory issue, I call for help while doing initial basic interventions. If I answer a call for toileting and the patient can't tell me what kind of assistance they usually require, this is not an emergency and I will call the patient's RN/tech and find out how to handle. Etc.

***

All of that said, I pay no mind to what others are doing with charts for the most part. Reporting coworkers for HIPAA violations just because we don't like their general behavior or what they do with the information (such as the case in the OP) - - meh...I've been doing this long enough to know it's going to come back to bite. A situation/culture where everyone reports each other willy-nilly for quasi violations hurts everyone. Including patients.

[JKL33]

This gal actually has a full-time job elsewhere, and is working two days a week at this facility. I used to work at her other job and I was going to ask around.

I wouldn't. She may be annoying, but you don't want to be "that person," either - - which can be just as bad as the original annoying behavior. If this is your per diem job then you're in the ideal position - - the one where you float in and float out without becoming entrenched in, and bogged down by, all of this kind of nonsense.

Is there a "cat video" or "cute-but-annoying-video lover" on every unit, or what? I guess there must be. I have about a 15-second tolerance for such. I smile, chuckle, whatever it is that will make the purveyor not feel rejected, and then say, "okay...gotta chart now" and literally turn away. If I don't think that's gonna work for whatever reason, I pull out my work phone and step away as if they have inadvertently caught me right in the middle of something. Sometimes, if I know the "video behavior" is an issue but I haven't directly encountered it...when they come my way I will smile/laugh and say "sorry, don't do videos...." or something similar that is lighthearted. Then I look for other ways to make the person feel accepted, such as helping them with patient care if I know they need it, or asking if there's anything I can do to help them. In other words, I don't entertain the behavior, but I seek to not reject "the person." This is important, I think, because most of us have idiosyncrasies for which we wouldn't want to be rejected.

I am straighforward when it's important. "_____, I understand that you wanted to help by making your suggestions, but when you talk like that in a patient's room it can be confusing for the patient, since I've already made a plan with them that you don't know about. If you have a suggestion about something I'm doing, we'll need to discuss it outside the room unless it's an immediate matter of life and limb."

[djh123]

We have 'one of those' where I work ... a little different, but 1) knows everything, 2) works harder/better than everyone else, 3) whatever happens to HER is more important than whatever happens or is going on with any of us other meaningless peons, 4) is bossy, 5) often angry, complaining about trivial matters ...

[Purple_roses]

This reminds me of Andy Bernard from The Office!

[theatretonursing]

I legitimately and sincerely pray I never end up working with a person like you. You sound like a Mean Girl.

[SpankedInPittsburgh, DNP, RN]

I'm not sure what was said that has somebody being labeled a "mean girl". I'll admit to not knowing or really caring what a stage director does so if that makes me inferior in your judgement oh well. I also refuse to look at endless picture of cats, dogs, significant others, kids..... I don't go to work to do that. I actually go to help sick people & I actually do. It's not "nice" to let these people Shanghai you. It's codependent and it robs time from your patients or at the very least robs you of emotional energy to deal with patient needs