Duty to Warn and HIPAA

I work in acute psychiatric on the highest acuity unit in my hospital. I get the cream of the crop so to speak.

I have had duty to warn situations before where there was already a named victim or a therapist that was threatened.

I have a new situation and I’m looking for some feedback.

I have a person that I would call a legit psychopath right now. He has been stopped from doing a mass shooting more than once.

He has been obsessed with a girl since high school. She never dated him. She never wanted to. He wants to murder her with a firearm is what he reported today.

I can’t say to much specifically but he is well know by the police.

Here is the thing. At this time I only have her first name. No other information. I am working on that though. My thoughts are she needs to be warned not only is she being stalked (yes he is doing that) but she is in danger.

If I do find out the rest of her information how much can I legally say to the police to try to protect her? For example can I say he is in patient right now and where so she could have him served with a PFA? Or is that outside the bounds of duty to warn?

I’m really worried about this case.

Scared shitless honestly.

I’m in the US. Any feedback is appreciated.

I also find it interesting there is no actual diagnosis yet in the DSM 5 about people who want to commit a mass shooting. I’m guessing it will be coming in the next one?

Sigh.

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u/serastar18 — 10 days ago

[update] Still Pissed. Still Want to Burn it to the Ground!

Link to my original post: https://www.reddit.com/r/GirlDinnerDiaries/s/wuHsVWFDcQ

NSFW cause I cuss like a grown up.

Since I had so much amazing support on my post about my current heath issues and struggles with the US healthcare system I thought I would give an update.

I went for my endoscopy yesterday. It was an 800$ copay and if you read my thread I said I had no plan to pay the payment plan other than the 400$ that I had to pay to get the procedure.

Ha! Well, those pig fuckers made me sign a payment plan agreement that allows them to automatically debit my credit card for the next 3 months. They wouldn’t do the procedure unless I signed. Little do they know, I maxed that credit card out for that endoscopy so they can eat my whole asshole on trying to get the rest.

Part of my pain was that whenever my stomach even started to be less than full I would be doubled over in agony. So having to not eat or drink for hours before the procedure had me fucked up. I honestly thought of just eating because it was fucking killing me. But I somehow made it.

Then when I was wheeled into the procedure room the DR actually tried to fucking gaslight me! This bitch immediately started telling me that she didn’t think they would find anything wrong with my stomach and that I would need another procedure to check my bile ducts. Like, fuck you asshole.

I was laying there starting to panic that I wasn’t going to get answers and that I would have more OOP fees that I quite literally cannot pay for. I told her I know it’s my stomach that’s hurting. I understand pain radiating but this hasn’t been doing that. She just kept hard on this rhetoric that it wasn’t likely there was anything wrong in my stomach and I had more than likely been referred for the wrong thing.

My blood pressure must have started going up or my heart rate because the anesthesiologist leaned over me, got my attention, and said “breathe it’s going to be ok” then knocked my ass out.

I woke up like 20 mins later and the first thing I ask was “Did they find anything?” The nurse said “I think so”.

Then i hear the fucking DR from off behind somewhere speaking saying that yes they did and she could come talk to me when I’m more awake.

Fucking asshole DR. I used all my will to wake up fast and know what the fuck is wrong with me. I was in so much pain at this point. It was an 8/10 and I’ve given natural birth 3x so that’s saying something.

I kept asking for the DR to come back and she did. She had the mother fucking nerve to act surprised/excited. Saying how she was so shocked when she turned the camera down some area of my stomach and BOOM A HUGE FUCKING ULCER!!!

Yep. I have an ulcer! A good sized one too. The DR was “surprised”. I wasn’t surprised I said from the first day it hurt I think it’s an ulcer.

Then she said I also had black spots throughout my stomach so she biopsy them.

I immediately started sweating more. Biopsies are not covered by my insurance of course. She took multiple. Each one is OOP cost of $600+

Fuck me. Fucking fuck fuck fuck.

I guess there’s a bacteria that can cause ulcers and if I have that then I need the antibiotics. Why can’t they just do the antibiotics? Why can’t we just assume it’s that!??

Also, they will likely want to do another endoscopy in a few months to see if the ulcer healed. I won’t be doing that. I won’t be able to afford it. I’ll also know by the pain if it’s healed.

Oh, she also said she would call me in meds.

I get to the pharmacy many hours later, no meds. Call the office they say they will call them in, they don’t. Call back, still no meds.

I ended up having to go to THREE pharmacies to get my meds to start.

What I didn’t say in my last post is I’m flying this morning to see my adult kid who I haven’t seen in 2 years. Trip has been planned for 4 months.

Nothing was stopping me from getting on that plane. But I really wanted the meds before leaving because the pain is going to severely affect the trip.

Sigh. I got the meds. I started them last night. So far no improvements. I still have to have food in my stomach all the time. Wake up all night to graze when the pain hits.

At least I got an answer. Fuck that ass home DR for not even looking before she decided I didn’t know my own body that I have lived in for 50 fucking years.

I want to say thank you to everyone who commented on my last post. Many of your stories really kept my own situation in perspective. It could be worse. It could be a lot fucking better, but I could have it way worse.

My heart goes out to everyone going through this unbelievable fucked up Medical Industrial Complex bullshit.

We really need to BURN 🔥 this shit to the mother fucking ground!

Fuck you United Healthcare. Fuck you Capitalism. Fuck you Big Pharma. Fuck you All insurance. You are the literal leech’s on the infected boil on that orange maggots ass.

TLDR: American Healthcare can eat a whole bag of rotten donkey dicks.

