The ethics and laws associated with keeping a personal diary

Nurses General Nursing

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Who here keeps a personal diary? Of those that keep a diary how much nursing stuff gets thrown in there?

I've been keeping a diary since June and I've been kind of scared to mention too much about my working life in there because of HIPAA, but there are just so many things that I think I'd benefit from writing down in detail so I don't forget them later. I'd also want to use names so that if, god forbid, I ever had to go to court I could look up the day in my diary and use that to jog my memory. I can write things in my diary that I can't write in the notes, if you know what I mean.

But at the same time I think that it might be a huge HIPAA violation for me to have a book with tons of people's medical information and outcomes in my possession. What if this book was ever found? Could I get in trouble for it? Or would my right to privacy to keep a journal of my own personal experiences that I was directly involved in supersede somebody else's write to medical privacy?

And for the record, this question is purely academic. I've been too scared to write anything too detailed about work or clinicals in my diary.

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Specializes in Oncology.

I keep a personal diary, and rarely does work stuff make it in there. If it does, first names, or nick-names only. I would certainly not use full names. If you have a law suit, you have your charting to jog your memory.

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To me I really don't see how keeping a personal journal is any different than writing a book about strange patient diagnoses or just patient stories in general. I read a lot of books regarding those topics and they always have a disclaimer that all names have been changed in order to protect the patient.

So unless you are writing down this patients family tree and mentioning their name in every other sentence and complete medical history I don't see how it would be a problem.

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To me I really don't see how keeping a personal journal is any different than writing a book about strange patient diagnoses or just patient stories in general. I read a lot of books regarding those topics and they always have a disclaimer that all names have been changed in order to protect the patient.

So unless you are writing down this patients family tree and mentioning their name in every other sentence and complete medical history I don't see how it would be a problem.

Good point, at my facility apparently it's not a hipaa violation to label med drawers or belonging lockers with the first three letters of a patients surname and first three of their first name. Maybe I'll do that. But this becomes a problem when your patients name is something like "Lee Wu" or something else short. But apparently nobody has brought this up. :rolleyes:

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When I was much younger, I always kept a journal. While I didn't write anything like what you're describing, I did use a sort of code or abbreviations that would only mean something to me just in case anyone else ever got ahold of it. Which turned out to be a good thing since I accidentally threw them into a dumpster with some other stuff a few years ago and my area is wrought with dumpster divers! :eek:

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Specializes in NICU Level III.

I journal. Don't really mention names and no one reads it. Sorry but the gov't isn't going to forbid what I express in my PERSONAL journal. It's my outlet and I've done it since elementary school.

ETA: I never put pt specifics in it, just things that I had a hard day at work, frustrations w/ ostomies, etc.

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Specializes in Med Surg.

When does possesing patient information become a HIPAA violation? When a patient is discharged, your knowledge of that patient doesn't go out the door with them. And as far as I know, they haven't yet come up with a method to erase a particular memory although I'm pretty sure someone is working on that. It only becomes a HIPAA problem if you transmit this memory or information to an unauthorized third party.

As far as keeping a diary, it would only become a problem if you showed it to someone else. Sooooooo, if you want to keep a personal diary with specific information in it, you need to be certain there is no way it will fall into someone else's hands during your lifetime. Just remember, nothing is as secure as you think. Just ask our state department.

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Specializes in Psych (25 years), Medical (15 years).

CNA_IN_ADN:

I've NEVER kept journals since the 70's. I don't give the Participants cute nicknames or draw funny little caricatures of them. I don't write humorous prose about circumstances pertaining to said Participants, either.

And if you say that I did, I'll deny it.

Dave

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I started keeping a journal this past year and I do include quite a bit of job related info in there but primarily as it pertains to me, not to the patients. When I do refer to patient's it's by initials or room number, never their actual name.

However, I will say that I once was deposed for court when a patient sued my hospital after falling and the hospital attorney did ask me if I kept a journal or diary where I would have written any information about the incident. He also asked if I had told anyone outside of work details about it and that if I had, they could be questioned about what I'd told them. At the time, I was able to truthfully answer no regarding the journal, but if I had I'm not sure what the impact would have been if I'd had one. I do know that the hospital forbade me from looking at the incident report from the fall as it wasn't part of the patient's chart and the attorney said if I viewed it they would have to turn it over to the patient's attorney as well. I would hope they couldn't force me to turn over a private journal but I don't know what the law actually says about it.

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Specializes in Nephrology, Cardiology, ER, ICU.

Bad bad idea to keep a journal where you mention, even in passing, even with nicknames anything about work.

If any issue/incident/care details go to court, you WILL be asked if you keep/have any notes regarding this and they WILL be admissable in court.

Again....bad bad idea.

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Specializes in Psychiatry.

This is a great thread! I've never thought about this. I have nothing to add, but I'm curious as to what everyone has to say about it.

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This is an interesting topic! In a legal lab, we WERE advised by a nurse-turned-attorney to keep a personal journal. In it, we could write down details of any event that may in the future cause problems. If deposed, we could better jog our memory about details that were not included in the patient record ... timelines, circumstances, conversations held, etc.

Of course, some protection of the patient name would be in place.

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