How to respond to identity suspicions at work?

Jelson

Leaf-

Is it possible that hospital personnel who are interviewing/working with pre-op, have been trained to form a connection in order to help calm the patient who is facing surgery, has that training included forming personal connections? I ask this because the last time I was in the hospital for outpatient surgery, the nurse who was prepping me noted that I had provided "Jewish" for religion and she explained that she was Jewish too and started a whole rap on her child's Bar Mitzvah and local people to whom she was related. If I was a more active member of the local Jewish community, it might have been fun, distracting and comforting but IT was only distracting and weird!!! Anyway, I am wondering if reaching out and establishing personal connections was ever part of the curriculum, It should certainly be eliminated NOW. 

also, I get agitated when I can't "place" a person with whom I am interacting. I agree that Barb's suggestion " I am going incognito today" would be a good first response. It acknowledges that you might indeed be familiar - bingo! but lays out the game plan for the day, you are not going to participate in figuring out why you look familiar. 

Barbe, sometimes you have to wonder whether hospital volunteers cause more problems than they are worth, esp with HIPAA. 

Julie

leaf

Oh gad, Barbe.  What an embarrassing thing to go through - especially when you were doing what you were asked to do!!  I know I will be very nervous, but I really hope I can start out with your suggestion.

Jelson - thank you very much for your insight.  I think your guess is right! I think it makes sense that they are trying to make me feel less nervous by trying to connect with me.   I would have been irritated if some went on making assumptions about my religious beliefs too.  That's not an appropriate subject.  It must be hard to make 'small talk' to make a patient more comfortable. From what I've seen of nurses, some are a lot better at making a patient more comfortable than others.  (Just like pharmacists, or any other profession.)

I really like my health care professionals to 'really be present', not burned out or lost in their own thought.

I really appreciate all the time you have taken to think about my situation and all the help you've given me. It makes me feel more prepared. I'm sorry you had to go through your experiences to earn your wisdom.

I will post how it goes on Tuesday.  Thank you again.

barbe1958

Actually, the silly thing is that I kept my underwear ON anyway. I knew I wasn't going in for a hysterectomy again!

leaf

I'm sad you have to do all of this to get good care,Barbe!

I've decided to start out with "Ah, I'm going incognito."  (Not adding 'today',because I don't want them to breach my confidentiality tomorrow or the next day either.) "I've had my confidentiality breached in the past."

If they persist, "I've had my confidentiality breached in the past.  I don't want to answer your question because I don't want that to happen again."

If  they persist,  I'll just ask for a HIPAA person to come.

barbe1958

Good luck!! We're waiting to hear a positive experience one way or the other (positively horrid or positively perfect) as perfect as any procedure can be....

leaf

Thanks, Barbe!  I'll report back.  Your support means so much to me!  I'm off to the hospital now.

barbe1958

God Bless and God Speed leaf!!

Leah_S

Leaf, I hope all goes smoothly for you today.

Best of luck.

Leah

leaf

Thank you, Leah and Barbe.

I think at least 2 of my caretakers knew who I was, and didn't even ask. I am guessing there is a 'popup' on my identity verifying the person really wants to access my file.

Well, as I was walking to the surgery center (in my street clothes), I rode down on the elevator with a nurse who knew me.  I was angry, and glared at her,  then explained I'm going incognito, and that my confidentiality had been breached in the past.

She totally understood; she made a 'zip my mouth' gesture on herself.  Luckily I had her as my post-op nurse too.

The pre-op nurse luckily couldn't pronounce my antidepressant, so I doubt she had any clue what was going on with my mental health issues. (I didn't cringe more than momentarily.) For my other medical conditions, I only described the symptoms, not the name of the disease.  I told them all about my past confidentiality breach (about the mastectomy recommendation.)

I only told the anesthesiologist my other diagnoses.  That did affect the optimum choice of anesthesia.  

After my recovery, the charge nurse came in, and knew who I was without asking, and asked if I wanted to walk out as opposed to getting wheeled out, and they'd have a person follow me out to my ride's car, in case of trouble. 

