I just got a new job, a nursing co-op at a hospital. When I was going through my health and drug screening I had to answer questions like what meds I was on. Obviously the nurse doing my screening realized I had diabetes (as if my visible site wasn't hint enough). She asked the usual questions like type 1 or type 2, how the pump works, and what do I do when I take a shower or swim. After all the chit chat she stated that I was required to let my unit know. I ALWAYS let people know I have diabetes just in case and usually in a large group so I can get all the same questions out of the way. But required? I sat there thinking about that word: required.
ugh I don't like that word. I generally prefer not to disclose, but in this case I guess you have to.
I have always tried to keep my diabetes hush, hush, especially on my job.
If you were an accountant that would be one thing, but being in the medical field I imagine there are different requirements.
Dear Abbie,
Pardon my essay! I'm delighted you're in nursing. Normally "required" is said by the person hiring, or by the supervisor.
I look at "required" as a means to ensure when the action is fast and heavy, other nurses who find me dazed will put 3 half-glucose tabs in front of me and say, "Take these," -- because I told them that's how much I will need when I was hired. It's when there's a lot on our mind that we miss the little clues ourselves. This requirement provides needed backup and safety for everyone.
I look at it the same as I looked at being required to take a chest x-ray every year of my school and working life - I was TB+ from age 8, after having lived with my grandfather who had TB. It was the professionally required thing to do.
When people can be put in danger due to a health worker's status, it is incumbent on the health worker to take specific actions that provide backup or that mitigate.
Our finest hours come when we carry out the actions that show we're professionals.
And that same requirement goes for everyone, the pharmacist, the anesthesiologist, the ER physician.
Your supervisor should not "require" this of you. This should be a corporoate policy. Individuals should not go around making stuff up. You are within your rights to ask to see the policy. If your company is large enough, it also is required to have a corporate officer who is responsible for assuring compliance with the laws governing discrimination (particularly the Americans with Disabilities Act). And in this case, unless your job falls into an area where diabetes presents an issue in you doing your job (like commercial airline pilot), asking about your diabetes and "requiring" that you divulge private health information to your coworkers represents discrimination.
If you are not satisfied with the answers you get about policy, it would be appropriate to seek out your corporate EEOC office or EEOC officer and tell them what has happened. Generally, your EEOC office will be your friend, their job is to make sure the company obeys the law and if they don't they will take whatever corrective action is necessary. The last thing they want is an EEOC problem. If you are not satisfied, then you can certainly escalate it.
You may be told as a nurse that you are in a profession (like pilot) which requires disclosure as it affects your ability to function at your job. But that is different than just being told you are required to divulge private information for no reason.
I actually don't think you can be required to disclose. There are certain jobs that legally "require" one to disclose certain health conditions (like diabetes) because of the risk (pilots, truck drivers, etc), but I don't think nursing falls under that requirement. You should call the EEOC and ask. I am curious myself. If you disclose your health status to a whole unit, you're essentially giving up a significant amount of medical privacy. This could have implications not just for your current position, but also for any future jobs. I would seriously call the EEOC and inquire about this. In addition, I would ask that nurse who informed you of this to provide some sort of written information that requires disclosure. And I might take the opportunity to remind her that the information she learned during your physical is (as far as I know) protected health information.
Hi, Abbie,
Having been on both sides of this issue by virtue of various positions, I believe you can fight the "requirement", but you lose in the long run when you do. Your co-workers ask "what are you losing?" Your supervisor (I've been there, too) asks, "How could you not tell us? What do you think we do with the information?" Telling a unit does not mean telling non-professionals.
I fully agree with the idea of 'why should I be "required" to disclose' question. The presence of a dead patient and you spaced out in a hypo is answer enough. That's the bigger loss.
I've always fully disclosed my diabetes but usually after I've worked in a position long enough to establish myself.
That being said, I agree that the word "required" gave me pause also due to privacy issues. But your description of going through a health screening also made me raise my eyebrows. In 29 years of working professionally, I've never been "required" to do a health screening of any sort.
If it's a union nursing job it may be required by the union contract,
Thanks everyone for the feed back!! I am in corporate orientation this week and will get to meet my supervisor on Monday. I think I have decided to just tell the nurse manager of the unit and work down the chain!
Before you do, take a close look at this document:
http://www.eeoc.gov/facts/diabetes.html
You are not required to disclose any information about your diabetes. Because you have diabetes, your employer can not assume you will be a risk to your patients for any reason whatsoever.
Even if you decide to disclose that you do have diabetes, you cannot be grilled on it. Really, the only questions they can ask you are regarding the reasonable accomodations that you require to do your job in a satisfactory manner.
Me too... and I find that hard to believe you are REQUIRED to disclose ANY health information...um HIPPA.
I work in the health field and I've NEVER been required to disclose ANYTHING regarding my diabetes.
I work in hospital based healthcare and there have always been policies stating that employee health and or infection control can make requirements of staff either individually or globally throughout the organization to ensure patient safety. Laws governing health careworkers change all the time and are different. There are physical requirements for nursing and I’ve had to pass a physical every place I’ve worked. Certain types of injuries or illness require a Dr’s note to return to work. This was all made clear during the hiring process and orientation so it’s not like it’s a surprise.
