I need some opinions. The other night I was helping out in PACU. (I am usually in ER or Preop, but occasionally go to PACU when needed) I was asked by another nurse to transport her patient upstairs. The patient was early 30's female, very nice, always saying thanks when people helped her. We talked as I took her to her room. She had surgery for a cancer recurrence, so we talked about the surgery, her young kids, her family, etc. It was shift change, so I ended up having to wait with her for quite a while to see her nurse, the PACU nurse has to have face to face time with the receiving floor nurse. During this time we chatted some more. Then I left when her nurse got there.
The next day I was off. I was thinking about this patient and how nice she was. I called her room to check on her. I just let her know I had been thinking about her, and asked how she was doing...get well soon, etc. She seemed very appreciative.
A few days later I told her PACU nurse that I had spoken with her. This nurse was very offended with me and said I had broken HIPPAA (sp?) laws by calling the patient to check on her. Is this true? I just thought I was being nice. When I had my daughter, the L&D nurse called the next day to check on me. I know hospitals can be lonely places and thought one might like to hear a friendly voice and know someone was thinking of them.
1) the patient wasnt her patient, she was asked to transport her upstairs, thats all.
if transferring patients requires a r.n.,or l.p.n. as it does when patients leave pacu, then physical and mental monmitoring is required to identify possible problems. i think that we should take the example that the u.s. reform of health care act identified, that mental care is as important as physical care (the head being connected to the body). therefore, rachelita was that patient's nurse.
2) she called from her home, on her day off to the patients room, uninvited. if the patient had asked to stay in touch it would be different, if they had met in the hall, it would be different, but to call from home....i am sorry but in this day and age, it is weird and not recommended. if the nurse wanted a connection, she should have asked the patient, would you like me to call on you tomorrow...
patients leaving pacu are often groggy and may not say all they would like to have said, like invite a nurse to call.
we really are making more of this than it deserves, i think. there is nothing weird about a nurse wanting to check on a patient's progress the next day. doctors call patients from their homes (uninvited to do so) - sometimes just to be nice, show their concern - so why shouldn't we?
3) i would agree that no hipaa laws were violated per se, but it is certainly unusual. while she was just being nice, and we all agree that she was, sometimes the best intentions....
4) lastly, what was she trying to do by telling the pacu nurse that she followed up contact? was she boasting? was she trying to make an impression? if she had done it to be nice, than why bring it up to the pacu nurse?
just a humble opinion, nothing more.
#3 is the crucial error that she made. it's an example of how we must tippy toe among our colleagues to see what state of mind they have, before entrusting them with any information about us.......i would guess that rachelita had no idea that the regular pacu nurse would react in the way she did, or she wouldn't have said anything. i think she was making conversation, possibly raising her telephone call to let that person know that she thought about patients after caring for them, and let them know that....
Specializes in Peds/outpatient FP,derm,allergy/private duty.
lamazeteacher i also zeroed in on the dx of recurrent cancer in the mother with young children, just happen to be hearing of a few too many of those in the last few months. this topic is certainly one where i can honestly see truth in everyone's perspectives. so much of it would depend on the unique interaction between the op and the patient that none of us saw or heard. the boards strip alot of the subtlety of tone, inflection and gesture out of our communication when in a case like this they can make all the difference in the world.
excellent creative use of the smilies. i'm still saving "i made a boo-boo" for the really nutso off-the-wall post i am sure to write at some point even though i am a night owl at the moment.:)
#3 is the crucial error that she made. it's an example of how we must tippy toe among our colleagues to see what state of mind they have, before entrusting them with any information about us.......i would guess that rachelita had no idea that the regular pacu nurse would react in the way she did, or she wouldn't have said anything. i think she was making conversation, possibly raising her telephone call to let that person know that she thought about patients after caring for them, and let them know that....
or could it be that she knew what she had done was questionable and wanted validation for having done so. same as many people do after they know what they have done was wrong and need someone to tell them its ok. there may be many reasons for her actions and we are simply trying to demonstrate how a wicked district attorney and a civil lawyer can raise doubt and cause her pain and suffering. in the future she needs to err on the side of caution.
or could it be that she knew what she had done was questionable and wanted validation for having done so.
