Caregiver taking naked picture of patient

[Aloe_sky]

Hello all,

Today a patients Caregiver was caught taking pictures of a patient by a nurse. The nurse told the patients nurse, she didn't think it was a big deal since it was the Caregiver (pt is comatose). The other nurse walked pass again and noticed the Caregiver taking pictures of the patients genital area. The nurse told the patients nurse again. The patients nurse said since the Caregiver makes decisions, she didn't know what to do?!?

Anybody experience this? I would think it's inappropriate even if it is the Caregiver. Anybody have a policy on visitors taking pictures of patients? How would you guys handle it?

[roser13, ASN, RN]

What is your definition of Caregiver? A relative? A hospital employee?

[caliotter3]

If this is occurring in a facility, provide a written statement to the Director of Nurses or Administrator.

[Flatline, BSN, RN]

The appropriateness will depend upon the relationship of the caregiver to the patient and the intention.

For example, it is common to take images in wound care to track healing. Keep in mind though that a "caregiver" in the traditional sense is not a covered entity under HIPAA or anything like that.

[RiskManager]

As the risk manager, I would want to hear about this. I would followup to see if the photography was for a legitimate clinical purpose (wound care, decubiti, evidence of abuse or neglect) or some other acceptable purpose. If I had a concern that it was not for a legitimate purpose, I would be calling my friendly local case officer at Adult Protective Services to chat about my concerns.

[Aloe_sky]

Turns out it is not a caregiver but a family member that makes decisions for the patient.

[Aloe_sky]

The patient also dI'd not have any wounds.

[RiskManager]

What kind of facility is this? With this new information, the first thing I think of is that the patient is in long-term care, and the caregiver may have some concerns or suspicions that the patient is being sexually abused in the facility, and is taking pictures for documentation or to show to law enforcement.

[KatieMI, BSN, MSN, RN]

What kind of facility is this? With this new information, the first thing I think of is that the patient is in long-term care, and the caregiver may have some concerns or suspicions that the patient is being sexually abused in the facility, and is taking pictures for documentation or to show to law enforcement.

Or the family member was going to expose the pictures on Facebook with something like "my fiancee is in ICU... they put THAT thing into his privates... can I EVER have sex again with him??? with THAT thing still in??? will it ever come out??? It is SOOO TERRIBLE!!!! Please HELP!!!!!"

Had just such case quite recently, the "thing" being Foley cath; once the fact became known, the Powers came down flying in full force and did their d***edest to make the patient "the ward of the state" with the supersonic speed, which removed the family member's visiting privileges, and to move him out of there, vent and all.

[RiskManager]

The oddest such case I ever had to look into was a young woman who had her boyfriend taking close-up pictures with his cellphone, in a semi-private room, prior to surgery, of her clitoral hood piercing. The piercing had a diamond in it, and the patient was concerned someone in the hospital would steal it while she was in surgery or recovery, and wanted to document that it was there prior to surgery. One of the pictures allegedly included the front page of the local newspaper so as to document the date the photo was taken. The most valuable thing I took away from this incident was that if you Google 'clitoral hood piercing' to learn something about the subject, what is subsequently seen cannot be unseen.

[cleback]

Whether or not that person is their decision maker doesn't matter. If it's abuse, it's abuse. Unless I was given a super good reason why the photos were necessary, I'd report it.

[Aloe_sky]

As the risk manager, I would want to hear about this. I would followup to see if the photography was for a legitimate clinical purpose (wound care, decubiti, evidence of abuse or neglect) or some other acceptable purpose. If I had a concern that it was not for a legitimate purpose, I would be calling my friendly local case officer at Adult Protective Services to chat about my concerns.

Are visitors or decision makers allowed to take pictures of patients as long as it's for legitimate reasons?