I maybe in trouble, HIPPA Violation

Nurses HIPAA

Published

It might be easier to discuss what I know about HIPPA. I am a nursing student to begin with. From what I've learned is that sharing patient information with those who are not directly involved with that patient's care is wrong. Talking about the patient even when there is no mention with names or any way to identify the patient is even wrong whether it be in an elevator or any other place.

My infraction:

In this world we now share our thoughts and beliefs with the online world, Facebook is something that so many people utilize now to stay in touch with friends and family. Unfortunately I made a posting about my experience that day in the healtch care setting. I spoked about how I got to see preocedures and aid in it, how I felt about it, the way I smelt after wards. I wrote all of that unknowingly that I was violating HIPPA because I had not mentioned names, I wasn't speaking about any specific patients it was gross because I had talked about smelling like lady parts and onions(the onions coming from my sandwhich really not the patient), I didn't mention where I was working at they were strictly reflections of my experience. The content of it was inappropriately gross but I didnt' feel like there was a violation that I had comitted. In essence it was offensive to some people and it came near the line of violating HIPPA, one of my class mates had reported me to my program coordinator and I am having to write a paper for him citing how I will correct myself and what interventions I plan on doing. My coordinator also told me that there will be a punishment that I will learn later in few days before lecture. He will discuss his interview with me to other people to decide what the punishment will be, I'm scared of being thrown out of the program or worse, delaying or not allowing me to graduate or sit for the NCLEX. I'm scared of not being able to graduate and delaying my time. What could happen to me?

Specializes in Forensic Psych.

Wow...I honesty don't understand how in the world that is a HIPAA violation. We can't even speak about procedures we do anymore? I called my husband this evening and told him I put in my first NG tube today....did I violate someone's privacy?

School's are insanely paranoid about two things:

HIPAA and cheating. To the point of annoying me.

Your post was absolutely unprofessional and inappropriate, but none of your school's business without any kind of patient info/location.

Specializes in ED.

I don't post anything about work on FB, AT ALL. At my school, there were three hospitals you could be at for a clinical rotation. You might not post any identifiers, but if someone you knew knew someone...they might figure out who you were talking about. And now that everyone I know knows where I work...not worth it. We actually had someone kicked out of the program my last semester just for checking into a clinical site on FB. It doesn't sound like you'll be removed from your program, but just use this as a learning experience and don't post ANYTHING about clinical days again, aside from a "yay, had a great day, finally placed an NG tube" or something like that.

Specializes in Hospice, Palliative Care.

Good day:

Facebook may be implementing forced GPS location to its posts; where your geographic location may be included in each post without regard to whether you want such information published.

In those cases, using FB at work or in school can cause more trouble than any value gained.

Thank you.

As a current nursing student and a current LPN, I see both sides of this story. What you did post was highly unprofessional. While I don't think you broke HIPAA you did put a dent in it. Just IMO. I also understand that you just wanted to share your experience with your FB family/friends. We all are proud of this profession and want to brag on ourselves from to time but we all need to learn how to brag on ourselves. You should've said something like "great day in clinical's!" Or maybe "got great hands on experience today!" The best thing you can do is learn your lesson. You may want to think how your FB friends will think of you as a nurse for posting things like that too. Would you trust a nurse who's FB has status updates similar to the one you posted? Always think twice before posting anything!!

Specializes in Emergency, Telemetry, Transplant.

In the OP's situation, the FB post is most clearly not a HIPAA violation. The FB post is, most definitely, inappropriate and unprofessional. Without identifying information, it is not a HIPAA violation, however, the post may have been a violation of policy of the facility/school. HIPAA does not cover "unprofessional" acts, but rather those that acts that result in confidential information made public. For example:

"Yuck, today at work I saw maggots crawling out of someone's lady parts." (Sorry if this is too graphic.) Not a HIPAA violation because of a lack of identifying information. If, however, I posted this on FB, I may be fired as this violates my hospital's social media policy.

OTOH, I could post "Saw Icabod Issacs today. Hope I get the chance to see him under better circumstances...no when he is a patient in the ER." Generally non-offensive, but a huge HIPAA violation since personal information was disclosed.

As a rule, I never post about work on FB...nothing! Not even "Wow, I had a great day at work." Even though what you post may not be a HIPAA violation your school, employer, prospective employers, etc. may be able to see those posts and who knows how even the most innocent post may become twisted.

Specializes in Emergency, Telemetry, Transplant.
Your post was absolutely unprofessional and inappropriate, but none of your school's business without any kind of patient info/location.

It may not be the school's business, but suppose the OP goes to apply for a job as an RN after school. The facility to which she applies "researches" her on FB and this post comes up. Before they have even met her, this facility now has a not so positive view of the OP and it can very negatively effect her chances of getting a job. So, no the FB post is not a HIPAA violation, but it still may paint the OP in a poor light.

