A Twist on HIPAA: When a Colleague Is Your Patient
All (I hope) nurses know about HIPAA and patient privacy. Those of us who are relatively new to the field had it drilled into us in nursing school, at every clinical site, and then at our eventual workplaces. More experienced nurses have watched patient privacy take a more meandering course through paper charting to computerized everything and a more rigorous tracking and protective view of patient privacy. I have written online and published print articles about HIPAA and social media, but I and others have neglected to emphasize another area we need to consider: what if a colleague is your patient or a patient in your department?
Stop and think about this now, particularly if you live in a small community. My town has one hospital, so the chances of an associate being a patient are decently high. Nurses are not so good at protecting patient privacy to begin with, and, anecdotally, they seem less so when they know the patient in question. This is anecdotal because I can’t find any studies on it, but I have been in health care less than a decade and have seen five terminations as a result of in-house chart accesses. One was for accessing my chart, and I can tell you that it does not feel good. On the other end of the spectrum, one was because one CNA intentionally used another’s open charting session to look up information on a family member. Both were terminated. The phrase “skating on thin ice” was invented for these situations.
Here are the ways I see HIPAA violated daily.
- Nurses are curious about another patient’s lab results/H&P/medication history—more so if it is a coworker—and take the opportunity to open the chart and look. It’s right there, tempting. DO NOT DO THIS. Not only is it a violation, unethical, and illegal, but because of the advent of and requirement for electronic charting, it can be easily tracked. Have a reason to open a chart or don’t do it. If you open it by accident, find out your facility’s procedure for documenting accidental chart accesses and use it. Don’t have time? Do you have time to find a new job?
- Nurses from one floor see that a colleague is admitted to another floor and go there to visit. They have good intentions, I’d like to think, but it’s still illegal. If your coworker wants to tell you about her appendectomy, let her bring it up on her own time, just as if it happened at another hospital.
- A nurse who has cared for a colleague discusses the illness with the colleague/patient or with other colleagues. Even if lighthearted, concerned, or well-intentioned…it’s still illegal (and unethical, and all that). I once saw a colleague receive a get-well card because the unit knew of a hospitalization she did not want to be public knowledge. Again, intentions were probably good, but they went astray.
Curiosity killed the cat and got the nurse fired. Treat your associates’ health information with great, great care. Corporate compliance officers now routinely investigate chart accesses for all employees admitted to or seen through an institution. Names on the list who were not involved in the patient’s treatment have some ’splaining to do. Make sure yours isn’t on there. And if your work friend is in the hospital, please do not barge into the room to say hello. Become a regular visitor and ask if visitors are desired; go through the proper channels. This is not a place to take shortcuts.
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