Who am I, the HIPPA police?

[ICRN2008]

"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 :)

[Marie_LPN, RN, LPN, RN]

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?

To me, i wouldn't do it, it's wrong to me.

The overall point in this thread, aside from the fact what the nurse was doing was unethical, is that she was asking someone else to be uneithical as well, and when the person refused to, caught crap for it.

[lsyorke, RN]

How sad that our litigious world has forced us to question every word that comes out of our mouth. The nurse in question was obviously known to the lab tech(otherwise how would the OP know that she was giving her own name) If she had such a problem with it, just say no. If the ER doc called WITH the nurses permission, then it's legal. Now a person trying to get results of blood work on herself is now turned into a bureaucratic circus. Very sad.

[Marie_LPN, RN, LPN, RN]

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.

It's pretty sad that someone was expecting someone else to bend the rules for them, then gets an attitude when the OP did refuse.

[tcdtx]

BSNDec06:

Nurses have no business pushing anyone around to get what they want. I was an ER tech while I was in nursing school, and it has given me a much greater respect for techs as well as other personnel such as lab, radiology, etc.

The law has become so strict, and there are such serious consequences that I think: when in doubt, don't do it. And if someone gets cranky with you (including doctors and nurses), refer them to a supervisor.

Personally, I don't like releasing any information on the phone, because there's no way to know who is on the other end of the line.

[ICRN2008, BSN, RN]

I just want to clear up any confusion about my role as a medical technologist. Some of the posters have compared my position to that of a patient care technician or ED technician, but this is not the case.

Medical technologists (clinical laboratory scientists) graduate from a NAACLS-accredited bachelor's degree program and complete an internship at a hospital laboratory. We are nationally certified, most of us by the American Society for Clinical Pathology. In many states, clinical laboratory scientists are also licensed. We report to a laboratory manager, who in turn reports to the MD Pathologist and the laboratory director (usually a PhD scientist with some management training). We are componsated at a level equal to that of an RN and have an equal level of autonomy and professionalism.

The reason I'm bring this up is to make it clear that there was not a power differential at play in this situation, and I personally am not one to be intimidated by anyone (though I must say that I'm not a fan of people who become aggressive during a conflict).

I think there is a lot of confusion on these boards about what medical technologsits (also known as med techs) actually do, who we are, what our training is, and how much autonomy we have. I hope that my explaination has helped a bit, and if anyone has any questions please let me know. :) Thanks!