  So my alias hopefully worked for my department, but I'm pretty sure every nurse who saw me knew who I was, regardless of my alias.

barbe1958

Crossing fingers that you weren't the "flavour of the month" around the water cooler yesterday leaf! I hope you have a couple days off so they forget about it when you go back. If you're posting, it must have all gone well, whatever "all" was! You done good!

Beesie

I'm glad that it's over and done.  It's a difficult, awkward situation and you handled it well.  I think that by mentioning the previous breach in confidentially, you made it clear why you were going incognito - you weren't trying to be difficult, you weren't being silly - you had a legitimate reason. I would think that any medical professional should be able to identify with your concerns about confidentiality when undergoing a personal procedure so I hopefully that will keep them from saying anything.

How are you doing?  

redsox

I do think the norms have changed since HIPAA has become the law for medical practice.  I work in medical research with many people from many institutions.  Before HIPAA I would get calls from people across the country asking how so-and-so was doing because word had spread (in minutes) that s/he was hospitalized.  It was well meaning, genuine concern but there were no secrets!  Now the situation has changed completely and no one spreads any health information. 

If you have any problems, not only do you have a very legitimate complaint, but you can insist that they need to do another round of thorough HIPAA training for everyone.

Of course, the original problem with the radiology clerk is not just privacy but also the clerk making any treatment recommendation.

leaf

I'm doing quite well physically, but I just found out there was an expected death in the immediate family.  I was having my procedure at the time.  I was not close to this person, but there are a lot of issues involved.  Glad I'm seeing my therapist tomorrow.  I'm going in to work tonight.  If nothing else, it will be a distraction.

I think that if I had gangrene of the foot and the radiology clerk recommended amputation of my foot, it wouldn't be as bad as recommending removal of my breasts or genitalia.  He didn't even know me.  I guess he thought he was being helpful since LCIS is unusual.

Thank you all for all of your suggestions and comments, particularly Barbe's incognito suggestion.  It helps reassure me I'm not completely nuts, at least not nuts all of the time :-).  

leaf

I had my first appointment with my new oncologist on Friday.  (My old oncologist retired.)  At registration, the registrar looked at my alias name and my real name (on my insurance card) and told me she'd need to change my alias name back to my real name. (My reaction: Not again!) I told her this went through the HIPAA officers, and I'd need to refuse care if this happened.  She told me she'd wait while she checked with her supervisor.  After telling the supervisor the story, she checked with the HIPAA office.  Supervisor came back to me and said in an astonished tone "What you said was true!"

However, my new oncologist (because she was asking why there were 2 different names on the records) said, "Yes, that's shocking, but its very common." (My blood pressure was 150/90, where it is usually at max 130/90.  I told the nurse that I was nervous.)  

Do you think its common for <essentially> male strangers to tell you that you need mastectomies?  I don't see many reports of that in the 'Stupidest thing that people say to you' thread in Anxiety, Depression and PTSD forum.

barbe1958

I guess your world is like an office workers world standing around the "water cooler" and gossiping. It's everywhere. One of the reasons I made my diagnosis very public. I didn't want to worry about the chatter behind my back.

Glad to know you were right! As we knew you would be!!!! Why do they make such a big deal of it? Why can't they just honour your wishes....sigh.

And yes, some of us have had virtual strangers - our surgeons - tell us we need mastectomies!

{{{{{{{{{{{{{{{{ leaf }}}}}}}}}}}}}}

leaf

Oh Barbe - what would I do without you.  I just love your posts!!!!!!!!

leaf

Update: (To summarize those that don't want to go through this whole thread: I work at the hospital I'll be having a procedure, and had an alias because I have had confidentiality breeches in the past.) 

I was informed by the HIPAA officer that all aliases have been eliminated. I have an upcoming minor procedure (nothing to do with my breasts) in Day Care Surgery.  For some patients, you have to re-enter your password to access their chart.  It was strongly implied in training for the computer system they could track who had access. I asked if there was a way they can audit who has accessed my information.  The reply was that they will be getting new software to do a better job at monitoring that in a few months.  That sure makes me confident that they can tell who has accessed my information - not.