if we know what we did was possibly wrong, most of us would tell someone to whom we were closer, than a pacu nurse who we worked with once, someone whose opinion we respected..... who was a nurse with experience and expertise we admired.
same as many people do after they know what they have done was wrong and need someone to tell them its ok.
if you knew what you'd done was wrong, it wouldn't help to have someone tell you the opposite, unless you dwell in a world wherein only what others think, is valid.
there may be many reasons for her actions and we are simply trying to demonstrate how a wicked district attorney and a civil lawyer can raise doubt and cause her pain and suffering. in the future she needs to err on the side of caution.
it wasn't that big a deal!! let's give this a rest, for heaven's sake.....
Something for the OP to think about here: Considering the breadth of opinions here, what if your supervisor, DON or HIPAA compliance officer is one of those on the end of the spectrum considering your actions grossly inappropriate? All of those posts saying you did nothing wrong will make no difference. Why open yourself to that possiblility? Stay well within the parameters of "acceptable behavior" and spare yourself the trouble.
What happened to being human? You made a connection and probably made that person feel your caring. You did not access her medical history, personal demographics, or other information. You spoke with her and expressed your wishes that she was recovering. No HIPAA violation.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
I know some nurses will attend the funeral of a patient who has died, because they made a connection with that patient and/or their family over the course of their hospitalization or residence in a LTC facility. I personally don't see that as crossing any boundaries or violating any laws.
I think that nurses are, by definition, caring people. That means that nurses are caring AND they are people. Sometimes you connect with someone on a special level, just as a result of your compatible personalities. Had you met at a PTA meeting you would have been friends, but you just happened to meet in your place of employment, which just happened to be a medical setting with this "special law" situation. When I go for my annual pap smear, my midwife HUGS me right there in the exam room. :eek: I don't feel stalked or violated... I feel cared for and cared about.
I think we need to give the OP the benefit of the doubt that she felt that her inquiry would be welcomed by the patient. The OP didn't "just transport" the patient -- she spent a considerable amount of time with her and conversed with her at some length:
The patient was early 30's female, very nice, always saying thanks when people helped her.
We talked as I took her to her room.
She had surgery for a cancer recurrence, so
we talked about the surgery, her young kids, her family, etc.
It was shift change, so
I ended up having to wait with her for quite a while
to see her nurse, the PACU nurse has to have face to face time with the receiving floor nurse.
During this time we chatted some more.
Then I left when her nurse got there.
I do agree that the OP needs to check on any rules that are specific to her facility, but I also think we need to give her the benefit of the doubt to know when she has made a special connection with another human being who could use just a little bit of TLC at a very trying time in their life.
I appreciate all the replies to my post. I was totally not trying to do anything stalkerish or creepy. I usually do not have the opportunity to just chat with a patient. And this patient was my age, had a child with the same name as mine, and was worried about her kids and her ability to continue to care for them, which I probably overempathized with. I have never called to check on a patient before, so I was definitely guilty of playing favorites. In retrospect I can see that is not acceptable, however, it is very human.
When I was hired by this hospital, I had to take an entire day and sit in front of a computer reading every single policy and procedure that could possibly pertain to me. So, I know my actions were not against a policy. However, after reading all the comments, I guess I did over cross the boundaries.
Let me pose a question. some of my colleagues have pursued "business relationships" with former patients. For example, with the dentist who tore his ACL during a triathlon, an RN and CNA now go to him. I know a nurse who found her vet after he was a patient. A friend who is a floor nurse told her patient about a fender bender she had on the way to work. Then she went to the patient's husband for a deal on body work. We live in one of the biggest cities in the US, so there are hundreds of dentists, vets, car repair shops. Is this boundary crossing as well?
Anyway, thanks again for all the input from everybody. I will be more mindful of professional boundary setting from now on. I just tend to empathize and picture myself or my Mom or my Grandma in the patient's position. In a way this is good because I treat them how I would want to be treated or how I would want someone to care for my beloved family member. It has never gotten in the way of providing top quality nursing care. However, it may make me in a way care too much and take work "home with me". I will try to be more professional in the future.
