If you’ve watched shows like “ER,” “Grey’s Anatomy,” or “Blue Bloods,” you’d be convinced that hospital staff and emergency responders are cut from the same cloth and frequently help each other.
In most cases, that’s the truth.
The connection between medical responders and law enforcement is close. They frequently do work together.
But, television medical dramas aside, the reality is nurses and other healthcare providers often find themselves in the crosshairs of protecting patients’ rights
Sometimes that means the healthcare providers must stand up to the police. When this occurs, the normally cordial relationship can sour quickly.
That’s what happened with Salt Lake City nurse Alex Wubbels.
As the charge nurse in the University of Utah Hospital’s burn unit, Wubbels was responsible for a truck driver who had been severely injured in a head-on crash with another vehicle that was driven by someone fleeing police.
The driver the police had been pursuing was killed in the July 26 crash. The truck driver was unconscious.
Jeff Payne, a part-time paramedic who also has been on the Salt Lake City police force for 27 years, arrived at the hospital to draw blood from the truck driver.
However, state and federal laws, as well as the hospital’s policy, forbid police officers from drawing fluids without a warrant or patient consent. Payne had neither.
Wubbels explained to Payne she wouldn’t fulfill the request.
In the video of the incident, released by Wubbels and her lawyer on August 31, Wubbels is seen talking to a hospital administrator and holding a copy of the hospital’s policy.
“The patient can’t consent,” Wubbels says to the person on the phone and the police officers surrounding her. “He’s [Payne] told me repeatedly that he doesn’t have a warrant and the patient is not under arrest. So I’m just trying to do what I’m supposed to do. That’s all.”
Payne responds, “So I take it, without those in place, I’m not going to get blood. Am I fair to surmise that?”
Wubbels appears confused as to Payne’s aggression. “I have no idea why he’s blaming me,” she tells the person on the phone.
Then Payne lunges at Wubbels and proceeds to aggressively push her out of the hospital and handcuff her with her hands behind her back.
This footage was caught on an officer’s body camera.
The hurdles faced in the hospital
The Utah incident rings all too familiar with Nicole Dearing.
She’s a former registered nurse who worked 7 of her 14 years as a nurse in an emergency room.
For Dearing, family members and friends who asked for information were often understanding of the rules and regulations that protected patients.
“I can tell you that having families press for information was easy to handle as everyone is familiar with HIPAA [Health Insurance Portability and Accountability Act]. Often, if a question came up from a family member about a patient, it was easily solved by asking the patient if I could talk openly to their family, and I always tried to do that in the presence of the patient,” she told Healthline.
However, her years spent in the emergency room offered situations that were a little harder to handle.
“We often had police come through just to hang out with the nurses and staff if they happened to bring someone in. They often felt entitled to sit behind the nurses’ station with us, which allowed them to see who was in the ER, but not any private information,” said Dearing, who is now a chiropractor in Gaffney, South Carolina.
“This got tricky for me once when one of the patients in the ER was an estranged family member of the officer that was there that night. He did ask questions that I wasn’t legally able to answer, and I let him know that,” she said.
“He was unhappy with that response and demanded to see the chart,” Dearing added. “At that time, he was asked to leave. When I brought up that our written policy was that no one other than hospital staff should be in the nurses’ station, he became belligerent and made a comment along the lines of ‘See how fast we respond next time you call.’ They were our backup to security. The hospital did stand behind me on that. However, tension continued between that officer and the staff for quite some time.”
As for what happened in Salt Lake City, Payne, as well as his supervising watch commander Lt. James Tracy, was put on administrative leave. Payne also lost his job as a part-time paramedic.
Salt Lake City police and the mayor’s office are investigating the incident.
“Your conduct… was discourteous and damages the positive working relationships the Department has worked hard to establish with the hospital and other healthcare providers,” reads the Salt Lake City Police Department’s internal affairs investigation report.
“You demonstrated extremely poor professional judgment (especially for an officer with 27 years of experience), which calls into question your ability to effectively serve the public and the department in a manner that inspires the requisite trust, respect, and confidence,” the report adds.
How safe is your health information?
“Patients’ rights are patients’ rights, and those don’t change because of an investigation,” said Jennifer Bates, president of HIPAAStrategies, a firm that provides HIPAA automation and consulting for medical practices.
“Anyone who wants access to medical records must go through the same channels, albeit there are some exceptions for law enforcement,” Bates told Healthline. “The HIPAA laws address who those records can be released to and how they can be released.”
HIPAA laws require healthcare providers to protect medical information, and they mandate how patient information can be stored, shared, and sent to other people.
Your HIPAA rights are understood and enforced, even if you haven’t signed that you’re aware of them.
This helps patients like the unconscious driver from the Salt Lake City incident be protected at all times.
“Patients have very strong rights of privacy under HIPAA. While HIPAA protections don’t apply directly to the police, they do apply to healthcare providers, who have an obligation to protect patient privacy from unlawful police requests,” said Josh King, chief legal officer for Avvo, a legal consultation site.
“And as for the police,” King told Healthline, “the Fourth Amendment dictates that they can only access medical records and patient fluids in accordance with lawful process. In most cases, that means a warrant.”
However, hospitals and health providers are required to turn over certain health information about patients.
This includes cases of abuse, involving either adults and children, as well as communicable diseases, like sexually transmitted diseases.
Otherwise, your information is private, and only you can decide who is able to see or receive it.
What healthcare providers should do
King suggests hospitals use the events in Utah as an opportunity to review policy and put into place practices that can help protect patients and providers alike.
“First of all, before this even happens, any healthcare worker who might remotely face this issue should familiarize themselves, intimately, with their institution’s procedures for dealing with such requests from law enforcement,” King said.
If hospital policy isn’t clearly stated, inquire with supervisors and administrators to make sure you’re aware of it and clearly understanding every aspect of it.
“That’s what we saw in the case of nurse Alex Wubbels, whose familiarity with hospital policy enabled her to confidently defend the rights of her unconscious patient, even in the face of being arrested,” King said.
“Healthcare organizations should have a policy on this, and it is the responsibility of the employee to read the policy,” said Jennifer Mensik, PhD, a nurse, nurse leader, and vice president of CE Programming for OnCourse Learning, an e-learning platform. “If there is no policy, then an employee should talk to their manager. Healthcare organizations have not typically trained employees on this exact situation, however. They typically train employees on how and what to do with a hostile family or patient.”
The second step you should take as a healthcare provider is to know how to read a warrant, King said. “You need to know how to tell it’s valid, which patient it applies to, and what information or physical evidence is covered.”
Finally, get backup and support from a supervisor or co-worker.
“This can be critical if a law enforcement office is attempting to threaten, badger, or cajole his or her way into getting more evidence than what is covered by the warrant,” King said. “It’s not an everyday occurrence, but as we saw in Salt Lake City, it does happen. The example of Nurse Wubbels provides a great jumping off point for making sure that you and your co-workers are fully briefed on your most up-to-date policies for dealing with law enforcement.”