S03. E04: This Is All I Need

[AnnA]

On 3/26/2021 at 11:08 AM, Sake614 said:

Regarding the police presence in the ER, I don’t know a single hospital, especially those part of NYHHC, that do NOT have armed police officers stationed in the ER. Granted, not to the extent shown on New Amsterdam, but they are most definitely there. My mom was at Brookdale and there’s a police officer at the front entrance and another in the ER. The majority of staff are people of color, and while I didn’t ask them if they were comfortable with it, I didn’t see anything to suggest they weren’t. ERs, especially at public hospitals, can be dangerous places. As someone mentioned above, we’ve seen it before at NA. So I’m surprised they didn’t already have cops stationed there. 

I agree and law enforcement for health or safety reasons is an exception to HIPPA laws.

10 Times HIPAA May Not Apply | Emergency Physicians Monthly (epmonthly.com)

[circumvent]

7 hours ago, ams1001 said:

When my mom had surgery a few years ago, my dad said they had an electronic board in the OR waiting room that showed patient status (like if she was in prep, in surgery, in recovery..) and estimated finish time, but it used an ID number, no names. Only my dad and the hospital staff knew my mom's number. I assume to prevent people waiting for loved ones from repeatedly asking for updates from the staff. (Thankfully I haven't been in an ER in almost 20 years, and I was in a neck brace/backboard at the time so I wasn't really paying that much attention to what might be on the walls.)

I know we saw the OR assignment board, and we also see that on Grey's a lot, but I don't know if that's somewhere visible to non-staff.

Yes, that's right about the OR waiting area. I have been in a few of them and in different hospitals, so it is common practice by now.

In ICU's you might get a glimpse of a board with names and room numbers, plus the name of the nurse responsible for that patient, but it is usually a more restricted area. Since it is just a name and no other information, maybe it is a loophole or acceptable practice to make things more practical and faster in a place where speed of providing care might be needed in a regular basis.

[circumvent]

1 hour ago, AnnA said:

I agree and law enforcement for health or safety reasons is an exception to HIPPA laws.

Yes, but law enforcement standing around patients that they don't know needs to be watched, and they cannot know is a danger to anyone (unless they are psychic) is a violation of HIPAA. Imagine if you are in the ER, and officers are walking about and near where you are. The nurse is asking you questions about drugs and you mention that you smoked marijuana earlier that day. You live in a pace where recreational marijuana is not legal but you can safely tell this to the nurse. The cop hears that and requests a test, threatening you because you broke the law. Your 4th Amendment was violated.

Cops in certain strategic areas of places like hospitals are there for cases of "limited purposes" but not to basically eavesdrop and turn you into a felon because you sought help for something maybe unrelated to pot - something you disclose because you trust that the more information you give, the better care you get.

That's not what happened in the show. Cops (and the bouncers) were walking around, mingling with the patients. The patients would have to say it is ok for them to be there. 

The chart you provided does't go into specifics. You need to read all the exceptions and details in the rules they cite, or take the course. It is actually a very good one, it is done online and you learn a lot. 

[doodlebug]

On 3/27/2021 at 3:05 PM, circumvent said:

Yes, but law enforcement standing around patients that they don't know needs to be watched, and they cannot know is a danger to anyone (unless they are psychic) is a violation of HIPAA. Imagine if you are in the ER, and officers are walking about and near where you are. The nurse is asking you questions about drugs and you mention that you smoked marijuana earlier that day. You live in a pace where recreational marijuana is not legal but you can safely tell this to the nurse. The cop hears that and requests a test, threatening you because you broke the law. Your 4th Amendment was violated.

Cops in certain strategic areas of places like hospitals are there for cases of "limited purposes" but not to basically eavesdrop and turn you into a felon because you sought help for something maybe unrelated to pot - something you disclose because you trust that the more information you give, the better care you get.

That's not what happened in the show. Cops (and the bouncers) were walking around, mingling with the patients. The patients would have to say it is ok for them to be there. 

The chart you provided does't go into specifics. You need to read all the exceptions and details in the rules they cite, or take the course. It is actually a very good one, it is done online and you learn a lot. 

This is correct.  These days, most hospitals, especially in busy, urban areas like New Amsterdam/Bellevue; would routinely have a uniformed guard present in the ER.  However, that person would be stationed away from patient care areas unless there was need for their presence due to a patient who is out of control or pulls a weapon or some other potentially dangerous situation.  I can think of no reason that a police officer would be wandering around having random contact with patients or visitors as part of their job.  Patients must be guaranteed confidentiality or people will stop seeking out healthcare.  Even in the case where a caregiver suspects child abuse, the security officer would not immediately be involved.  Instead, Children's Services and perhaps the hospital social worker would be the first contacts with a police officer only providing backup as needed.

[Madding crowd]

As I mentioned earlier my husband is a police officer currently on duty in a big hospital. He is not wandering around but is generally stationed at access points and is called if there is a patient fighting staff or gang members attempting to find someone etc. He is quite busy and has zero time to listen in on patients. He also would never talk about anything he sees because that is not part of his job. He actually works for the hospital now similar to private security but without people like him the staff would quit. Just today he had a patient hit a nurse and could have seriously injured her. Lots of stuff goes on in these hospitals.

