Am I On Camera? No Paparazzi Please!

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    In a time where technology seems to be the common theme throughout the world, and the majority of people have smartphones with video and camera capabilities at their fingertips, it is most certainly changing healthcare. Have you ever been asked by a family member to be recorded during standard care...or even thought you were being secretly taped by them?

    Am I On Camera? No Paparazzi Please!

    There have been lawsuits and stories galore about HIPAA violations related to healthcare practitioners taking pictures of interesting wounds, markings, tattoos, etc. on patients, and when patients found out, they became upset and sued for violations of their privacy. If you are a patient with an interesting medical case, there are two ways it can go: you want to hide under a rock and just get treatment, or you may be interested (especially at a teaching hospital) in having your case discussed at multiple levels and allow pictures of every step of your case so that others can learn from what you experienced.

    I understand both sides, which is why most hospitals, if not all, have releases that patients can sign for medical use of photographs (as part of the medical record) so that patients are aware pictures may be taken, but they are being used for medical educational purposes. Patients have the ability to approve or decline the use of pictures, and it gives them that power of decision over their body, in a time when they can feel helpless, which is crucial for them.

    Recently there has been a new trend that I have seen at my own hospital, but heard about from various nurses throughout the country, and it is the reverse: patients (or their families) taking videos and pictures of healthcare providers, during routine care and/or family meetings without telling them. During family meetings, especially if a patient is in a critical care unit and family members may be making decisions for a loved one who cannot make decisions for themselves; they may be stressed during the conversation, worried if they are making the right decision and wanting to remember every word of the conversation to relay to other family members to explain their decision making process, but does that give them the right to secretly record our conversation?

    I don’t think there is anything to hide, but I can also understand how healthcare providers might feel worried that if they are recorded, or videotaped, that this somehow might put them in a position for a possible litigation later on, especially if the outcome of the patient isn’t what their family hoped for (and we all know that healthcare providers do the best they can, but we cannot save everyone.)

    As for being videoed during routine care of a patient; I don’t see what the benefit is for the family, or for the patient. I don’t videotape my mechanic when I get an oil change, I trust that they are the expert: they remove the old oil, put new oil in, and my engine is happy and healthy. Granted, I don’t have a great relationship with my mechanic, but videotaping their every move would be weird, and I wouldn’t blame them if they declined to be videoed.

    Maybe that is a bad example, but as a nurse, I form a relationship with my patient and their family members (or at least I do my best to have a trusting relationship) so I think it is even more of an offensive request to videotape me when I am performing care.

    Are they wanting to do it to make sure that I am doing things properly? Will they compare and contrast how each nurse cares for them/their loved one? As we all know, there are variations in nursing care, due to personal style, but that doesn’t mean that one way is wrong and another is right, the end result can be the same, even though two nurses might go about care in a different way; to an untrained eye, or someone who has no idea about current evidenced based practice or hospital policy, they might think small variations are important, that aren’t.

    I know some nurses double glove all the time, for no particular reason other than that if they are, for example, removing an IV, they like to take out the IV and pull in into the top glove to throw it out and remove the risk of dirtying a bed. Other people don’t do that, but it doesn’t mean the nurse is not removing the IV correctly. Those two scenarios look very different to a layperson.

    Nurses normally explain what they are doing with a patient either before or during the process, to not only empower them with knowledge, but to make them more a part of their care; doesn’t a family member videotaping this make it seem disingenuous, invasive, and distrusting? Where is the trust and the relationship formed with families/a patient when they tape my interactions?

    We give patients the power to approve use of pictures of their medical cases as a part of their medical records, but we have had cases of “secret” videos by families, that we found out about afterwards, but were never asked if it was OK. Where is our power to say no when someone is secretly videotaping us? There is no form that has to be signed, as healthcare practitioners to allow families to record us, and if we allow it, do we then have to worry about possible litigation after the fact, even if they were intended just for informational purposes?

    Technology is a great mobility for information and keeping people connected electronically, but there are times we need to leave technology at the door, and connect as humans.
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    71 Comments

  3. by   DeeAngel
    I would immediately call my charge and ask what to do and depending on what they say I may call the House Supervisor. This is not OK and I will not be filmed without my consent, it's just not going to happen. If the hospital would insist on allowing it then they can explain their hostile work environment beliefs to a jury.
  4. by   Rose_Queen
    One of the perks of working in the OR: no family, and the patient isn't awake to record anything. We have had some patients followed by a news crew to document their journey with their condition, including the actual surgery. Staff were asked to volunteer to be assigned to the case, each person who was on camera had to sign a release (and that included the person walking by whose elbow appeared in the teeniest corner of a few frames), and it was planned well in advance.