That being said I have never been required to disclose to co-workers that I have diabetes.
In an ideal world nurses with diabetes would always be successful at preventing lows in the first place but if that fails you do need to be able to quickly treat lows on the job. Every place I’ve worked has a policy where food and drink is not allowed in patient care areas. Your locker could be several floors away and not immediately accessible. Neither can you just take a break whenever you want. By disclosing I can keep what I need to treat a low in my work area or I can corner the charge nurse to cover my patients on short notice for a few minutes till the brain fog clears. A few simple accommodations allows me to keep my patients and myself safe. It’s rare that I’ve needed to use them but I’ve been glad to have the option when needed.
There are places where HIPPA takes a backseat. I work in the nuclear power industry and people with a federal license to operate have to inform the Nuclear Regulatory Commission (the US government) about all changes in medications and healthcare status.
Required? Hmmm. Here are my thoughts on this subject.
I never disclose I have diabetes in the hiring stage (not that I have had a lot of jobs; Just retired from my thrid adult job of my life.)
However, once I am in a new work location, I let people know straight out. I explain what it is, how I might act if low, and what to do if that happens. I always have a list of emergency numbers for anyone to call, with basic instructions to treat a low if needed. Let me say, that has been very helpful, as they tend to remember what to do when it is needed. I had one of my staff feed me diet coke when I was low, until someone read the instructions and changed to regular coke!
I worry about those who keep it hidden. What happens if you need help? In all my years of work, I have only needed real help two times. But if no one had been aware, what would happen?
Same here. I told the PA in Occ health at the request of my Dr. but no one else on this site of 1,000 staff know about it. I've only told two non-medical people about it; one of my sisters, and a friend who sometimes stays with me for over a week. Kind of hard to hide it for that long, plus she has a T1 brother and sister.
Agree. HIPPA laws relate to patients not employees for an organization. Laws regarding safety trump everything. Even in the links provided by the Americans with disabilities act and the EEOC links there are specific examples where it is legal for an employer to ask questions about an employees diabetes status when safety is a factor.
I wouldn't want a nurse administering a medication to me where an error could be dangerous or fatal while their blood sugar was 52. Once the low was corrected and they were thinking straight no problem carry on.
This is an Americans with Disabilities issue, not a HIPPA issue. You do not have to disclose information about your diabetes to your employer. If you choose to do so, that is your choice but your employer cannot require it.
Yes, an employer can ask questions under certain conditions. Here is the clause from ADA:
The ADA strictly limits the circumstances under which an employer may ask questions about an employee's medical condition or require the employee to have a medical examination. Generally, to obtain medical information from an employee, an employer must have a reason to believe that there is a medical explanation for changes in the employee's job performance or must believe that the employee may pose a direct threat to safety because of a medical condition. (See Question 6 for other instances when an employer may obtain medical information.)4. When may an employer ask an employee if diabetes, or some other medical condition, may be causing her performance problems?
If an employer has a legitimate reason to believe that diabetes, or some other medical condition, may be affecting an employee's ability to do her job, the employer may ask questions or require the employee to have a medical examination.
Example: Several times a day for the past month, a receptionist has missed numerous phone calls and has not been at her desk to greet clients. The supervisor overhears the receptionist tell a co-worker that she feels tired much of the time, is always thirsty, and constantly has to go to the bathroom. The supervisor may ask the receptionist whether she has diabetes or send her for a medical examination because he has a reason to believe that diabetes may be affecting the receptionist's ability to perform one of her essential duties sitting at the front desk for long periods of time.
5. May an employer obtain medical information from an employee known to have diabetes whenever he has performance problems?
No. Poor job performance often is unrelated to a medical condition and should be handled in accordance with an employer's existing policies concerning performance.
Medical information can be sought only where an employer has a reasonable belief, based on objective evidence, that a medical condition may be the cause of the employee's performance problems.
Example: A normally reliable secretary with diabetes has been coming to work late and missing deadlines. The supervisor observed these changes soon after the secretary started going to law school in the evenings. The supervisor can ask the secretary why his performance has declined but may not ask him about his diabetes unless there is objective evidence that his poor performance is related to his medical condition.
6. Are there any other instances when an employer may ask an employee about diabetes?
An employer also may ask an employee about diabetes when an employee:
has asked for a reasonable accommodation because of his diabetes;
is participating in a voluntary wellness program that focuses on early detection, screening, and management of diseases such as diabetes.(4)
In addition, an employer may require an employee with diabetes to provide a doctor's note or other explanation to justify his use of sick leave, as long as it has a policy or practice of requiring all employees who use sick leave to do so.
For me, the lne is "must believe that the employee may pose a direct threat to safety because of a medical condition" is the concern.
I get it. We know there are dangers with diabete that can lead to catastrophic results. Does that mean that I'm required to tell an employer that I have diabetes if I have responsibility over other peoples lives? I don't think so. It is incumbent upon me, as a diabetic to insure that, with reasonable accomodations, I am performing my job satisfactorily.
By requiring me to disclose that I have diabetes, me and my employer both agree that diabetes, in and of itself, is a danger or will affect my performance. That's exactly what the ADA was written to protect employees from.