Confidentiality

yay4stress

Forum Crew Member
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I got a question about patient confidentiality.

I was on a call the other day to an apartment building. Our PT was an elderly woman, in fact, that describes most of the residents of the building. I know from many, many, many, past calls to this place that residents there tend to be rather nosy about why the ambulance is there. Sometimes, this can be helpful when we need to know more about a resident.

This particular call, however, I encountered a situation I wasn't quite a sure about. I was in the hall, prepping the stretcher, and someone came down the hall and asked if I was going to be taking the person in that room to the hospital. I asked if he was family, he said no, and I sort of shrugged it off saying I didn't not yet.

Now, either way, I wouldn't have given out any information about condition or why we were there, or any otehr personal information. But situations like this are notoriously tricky about what you can and can't say on a call. My reasoning went like this:
"He is able to get into this building, and knows which room this is. Me telling him that we were or weren't going to transport could possibly lead back to him knowing something about the pt that she wouldn't necessarily want him to know".

Am I being over-cautious here?
 

LucidResq

Forum Deputy Chief
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No I don't think so at all. Besides it's better to be overly cautious than underly (is that a word?) cautious, especially when you're dealing with a complex ethical AND legal dilemma. When you're in a situation like that you have to think about two things before you speak: "could saying this potentially cause harm or embarrassment to the patient?" and "could saying this get my *** in hot water?" If you can say no to both questions, you're probably okay saying it. In the situation you were in saying nothing at all or saying exactly what you said have virtually no potential for patient harm or getting you sued.

That guy didn't need to know anything about the patient, so why tell him anything? Tough sh*t for him if he doesn't like it, bystanders are at the bottom of your list of priorities, especially when they just want meat to gossip about. So stay on that cautious side. Good job.
 
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JJR512

Forum Deputy Chief
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My general practice is to play dumb, until they get to pestering, then it's time to politely explain that I can't comment.
 

Grady_emt

Forum Captain
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My general practice is to play dumb, until they get to pestering, then it's time to politely explain that I can't comment.
Glad I'm not the only one...
 

firetender

Community Leader Emeritus
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Good job asking "Are you family?"

Getting a negative response you simply say, "I'm sorry, but I can't say anything to other than identified family."

That's both reasonable and courteous.
 

BossyCow

Forum Deputy Chief
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Yep, good job! One of my biggest concerns is that the bystander I talked to, may twist what I said, and pass it on to others as having come from me. If I say nothing, it can't trace back to me.

We had this happen with an MVA teens+ETOH. The younger sister of one of our volunteers made up a bunch of stuff about the wreck and spread it all over school the next day, attributing it back to her brother. The family of the driver threatened to sue us and the school over it. Ended up going nowhere, but showed me how easy it is for stuff to get twisted about.
 

MedicDoug

Forum Crew Member
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Totally apppropriate response. Generally the less said the better to humans unknown to you. Although my smart-aleck side would be hard pressed not to come back with some witty "no sir, her grandson is coming to visit and I'm making up an extra bed" comment.
 
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ccems644

Forum Probie
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I think you did the right thing not telling. I to usually ask if they are family. If not, I just Say "Sorry because of HIPAA laws I cannot let out any personal information" Most everyone has heard of HIPAA these days and 9 times out of 10 go about their business and leave me alone.
 

emergmedik

Forum Probie
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you did the right thing by not saying anything...... it's tough when you've got bystanders lingering about to try and not appear gruff or hard *** about the situation......but it's also better to cover your *** than to get hauled into court and have to defend yourself later! working in a small area where "everybody knows everybody" is tougher yet!
 

MSDeltaFlt

RRT/NRP
1,421
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Yay4,

Yes, you did good by saying nothing. Here's the deal with patient confidentiality and HIPAA: unless they are intimately involved with the pt, it is none of their damn business what goes on.

Dude: "Hey, what's goin' on?"
You: "Are you family?"
Dude: "Uh... no."
You: "Then I'm sorry, sir, but I can't discuss this with you."

Leave it at that.

Pretty much the way you handled it, but I wouldn't play dumb. Playing dumb is acting dumb. Acting dumb gets you treated like you are dumb, and that's counter productive on future calls with regards to respect on scene from bystanders.

Give them a polite and professional "no", and leave it at that.
 

paramedix

Forum Lieutenant
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Yeah people are nosy... and sometimes plain arrogant!

I have attended numerous calls where you suddenly noticed that you are being recorded on a bystander's cellphone. For what stupid reason I do not know.

The one day I was standing next to a patient at an mva scene and noticed this guy passing for the third or fourth time. Every time he had his cell phone against the window recording or taking pictures of the scene. Now what the heck you want to do with that I have no idea.

That's just looking for a secondary collision or something.
 

Jon

Administrator
Community Leader
7,996
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I tend to just be very vague and noncommittal. I don't start playing the HIPPA tune unless they really push. I prefer to not make an issue of it, because some people will start arguing with me as to WHY I should tell them.

Neighbor:
"Is Mr. Jones Sick? Is he going to the hospital"

Me:
"I don't know". It is usually the truth, because at this point I'm usually working as the driver and my partner is working the patient and trying to figure out transport.


I actually had a neighbor follow me into a house last weekend... I was so surprised I didn't do anything about it... he spoke with the CNA and the PD, and then left :)
 

Ridryder911

EMS Guru
5,922
38
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I always tell them .... "It's a shark bite, be careful they have not caught him yet".. now, remind you I am in the Southwest not near any ocean.

R/r 911
 

CFRBryan347768

Forum Captain
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I have never

encountered that situation but i always get the, "what happened, are they ok?" my answer is simply dinosaur attack, would you be ok? and continue about my business.
 

Outbac1

Forum Asst. Chief
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Steve Berry (I think thats his name, he does the cartoons for Jems), came to speak at a medical conf about a month after 9/11. He related a story that while enroute to the conf. while waiting for his flight at an airport a woman fell over in cardiac arrest. So he dutifuly went and started cpr. While doing cpr and waiting for the medics to come the crowd around him got closer and closer. This was starting to bug him but he was trying not to say anything until one person said "What do you think it is?" To which Steve said he replied "Anthrax". Cleared the room very quickly I'm told.
 

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