What are the rules of what we can tell patients?

[NursingInChaos]

As a new nurse I am a little confused about what results we are allowed to tell patients. All the nurses at my job have given me very different answers lol

Some say it is their right to know it all as it is their info (ehhhh I thing that is extreme) and some won't even tell them a basic lab value ... I heard a fellow nurse telling a patient the results of his X-ray an hour earlier before the doctor even saw it - giving the patient the radiology impression info. Am I right in assuming that was not right to do?

Then what about my patient that knows they are watching her BUN levels daily and just wants to know if this mornings bun level is better than yesterday? Can I tell her yes or no - or what about the actual number of the lab value?

How does this transfer to bedside shift report- telling the oncoming nurse abnormal lab or test results in front of the patient- if we can't tell the patient that info until after the doctor has then how can we at bedside shift report?

If the small town hospital I worked at had an easier way to access policies I would look there but they are a mess right now lol

[loriangel14, RN]

If it's regular lab work and the patient wants to know how the latest numbers look I would tell them. If it's something like X-rays, an ultrasound etc. I wouldn't be allowed. The doctor needs to disclose these results and discuss the implications. I have told a patient they have tested positive for a UTI in the course of explaining why they are now getting an antibiotic.

[MunoRN, RN]

I don't think it's "extreme" to say a patient has a right to all of their own information, that's pretty basic ethics. Keeping the patient informed as to the progress of their care which includes test results and educating patients about the meaning of those results is not only something nurses are allowed to do, but is a required expectation of the license. There are certainly those instances where a nurse would not be able to effectively explain the results and plan of a test in which case it's totally appropriate to defer to the MD.

[Anna Flaxis, BSN, RN]

Yes, you are allowed to disclose laboratory values to patients. As a licensed nurse, you should have a basic understanding of common lab values and what they mean, and keeping the patient informed of their health status is a basic function of nursing.

When you give supplemental potassium, do you not inform the patient that their K+ was low? When you give a blood transfusion, do you not inform the patient of their H&H? If you're monitoring serial troponins, do you not keep the patient informed of the results?

[nursej22, MSN, RN]

Regarding tests other than labs, I will usually tell the patient if they are negative: no broken bones, that sort of thing. But I stay away from abnormals that will require a provider's interpretation.

[blondy2061h, MSN, RN]

When you check someone's glucose, don't you tell them the result?

Sometimes this depends on policy, but in general, you can give lab results to patients. Now all of our patients can see their results on our patient portal online pretty much as soon as they're available. The other two big hospital networks in this area have the same set up. Before that, it was a bit murkier, but the service I work with has always had a standing policy that patients can get lab results printed off for them in the AM.

[NOADLS]

I don't like to have to be the one to tell my patient a result which could have them antsy on my shift.

Patient: what were my blood test results?

Nurse: sorry, the computers are down for the night. the tech gets here at 7. ask the nurse then.

It starts around 1:15. The rest of the video is on basic ethics which apply to any profession.

https://www.youtube.com/watch?v=POeiWI27tkM

[Karou]

I think a combination of nursing judgement and facility policy can be used to differentiate between what you should and should not tell your patient.

I have no problem telling my patients their labs and how that relates to their care. If it's radiology, I am more cautious. I may or may not read to them the radiology report, but always explain that the physician will be the one to discuss it fully with them and that as a nurse, I cannot interpret the report.

For what it's worth, my facility has an online patient portal where they can access this information themselves.

I won't explain some sensitive things like imaging study that shows probably cancer, or lab results showing elevated tumor markets, ect... I wait for the physician to discuss that with the patient first.

[MunoRN, RN]

Karou said:

I think a combination of nursing judgement and facility policy can be used to differentiate between what you should and should not tell your patient.

I have no problem telling my patients their labs and how that relates to their care. If it's radiology, I am more cautious. I may or may not read to them the radiology report, but always explain that the physician will be the one to discuss it fully with them and that as a nurse, I cannot interpret the report.

For what it's worth, my facility has an online patient portal where they can access this information themselves.

I won't explain some sensitive things like imaging study that shows probably cancer, or lab results showing elevated tumor markets, ect... I wait for the physician to discuss that with the patient first.

The radiology report are the results that have already been interpreted by the Physician.

[Benito Ezekiel]

It seems other results must be given and others not

[MunoRN, RN]

nursej22 said:

Regarding tests other than labs, I will usually tell the patient if they are negative: no broken bones, that sort of thing. But I stay away from abnormals that will require a provider's interpretation.

I agree that we should defer those things, which are relatively few, that would require a discussion only an MD can provide, but I don't think that all abnormal results can or should only be explained by the Physician, maybe I'm misinterpreting what you're saying.

[Karou]

MunoRN said:

The radiology report are the results that have already been interpreted by the Physician.

True. Thank you for the correction.