I am hoping that my trusted co-worker will be able to verify my orders when I have my procedures.  Even if a co-worker keeps your medical information private, I don't want someone who I don't like/trust knowing my information.

I wish that some of the people who are making these decisions had the ability to put themselves into the shoes of others, and could imagine they had strangers of the opposite gender come up to them during work and recommended they be castrated.  Or, more importantly, that because they were upset during their last surgical procedure, that meant they are mentally unstable and would not be rehired back after their procedure, which meant they will lose their medical insurance and job.

 Boy, these new policies really eliminate my concerns about privacy - not.

farmerlucy

Yikes Leaf! Sounds like a tough situation! Good luck with your procedure. Thanks again for your invaluable assistance on these boards!

Jelson

Yes, hope all goes well in all respects Leaf.

leaf

Thank you so much. 

I don't know if there actually have been situations where their doctor informs the patient's boss about the patient's emotional health during surgery.  I have seen posts that claimed the patient was not re-hired back because the surgeon told the patient's boss that the patient was suicidal (obviously a HIPAA violation),  so the patient  was not rehired back again, and thus lost their health insurance.  The company can claim they didn't rehire due to financial reasons. 

 I don't know if that story is true or not, but I bet in this cost conscious society, some places will use whatever they can to reduce the number of employees.  I'm not suicidal, of course, but I did have a traumatic wire insertion 8 years ago.  I have been advised to say to my anesthesiologist when they ask how I am, to say "I am terrified because I had a biopsy that caused unbearable pain during the procedure.  I'm so glad you are here so you can take care of me."  In my many procedures, I have never had a bad time if an anesthesiologist was involved.

I'm glad there are some people here who 'get it'.  Thank you again.

Solen

You got a lot of great support and advice!!

My son, used to watch this video clip of a little girl saying, loudly "NONE YOUR BIZZNESS" in the snottiness of tones. 

He started saying it. Now, me, my husband and some of the other moms use it when people stick their nose into other people's "BIZZNESS ". It is done in a joking way, but it gets the point across.

Really, people are way too nosy, mostly for schadenfreude reasons ( LOVE that word, if someone is too nosy, you can ask them if they suffering from it! LOL!)

Now keep in mind, some people want to know because they come from a kind and caring place as well. But you are entitled to your privacy. 

Good luck, I hope the procedure goes well for you .

leaf

Thank you so much, Solen.  I had to look up schadenfreude, but that explains a lot!  Yes, I know some people do come from a kind and caring place.  Still, there are some people you like and don't mind having the information, and there are other people that you don't like.  Even if that person you don't like doesn't talk, you still don't like them knowing your information.

Solen

Leaf, I agree completely!!

And I love that the Germans have a word describing people's joy in other's misfortune.  It is considered a REALLY bad trait there, and it is such a fun word to throw at someone when they deserve it.!!!   LOL!!

And I totally understand the privacy thing.  My son is on the autism spectrum and when he was in public school he was in the gen ed population.  There was a lot of gossip, and misunderstanding about me and my child, yet I didn't feel that I needed to explain to others and or make excuses to them as it was "NONE their bizzness"  I am sure the teachers talked and gossiped as well even though it was against the law ( privacy laws apply there as well)  So I know about people you just don't like and don't want to share info with!

I just am sorry that you are feeling this added stress to your situation!!  The ladies here have given you some goo ammo to be prepared with.  I have learned through teaching my son, (and myself) that if you go into a situation and have some practiced lines to deal with it ahead of time, it helps a lot.  Often people say things to me and I cannot respond, because I am so dumbfounded by what they have said.

I hope I can make you laugh when I tell you the French have an expression "L'esprit de l'escalier" which "describes the predicament of thinking of the perfect retort too late"  It refers to as you are leaving a social situation and you are going down the stairs, you think of the witty comeback you SHOULD have said.  I suffer from this a lot!  But you have received a lot of help as to handle the situation and I very much hope it goes smoothly for you.

BTW, I am NO expert on foreign languages, but these two expressions are so apt to so many situations and we don't have the equivalent in English!!!

Wishing you the best.

Solen (Karen) 

leaf

Thank you so much, Karen. You've given me lots to think about!