Will I get in trouble ? ? ?

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  1. Did this violate HIPAA ?

    • 43
      YES
    • 15
      NO

58 members have participated

Hello,

I am a 2nd yr nursing student, I graduate in May. I had an OR observation

yesterday and was able to watch an endo lap chole. I may add that I was very

excited as my goal is to become an OR nurse.

When the gallbladder became visible on the monitor I took a picture of it with

my cell phone. The picture only included the endo monitor with NO identifiable

info on it. Is this a HIPPA violation? I was excited and didn't think anything

about taking a pic of the gallbladder on the monitor. The nurse seen me take

the picture and immediately told me that was not allowed and that I needed to

delete the picture, which I did.

Upon returning to the floor my clinical instructor had received a phone call from the hospitals edu department letting her know that they need to see me and to bring my phone. I went and explained what had happened, show them my phone to prove that the pic had in fact been deleted and I was told that was okay, I' not in trouble.

Today I get an email from the Head of Nursing at my school saying that I need

to come in and see her in the morning before I go to class. Can I be kicked out

of the program for this? She stated in the email that it was a HIPPA violation

but everything I can find states that it's not a violation as long as there is

not any identifiable information related to the patient.

Does anyone have any suggestions and/or advice about this situation or how to

handle my meeting at school tomorrow morning? Any information or suggestions

would be greatly appreciated . . . I did not mean any harm; I was just excited

to see the gallbladder come up on the monitor :no:

I'm not sure if this is a HIPAA violation or not, but I wouldn't be surprised if it is. I know you stated that there were no patient identifiers in the picture. However, lets just say hypothetically speaking, that this patient's spouse over heard you discussing the "neat" photo that you took of a patient's gallbladder, and prior to the procedure the surgeon had told the patient and the patient's spouse that no other patient was having that procedure on that given day...(not sure if they actually tell patients that) So, now the spouse knows that this is his/her loved ones gallbladder in the photo...and it upsets them. My point is that you can never know for certain that the photo is unidentafiable. If I was in the patient's shoes, I wouldn't mind if a photo was needed in order to determine my treatment or for other medical reasons...but I would not feel comfortable knowing that a nurse took a picture just because she felt excited and wanted to capture the moment. I know you meant no harm, and that you have learned a lesson. I hope that your school is willing to give you another chance :)

Ay yay yay....was the picture really necessary? There is no need for you to be taking pictures in the clinical setting. If not a HIPPA violation than it is still EXTREMELY unprofessional. You'll probably just get reprimanded but PLEASE don't do it again!

Specializes in ER trauma, ICU - trauma, neuro surgical.

I am not an OR nurse, so maybe someone could answer this....When patients are in surgery and there is a monitor being used, isn't the name, case number, medical record on the screen in case a screen shot is taken for the chart? If there were any identifying numbers or name, that would absolutely be a HIPAA violation.

A word of advice...When you are in school, always and I mean always ask for permission to do anything. Even turn a knob can get you kicked out. Have a nurse/ instructor at your side or ask permission to do something. You will never get in trouble if you follow that.

Specializes in OR, Nursing Professional Development.
I am not an OR nurse, so maybe someone could answer this....When patients are in surgery and there is a monitor being used, isn't the name, case number, medical record on the screen in case a screen shot is taken for the chart? If there were any identifying numbers or name, that would absolutely be a HIPAA violation.

Information displayed on the screen can vary from facility to facility. Mine has no information showing on the screens the surgeon and assistant look at. The system that records and prints photos must have patient information entered manually, which does not display anywhere but the computer screen or, if the pictures are printed, it can be printed on the top of the paper.

OP, I can understand and appreciate your enthusiasm, but it is not an excuse. While the patient signed a consent that included allowing pictures to be taken, the picture you took doesn't really fit into that as it was not meant to be part of the medical record nor approved by the facility.

Even in times of patient approval, I will run taking pictures by someone higher up than me if I have questions, such as the time a patient wanted us to take pictures of injuries from a car accident for insurance purposes- management did give the okay, since the patient had given consent. I was questioning because I'd never experienced such a request before and wasn't sure if the hospital would allow it because it involved litigation (against the other driver, not the hospital).

Specializes in HH, Peds, Rehab, Clinical.

Why in the WORLD are students taking cell phones into clinical settings?! This was immediate dismissal at my school, and when I hear stories like this, I'm inclined to agree!! If they DO kick you out, I suggest you pack your things quietly and go and be thankful they aren't holding you accountable for a HIPAA violation!