Actually you should be praised at going above and beyond the call of duty. It's these extra little things that makes a place a great place to be a patient at and for the staff to work at.
Specializes in Med/Surge, Geriatrics(LTC), Pediatricts,.
gusblom does hit on a good point, as much as we don't wish to admit it sometimes, male nurses are treated much differently than us females. And if a female nurse stands up for herself, and shows some back bone, then she's chastised. On this thread and others like it, I still contend, check your facilities policy/proceedures, you can never go wrong with abiding by them no matter how rediculous you may think they are. It's not paranoia, it's abiding by the rules. If you don't like the way things are, then, in the correct manner, request to be on the committie to change things. Remember, all these things aren't written in stone, they are on paper. And as long as you stay within the guidlines of the legal realm of things, then it'd be ok. But, also remember, rules were made for a reason, and the reason usualy is or was that something happened that a particular rule had to become a policy. And having experience writting policies for a facility, the policies and proceedures are done so with the advice of legal council.
One thing I find when I'm orienting a new nurse, fresh out of school, the young ones, 18,19,20 year old range, and I'm not bashing anyone here, I know not all younguns are like this, but the majority of those whom I've oriented, want to know the "shortcuts" to get the job done. In our profession you can't take short cuts or cut corners and still advocate for the patient. And the young nurses in this bracket, want to take the shortcuts so they can "have more time to spend with the patient." I know this is a bit off the track here, but, it does bring home my point of always follow P/P's. If it's your facility's policy that it's ok to contact the pt on your free time, then go for it, but if you have to ask if your actions were inapproprate, then refer to the facility "Bible" the P/P book. If you don't like a policy that is in place, find out why it's there in the first place, that may make a difference on your opinion of it, and like I said, go about change in the correct manner, don't go freelancing. That's what get's us all in trouble and thus creates those policies we don't like.
rachelita did check the hospital's policy, and saw nothing in there that contraindicated her telephone call to a patient about whom she cared. I doubt that any hospital does have a policy forbidding that, there are just nurses who are over critical and get bent out of shape easily.....
We also need to keep in mind that nurses compose a team, need to answer the call bells of patients to whom they are not assigned, etc. Now if rachelita called the patient the day after she responded to her bell/call system, and had only slipped a bedpan under her, and did/said nothing else........
We all need to accept that most of us have human frailty and can occasionally "open mouth and insert foot", which I think was the only thing rachelita could have not done, with no resultant problem.
Specializes in Med/Surge, Geriatrics(LTC), Pediatricts,.
Ok, then no problem, if she checked her facility's policy, and no problem there then no issue re inappropriatness. But for discussion, it does seem quite a few new nurses for some reason don't check the policy book for anything, would rather as a coworker and take their word for it. I know it's a big and bulky book that's more than likely going to have pages fall out when you take it off the book shelf in the nurses station, and will get the Unit Secretary up in arms toward you, but who cares? You will if for that one policy you wing it, and end up being wrong, and brought up on charges, and loose your license, or job, or both. Yes, you can label me as paranoid, I worked to hard to get my license to take my job lightly. I do care for my patients, and I care for myself as much. If I don't take care of myself and my license, how can I take care of my patients? And yes, some facilities do have policies in place that forbid calling patients, either in the hospital or who have been discharged home, on your free time. They are there for reasons, and if you want to keep your job, have to abide by the policies. Smaller communities where the patient is possibly a relative of yours, or your neighbor, that's treated a bit differently. But if you are in a hospital where the facility is so big it has it's own zip code, then it does become a privacy issue. If the patient needs care after going home, that's what HomeHealth care is for, Nurses who are just as careing, and do their jobs just as well as Hospital Nurses.
i'm still saving "i made a boo-boo" for the really nutso off-the-wall post i am sure to write at some point even though i am a night owl at the moment.:)
:eek:
lamazeteacher
2,170 Posts
#3 is the crucial error that she made. it's an example of how we must tippy toe among our colleagues to see what state of mind they have, before entrusting them with any information about us.......i would guess that rachelita had no idea that the regular pacu nurse would react in the way she did, or she wouldn't have said anything. i think she was making conversation, possibly raising her telephone call to let that person know that she thought about patients after caring for them, and let them know that....