work excuse and privacy issues

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Specializes in Emergency, Telemetry, Transplant.

Some words of wisdom needed...

I had a pt that was a passenger on a bus involved in a minor MVC. She was seen at our ED the day of the incident, diagnosed with a foot contusion, discharged with Rx for ibuprofen.

She came back 3 days after her first presentation saying that her shoulder was still bothering her (she was 'my' pt this visit). Xrays negative. Discharge with dx of shoulder sprain. Main reason she came in was for a work excuse. The doctor on filled out the excuse for "was seen in the ED on xx/xx/xx." No days off from work listed. When discharging the pt I gave her the excuse and she said "this isn't good enough, my boss will demand to see more." The doctor said well, if her boss wants to see more then she can show her boss his discharge instructions. When I told this to the pt, she said, "well it doesn't have my age on it does it? My boss will put it in our assignment binder and my coworkers will take it out and make copies of it and pass it around." (sidebar: I find it interesting that she only seemed to be concerned that they would see her age on the papers and not any of the other information). I went on to tell the pt that her boss could not do this and not to let her boss take the discharge papers. The pt seem to accept this and left uneventfully. My question: does this need to be reported? What else could I have done in the situation?

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Specializes in ER, ICU.

This is not your issue. You informed her of privacy issues, (which she may disregard if she chooses) and gave a work excuse. It is not our job to satisfy whatever obtuse requirements her job may have.

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Specializes in Home health was tops, 2nd was L&D.
This is not your issue. You informed her of privacy issues, (which she may disregard if she chooses) and gave a work excuse. It is not our job to satisfy whatever obtuse requirements her job may have.

I agree.. stop sweating the small stuff.

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Specializes in NICU, PICU, PACU.

Really, what is the big deal with the doc putting dates on the paper? It only takes a few seconds to print out a sheet, esp if you have e-charting. When we call off work and have to have a note we have to have the days on there too so that we don't accumulate points for those absences. And he is totally in the wrong to have said to show them the discharge papers, there is personal info on those sometimes and it is no ones business.

Report it to who though? It isn't HIPAA and you cant' control what they do at work.

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Specializes in ER, education, mgmt.

Refer to Occupational Medicine if available (family MD if not). They can determine if someone is fit for their particular job duties.That is not ED issue.

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Some words of wisdom needed...

I had a pt that was a passenger on a bus involved in a minor MVC. She was seen at our ED the day of the incident, diagnosed with a foot contusion, discharged with Rx for ibuprofen.

She came back 3 days after her first presentation saying that her shoulder was still bothering her (she was 'my' pt this visit). Xrays negative. Discharge with dx of shoulder sprain. Main reason she came in was for a work excuse. The doctor on filled out the excuse for "was seen in the ED on xx/xx/xx." No days off from work listed. When discharging the pt I gave her the excuse and she said "this isn't good enough, my boss will demand to see more." The doctor said well, if her boss wants to see more then she can show her boss his discharge instructions. When I told this to the pt, she said, "well it doesn't have my age on it does it? My boss will put it in our assignment binder and my coworkers will take it out and make copies of it and pass it around." (sidebar: I find it interesting that she only seemed to be concerned that they would see her age on the papers and not any of the other information). I went on to tell the pt that her boss could not do this and not to let her boss take the discharge papers. The pt seem to accept this and left uneventfully. My question: does this need to be reported? What else could I have done in the situation?

She could black out information she doesn't want the boss to see on her discharge papers.

What would you report this for?

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Specializes in Emergency, Telemetry, Transplant.

Let me clarify it here...

I have no problem with our MD not offering a more elaborate excuse. That was just background info on the situation....if the boss wants more, now it is on the pt, and I am certainly not sweating that...

My issue is that her boss would take the discharge instructions and post it for all to see. Maybe "who to report it to" was the wrong phrase. I guess I should have asked "To whom should I tell the pt to report this if her boss does indeed try to post her medical information?"

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

That would probably be something for the pt to discuss with HR in her workplace.

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No matter what the patient's boss does with the info it's still not your issue. She'll have to handle it herself.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

you're right -- the boss is horrible. but it's still not your problem. you can't fix it.

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