Ep 59: An ED RN Isn’t Telling You Shit
Preamble:
Welcome to It’s An ED RN, on today’s episode we’re going to talk about patient privacy, particularly as it pertains to the involvement of law-enforcement and the lies that they will lie to get you to divulge protected health information that they in no way should have access to. This might get heated.
I’m your host, an ED RN and I hope you’ll stick around to listen;
Intro Song
Episode 59: An ED RN Isn’t Telling You Shit
Welcome:
Welcome to my podcast, It’s An ED RN
I am your host, an ED RN and today we are talking about:
This;
If you’re new to the show:
Introductions:
Nurse x13yrs
5yrs Admin
Back to bedside in ED
Federal Law: HIPAA Guidelines
Summary of HIPAA Law for Nurses
Purpose and Intent
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. Its primary purposes are to:
1. Protect Patient Privacy: Safeguard the privacy and security of individuals’ medical records and other personal health information.
2. Standardize Electronic Health Transactions: Establish national standards for electronic healthcare transactions to improve the efficiency and effectiveness of the healthcare system.
3. Ensure Health Insurance Portability: Facilitate the transfer and continuation of health insurance coverage for individuals as they change or lose their jobs.
Important Considerations for Nurses
• Always verify the identity and authority of anyone requesting PHI.
• Follow your facility’s policies and procedures for disclosing PHI.
• Report any suspected breaches of PHI to your compliance officer or supervisor.
• Provide the minimum necessary information when disclosing PHI.
HIPAA permits the disclosure of protected health information (PHI) to law enforcement officials under specific circumstances, even if the patient is unable to give consent:
1. Required by Law: If the disclosure is required by another law, such as mandatory reporting of certain injuries or conditions (45 CFR § 164.512(a)).
2. Identification and Location Purposes: Limited information can be shared to identify or locate a suspect, fugitive, material witness, or missing person (45 CFR § 164.512(f)(2)). This includes:
• Name and address
• Date and place of birth
• Social security number
• ABO blood type and rh factor
• Type of injury
• Date and time of treatment
• Date and time of death, if applicable
• Description of distinguishing physical characteristics
3. Victims of a Crime: If the patient is a victim of a crime and unable to agree to the disclosure due to incapacity, information can be shared if law enforcement represents that the information is necessary to determine if a violation of law by a person other than the victim has occurred, and the information is not intended to be used against the victim (45 CFR § 164.512(f)(3)).
4. Reporting Crime on Premises: Disclosures can be made to law enforcement when the crime occurred on the premises of the covered entity (45 CFR § 164.512(f)(5)).
5. Emergency Situations: If the disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public (45 CFR § 164.512(j)).
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(My State) State Laws
• State may have additional state-specific reporting requirements, such as mandatory reporting of gunshot wounds, stab wounds, or other serious injuries.
• State laws can also mandate reporting of suspected abuse, neglect, or domestic violence, which may necessitate the disclosure of PHI to law enforcement without patient consent.
You may have heard about this Utah nurse who refused to draw blood on an unconscious patient for law enforcement and was arrested, even though she was following HIPAA law, state law, and the policy of her own hospital
The full story is even worse and shows that even when a patient is the victim of a crime often times police will use health information against them
The cop that arrested that Utah nurse for doing her damn job now has another job working in the medical wing of a jail
Change did happen:
The protocol for police entering University Hospital, where Nurse Alex Wubbles was unlawfully arrested in July, has been changed. Police will no longer interact with nurses and are not allowed in patient care areas. They must enter through the front, check-in and be escorted through the hospital by supervisors "who are highly trained on rules and laws.” Previously, they were permitted to enter through the emergency room.
#endnurseabuse
Tips and Tricks:
Tip #1: Know the Rules. Do the work to fully understand HIPAA law state law, and your hospitals policies around patient privacy
Tip #2: Use the Robots. AI is an amazing thing you can copy and paste your institutions, patient privacy policy to ChatGPT and ask it to analyze a specific situation that has happened and to determine according to HIPAA and state law if a patient’s rights were violated and it’ll give it its best shot and it’s a robot so it’s gonna be pretty good
Tip #3: Utilize Your Resources. Every hospital has someone who is designated as the patient privacy person and they likely have a general email to which you are supposed to report violations of patient’s privacy and while this doesn’t always mean a goddamn thing because I’ve used it before too very little success, but at least you have that person you can send them specific scenarios and they will give you a determination of whether that scenario violated your patience right to privacy and then you can save those emails in a folder right there in your Microsoft inbox to reference later on
Trick: Defer to Leadership. Send all cop calls to your Charge nurse. This is a great little trick your Charge nurse you’re supervisor your manager you know you got a lot to do in your day and frankly there’s a reason you aren’t a supervisor or a manager, and that reason for me anyway a lot of the time is I don’t have to have these conversations so when I’m asked for specific information on a patient and I know for goddamn sure it does not fall under the purview of law-enforcement to know I just tell him to talk to my Charge nurse and done and done
Closing:
I hope you’ve enjoyed this episode; if so, leave a review, find me on socials and tell your nurse friends to listen;
Stop talking to the cops I mean this generally speaking but especially when it has to do with your patience healthcare information be as polite or not as you want. Send them to your Charge. Be careful don’t get arrested shut your mouth.
Thank you for listening and have a safe shift.
