What would you have done?

[NJNursing]

Ok we had this patient the past 2 weeks. He's a professional athlete who had a of things go wrong during his admission. As charge nurse (and for the first week or so I knew nothing about him other than some people relayed to him as a PITA) I felt compelled to help smooth things over. So last week I went in to introduce myself and try to make his stay better. Everyone (administration included) were bending over backwards for this guy, so needless to say I payed extra attention to him to make sure his needs (physical, emotional, etc) need were met and he's really a nice guy and I enjoyed talking to him. He's very far from home and it's the holidays. He had a lot of people's cell phone numbers (mine included in case any issues arose when I was off - i'm the only 'official' night charge). On saturday he called me up (my day off) and asked if I could pick him up and take him to his hotel as his kids (early 20's) had gone to get airline tickets and he wasn't anticipating on the discharge. I was already out shopping and in the area and the hotel was about 1.5 miles away. I said yes. I picked him up, asked him how the last few days had gone and if he had felt better. He said he was and was glad to be going home.

Cut to Christmas Eve. My director calls me at home saying she wants to have an extensive meeting tomorrow morning. Do you guys think I was over the line? I felt like I was helping both my unit and the patient and avoiding issues all the way around. It was my day off, so it's not like I was on the clock. I'm so worried now about getting my tail chewed off that I haven't slept since Christmas eve and I'm having terrible GI distress.

[mom2michael, MSN, RN, NP]

Here is my opinion for what it's worth.

As long as every person who walks thru that door gets the same treatment down to personal cell numbers....who cares right??? But what is good for one needs to be good for all. If one isn't willing to always give out their cell # to everyone that walks thru the door, the cell # needs to stay private.

As far as the info disclosed - less is usually more on a public forum such as this.

I work in a very rural area, most of the people know me and my family. It doesn't change though the legal side of it and if my manager says no, then the answer is no. I work in a small rural ER and believe me, I have come up with some very creative ways to get people where they need to be (we have no taxi and no bus service and police who aren't always will to help out when we need them). But I would do the same for my neighbor as I would the drunk homeless man who wandered in off the street.

And I agree, being a nurse is more than just passing meds and charting assessments but lines are made for a reason and some are just not worth being crossed no matter how good it makes you feel.

Edited to add: I think management was a bit harsh with the OP espeically if this was the 1st offense of such nature. They thought they were doing a good thing for the hospital and smoothing things over....it was an error in judgement that I doubt will be made again.

[shellsincanada]

I somehow doubt you know who it is based on that little bit of info. Do you know how many extreme sports athletes there are out there? Hundreds. I never said which extremem sport (there's tons - skateboarding, motocross, skiing, snowboarding, wake boarding, rock climbing, cliff diving, parachuting and so on and so forth....). To be able to pick one out of the hundreds (if not thousands, I don't know I don't follow the sport) is ludicrous.

And thanks stevielynn. Yes, I went above and beyond for this person, but I had done it for others too. We had a truck driver a few months ago from a southern state with a broken leg. He didn't have a lot of money and before he left I picked him up a phone card and I had called his wife from MY cell phone and spoke to her at length and with the patient because he was homesick and she was missing him.

Other nurses have taken patients home if family couldn't come and it was either a) not far from the hospital or b) on their way home. To me that crosses the line more than if someone came in on their day off like I did.

I'm still really irritated about the whole situation. I did the same as everyone else in the hospital had done (including higher up administration - like our CEO!) but I seem to be the only one getting reprimanded for it. I don't know if it's because I'm the low nurse on the totem pole in this whole chain of command or what. Who knows. It's certainly a learning experience and has kind of soured me a little thinking I don't ever want to go "above and beyond" for ANY patient ever again lest I get chastised for it.

I think it is quite possible that they would know who it was. Sure there may be 1000's of people who are in the same high profile feild, but how many would have been hospitalized recently in your state? how many are from the state you said he was from? you mentioned other things like children etc. all these things along with other health related info is screaming who this could be. Like others have said- yes it could be identifiable especially if you are interested in the sport he is in.

