Question:
Dear Nancy,
In the final days after giving notice in my position, I was asked to hold on to a nurse's keys while she left to take another employee home. Her CNA told me the nurse had just punched out several narcotics and put them in her pocket. I checked and the count was off and too many pills had been taken out for one patient. This nurse had come under suspicion in the past and was reported for having white powder on her nose. The DON said she would keep an eye on her, but didn’t seem to want to deal with this. I reported this to three supervisors, gave them a copy of the narcotic sheet and kept a copy for myself. This made them angry and they said I was violating HIPPA rules. They are trying to ban me from visiting a patient and asked me to leave or they would seek further action. Did I violate HIPPA by copying a narcotic sheet to give to them and one to save for proof? My copy was in a safe place and was not shown to anyone.
Dear Nancy,
In the final days after giving notice in my position, I was asked to hold on to a nurse's keys while she left to take another employee home. Her CNA told me the nurse had just punched out several narcotics and put them in her pocket. I checked and the count was off and too many pills had been taken out for one patient. This nurse had come under suspicion in the past and was reported for having white powder on her nose. The DON said she would keep an eye on her, but didn’t seem to want to deal with this. I reported this to three supervisors, gave them a copy of the narcotic sheet and kept a copy for myself. This made them angry and they said I was violating HIPPA rules. They are trying to ban me from visiting a patient and asked me to leave or they would seek further action. Did I violate HIPPA by copying a narcotic sheet to give to them and one to save for proof? My copy was in a safe place and was not shown to anyone.
Lynn
Nancy Brent replies:
Dear Lynn,
Your best guide in this situation is a nurse attorney or attorney in your state who can help you with the HIPAA allegation, as well as other possible legal issues. Only some general comments can be made here.
In addition to a possible HIPAA violation, there is always a potential violation of patient confidentiality and privacy laws when a copy is made of any hospital record and taken from the facility. Although yours is "in a safe place" and "not shown to anyone," your actions are not supported by the ethical and legal mandates requiring patient privacy and confidentiality be protected, nor by facility policy.
Your intentions were good concerning the nurse who is diverting drugs from the facility. This problem is not only the specific nurse's, but the facility's as well. To ignore this type of behavior will not be helpful to the nurse, the director of nursing and the facility when discovered by outside regulators.
When something like this is discovered, and your concerns fall on deaf ears, the place to report this, initially, is to the board of nursing. The board then takes over the investigation, and with its powers, can determine who is involved with the diversion as well as who enables it, and then takes appropriate action.
You need to think carefully about your ongoing relationship with the patient you refer to. Again, although your motives are well intended, crossing professional boundaries can be very problematic for you. You might want to read the National Council of State Boards of Nursing's brochure “Professional Boundaries: A Nurse's Guide to Professional Boundaries.” It is available on the council's website at www.ncsbn.org. Also review your state nurse practice act and rules. Many contain crossing professional boundaries as grounds for discipline.
Dear Lynn,
Your best guide in this situation is a nurse attorney or attorney in your state who can help you with the HIPAA allegation, as well as other possible legal issues. Only some general comments can be made here.
In addition to a possible HIPAA violation, there is always a potential violation of patient confidentiality and privacy laws when a copy is made of any hospital record and taken from the facility. Although yours is "in a safe place" and "not shown to anyone," your actions are not supported by the ethical and legal mandates requiring patient privacy and confidentiality be protected, nor by facility policy.
Your intentions were good concerning the nurse who is diverting drugs from the facility. This problem is not only the specific nurse's, but the facility's as well. To ignore this type of behavior will not be helpful to the nurse, the director of nursing and the facility when discovered by outside regulators.
When something like this is discovered, and your concerns fall on deaf ears, the place to report this, initially, is to the board of nursing. The board then takes over the investigation, and with its powers, can determine who is involved with the diversion as well as who enables it, and then takes appropriate action.
You need to think carefully about your ongoing relationship with the patient you refer to. Again, although your motives are well intended, crossing professional boundaries can be very problematic for you. You might want to read the National Council of State Boards of Nursing's brochure “Professional Boundaries: A Nurse's Guide to Professional Boundaries.” It is available on the council's website at www.ncsbn.org. Also review your state nurse practice act and rules. Many contain crossing professional boundaries as grounds for discipline.
Sincerely,
Nancy
Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.
