When a staff member comes in as a patient

[NickiLaughs, ADN, BSN, RN]

So if a staff member comes in as a patient, and it's a DUI for example. And it became obvious and they told us they started their "desired drug" on shift, how does that work? I know it's reported to DMV by docs, they lose their driving license. But as far as them being a staff member there. Would HIPPA protect them from any trouble with their job? I'm just curious, I've seen this situation a couple times, but never know the exact outcomes and I've always wondered.

[OhioCCRN, MSN, NP]

ouch.... hard..... let us know how it went

[sandyfeet]

Wouldn't the BON find out about how they lost their driver's license? I haven't had to renew my license yet, but was told by others that in CA you have to report all traffic violations (speeding tickets, etc). Could the BON then restrict their license based on the nature of the violation? Would their employer then find out?

[Meriwhen, ASN, BSN, MSN, RN]

I would ask your risk management or HIPAA compliance officer, as they'd have the most accurate answer.

[NickiLaughs, ADN, BSN, RN]

Thanks, I didn't want to inquire too much because they were a coworker. I will ask quality. I would think though that the Board would find out about it for sure because of them losing the license. I just was curious about how that all plays out when it's a coworker. Seems like there would be some very fine eggshells to walk.

[T-Bird78]

Just handle it like you would any other patient. Their place of employment shouldn't affect how their case gets handled.

[Meriwhen, ASN, BSN, MSN, RN]

Thanks, I didn't want to inquire too much because they were a coworker. I will ask quality. I would think though that the Board would find out about it for sure because of them losing the license. I just was curious about how that all plays out when it's a coworker. Seems like there would be some very fine eggshells to walk.

You could phrase it hypothetically: "What if..."

Or if you need a story to feel more comfortable with approaching the RM with, go the "This happened to a friend of mine at another facility, how should I handle it if it were to happen here?" route.

I'm fairly certain that a RM/HIPAA officer would rather educate you about HIPAA in these instances before an incident, than have to do it after the fact.

And while I can appreciate your concern regarding your coworker, ultimately your coworker will have the face the consequences of their actions. What your coworker chooses to do is not your fault.

[Inori, BSN, RN]

eh i'd treat them as i would any patient. would you ask your patient what job does he do then promptly pick up the phone to report his drug use or her to thier employer? I'd think not. SO treat them for what they are here for and for all intents and purposes they are your patient, not your coworker, what they told you as pt stays in the pt folder. If he had an overdose it happend off the clock, off company property. The story would be different if he was found using or high at work on company time then you'd have no choice but to report up the chain of command. Its not a crime to be high as its only illegal to posess the drug. AND again we're not law enforcement. Haha though that being said I would be keeping a very close eye on said coworker if I were to ever be partnered with him because I would not want to be blamed for any missing narcs on mny shift.

[BrnEyedGirl, BSN, MSN, RN, APRN]

In my state we can't even report the DUI! If the pt comes in with law enforcement we can draw labs if the patient agrees, otherwise it is against the law to report drug or alcohol use to authorities even if the patient was driving! I would tread lightly here my friend. Any information you obtain about a patient during the course of caring for him/her is protected, unless it involves suicide/homicidal ideation, gun shot wounds, or dog bites :)

[nurseprnRN, BSN, RN]

I'd report to the hospital risk manager, who would be very interested to know that a staffer was intoxicated (on anything) while at work. That risk manager would be obligated to keep your identity to him/herself, but would be mandated to report to the appropriate authorities, including the BON.

The ANA Scope and Standards of Practice for Nurses, the ANA Ethical Standards, and your state's Nurse Practice Act all obligate you to report incompetent, illegal or impaired practices. Since this person was intoxicated while on duty, there's no HIPAA violation in so doing. HIPAA is not designed to shield people from legal repercussions for illegal acts (which this is) or to deter law enforcement or licensing boards from information they need to protect the public (you can look that up).