Well my school requires us to have a smart phone/ipod for use during clinical. However we are to have them in airplane mode and was told on the first day that under no circumstance were we to take pictures, not even of yourself. The warned us with the story of the nursing student who took a picture of a womans placenta...

I hope everything works out for you, but you made a very poor choice.

Specializes in Loving everyone.

Everything that I have found in regards to HIPAA states that a violation includes individual identifiable information, which there was not & the one picture was deleted before leaving the OR.

Im in no way trying to imply that I did no wrong but I do believe that being removed from the program seems pretty harsh for a student that has never had a unsat anything, no write ups, no probations. I have a lot going on right now, Ive been on prednisone for almost 2 months, Im sleep deprived & I have a son who is getting ready to graduate + some other things that may contribute to my severe lack in judgement, which by the way says nothing about my character or the kind of nurse I will be, I am an excellent nurse !

When I left the OR the OR manager wrote down her name for me to use as a reference when applying to the OR. I just wish everything would be taken into consideration & not just this incident . . . Such a hopeless feeling !

Specializes in OR, Nursing Professional Development.
Everything that I have found in regards to HIPAA states that a violation includes individual identifiable information, which there was not & the one picture was deleted before leaving the OR.

Im in no way trying to imply that I did no wrong but I do believe that being removed from the program seems pretty harsh for a student that has never had a unsat anything, no write ups, no probations. I have a lot going on right now, Ive been on prednisone for almost 2 months, Im sleep deprived & I have a son who is getting ready to graduate + some other things that may contribute to my severe lack in judgement, which by the way says nothing about my character or the kind of nurse I will be, I am an excellent nurse !

When I left the OR the OR manager wrote down her name for me to use as a reference when applying to the OR. I just wish everything would be taken into consideration & not just this incident . . . Such a hopeless feeling !

Depending on facility policy (which your school and its students are required to follow) and the school policy, they may be well within their rights to dismiss you from the program. Outside factors that may contribute to your lack in judgement really don't matter; all students have outside factors of some kind affecting them.

And please, do not refer to yourself as an excellent nurse. You are a student who does not have a nursing license; therefore you are not a nurse of any kind yet. That may seem harsh, but there are states that protect the title nurse and there can be legal penalties for calling yourself a nurse without holding the license.

OP, you should review your student handbook to clarify the rules and expectations of your program. HIPAA violation or not, there may be enough grounds from the school's policy to kick you out. You'l have to look more into it but I would make sure that I knew the school policy before I try to defend myself.

I would just apologize, admit 100% fault, and ask that your whole performance in school be considered when deciding your spot in the program. I know you have other things going on but I really can't see any of them providing enough support to defend the action of taking a picture of someone else's surgery when the picture did not have anything to do with the patient's care or serve as a learning tool in school. It was a bad call. Just own it and hope for the best.

As others have states I admire your enthusiasm, and share your interest in all things medical- especially OR. But I think the major question you need to ask yourself in this situation, and any clinical/work/patient interaction is "how is my action benefiting the nurse-client relationship?". If the reason for your action is personally motivated, or only you stand to gain and not the client, you may want to reconsider.

If you google "nursing student placenta", you can find the story of a girl who paid a hefty price for her over zealous, and earnestly and innocently motivated, interest in her clinical placement.

Don't ever lose your passion and interest in your career choice, it is admirable. But always think of the patient first, and your responsibility as an individual entrusted to care for them.

I hope everything works out for you!

I work in home care and we often photograph wounds at our agency. Per HIPPA, and agency policy, the pt must sign consent any time a pic is taken. Additionally, there can be no way to identify the pt in the photo....no face showing basically. For what you did to be legal IMO, the pt would have had to sign a consent with your *school*....not the hospital. You are not a hospital employee in your student capacity, and though they may have signed consents, it was not ment for you or your school, just the hospital. From that standpoint, I think it *is* a HIPPA violation, and pretty darn stupid because I suspect that like most nurses and students, HIPPA has probably been beaten into your head from day one. When in doubt, don't do it!

Specializes in Emergency, ICU.

I had to find the nursing student placenta story. Turns out her school did in fact throw her out but she sued and won:

http://blog.internetcases.com/2011/01/22/chicago-facebook-attorney-lawyer-college-must-reinstate-nursing-students-who-posted-placenta-pics-on-facebook/

In any case, be prepared for the worst although I do not agree that taking a picture of an organ is a HIPAA violation. Not the best thought process, but not a violation.

Good luck tomorrow.

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