[Bacon, egg, avocado sandwich from the airport. No, it wasn’t good]

u/serastar18 — 28 days ago

I’m so Pissed. I want to Burn Something.

[Chicken Fajita’s at a real Mexican place. I live close to Mexico so it’s legit]

Been reading here awhile. First time posting.

NSFW cause I fucking swear a lot.

This is NOT a relationship post.

Fuck you US healthcare system. Fuck you up your fucking shit hole.

I have insurance. Fucking useless fucking United Healthcare. The boil on the ass of Americans. It’s doesn’t cover shit. My deductible is sky high because, the plan with the lower deductible not only cost way fucking more, it had a lot less in-network providers. Go figure. They fuck you every way.

In June I had my first colonoscopy. I was a few years past due so I went. Colonoscopy covered by insurance. Anything they remove while roto-rooting in your ass, not covered.

I had a polyp removed. It turned out to be PRE cancerous. So, ok good I got it out. 600$ bill.

Started having severe upper abdominal pain a week later. Felt like when my gall bladder was going bad, but that’s been gone 10 years. Thought about the ER but those fucking worthless assholes don’t do shit unless you are bleeding out. And it’s a 1200$ cost OOP for the ER where they will say I need a gastroenterologist.

Went to PCP got referred for CT. Went to get CT 300$ OOP up front. No payment plans. CT comes back clean.

PCP tried to gaslight me a little that it was just stress and I actually believed it for about 6 hours till the next bought of pain hit. Nope, not stress. Wakes up all night. Hot sweats. Nausea. Pain. All the time pain. No fucking stress.

I need an endoscopy. What a bitch to get. Same gastroenterologist I was at 6 weeks ago can’t just schedule the procedure. Nooo I have to have another consult. Translation, another way to bill insurance and inflate my cost so they can buy another vacation property. Also, 2-3 weeks wait for procedure. I was almost crying. “Sorry ma’am it’s the policy”

Fuck you heartless fucks.

Had screening today and DR was like oh yeah you need to get this done fast…ya think! Got me in on a cancellation for tomorrow. YAY!

Then they call me to tell me…oh by the way it’s 800$ OOP up front. Are you serious?

I live paycheck to paycheck. I have no savings ever. I have a 14 year old car w a cracked windshield, no AC (110 degree heat daily here), when I push the brakes the headlights come on. Plus other random old car weird shit.

You really think I have 800$ coming out my ass. Then they say…like they are doing me a fucking favor “you can pay 400 up front and payment the rest for 3 months”.

Great. Wow you are so helpful. Really.

I have an emergency credit card that has 400$ on it so I’ll be maxing that out in the morning and the fuck with your payment plan. You can eat a whole bag of dicks. You think my 570 credit score is scared of you!?

Pffffft please!

But also, I’m in pain all the time. I have insomnia already and this has made it so much worse. I just want to feel better. I want to know what is wrong.

Im so sick and tired of this fucking world and stupid rich or wanna be rich assholes who just keep passing laws, fucking people over, acting like if someone is poor they don’t work hard. Or like being poor is a moral failing of some kind.

There’s a reason Luigi did what he did. Right or wrong, there was a reason.

How do we keep the man from grinding us down when the only place I’ve ever lived is under that man’s fucking boot?

u/serastar18 — 29 days ago

Uncomfortable Audiobook Moments?

Have you had uncomfortable moments listening to audiobooks?

I have had 2 that were like…ugh.

  1. Was listening to Stephen King’a IT and if you don’t know that book has parts that are definitely hard on the N word. Like, whole rants from various characters.

So, one day I was listening while driving with the windows of my car down. Pulled up to a stop light without really thinking much and one of those rants hit. 2 POC stopped directly at my passenger from the sidewalk with mouths wide open and looking at me like I was the worst human on the planet. Totally freaking get it. I quickly turn it down and apologized and said it’s a book. …this didn’t make the situation less bad. It just made me look like I was listening to KKK books. The light turned green and I just drove off. Lesson learned. I keep the volume waaaay down if any kind of racist language is being used.

  1. This one happened today. Was listening to Brynne Weaver’s new book Harvest Season. It’s a beach blanket serial killer book. Lots of explicit sex scenes.

I went to Target today and turned off the book mid sex scene. Went shopping and totally forgot the book was playing at a sex scene. Got in my car and started it. Windows down (I have no AC) and the book starts auto playing to my car. At the exact time a whole ass family of little kids are getting to the van parked next to me as there’s a whole anal sex thing graphically happening! I almost broke the knob off the radio turning that down so fast!

So, my question is does anyone else have these similar experiences with audiobooks?

Tell me I’m not alone out here!

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u/serastar18 — 2 months ago

When the Clinical Director Lies

Ok, so what happens when the clinical director lies and a SW is formally reprimanded for following a directive that the clinical director gave verbally?

When it is the SW word against the Director what can a SW do to protect themselves?

Is there any recourse?

What about when a hospital is trying to institute a directive that is in violation of a state law?

What can a SW do to make sure they are following the law without being terminated for following the law?

What if a SW knows about illegal practices at a hospital they work at. How can a SW keep their employment safe and the patients safe at the same time?

Asking for a friend…

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u/serastar18 — 2 months ago
▲ 216 r/Tucson

To the person in front of me this morning who paid for my chai and snack, THANK YOU 🙏🏼

I don’t know why you did that but it was really nice and I had a hard week so extra appreciated kindness from a stranger.

I paid it forward to the next hoping it made them smile the way you made me smile.

😊

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u/serastar18 — 4 months ago