[shellsincanada]

oh and also if the fact that you may have revealed this person's identity doesn't scare you - think about how you have also revealed WHO you are in terms of if your hospital/board of nursing could figure out who is posting this info( you say you are the only one in trouble for this vip treatment) Just think of what happened when george clooney was hospitalized and hippa violations happened.

[Bella RN, BSN, MSN]

I believe that you are a kind hearted soul and did not mean any harm in helping that patient. But your argument in your meeting if this happens to come up is that not only yourself but other adminstrators went beyond their call of duty by giving this VIP their personal numbers. That is not neccessary at all.

I personally would have declined assisting him, not to say that your deemed "bad" or "wrong". Let them know in the meeting that you wanted to make sure that you were trying to emphasize an act of kindness to someone who may have some troubles--but after the incident you have given much thought and acknowledge that boundaries have been crossed.

I would also ask them if a celebrity is to be admitted to this facility again--is it okay for administration to hand out personal numbers to that particuliar client;and if so how is that justified???

That is my two cents--Enjoy your holidays. You will be fine!! You should not be written up for that, but she will definitely discuss it with you.

[Valerie Salva, BSN, RN]

Thats how it is here, too. (rural) We think nothing of giving our patients rides home, taking paperwork to them that they forgot to sign or special instructions, etc. Most of our patients are my neighbors or go to my church. How can I say no if one asked me for a ride? I already know them, or know them quite well from being in the hospital so many times over. (we get the same patients over and over.) Most of the patients know where I live, I know where they live, same with the doctors. They are also listed in the phone book. I can't imagine telling them no if they asked for a ride! They would give me a ride if I needed one! Many have offered when they saw me out walking with my dd if it was raining or whatever.

I have worked in a very rural area, and it is a whole different ball-game. There are things that are fine to do in a rural setting that are a huge no-no in a metro area, and can get you in a lot of hot water in a big city.

The whole dynamic is different in a small, rural area.

[NJNursing, ASN, RN]

oh and also if the fact that you may have revealed this person's identity doesn't scare you - think about how you have also revealed WHO you are in terms of if your hospital/board of nursing could figure out who is posting this info( you say you are the only one in trouble for this vip treatment) Just think of what happened when george clooney was hospitalized and hippa violations happened.

Well George Cloony was a different situation all together. People who had no business being in his medical file were accessing it just for the sake of curiosity and those people were just blatantly violating his rights. With the pt I had, all personal info (SSN, home addy/phone #) were omitted out of the computer system on purpose because of that whole George Cloony issue. And for people who accessed his computer charting had a prompt and had to put in a reason why they were accessing it and it was being double checked against who actually had direct patient care with him.

I still don't think it was too much info. NJ has hundreds of hospitals and celebrities are in them all of the time - it's just that no one knows about it. And I tried to google the info I had posted (extreme sports, kids, state of origin) and nothing came up anywhere close to who my pt was. I did double check myself and felt confident enough that never in a million years could anyone know who it was unless it was someone who actually worked on my floor (which is a small floor). If I worked in a large metro hospital, perhaps I'd feel differently that more people would pop up here.

[rn/writer, RN]

It may not be "too much info" for total strangers starting from scratch. But what about co-workers who find their way to this site? Last year, the moderating staff had to come to the aid of a nurse who had chosen this forum to vent in. She posted about a situation on her unit that she felt was unsafe. Nothing had happened yet, but she thought the potential was there. She actually posted less information (and less incriminating information) than has been deleted from this thread, and she still ended up in a lot of trouble.

