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

[Anna Flaxis, BSN, RN]

MunoRN said:

So to use your example of a PE, when the physician puts in an order for a heparin drip, do you just go in and start the drip, what if a patient asks what it's for? Do you tell them you can't reveal that?

I'm not sure where you get that impression.

If the patient is being worked up for a PE, they already know that. Of *course* I will explain why I am hanging the heparin gtt. That does NOT excuse the physician of their responsibility to speak to the patient about the diagnosis, treatment plan, and prognosis.

[Anna Flaxis, BSN, RN]

MunoRN said:

Part of what I do in my job is to be a direct patient care representative in outcomes and compliance projects. I was really skeptical at first when I heard claims about the disturbingly large numbers of patients who are unaware of vital information that should have been provided to them during their hospital stay such as their need for follow up imaging, or even what they were being treated for, after hearing people's views it's not as unbelievable which is pretty depressing. If an RN doesn't want to do the job then please make room for someone else who will.

Do the job of what, specifically?

[UTVOL3]

This is a really good question. I agree nurses get kind of mixed messages about it. The info belongs to the patient, period. In this day of electronic medical records with online patient portals, we can't keep results from patients anyway.

I think where your responsibility as a nurse comes in is in how you deliver the information to the patient. Avoid using words like 'good' or 'bad'. If they want to know the exact value of their BUN tell them. If they are asking if it's better, I'd say something like 'the result is lower than yesterday.' Let the doc make the interpretation of whether or not it's 'better' for the patient.

[Julius Seizure]

UTVOL3 said:

This is a really good question. I agree nurses get kind of mixed messages about it. The info belongs to the patient, period. In this day of electronic medical records with online patient portals, we can't keep results from patients anyway.

I think where your responsibility as a nurse comes in is in how you deliver the information to the patient. Avoid using words like 'good' or 'bad'. If they want to know the exact value of their BUN tell them. If they are asking if it's better, I'd say something like 'the result is lower than yesterday.' Let the doc make the interpretation of whether or not it's 'better' for the patient.

I will often say, for instance, that the patients potassium level is 2.9 and we like to keep it between 3.5-4.5, so I am going to give you a potassium supplement through your IV.

The "better" is implied.

[needlesmcgeeRN, ASN, RN]

What about an abnormal A1C result? I'm to be doing diabetic patient education, does the doctor need to discuss the results and implications first?