"Protecting private health information is not just good practice, it is the law!"
I heard this slogan during one of my many HIPPA trainings, and I really took it to heart. Apparently, some of my co-workers did not. As some of you know, I am a medical technologist. In my position, I have access to laboratory results for patients throughout our entire health system. I was working alone in the lab today, and one of my co-workers put me in a very compromising position. Here is my story; please hang in there because it is long...
A nurse called me while I was busy (getting platelets ready for HER patient) and asked me to look up some labs. I told her I was busy at the moment and would call her back; I assumed the results were for one of her patients and related to that patient's care.
When I called her back and asked for the medical record number, she said she didn't have it and proceeded to give me HER OWN NAME. She said "the nurse practitioner and I have been trying to look up the results and we can't find them in the computer". I told her that I could not give the results to her, nor could I release them to the nurse practitioner because the NP was not the ordering provider and was not directly involved in that nurse's (patient's) care. She snapped back "Well then, who do I have to ask, God?" and proceeded to give me attitude in general. I calmly told her that if she was interested in her lab results, she would have to fill out a request and submit it to the medical records department or call her physician's office on Monday.
About an hour later, I received a call from the ED physician. He requested the lab results on a patient, and proceeded to give me the SAME NURSE'S NAME. I didn't realize it until we hung up because I was involved in other tasks, but when I did figure out what was going on I immediately called him back and told him that since he was not the ordering physician he could not have access to those results (this is the policy of our laboratory). He stated that this nurse was now under his care as his patient. I had a strong feeling that he was lying to me because the nurse had not been admitted as a patient to our hospital, but I could not prove that he wasn't telling me the truth. At this point, with this being a gray area and the physician obviously being a lot higher than me on the power ladder, I gave in. I printed a copy of the results and sent it to him. I also made a note in the computer that I had done so in case I am questioned in the future.
How dare this nurse put me in such a compromising position! It makes me absolutely furious when people expect me to break the rules for them just because they are employees of the hospital!!!!! The thing that upsets me the most is that they are asking me to RISK MY JOB and sometimes VIOLATE THE LAW because they can't be inconvenienced to follow proper channels.:angryfire
There was another circumstance a few months ago when the charge nurse from the ED brought in a throat swab from her SON and requested that we run a rapid strep "off the books". This is absolutely a violation of laboratory policy, not to mention ethical standards. Why should she receive a free test just because she works here? And for her family member, no less! I told my co-worker that he should not make promises like this in the future, and if he did to make sure not to involve me. My co-workers have run numerous free pregnancy tests for their "friends" (fellow employees) on the floors.
Just to make sure I am absolutely clear, I am not bashing nurses (obviously, since I am in nursing school myself). The physician deserves equal responsibility in this incident. So please do not flame me as singling out nurses. I am in fact criticizing all health care workers who violate policys and laws.
We as members of the health care team should be above reproach. This means following proper procedures when accessing private medical records, obtaining a valid order for all tests run in the laboratory, and paying for all of the care we receive. How can we expect our patients to respect us if we do not hold ourselves to high ethical standards?
I am not looking for a debate, just a bit of support. Thanks for listening :)
Specializes in Infection Preventionist/ Occ Health.
Playing devil's advocate here:
What one has to be careful of is the reliability of the person calling on the other end. How can the receiver validate that it is truly the nurse calling for her own lab results? The caller could be another nurse, friend or family member who has no legal right to medical information.
This is exactly why we have such strict policies in place.
Here are some of the safeguards our hospital has implemented since HIPAA:
We have a list by the phone of the names of all the RN's at our facility, and I know many of them who work my shift. We only release results on patients who are currently admitted to our facility. In addition, we have caller id on our phones that tells us exactly which area of the hospital the call is coming from. We also have a policy only to give out verbal results in emergency situations. In all other instances, the results are sent to a printer in a secure area on the unit. All of these protections are in place to prevent inadvertent release of PHI to non-authorized persons.
"Protecting private health information is not just good practice, it is the law!"
I heard this slogan during one of my many HIPPA trainings, and I really took it to heart. Apparently, some of my co-workers did not. As some of you know, I am a medical technologist. In my position, I have access to laboratory results for patients throughout our entire health system. I was working alone in the lab today, and one of my co-workers put me in a very compromising position. Here is my story; please hang in there because it is long...
A nurse called me while I was busy (getting platelets ready for HER patient) and asked me to look up some labs. I told her I was busy at the moment and would call her back; I assumed the results were for one of her patients and related to that patient's care.
When I called her back and asked for the medical record number, she said she didn't have it and proceeded to give me HER OWN NAME. She said "the nurse practitioner and I have been trying to look up the results and we can't find them in the computer". I told her that I could not give the results to her, nor could I release them to the nurse practitioner because the NP was not the ordering provider and was not directly involved in that nurse's (patient's) care. She snapped back "Well then, who do I have to ask, God?" and proceeded to give me attitude in general. I calmly told her that if she was interested in her lab results, she would have to fill out a request and submit it to the medical records department or call her physician's office on Monday.
About an hour later, I received a call from the ED physician. He requested the lab results on a patient, and proceeded to give me the SAME NURSE'S NAME. I didn't realize it until we hung up because I was involved in other tasks, but when I did figure out what was going on I immediately called him back and told him that since he was not the ordering physician he could not have access to those results (this is the policy of our laboratory). He stated that this nurse was now under his care as his patient. I had a strong feeling that he was lying to me because the nurse had not been admitted as a patient to our hospital, but I could not prove that he wasn't telling me the truth. At this point, with this being a gray area and the physician obviously being a lot higher than me on the power ladder, I gave in. I printed a copy of the results and sent it to him. I also made a note in the computer that I had done so in case I am questioned in the future.
