Someone in my charts....

[Maevish]

I'm a traveler for the time being, but I've never had this problem before (on staff or traveling): This is a really small ICU and there're only ever two of us here at a time so it's been an adjustment (no legal breaks, no help, etc), but one thing is really starting to irritate me.

With the exception of two people, the nurses I work with are always in my charts. This is one of many examples I could give....A coworker refused an admit because he had a "newly extubated pt" (he was stable and had been since extubation about 14 hours prior) so whatever. I was a bit annoyed, but said nothing and took it. Then he got bored, I guess, and I see him scrolling down a progress note that belongs to one of my patients.

I'm pretty sure this isn't right so I asked him if he needed anything or wanted to take the patient. He was clueless at my passive aggressive play:inlove: and said he didn't want the pt, but kept on browsing the chart. I asked him to get out of it, please, and he did, but has continued to do it this whole contract so far (except tonight). This is only one incident and it's not just him, but I've never thought of going through someone's chart just because I can. If I'm not breaking someone and giving meds or helping with an admit, I don't see what's so hard about minding my own business.

This was a bit of a vent, but I thought that was a HIPPA violation as the nurses didn't have anything to do with the patient care of my patients at those times. I was thinking of reporting it or at least telling the manager (on my last day lol), but I want to make sure I'm not going overboard. I've never had to even think about this before cause it was always legitimate, either I was in someone else's chart because I was passing meds or vice versa.

Now, this place is SUPER slow (not a real ICU...I've only ever seen 2 vents since I got here and they weren't mine lol) so I get the boredom, but I didn't think it was ok for people do to this. Watch YouTube videos or practice your British accent, or troll Allnurses.com, just stay out of my charts!!

xo

[Shenurse67]

I worked in a small 4 bed ICU on an Indian Reservation. We did often read each others charts and were generally updated on each others patients because we were so small and had to have each others back. I believe it is considered a "Therapeutic Group" in a situation like this and therefore would not be considered a Hippa violation. Not certain but pretty sure. They should however not be reading charts of patients in the hospital that are not currently in the ICU. That is asking for big trouble!

[Maevish, ASN, RN]

I think this is the crux of the issue. In some small units, there is a reasonable expectation that you will provide care for any/all of the patients in your unit. For instance, in my ER, we provide care for one another's patients routinely, either because the primary RN is in another room, on a break, tied up on the phone coordinating a transfer, or any number of reasons- and we don't have a Charge, because we are so small. When a physician needs something done right this minute, and the primary RN is unavailable, whoever is available jumps in and provides the needed care. Whenever administering a medication or providing an intervention, understanding the rationale and any unique patient characteristics (i.e. whether the patient is opiate naive or on long term opioid therapy, whether the patient is unsteady on their feet at baseline, whether the patient has residual deficits from a previous CVA, etc) is pretty important, in my opinion as a professional ER RN.

I've caught some medication errors before they happened, because the physician placed an order on the wrong patient (easy to do with Epic, if the physician has the wrong window open, is in a hurry, and does not double check), caught only because the order didn't make sense for that particular patient. Had I not known anything about that patient, the medication would have been administered.

So, the question is whether this is the case in the original post- that RNs frequently provide care for one another's patients, and so knowing some basics about every patient in the unit is essential. It doesn't sound like this is the case, which I agree would make accessing the charts inappropriate.

I still think it would behoove the original poster to ask the other RN why they are accessing charts for patients that are not under their care. Is it possible that there was an event in the past, such as a Code Blue that went bad, and this RN thinks it's important to keep tabs on all of the patients for safety purposes?

My whole post I just wrote got deleted:mad: so I'll try again. I had always read the HIPPA stuff as, if you're not providing direct care in any way, it's illegal to be in another chart. The main culprit has gotten out of them a few times when I asked, but kept on doing it in most cases. However, the state is here so maybe that's why I haven't noticed it as much lately.

The guy nurse who does this is also a traveler who's been here the same amount of time as myself so him checking up on me doesn't fly. Also, they're all logging in under their own names and not using my info to do it (if I'd left it open or something) and there are no audits going on since I've been here. The manager said my charting is good so I really don't know why this goes on.

