What would you do?

Dixielee, BSN, RN · Aug 22, 2008

Unfortunately, in the ER we often not only give report but care to patients in the hall or on the other side of a curtain. It is not unusual for patients and or families to strike up conversations with patients on the other side of the curtain. A few hours in the ER and you feel like family.

Just overhearing part of report, or what care is going on next door does not violate the spirit of HIPPA. If it does, then I guess we will have to give report off campus or in our cars where all the smokers go. OH NO, don't let a governing body hear that, they may just try it!

soulofme · Aug 22, 2008

Geez....in our dialysis unit we'd be HIPPA'D right out the door:lol_hitti

BinkieRN, BSN, RN · Aug 23, 2008

My question... would you call the hospital and report this or would you let it go? If you would report it, who would you call?

Why report it? I would mind my own business, you don't have a dog in this fight :)

pagandeva2000, LPN · Aug 23, 2008

It is a difficult situation. On the units I've been on there is generally no place to give a report w/o others overhearing. This, although not ideal, is not what bothers me the most. The idea that a patient or visitor would hear medical information about others is not that appalling. It was not that long ago in our history that the patients were all on wards and there was no hope for confidentiality.
What I find inappropriate is the social conversations and disrespectful comments about patients throughout the shift, such as "OMG - he is crazy and driving me up the freakin wall", "I hate Dr. Blank", "have you seen his wound? It is disgusting", "damn, 57 is on his call light again - I hope his wife gets here soon so she wipe his..... etc.
I would not report this. However if I were the patient I would probably make reference to what I heard, making the staff aware that their voices carry b/c I feel that many people don't realize just how much patients hear.

I agree with you. If the friend heard unflattering remarks made about herself, I am sure that she would have probably asked who to report this to herself, rather than to make an off-hand comment to the OP. I do try to keep the inappropriate thoughts to myself, for sure because it does break the nurse patient relationship issue down, but geez, to want to report it? Even under the best of circumstances, this can inadvertantly happen to any one of us. Not trying to be hard on you, OP, but leave it alone, unless the patient asks you to intervene. And, then, give the basic information that everyone has a right to have and don't go any further. In addition, if you work there, it will be hard for people to trust you.

Christen, ANP · Aug 23, 2008

I work in an open unit where you have to pretty much whisper in order to not be overheard by everyone. :rolleyes: A lot of facilities have nurses give shift report at the patient's bedside, which of course wouldn't violate HIPPA as the patient should hopefully already know what's going on. During shift change, we have our family members vacate the unit in order to protect the privacy of others as best we can, but sometimes we can be loud and not realize it.

I would probably have your friend call the senior nurse / nures manager or write a note just letting them know that she could hear a lot of information on other patients so that they are aware. It won't hurt, and it might make them aware of a problem that they weren't aware of!

RazorbackRN, BSN, RN · Aug 23, 2008

I told her that that was a serious violation of HIPPA laws, and she (not a nurse) just blew it off and said she didn't care and that it didn't bother her. Well, it bothered me, because if she could hear, then probably other patients could hear about her and she could hear about other patients.

Surely you don't believe that EVERY single report you have given has been completely confidential. I can assure you, somewhere along the way, someone who is not authorized has probably heard you say something about a pt.

If you are in an ICU, then it's almost impossible to have COMPLETE privacy. If you're not, then you should understand the challenges faced by being at a nurses station or in a semi-private room.

Even if you give report in a separate room out of the public eye, I can still bet that somewhere along the line someone has heard you on the phone, speaking with a family, or some other staff/discipline.

Why would you even encourage the whole "violation" thing? Don't you believe that nurses are persecuted by the general public enough already?

Riseupandnurse · Aug 23, 2008

I am surprised that there are not a lot of complaints about HIPPA violations during report. We HAVE to give report out in the hall in front of the patients' rooms because each room has their own chart outside the door and SBAR says that's where we are to go, to look through the chart as we give report. Naturally people are going to hear what is said.

suanna · Aug 23, 2008

Yep, it's a HIPPA violation. Would I call to report it- no. What's the point- just to stir trouble? As a rule most nurses I know have always tried to be discreet when giving report- esp with sensitive information. I've always thought HIPPA regulations just made good information sharing more difficult for everyone. It isn't as if they were discussing the details of her STD in the cafeteria- they were giving report at the nurses station. There is always going to be the chance that report will be overheard- we don't have a

" Dome of Silence" like Maxwell Smart. Unless the violation was blatant and your friend was upset by it I think you are best just to let it go and take a word of warning to be more careful in your shift change reports. If you know the nurses involved it wouldn't hurt to mention what happened to them one on one. Official reporting of this is just stirring the pot and making everyones job more difficult.

Bortaz, MSN, RN · Aug 23, 2008

we don't have a "Dome of Silence" like Maxwell Smart.

LOL. What about a shoe phone?

suanna · Aug 23, 2008

LOL. What about a shoe phone?

Silly- the shoe phone dosen't come in "Nursing White"- just black oxford.

Bortaz, MSN, RN · Aug 23, 2008

Haha.

RNgonewild · Aug 23, 2008

God, what a pain and crock HIPPA is. And JCAHO too. We are starting that walking room to room report on Monday, if that isn't a pain, with trying to find 3-4 different nurses and then run to outside the rooms. Or maybe all 8-10 of us will be trooping down the halls together, so old school. I wish HIPPA and JCAHO would just fight it out. May the best man win.