Written by Elizabeth Cairns, Mobilize Recovery Special Projects, and reviewed by Code Recover Peer Advisors, August 2026

Privacy Protection is the Law

Working in a hospital means you are entrusted with sensitive patient information. HIPAA (the Health Insurance Portability and Accountability Act) is a federal law that requires patient information to be kept private. For a peer, understanding HIPAA regulations and obeying them is just as important as it is for the clinical team.

While most healthcare settings require employees to be trained in HIPAA, it is important to learn about "Part 2" stipulations specifically for SUD patients. These stricter rules protect SUD patients from having their medical records used against them. (source)

As a rule of thumb, limit the information you access to what you need to perform your job. For example, if you have access to electronic health record systems, only view records for patients you are actively assisting. Never discuss a patient's status or information in public spaces such as a hallway, elevator, or cafeteria, even with other staff. Keep patient conversations behind closed doors or in designated private areas. Obtain patient consent before discussing their care with anyone else, such as a family member.

HIPAA allows, and state law often requires, sharing of personal health information without patient consent when there is an immediate threat to the safety of the patient or another person, such as current abuse or neglect, suicide risk, or other imminent harm. (source) In these cases, you should be transparent with the patient about your requirements to share this information with the clinical team.

Physical Safety in the ED

The Emergency Department is a fast-moving and sometimes unpredictable environment. Your physical safety is just as important as the patient's.

• Standard Precautions: Take standard precautions against bloodborne pathogens and other infectious agents. Never touch used needles, even to dispose of them. If you are in a room during a procedure, wear the required Personal Protective Equipment (PPE). Sanitize your hands upon entering and leaving a patient's room. While you will want to dress in a way that is relatable for patients, you'll also need to be mindful of what is acceptable in the ED environment; for example, you will want to wear closed-toed shoes to protect your feet.
• Room Positioning: When entering a patient's room, always keep yourself between the patient and the door. Never position a patient between you and the only exit.
• Situational Awareness: Pay attention to the "vibe" of the unit. If a patient is becoming physically aggressive or if a security "code" is called, step back and let the trained clinical and security teams handle the situation. Your role is engagement, not physical intervention. If you feel unsafe at any time with a patient, excuse yourself. You can say, "I'm going to step out to check on a resource for you," and immediately notify the nursing staff or your supervisor.