May 16, 2010

Can Religious Nurse Handle Patient With Atheist Friend?

Nurses and nursing
Nurses and nursing (Photo credit: Wikipedia)
I received an email recently from a reader named Bob that really stuck a nerve. The situation he described taps into one of my worst personal fears (i.e., being dependent on religious crazies for necessary medical care), and I want to share it in case any of you has some wisdom you could share about it.

I am paraphrasing here, but the situation is that Bob has a good friend who is disabled and lives in a nursing home. He's only been in this particular facility for a few weeks, and it turns out that one of his nurses is a Christian extremist. When Bob was there visiting his friend, he happened to say "Jesus Christ" a couple of times in a non-religious context and was scolded by this nurse.

As he left the facility, she god blessed him. He asked her to please refrain from making that statement to him in the future and explained that it did not mean anything to him because he was an atheist. At this point, the nurse wrote this in his friend's (i.e., her patient's) file.

What does Bob do now? He's understandably concerned that his disclosure is going to affect the care his friend receives from this nurse. He does not think that his atheism belongs in his friend's medical chart, but is not sure what he can do about it.

I will share my thoughts below, but I'm interested in yours as well.

First, since Bob is a friend of the patient and not the patient himself, he probably has few if any legal rights about the contents of his friend's medical records. However, under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Bob's friend has plenty of rights pertaining to the contents of his file. In fact, the patient may view the contents of his file, request amendments, and dispute inaccuracies. HIPAA offers a number of such protections, but they belong to the patient and his legal guardian (if relevant).

Second, legalities aside, it sounds to me like Bob has some legitimate concerns about the suitability of this nurse to care for his friend. I would think that the place to start would be with her supervisor. I could imagine Bob gently raising his concerns with the supervisor, emphasizing that his religious beliefs or lack thereof are not relevant to the care of his friend. Depending on the size of the facility, there may be multiple levels of administration. But even in the smallest, there should be someone with greater authority than this nurse.

Third, nothing Bob said suggests that his friend has in fact been treated differently because of Bob's atheism. I think it makes sense to hope that this nurse is professional enough to handle the situation appropriately. However, if his friend reports being mistreated in some way, then Bob can be prepared to escalate the situation quickly. There are a number of ways this can happen, but filing a formal complaint with the nurses employer is probably the first step.