[Leeds]

On 3/26/2021 at 7:42 PM, circumvent said:

Talking about a patient when other people are around is a violation of HIPAA. I have to take the test every year and one of the "situations" they present is: you and a co-worker enter an elevator and there is someone there. You start talking about a client. Did you violate HIPAA? The answer is YES. Another: a behavior analyst goes t a group home to see a client. Nobody is at home. What should the behavior analyst leave at the door (multiple choice of card with name and phone, card with name, phone and reason for visit). If you answer card with name and reason for visit you made a mistake. If you talk about a patient, you have to make sure anyone listening, or possibly listening, is authorized. 

What if you're talking to a patient on a ward and the patient(s) in the next bed(s) can hear?

Edited May 1, 2021 by Leeds

[circumvent]

1 hour ago, Leeds said:

What if you're talking to a patient on a ward and the patient(s) in the next bed(s) can hear?

My experience in ERs - where this can potentially happen - is that one, there are at least curtains, so you don't see who the patient is. New hospitals tend to have actual rooms in the ER. People don't talk loud either. So the patient in the next bay might be able to hear but not really identify who/what is going on. At least this is my experience. The times I had to be in the ER with someone, they even asked me to not walk around, to stay in the little cubicle, all due to privacy. So I guess it can happen that a person overhears some private information, and that would possibly be a HIPAA violation since at least some hospitals are careful to keep it all private. 

As for admitted patients, I haven't been in any hospital that have double rooms. I guess the same would apply - keep private info private, make sure the other patient cannot hear what they are not supposed to. For sure, if there is a visitor, ask them to leave the room for a while. I was once visiting my husband at the hospital and they asked him if I could stay in the room while the doctor gave her report and treatment plan. Even being next of kin, unless the patient is unconscious or unable to give consent, such consent is needed

[possibilities]

I have been to many medical facilities and not a single one of them makes any effort at all to protect anybody's privacy. We all sign forms saying we have been informed of our rights, and then everybody blabs with people standing around, it's worse than a joke. HIPAA is only as good as enforcement, which is shite. So, again, as terrible as it is, and how wrong, New Amsterdam seems fairly accurate, to me, in terms of how bad things are. Outrageous? Yes. But the world is shitty that way. I keep finding myself laughing about how accurate they are in their bad behavior, actually.

A friend of mine had a major stroke and is in a nursing home (hopefully temporarily). She has a roommate and when I was talking to my friend on the phone, the nurse was talking very loudly (near to shouting) to the roommate about the roommate's medical situation (maybe the roommate is hard of hearing-- I'm not sure-- it wasn't angry shouting but it was very personal stuff and very loud-- and the roommate was crying about it and the staff was just plowing ahead loud enough that I could hear it even over the phone).

I agree it's extremely unsafe to have police in the hospital, and it's not paranoia, it's a lived experience and documented to be dangerous. They need security, but like in every other area of our society that needs security, we ought to be training a totally different set of people and establishing healthy infrastructure to do that, not inserting cops into the system. So I appreciated them having the staff intervene with Bloom to highlight this issue, even if it made Bloom look stupid, and even if hiring bouncers with no training in hospital security was rash. I do think that in the long run, starting from scratch with people who ARE trained in hospital security, would be a good idea, and why not train out of work bouncers... basically, anybody other than police would be better than police. So, even if it's common practice to have cops, it's still wrong and I like that the show made a point of establishing that fact.

Of course, Max also ought to wear a staff ID badge clearly visible, so the security staff knows who he is. They did kind of show how the insta-hire of untrained bouncers was not a great solution, as they were hovering around and didn't seem to have any protocols in place. Actually, the clumsiness of it seemed somewhat realistic for a change!

I miss Kapoor. It sounded like he'd need a heart transplant, but they didn't mention that as far as I noticed. I hope he's not gone.

[bros402]

7 hours ago, possibilities said:

I have been to many medical facilities and not a single one of them makes any effort at all to protect anybody's privacy. We all sign forms saying we have been informed of our rights, and then everybody blabs with people standing around, it's worse than a joke. HIPAA is only as good as enforcement, which is shite. So, again, as terrible as it is, and how wrong, New Amsterdam seems fairly accurate, to me, in terms of how bad things are. Outrageous? Yes. But the world is shitty that way. I keep finding myself laughing about how accurate they are in their bad behavior, actually.

A friend of mine had a major stroke and is in a nursing home (hopefully temporarily). She has a roommate and when I was talking to my friend on the phone, the nurse was talking very loudly (near to shouting) to the roommate about the roommate's medical situation (maybe the roommate is hard of hearing-- I'm not sure-- it wasn't angry shouting but it was very personal stuff and very loud-- and the roommate was crying about it and the staff was just plowing ahead loud enough that I could hear it even over the phone).

I went to one of my doctors on Friday and a new (to me) nurse walks in - first thing she says "I get to see the famous [bros]! I'm so excited to meet you!"

That is probably because I am on a clinical trial, but i'm sort of surprised that out of the ~80 people in the trial, I am the famous one :P

I mean that could be because of the rarity of my case, but still

at least with your friend, the nurse talking to the roommate about it makes sense, but yeaaaah she shouldn't have been yelling it, especially if the patient was objecting to it being said so loud. Since I can understand in an inpatient setting that sometimes there isn't a place for a private setting to talk about a medical issue.