Social media in the workplace especially in medicine is huge. They may just want to make an example out of you and take you out of the program. If it was me I would just think the worst but hope for the best. Almost every class I am taking right now discusses HIPPA violations and social media in some way and they always try and mention a story of one student who did "something" and got kicked out to try and show student it can happen to you. The way it was explained to me is this, even if you are discussing your experience that happened in the work place (not mentioning ANY names only what happened etc) there could be someone on facebook or other sites who knows that person or knows someone that happened to and put 2 & 2 together. This has happened in the past. Another example would be discussing your clients (patients) cases with your significant other or a friend. Even though they do not know who it was someone can over hear your discussions and know that person. Confidentiality is key. Im not saying dont ever discuss your line of work with anyone but you have to be VERY careful these days.

I would honestly do anything to stay in the program, why dont you try mentioning to them that you werent properly educated on what you can or cannot do/say regarding social media?? With all due respect it sounds like you may not have been and that would give them the opportunity to reevaluate their program and teaching methods regarding issues like these... If you did not know it really is not your fault they are supposed to teach you these things.

I think about it like this, yes you didn't mention names, but think about what you wrote, very unprofessional. If you read that on someone else fb status, would you want that person as your nurse? I know I wouldn't! Things are embarrassing enough for some pts without their nurses making fun of them, especially on fb!! And you don't know who knows who that would see that post, someone may know someone in a hiring position and warn them off of you. I'm not saying non of us have never made comments about experiences (i know i have), but most definitely not on fb. The world is a lot smaller then you realize and even though you don't mention names, people generally know where your clinical hospital could be, and things get figured out very easily. Future employees and current ones constantly look up their employees on fb and the way fb is ALWAYS changing their privacy setting, you never really know what can been seen and what can't be. We were told in our school, put absolutely nothing good or bad, your much safer that way. A girl last semester got kicked out because when she was at the hospital doing her pt research, a nurse walked by and she was on her cell phone talking while she was looking at a pts chart. She was on the phone with her clinical teacher, but it didn't matter, it was the potential of privacy breach, or perceived that way anyways and the fact that she didn't think about it!

Like everyone else said, own it, apologize and take whatever they hand you and think about what you post before you do next time. Turn this into a learning experience.

Actually, it is your schools business. You are representing THEM. Anything you say or do reflects on them. I almost lost my job because of a situation like that. I made the comment "Total hips, ALL DAY LONG!". I was told that it was a HIPPA violation, makes it look like I don't like my job, and that it reflects poorly on the hospital. No where did it say where I worked or the name of any patients. Our hospital now has a social media policy that says if you have your place of work on your Facebook page, you have to have a disclaimer that your views do not necessarily reflect the views of the hospital. People are being fired over things like this. You have to use common sense. Would you want someone saying those things about you even if they didn't use your name?

Your post was absolutely unprofessional and inappropriate, but none of your school's business without any kind of patient info/location.

On the contrary, the school has a valid interest in its own reputation, which is reasonable. If someone searches the OP's posts and discovers what school s/he attends, that can get back to them. So yes, it is their business if one of their students is posting unprofessionally about something that s/he observed or performed while in the student role. We know that there is no HIPAA violation, and frankly, often people scream "HIPAA! HIPAA!" to frighten people without the slightest real understanding of what PHI (protected health information) is, but this is not the issue here.

So I would anticipate that your punishment would include expressing how embarrassed and sorry you are to have embarrassed the school by your unprofessional words. As my sweet old grandmother used to say, "Some of us are put on this earth to be examples to others," one way or another. You have just done your classmates a service. Go forth and sin no more.

Specializes in Forensic Psych.

Schools can feel however they want about how students are representing them, but since we are paying them for their services they do not have carte blanche when it comes to acting on their displeasure.

We sign a HIPAA acknowledgement agreement when we start our program. I did not sign an "unsavory Facebook posting" agreement. In order to be officially punished, I'd better have broken an official rule, or what protection to any of us have from the subjective whims of the powers that be?

Odds are the OPs program has no such rule and is hiding behind HIPAA as a loophole, which is complete bunk.

Don't get me wrong, I'm not actually feeling sorry for the OP. It's a hard lesson to learn, but we all have to learn it. I'm just annoyed at the way people are constantly throwing around HIPAA violations.

The case could be made that the posting did not violate HIPAA but that doesn't mean the poster should not be disciplined in some way. She seems to be OK with that and willing to learn from the mistake, so kudos to her.

As much as our employers -- and in this case the school -- would like to govern and micro-manage our professional and personal lives, the fact is that they can't. So the onus is on us as professionals to govern ourselves and to know what kind of behavior crosses the line, even if it is allowed or not expressly forbidden. Even if no one has written a rule or laid out consequences for this, that, or the other.

No one can come up with a policy that explores every single possible type of behavior that could possibly be construed as inappropriate or in what way. We would have to sign off on a thousand page legal document if that were the case -- every single time we walk onto a new job or new study program or a new clinical rotation.

We're already drowning in paperwork as it is.

We're human, we make mistakes. We're also in a profession that requires us to have a heightened sense of accountability and a lot less wiggle room to be our naturally flawed selves -- at least in public. That's the nature of the job. Our patients need to be able to trust us to be looking out for their best interests, our employers need to know that we are up to the task.

There are hundreds of applicants out there for every nursing job, so best strategy to survive in this market is to keep private lives and thoughts and impulses private. May not be fair, but it is what it is.

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