Theoretical Situation

soliant12 · Jul 3, 2006

Why not? A physician is obligated to report a seizure disorder to the DMV. I would imagine they would be obligated to report it to the BON.

jetsetter · Jul 3, 2006

I don't think so. We just had this happen were I work, after d/c, she went to rehab. As long as she's not intoxicated/whatever AT WORK, I think hippa protects her.

Jolie, BSN · Jul 3, 2006

Sounds like a question for the hypothetical hospital attorney.

sheldon09 · Jul 3, 2006

I don't think so, she is not caring for a patient, she is patient, therefore, I think she should be protected under HIPPA as a patient.

subee, MSN, CRNA · Jul 3, 2006

Let's say an RN has a severe drug addiction (by her own admission) and one day she O.D.'s in an attempt to kill herself. She ends up in the local ICU of a small town hospital where alot of people know her.
If the nurses/doctors/hospital caring for are following HIPAA guidelines, can they report her to the BON?
This question is NOT about whether she should be reported, but if by following privacy guidelines she can be reported.

You say an addiction "by her own admission". When was the admission made - before she was admitted or during the admission? If the admission of addiction came about as an admission for a suicide attempt, then she cannot be reported. However, by the time an addict attempt suicide, there have been lots of signals that a serious problem is going on. Certainly the psychiatrist caring for her needs to know that peer assistance is out there and available to the nurse. Then the psychiatrist or someone who is close to her can encourage her to voluntarily surrender her license so that the pressure to work is off while he/she is in early therapy. The problem as presented is one of confidentialty. There's a lot of ways to get this nurse on the program without a member of the nursing staff violating her right to confidentiality.

ZASHAGALKA, RN · Jul 3, 2006

That was not such a theoretical situation where I worked once.

While it is, as you suggest, quite IMPOSSIBLE to maintain any semblance of 'privacy' to his peers, who have eyes and ears, it is my understanding that 'official' privacy was maintained by it not being reported.

Of course, that was aided by that nurse immediately resigning their current position. The hospital was not put between the rock and hard place of choosing that pt's privacy OVER their workplace integrity.

~faith,

Timothy.

chadash · Jul 3, 2006

That was not such a theoretical situation where I worked once.
While it is, as you suggest, quite IMPOSSIBLE to maintain any semblance of 'privacy' to his peers, who have eyes and ears, it is my understanding that 'official' privacy was maintained by it not being reported.
Of course, that was aided by that nurse immediately resigning their current position. The hospital was not put between the rock and hard place of choosing that pt's privacy OVER their workplace integrity.
~faith,
Timothy.

very admirable, all involved.

steelydanfan · Jul 4, 2006

The straight answer is, no they cannot.

Unless they have concrete evidence, stemming from before the suicide attempt that the addiction put any pt. in harms way, then all that happened before is moot.

I would imagine that if she was showing up to work under the influence, behavoir and nursing care have been suspect for some time, and an investigation was already underway.

However, some addicts do well until the crisis point, when they have a MAJOR meltdown, ie, a suicide attempt.

In any case, intervention and treatment become the key.

EricJRN, MSN, RN · Jul 4, 2006

Would just like to add that your state board of nursing can in some cases be a big help in these situations. Many boards have posted position statements on their websites. For example, here's the one that addresses the above issue from the Texas BNE:

http://www.bne.state.tx.us/faq-practice.htm#UInfluence