It makes me really uncomfortable and it's something I've never thought of doing (because I have an aversion to prison time) plus, I'd thought the HIPPA laws were pretty clear. It's clear that other nurses don't see it the same way, though, so I just wanted to make sure I wasn't being over sensitive. Unless I'm actually giving a med for someone, charting something, doing an audit, or am the charge/resource nurse, I don't go in other charts and this is the first place I've been to where it's a pretty regular thing.

I appreciate the input though, and since I don't want to go to the manager with this I'm going to call my recruiter and see if he has an idea of the best way to go about reporting this. On the other hand, if the state will be here until the end of my contract, I may not have to say anything because since they've been here it's only happened once.

xo

[Anonymous865]

My whole post I just wrote got deleted:mad: so I'll try again. I had always read the HIPPA stuff as, if you're not providing direct care in any way, it's illegal to be in another chart. The main culprit has gotten out of them a few times when I asked, but kept on doing it in most cases. However, the state is here so maybe that's why I haven't noticed it as much lately.

The guy nurse who does this is also a traveler who's been here the same amount of time as myself so him checking up on me doesn't fly. Also, they're all logging in under their own names and not using my info to do it (if I'd left it open or something) and there are no audits going on since I've been here. The manager said my charting is good so I really don't know why this goes on.

It makes me really uncomfortable and it's something I've never thought of doing (because I have an aversion to prison time) plus, I'd thought the HIPPA laws were pretty clear. It's clear that other nurses don't see it the same way, though, so I just wanted to make sure I wasn't being over sensitive. Unless I'm actually giving a med for someone, charting something, doing an audit, or am the charge/resource nurse, I don't go in other charts and this is the first place I've been to where it's a pretty regular thing.

I appreciate the input though, and since I don't want to go to the manager with this I'm going to call my recruiter and see if he has an idea of the best way to go about reporting this. On the other hand, if the state will be here until the end of my contract, I may not have to say anything because since they've been here it's only happened once.

xo

You don't have to report a possible HIPAA violation internally. You can report your concerns directly to the Office of Civil Rights. They are tasked with investigating HIPAA violations.

Filing a HIPAA Complaint | HHS.gov

Your complaint can be filed online.

[Njtex99]

This is true. I work in a military hospital and I'm not even allowed to access my own profile as I was military and a dependent wife for about 20 years altogether. I could fired for HIPPA violation even though it's my private information.

[MilliePieRN]

I work in a small Icu and I often see the need to look at charts. Say a critical gtt is running dry and the primary nurse is busy... I'm not going to hang anything that I've not checked myself. I'll check the emar for the active order and sometimes click on the MD's progress note to see the plan for the med/pt. I feel it's good to know what's going on with other critical pts in case of emergency. Our tele monitors are in the unit and if someone has a weird rhythm, I'll look through the chart and see if there is a history of it. I'm sorry, but sometimes it's better to check for myself than to just rely on the floor nurse to find the time. I can see many reasons for looking at pt charts that aren't hipaa violations. Not just being nosy...

[Ruby Vee, BSN]

I work in a small Icu and I often see the need to look at charts. Say a critical gtt is running dry and the primary nurse is busy... I'm not going to hang anything that I've not checked myself. I'll check the emar for the active order and sometimes click on the MD's progress note to see the plan for the med/pt. I feel it's good to know what's going on with other critical pts in case of emergency. Our tele monitors are in the unit and if someone has a weird rhythm, I'll look through the chart and see if there is a history of it. I'm sorry, but sometimes it's better to check for myself than to just rely on the floor nurse to find the time. I can see many reasons for looking at pt charts that aren't hipaa violations. Not just being nosy...

Those are legitimate reasons to look in a patient's chart.

We got HIPPA because we (the collective "we" of nurses everywhere) were just a bit too free with looking up and sharing information. If we had used common sense and a bit more ethics, it wouldn't have needed to happen.

[Steffy44]

It's a HUGE HIPAA violation and I'd turn him in. If he'll go through your charts with you standing right there who else's records does he go through. If I need to give a med for a busy nurse I can slip a note in the chart starting this so if there is an audit they will see why I was there.