    Legally, I would think that patients have a right to record as long as the local laws allow it. A hospital would likely be considered being out in public, and guarantees of privacy can't be made beyond what the law (mostly thinking of HIPAA here) allows. I certainly wouldn't be comfortable with it, though.
  5. by   traumaRUs
    I always provide my business card to all new pts and families so there is no reason to film me, they know who I am, what practice I'm from and contact info.
  6. by   MunoRN
    Everywhere that I've worked encourages patients or family to record discharging teaching, medication teaching, etc which I'm all for and I don't really see why any nurse would have a problem with that. Sure, it's always a bit weird to be filmed but I don't believe that supersedes patient safety or their basic rights for that matter. From a legal standpoint, unless your in the bathroom, locker room, etc there is nothing illegal about filming a nurse doing their job; their is no legal expectation of privacy for the nurse in that situation. From a liability standpoint I'm all for being video recorded. One of the worst situations you can find yourself in is to be stuck in a your-word-against-theirs lawsuit years after the fact, in general video evidence is going to do a lot more to protect me than it will hurt me.
  7. by   driggersa
    I have encountered this on a unit I worked on... not with myself, but one of my coworkers. She was very uncomfortable about being recorded and having pictures taken of her, especially since this was a family who had been complaining quite regularly about their frustration with the facility.

    Personally, I would not feel comfortable having someone filming me perform my duties, ESPECIALLY without my knowledge! ~ If a professor has the right to deny a student the permission to record (audio or visual) information from their lectures, we as nurses should be able to expect that same respect. ... Now, that being said, if a patient requested to record discharge education for future reference, I would not be opposed to that. But it should be MY choice.
  8. by   BD-RN
    Just today I caught a patient videotaping my colleague placing her IV, because she missed the first time. The reason I was upset? Because I was verifying my patient before I started her medication, who was in the chair next to her (outpatient infusion center). MY patients private identifying information was now caught on camera. HIPAA violation, right there. Our hospitals policy is that in order to photograph or videotape, you must have the proper permits, be approved and followed by the appropriate department. This is to ensure patient privacy. Therefore, no; patients do NOT have the right to videotape their care at their leisure.
    This was promptly explained to the patient, who deleted the video upon request (I hope).
    And PS Id LOVE to hear that case: I'm suing because my nurse couldn't get my IV. SMH
  9. by   imenid37
    Quote from Rose_Queen
    One of the perks of working in the OR: no family, and the patient isn't awake to record anything. We have had some patients followed by a news crew to document their journey with their condition, including the actual surgery. Staff were asked to volunteer to be assigned to the case, each person who was on camera had to sign a release (and that included the person walking by whose elbow appeared in the teeniest corner of a few frames), and it was planned well in advance.

    Legally, I would think that patients have a right to record as long as the local laws allow it. A hospital would likely be considered being out in public, and guarantees of privacy can't be made beyond what the law (mostly thinking of HIPAA here) allows. I certainly wouldn't be comfortable with it, though.
    If you work in OB, you can have people that want to tape C.Section or you caring for their baby. Some nurses do not want to be taped. They should definitely be able to refuse. Many patients now show up with a photographer or video crew. They figure it is their birth and their right to tape. To an extent, I agree with that. HOWEVER, it is the nurses right to say "I do not want you to show my face or I do not want you to record my voice or I do not want to be taped at all." Patients who agree to be videoed always have the right at any point to say no more. Our staff deserves that right. My pet peeve is when families tell (not ask) staff to move or wait to accomadate their taping. More and more people whip out the phone without asking and start taping. If it is an emergency, you do not notice. They have it on tape and they are not gonna erase it no way, no how.
  10. by   DWelly14
    I absolutely think the nurse should be told if she is being filmed or not. Just because I'm doing my job doesn't revoke my right to say who can take my picture or record me. I work in OB and it is a big deal. We're having a really hard time with our OR because people think they can just whip out their phone and photograph and record everything and when something does go wrong like a hemorrhage or something, we've had patients' family's threatening staff because they don't understand that nothing wrong was done, sometimes bad things happen and the staff gave the patient excellent care and did everything they should have in that situation. It's a tough one for sure.
  11. by   AuDDoc
    Sorry you don't have the right to record me without my permission. Do so and if I find out you will be seeing a lawsuit. Do so while I am working at a federal facility and I will see to it you get a lawsuit and charges brought against you.

    I cannot film you or interactions with problem patients so why should they have the right to record me without my permission?
  12. by   MunoRN
    The laws regarding filming people in places of public access are pretty clear, what gives people the impression that someone can't film you as a nurse or that they need your permission first?
  13. by   AuDDoc
    Because if anyone else is around you are now violating their privacy rights.
    Part of my job is to guarantee the privacy of protected health information. When someone whips out their cell phone and starts recording anyone else who might be filmed has now had their privacy rights violated.

    Also you might want to check the laws in your state. Many states require the person being audio recorded and video recorded have knowledge and agree to the recording. Federal facilities are a big no no
  14. by   MunoRN
    Quote from AuDDoc
    Because if anyone else is around you are now violating their privacy rights.
    Part of my job is to guarantee the privacy of protected health information. When someone whips out their cell phone and starts recording anyone else who might be filmed has now had their privacy rights violated.

    Also you might want to check the laws in your state. Many states require the person being audio recorded and video recorded have knowledge and agree to the recording. Federal facilities are a big no no
    The patients have an expectation of privacy, nurses do not (unless they are in a bathroom, locker room, etc). No states require permission for recording or taking pictures where there is no expectation of privacy. There are federal laws that apply to specific federal facilities, typically called secured facilities, but VA hospitals aren't one of these and federal privacy laws most definitely apply to federal buildings which by definition are public property.

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