Man I feel horrible..

[ForeignBody]

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I think inadvertently told someone's family today that their daughter is pregnant. I am usually really good about asking everyone to leave the room and verify who is able to get info, but I definitely dropped the ball on this one. I was rounding real early this morning asking the usual daily rounding Q's. Room is kinda dark and I see 3 people in the room instead of the usual 1 person in the room. Everyone is awake of course, lights are just dimmed. I tell patient I'll let her know the results of ECHO later today and that the OB/GYN residents are coming by later to talk with her..I go out of the room and I am walking by about 20 min later when the nurse comes out and says...oh you know her family doesn't know she's pregnant right? ..doh

 

[Eta Carinae]

just curious, how old is the daughter (the preg pt)?

 

[ForeignBody]

just curious, how old is the daughter (the preg pt)?

18 yo

 

[docB]

That stuff happens. If you hadn't said it the same info would have been passed when the OB/GYNs showed up at the bedside later in the day. Patient's have the option of not allowing visitors, phone calls, etc. as a part of their admission paperwork. If it's that important that they keep a secret they have that option.

 

[DutchgirlRN]

She's of legal age her parents will have to deal with it.

 

[Eta Carinae]

No harm done in the long run.

I had the same experience on my medicine rotation. This lady came into the ER with what seemed like your run-of-the-mill SOB/CP. She was older (50s) so I thought nothing much of it...until the phys ex.

😱

Her Left breast was rock hard and stuck as well as her L chest wall. My first thought was Inflammatory breast cancer because I assumed it had to have been the most aggressive form of breast cancer to have such extensive chest wall mets.

dude, like I went into the family room with a box of kleenex and started sharing the prognosis with the family, replete with studies I had printed out about inflamm BC. (I used up most of that kleenex by the way).

God, everytime I think of it I feel so stupid. My attending was really cool about it when she found out what I had done. She appropriately addressed the patients and the family and told them we needed imaging + biopsy to make a diagnosis and formulate a treatment plan.

In the end, she had a malignant pleural effusion and after several centeses, she ended up getting a pleurodesis procedure done.

She declined chemotherapy but consented to radiation therapy and was discharged after about 2 weeks, if I remember correctly.

But in the end, no harm, no foul. I don't think anyone really held it against me because it was only my second rotation.

I'm sure it will be overlooked now because you're a med student but as a resident, I would be wary of oral diarrhea!

You'll be fine.

 

[dragonfly99]

You should NEVER discuss a new diagnosis, especially of something serious (CHF, AIDS, cancer, pregnancy, etc.) with any visitors or other family members in the room, until you've said the magic words, "Is it OK to discuss your condition and test results with all these people here, or would you rather have them step outside for just a few minutes?". Also, if there is any doubt or I'm worried AT ALL that the patient wouldn't want people to know everything, I'll just straight away ask all the visitors to go outside. It's always easier to bring the people back for patient support and to provide more information, but once you've blabbed something it's just out there for everyone to know about. It's a HIPAA violation (federal law regarding patient privacy) to tell patient's confidential information to other people, so you need to be careful about that.

 

[jrgong]

Dude I think foreign body knows that he messed up, that is the whole point of the thread. That kind of stuff happens sometimes, the important thing is that he realizes that he made a mistake and attempts not to do it again. I think everybody, including FB, knows that disclosing any information without the patients consent is a HIPAA violation. No need to reiterate it. People seem to forget that physicians are human and make mistakes. We are not machines.

Instead of clarifying something that he probably learned in his second semester of medical school, why not stress the importance of communication with the patient? Showing good rapport and being able to take accountability can go a long way with a patient. Explain the situation and spend a little time with the patient to show them that you care and they will respond positively. Of course that does not always work.

 

[Eta Carinae]

Dude I think foreign body knows that he messed up, that is the whole point of the thread. That kind of stuff happens sometimes, the important thing is that he realizes that he made a mistake and attempts not to do it again. I think everybody, including FB, knows that disclosing any information without the patients consent is a HIPAA violation. No need to reiterate it. People seem to forget that physicians are human and make mistakes. We are not machines.

Instead of clarifying something that he probably learned in his second semester of medical school, why not stress the importance of communication with the patient? Showing good rapport and being able to take accountability can go a long way with a patient. Explain the situation and spend a little time with the patient to show them that you care and they will respond positively. Of course that does not always work.

👍👍

Like seriously, even a 12 yr-old knows about HIPAA

 

[michaelrack]

👍👍

Like seriously, even a 12 yr-old knows about HIPAA

Nearly everyone knows about it, but most people (including many doctors) misunderstand it.

There are plenty of people you can give medical info to under HIPPA- the patient's health insurance company, other treating physicians- without the patient's consent.

In my opinion, privacy protection is weaker under HIPPA than it was previously.