A co-worker recognized enough from this nurse's posts to peg her as the "culprit." Management was not happy to find she'd been airing the hospital's dirty linen on a public forum, and she was very nearly fired. We were able to help by removing the entire thread from view (which her supervisor was able to verify) and changing her username so that she would no longer be recognized by the co-worker. She was shocked that she could almost lose her job over something she viewed as innocent venting, but this site is a popular one and she had no idea that people she knew could come here and recognize her.

It's best to be as vague as possible when discussing patient matters. Focus on the specific matter in question and leave everything else out. Identifiers such as the hospital, the diagnosis (if not pertinent), the family situation, or anything else that might be used against you are risky at best.

One other thing--if other posters issue cautionary warnings, it's wise to listen and heed their advice. Confidentiality is not something any nurse should take liberties with.

[Kymmi]

After reading all the postings I have to ask the OP this one question...

If you didnt think you did anything wrong in the first place then why in your first post did you tell us about being called to have a meeting with adminstration and ask us if any of us thought it could be related to this whole incident??

I know when I think I've done something wrong then I worry however when I know I've done nothing wrong and I get called to adminstration I do not think about anything I thought I did right being the reason to be called to adminstration.

[NJNursing, ASN, RN]

I was called to have a meeting with my director. She called me at home on Christmas Eve saying she wanted to have a meeting. At first I thought she wanted to discuss the new orientee I just got off of orientation, but then I thought about it some more and figured it was related to that patient and then I started to think back on what I might have done wrong because she didn't sound her usual happy self on the phone. That's when I decided to come here where I'd find more seasoned nurses who may have been in the situation in other places who might be able to relate their tales of wisdom or experience. And at the time everything had happened, in the moments, they seemed like the right things to do, the nice thing to do, the "PR" things to do to help turn someone's hospitalization around and end on a positive note.

[Jules A, MSN]

I still don't think it was too much info. NJ has hundreds of hospitals and celebrities are in them all of the time - it's just that no one knows about it. And I tried to google the info I had posted (extreme sports, kids, state of origin) and nothing came up anywhere close to who my pt was. I did double check myself and felt confident enough that never in a million years could anyone know who it was unless it was someone who actually worked on my floor (which is a small floor). If I worked in a large metro hospital, perhaps I'd feel differently that more people would pop up here.

Your "unless" is the clincher. I realize there is no convincing you posting all the info you did was inappropriate but I hope that students or other new nurses reading this will be mindful that anything that can indentify a patient is a violation of their rights. The other day I was lurking on this section of the board with over 400 other people! Use your critical thinking skills folks.

Like RN/writer wisely said:

"One other thing--if other posters issue cautionary warnings, it's wise to listen and heed their advice. Confidentiality is not something any nurse should take liberties with."

[caliotter3]

The fact that the OP continues to post reply after reply and does not acknowledge that they perceive the problems with their actions or that the confidentiality of the patient was compromised, indicate that they are not open to well meaning warnings. Continued behavior of this nature will be the downfall of this person. I would not want them talking about me on a public bulletin board and have seen people fired over much less. You can read threads about those situations in the archives. I am surprised that site admins did not pull the entire thread, as they have in the past. Boundaries and patient confidentiality are two very important concepts in nursing. When not given proper consideration, much harm can come about. I'm not speaking about the person who breaches boundaries and patient confidentiality losing their job. Sometimes that is a necessary consequence of poor judgement.

[babynurselsa, RN]

I would think that a professional athlete would have the financial resources to hire a taxi service. I feel that catering to celebrities and giving them personal VIP service from the nursing staff is unethical and unprofessional. It sounds like everyone was starstruck.

THis was also my thought. I would venture a guess that a professional athelete could afford to hire his own cab. I have only provided cab passes to persons who cannot afford or arrange transportation home. I guess I am thinking that this person could have waited for his kids to come back from picking up the airline tickets.

I will also reiterate that I don't believe providing personal cell numbers is in teh job description of a charge nurse. The only reason I would do so would be for personal gain, even if it was in the name of patient satisfaction. It would be kinda awesome to say that someone famous called me.....