This nursing pulp fiction book is a classic. It was published in 1961.

“Her first impression was a huge head with silver-white hair, and fierce eyes. It was like seeing the Eiffel Tower or the Colosseum for the first time after having looked at it hundreds of times in magazines or on post cards. Lily’s professional smile was frozen on her lips.

Usually she would approach a patient briskly, her hand outstretched, and introduce herself. She had been taught how to do it in nursing school—with just the right amount of cheerfulness. But this was a man who simply didn’t lend himself to this kind of approach. This was a man who had terrorized the White House, a man even the President was said to be afraid of……”.

Who was Mister X?

If this were a current book, I’d guess that Mister X is Dick Chaney. He has a huge head, white hair, fierce eyes, and he shoots his friends when he goes quail hunting. I don’t blame President Bush if he is wary of Dick. Look out, George, Dick is watching you. Mister X didn’t want anyone to know that he was in the hospital. Today his secret would be safe thanks to HIPAA.

HIPPA is a great idea on paper, but it can be a pain in the posterior when you’re trying to talk to a patient’s family member over the phone.

Me: Hello, Mother Jones, RN, may I help you?

Family: I brought my wife/husband/child to the hospital last night and they were admitted to your unit. How is my family member doing today?

Me using HIPPA-speak: I’m sorry, but I can’t confirm or deny the presence of anyone on the unit due to confidentiality laws. If that person is here, I can give them a message and ask them to call you back.

Family: HUH? What are you talking about? I was there last night. I know the person is there. WTF?

These phone calls often end badly, and things get more fun when the family member, who now thinks I’m a jerk, comes to the unit for a visit. I humbly apologize for the frustration that I caused them by following the law, and explain, once again, why I can’t give out any information about their family member. I’ve had people ask me why I won’t give out information over the phone even if their family member has signed a release of information form. I tell them that I am protecting the patient’s confidentiality. After all, anyone can claim to be anybody over the phone, and how can I tell whom I’m really speaking to over the phone? I generally am able to make peace with the family, but only after spending copious amounts of time soothing their ruffled feathers.

As a side note, there’s been a lot of chatter in the blogosphere about medical bloggers and HIPPA regulations. Let me make this very clear. I write composite stories about many different people that I’ve cared for over the years. Names, dates, and other identifying factors about patients and their family members have been changed to protect the innocent AND the guilty. You are having ideas of reference if you recognize yourself in any other these stories. These stories are not about you.

Let’s hear it for HIPAA. Where would we be without those glorious regulations?