What and How Much Can You Tell to Patient's Family?

[CuteNurseUnl]

Once in a while, I would get a phone call presumably from a wife or son/daughter or even a friend (if the patient doesn't have anyone else) asking about the patient, sometimes asking about specific things. I'm always vague, but I would really like to know exactly what I can tell them without violating HIPAA. Also, if it's on the phone, how can I be so sure that it's really whoever they say they are?

[Esme12, ASN, BSN, RN]

Thank you so much everyone!

My unit doesn't have any formal protocols and these are all good ideas that I'm going to try to have implemented. What I've learned so far:

1) set up a type of password/code or pin number upon admission,

2) as well as a list of people approved by the patient or the one holding MPOA/HCP

3) proof of MPOA/HCP

4) keep the calls to a minimum (patient care and safety)

5) inform patient (if lucid) or MPOA/HCP if they're present about who is calling before giving any information

6) refer everyone else to contact the family - and if they don't know the contact info, then too bad

6) document (CYA!)

Please keep the ideas coming!

You now have your policy. Go to your manager and ask them how to implement these new changes to make everyone's life easier.

[BelgianRN]

What we sometimes do with VIPs or spectacular conditions/situations. Whenever someone calls claiming to be wife/husband/son/daughter we call them back on the listed telephone number in our PDMS to make sure it is indeed the person calling who they claim they are.

As to what to tell them it's always difficult. I try to keep it simple and brief whenever talking to family. But some of my colleagues love going over every single lab, vent setting and monitor value. It usually turns contact with the family into a spanish inquisition and I'm the monster when I tell them that under corticosteroids you can't really rely on white blood cells and lab tests to rule out/in infection.

[Jory, MSN, APRN, CNM]

I live in the South and as they say, we do things very, very different down here.

First of all, everyone that is admitted to the hospital is not coherent. I have seen many, many nurses and doctors play judge and jury and MAJORLY overstep their legal boundaries.

Let's say Mr. Smith is in a major car accident. We have no idea of what his health history is. The police contacts his wife and she shows up to the hopital. Do you think we are going to say, "Sorry Mrs. Smith, we don't care if you have been married for 50 years but unless you can show us some paperwork, total strangers are going to make decisions for your husband until you can get a lawyer and prove to us you are not legally separated and have the authority to make those decisions."

You do that around here and Mrs. Smith will come back with a gun and clear out the place.

In most states, UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE, this is the order that most states follow, assuming the patient is unable:

1. Spouses can make medical decisions for the other.

2. Parents make medical decisions for their adult, unmarried children. (this takes priority over siblings)

3. Where one parent is left, the children of the patient makes the decision for the parent.

4. An unmarried adult with no children, siblings make the decisions.

We go by what is reasonable until proven otherwise. So if Mrs. Smith shows up and says she is the wife, she makes the calls until someone says otherwise.

If you have a single parent and someone shows up and says they are their adult child, you go by that until someone tells you otherwise.

We don't get into domestic situations, etc. That is a legal cesspool and if a couple is involved in a domestic situation, that isn't our problem unless someone SHOWS UP that has a vested interest (adult children) and we tell them that if it's true, then they need to get an attorney to get a judge to write an order either granting the children the right to make the decisions or barring the husband from making them.