jiminyC_fan
DIS Veteran
- Joined
- Jul 24, 2001
As stated above, it has nothing to do about care. She wanted him to change his diagnosis. A school nurse should never, ever ask a doctor to change a diagnosis that a child has had for eight years.
Thanks for the explanation of posting at the same time. That definitely happens a lot. LOLWe posted at the same time, your post was not up.
Still, it is not a HIPAA violation. It was provider to provider communication. Whether what she asked for was "correct" or not, she did not violate HIPAA. If this was medical information given to her by the doctor and she had any question of concern it would be the physician she directly contacted. The physician gave her the medical info, assuming with his mother's permission, she questioned it. Whether she should have or not is a different story, but she did nothing wrong questioning it.
Thanks for the explanation of posting at the same time. That definitely happens a lot. LOL
Asking to reword his diagnosis is wrong no matter what. It has remained the same for 8 years. He remains the same for 8 years. I think that is why I am questioning whether or not she had the right to contact him. It had nothing to do with care, period.
Thanks for the explanation of posting at the same time. That definitely happens a lot. LOL
Asking to reword his diagnosis is wrong no matter what. It has remained the same for 8 years. He remains the same for 8 years. I think that is why I am questioning whether or not she had the right to contact him. It had nothing to do with care, period.
I often ask patients what their understanding of things is. It helps me know where they're coming from. If it happens to differ from what the plan of care is as I know it, then I work to bring the information together in a way that everyone can be comfortable with. It differs in every situation, but rare is it that we can't all work it out.
I'm getting the sense here that there is a dislike/distrust of the school nurse and that is part of the problem here.
Thanks everyone. I have written a text to my daughter asking her if she signed something. My daughter doesn't mind sharing info since it's in her son's interest but what does bother her is not knowing they are contacting the doctor. She has been through all sorts of things with doctors and has finally found one that she has a great relationship with. She doesn't want the school running to the doctor for minor info that she, herself, can provide. She wants him there for her in an emergency and not tired of always having to deal with the them for little things. This is the first doctor that will call her back ASAP. This is the first doctor willing to dig deeper. He has a severe non controlled seizure disorder called Doose.
Thanks everyone. This wasn't the case of questions about care she might administer. It was about asking the doctor to reword his document about his diagnosis. She actually asked him to change it. HER version of was full of mistakes and he didn't allow it. His case is severe and rare. She can't ask a doctor to change it because it's not what she is familiar with. He has several types of seizures not one. He has failed 18 meds.
Fortunately most nurses are professional. This particular nurse will talk to parents about other children not their own. Believe me, there is a lot of dirt on this nurse that I do not care to go into on a public forum. Her contact with this doctor had nothing to do about care. She, also, recommended a med. She isn't a doctor specialized in Epilepsy and she sure as heck shouldn't be recommending medication.
I wondered if it fell under FERPA. Thanks
Thanks to all for your insight.
As stated above, it has nothing to do about care. She wanted him to change his diagnosis. A school nurse should never, ever ask a doctor to change a diagnosis that a child has had for eight years.
Thanks for the explanation of posting at the same time. That definitely happens a lot. LOL
Asking to reword his diagnosis is wrong no matter what. It has remained the same for 8 years. He remains the same for 8 years. I think that is why I am questioning whether or not she had the right to contact him. It had nothing to do with care, period.
I 100% understand your situation in a partial care program. You are having a hand in their care. I would only hope a nurse would step in and articulate her concerns. And again, you are right. It isn't the same as what is happening with us. She definitely over stepped her boundaries suggesting a different diagnosis. For goodness sake, Epilepsy is difficult even for the well seasoned doctors. No case is the same as another. What I admire from all of his doctors is that they admit that the parents probably know more about the condition than the doctor.
I respect what you're saying. ^ But "challenging" is the wrong word, here, I believe.
It's not an adversarial relationship - everyone's best interest is the child's well being.
If there - heaven forbid - was a medical incident, the nurse would have to justify her actions or inactions. She has duties inherent in her position. That is all we're saying.
We recognize these situations have a lot of emotion involved.
Exactly. We have a situation where the OP heard from her daughter, who heard from whomever at the Dr's office. This is information possibly passed on through 3-4 people.
The conversation could have ranged from, "You are dead wrong, Child has This syndrome, not That and he is on the wrong medication," to "I've noticed X in Child, have you considered That Sydrome, I had another similar student who had That syndrome and he did well on Z drug,"
I, too, get the emotional involvement, and it's hard sometimes to find a diagnosis and the appropriate treatment. Again, the bottom line is, legally, there is no HIPAA violation or any other violation. There is nothing actionable in what the nurse did.
Even if she did actually, "challenge" the diagnosis, she is still within her rights or scope of practice to do so.
She can't diagnose the child, but she is allowed to question a given diagnosis.
I find it really hard to believe that if you had a child who had a rare syndrome that was diagnosed 8 years ago, who has been seen by several neurologists (who are experts in epilepsy), who have confirmed that this child does indeed have this rare syndrome, you would be happy to have a school nurse challenge your child's doctor. Really?
And I understand this is not a HIPAA violation. But I think she overstepped.
I was thinking the same thing. One of the big thing my pharmacology class emphasizes (I am a nursing student) is that nurses are held liable for any medication they administer, regardless of if it was the doctor who could be at fault (nurses have the right to refuse to administer a medication). If for instance, a doctor prescribes a medication dose that is way too much for the situation (like prescribing 100 units of insulin for a meal instead of 10 units), the nurse fails to clarify the dose with the prescriber, and gives the medication (and the patient has a serious adverse effect), the nurse would risk having his/her license revoked. If there's any questions, concerns, or misunderstandings, it's the nurse's responsibility to clarify them before implementing any care.The nurse would be carrying out the doctor's orders under the doctor's supervision and should be contacting the doctor for clarification whenever necessary, shouldn't she?