a nurses right to privacy as a patient??

1 disclaimer: This was a conversation my coworkers and I had the other day and was curious on opinions.

If a nurse were to seek help for alcohol and/or drug addiction and disclosed that he/she diverted narcotics from patients, would that counselor be required to report this to the board or to their employer?

My coworkers say no due to confidentiality. I think stealing drugs from patients would fall under the "harm to others" clause.

What do you guys think??

Also, if a nurse is drug tested and is positive for methadone or suboxone (for which they had a valid prescription) is that reportable??
I would say HIPAA and the protected counselor-client relationship trump all other concerns. I would hope the information would remain confidential. It will be interesting to hear what others have to say.

At first you should warn, after that you should inform to authority.

I think it would be a mandated report situation. Perhaps by saying you used to but stopped you'd avoid that, but I wouldn't want to put money on it.

I recently had a discussion in my BSN program about this. There is a great article on medscape all about mandatory reporting:http://www.medscape.org/viewarticle/585562There are different laws in different states that may or may not define in what circumstances a nurse has to report another nurse. Some examples given under the "State Laws" section of this article (2008): In Texas, you can refer the impaired nurse to abuse counseling instead of to the nursing board; Michigan states that if you are a nurse with a professional nursing relationship (you are caring for) another nurse, you do not have to report. In Nebraska, in that instance you still could report them if you deemed that not doing so would be a danger to public health (which I think would apply if you knew that they would continue to divert drugs from patients).You must know the specific laws of your state. In the "HIPPA and Mandatory Reporting" section, the author interprets HIPAA and breaks down your responsibility in the situation where you are caring for an impaired nurse into a step by step process: 1. Does your state mandate what and how you should report this? (If not, the author states, then don't) 2: Does the state law state that you should not report if the nurse is a patient (then don't report)? 3. Will exposing the nurse to the appropriate authorities "be limited to the relevant requirements of the law" or would they excessively violate her HIPPA rights?" and 4. Do you feel you have to report the nurse to protect the public?The article states that HIPAA does allow for the disclosure of this private information if that disclosure is required by state law, and when it is "necessary for the oversight of the health-care system;" the author of the article seems to state a nurse should only report if required by state law.In the "Patients in Alcohol and Drug Abuse Treatment" section, the author states that federal regulations regarding the privacy of nurses who you are treating for drug abuse or psychiatric issues (they are in your care and actively being treated for their addiction) override the state's requirement to report them.This article also points out that if you see a colleague (who's not your patient) doing these things, you are considered to have met your legal obligations by reporting it to management or a supervisor (someone who is "reasonably able to prevent or lessen the threat") who is supposed to take care of the rest (reporting it to the board, etc).The bottom line is that you should examine your state's laws and know when federal regulations override them.

http://www.hhs.state.ne.us/crl/SMRRequire.pdfhttp://www.medscape.org/viewarticle/585562_5

Quote from xtxrnhttp://www.hhs.state.ne.us/crl/smrrequire.pdfhttp://www.medscape.org/viewarticle/585562_5

If someone were to disclose information about me while I was a pt who actively sought medical treatment, I would be talking to a lawyer so fast.

Quote from chevyvIf someone were to disclose information about me while I was a pt who actively sought medical treatment, I would be talking to a lawyer so fast.

I get the whole diversion thing, but isn't a certain amount of proof required. What day, how much, what pt or pts? I work psych and the things people say and the actual event is rarely the same. If you're caring for a pt who happens to be a coworker and they tell you something that could be potentially fatal to their career, I would seriously make sure they have little standing under the privacy laws or your gonna get yourself into a whole lot of trouble. I think it becomes a different entity once the coworker is a patient. Very interesting topic.

Quote from chevyvI get the whole diversion thing, but isn't a certain amount of proof required. What day, how much, what pt or pts? I work psych and the things people say and the actual event is rarely the same. If you're caring for a pt who happens to be a coworker and they tell you something that could be potentially fatal to their career, I would seriously make sure they have little standing under the privacy laws or your gonna get yourself into a whole lot of trouble. I think it becomes a different entity once the coworker is a patient. Very interesting topic.