How dare this nurse put me in such a compromising position! It makes me absolutely furious when people expect me to break the rules for them just because they are employees of the hospital!!!!! The thing that upsets me the most is that they are asking me to RISK MY JOB and sometimes VIOLATE THE LAW because they can't be inconvenienced to follow proper channels.:angryfire
There was another circumstance a few months ago when the charge nurse from the ED brought in a throat swab from her SON and requested that we run a rapid strep "off the books". This is absolutely a violation of laboratory policy, not to mention ethical standards. Why should she receive a free test just because she works here? And for her family member, no less! I told my co-worker that he should not make promises like this in the future, and if he did to make sure not to involve me. My co-workers have run numerous free pregnancy tests for their "friends" (fellow employees) on the floors.
Just to make sure I am absolutely clear, I am not bashing nurses (obviously, since I am in nursing school myself). The physician deserves equal responsibility in this incident. So please do not flame me as singling out nurses. I am in fact criticizing all health care workers who violate policys and laws.
We as members of the health care team should be above reproach. This means following proper procedures when accessing private medical records, obtaining a valid order for all tests run in the laboratory, and paying for all of the care we receive. How can we expect our patients to respect us if we do not hold ourselves to high ethical standards?
I am not looking for a debate, just a bit of support. Thanks for listening :)
A lab tech at our facitility was fired for a similar situation. HIPPA does not give you any leaway, so you were right to be concerned and that nurse had no business pulling what she did. I would have written her up (I am also a nurse) so rank does not count.
With all these laws in place no wonder, people avoid helping car accident victims or someone in need, we are a country of so many laws that we really are afraid and think twice before helping someone out in fear of getting sued. I think sometimes you have to use your best judgement if its the nurses lab results well HELL just give it to her, sometimes you do have to bend the rules a little. And you all know we do it. We are not robots!!!!
Here's hoping you never find yourself in one of those "gray areas," I daresay you might think back on this incident.......oh wait, you're in nursing school?
It's a given.
Here's hoping she has a nurse with a sense of ethics as her preceptor once she graduated. Good grief.
She's taking advantage of the fact that she works there to circumvent that procedure that anyone else would have to go through. And she's putting the lab tech in the middle of it.
I'll willing to bet that no one would release the results to anyone else that happened to call that wasn't a nurse or staff member. We really don't have privileges above and beyond the man on the street. That nurse could get fired under the policies and procedures that I am certain her facility has in place.
Exactly.
I wouldn't call this incident a HIPAA violation, but definitely unethical, and the nurse should have known better.
(And before anyone asks, yes, i've worked 10, 12, and 16 hour shifts. And i'm doing that now. But my work schedule is not excuse for doing something unethical.:stone)
How can the receiver validate that it is truly the nurse calling for her own lab results? The caller could be another nurse, friend or family member who has no legal right to medical information.
What I find amazing is that people are still spelling it HIPPA instead of the correct HIPAA even after someone pointed out the error. No one can claim to be an expert or "police" on the subject if they don't even know what it stands for.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
The way I see it, you had no choice BUT to deny the request. Where I work, we have been warned against using our computer resources or other means to find test results on anyone not in our care---including ourselves. It's hospital policy---- and, Like the poster said before me---HIPAA or not, if it's policy, and you violate it, you ARE risking your position by not complying. You did the right thing, in my book.
What I find amazing is that people are still spelling it HIPPA instead of the correct HIPAA even after someone pointed out the error. No one can claim to be an expert or "police" on the subject if they don't even know what it stands for.
I think you did the right thing too. Yes, they are her lab results and she has a right to know them, but to put you on the spot was wrong. I've looked up my own lab results on the computer (knowing full and well I was breaking the rules) but if I get in trouble then it's my own fault. I've never been fully comfortable with asking someone else to do it for me. I've even done it at the request of my friends/coworkers but it doesn't make it right.
Is the facility rule superfluous in this case? FWIW I think so, but it's the rule now.
If she had walked down to verify her id, it would have been the same.
On a slightly different take:
My point is more global. We do work long hours, less pay (for what we do), and we do have and SHOULD have extra benefits. What about the nurse that knows the doctor who gives her antibiotics while she's working, or a prescription for same? Is it wrong to circumvent the system while others wait for an appt? or is it really saving time to allow another open slot for an office appt? Also is it saving a life by allowing a nurse to continue in the OR by getting meds early and missing less days?
How about a smallpox epidemic? Healthcare workers come first on vaccines.
All of this doesn't mean it is not against the facility rule or protect the OP. I think after verifying the id, it is a moot point--TO ME. To the facility though, I know it is the rules.
ICRN2008, BSN, RN
897 Posts
This is exactly why we have such strict policies in place.
Here are some of the safeguards our hospital has implemented since HIPAA:
We have a list by the phone of the names of all the RN's at our facility, and I know many of them who work my shift. We only release results on patients who are currently admitted to our facility. In addition, we have caller id on our phones that tells us exactly which area of the hospital the call is coming from. We also have a policy only to give out verbal results in emergency situations. In all other instances, the results are sent to a printer in a secure area on the unit. All of these protections are in place to prevent inadvertent release of PHI to non-authorized persons.