Kicked out of class for a "HIPAA" violation?

Nurses HIPAA

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Hello, I am a Senior nursing student and I was kicked out of clinicals and made to repeat the course for a few issues that happened during the day. I would be lying if I said I wasn't as prepared as I should of been that day, but I believe what happened to me was incredibly unjust. I am accused of violating HIPAA because I let another student into my patients room to look at her ventilator. As students, we are always trying to learn and he has never seen a ventilator before. I thought this was a good opportunity to learn, so I asked my nurse BEFORE we entered the patient room if it was okay for him to enter my patients room and look at her ventilator, in which the nurse said it was fine to do. A few days later, I get an email telling me not to go to clinicals and meet with my supervision. They were also appalled that I had to ask my nurse one of the medications were that we were hanging, and I also accidentally withdrew 30 iu's instead of 3 iu's of insulin AT the med station, in which the nurse saw and said that was way too much, in which I agreed with, apologized, and moved on.

The nurse reported me to her supervisors, which then contacted my school and were absolutely disgusted with my performance. When I met with my supervision, they completely sided with the hospital and were cared more about the school's image and less about my side of the story. If another student entering my patients room with permission from the nurse was a HIPAA violation, shouldn't the nurse be punished as well because she was the one who gave me permission to do so? That being said, I was removed from the course, 7 months away from graduation and had to sit out nearly 4 months before I could retake the class and pushes my graduation date back. Is this a legitimate case of a HIPAA violation?

HIPAA Violation Examples
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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
My problem with the insulin issue is that by having such a harsh punishment you do not encourage staff to be truthful and admit med errors. Seasoned nurses make med errors. So do students. You're supposed to have a second check for safety - I would never write up a nurse I co-signed for if they drew up the wrong amount unless they were making consistent med errors.

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We have all made med errors. There's a difference, though, between saying "My nurse caught it; no biggie" and then going on to complain about how Unfair your punishment is and saying "Oh my God! I can't believe I made such a huge mistake! I could have killed that poor patient!"

OP, you should be able to arrive at clinical, be assigned your patient(s), take report, and then get to your orders. Just a glance should tell you if you are familiar with a med or not. If not, you have many resources eg your drug app, your hospitals drug database, a book. No excuses. And if you don't yearn to know your pathophys like the back of your hand, you're a danger regardless.

Insulin. Following what's been written is the easy part. Knowing what the consequences of any delivery of insulin *might* be is what you seem to me to be totally missing, and is likely why you got canned.

You do need to "time-out" so to speak. Look. Once you've killed someone from being selfish, you're just done in every way.... and there is a sort of selfishness in your original post. You need to stop looking for a way out of things, and just deal.

We have all made med errors. There's a difference, though, between saying "My nurse caught it; no biggie" and then going on to complain about how Unfair your punishment is and saying "Oh my God! I can't believe I made such a huge mistake! I could have killed that poor patient!"

I never once said it was "no biggie" that the nurse caught it after I pulled the needle out of the vial. You need to stop putting words in my mouth and assuming how I feel or reacted. I told you that I felt horrible for what I did but I always double check my insulin with the nurse BEFORE I administer it to the patient. She just happen to catch the error at the med station. If we are going to talk about hypothetically administering 30 iu's to the patient, than we must hypothetically consider that I would of caught it bed side before administration. I feel that this situation was poorly handled by my school's end and so do other of my nursing friends who have been in the practice for quite some time. I don't feel like I am immune from the situation, but this is a first offense and there is no pattern of malicious behavior at any facility I have ever been to in almost 3 years of clinical experience, administering many units of insulin within that time frame. Stop assuming I don't care, you don't know me, don't pretend like you do.

I'm a new grad and that sounds really rough. Insulin mistakes like that are obviously serious, but that's what the double-check is for. At my institution, near-misses ARE reported (even self-reported!) for the sake of patient safety and QI research (because maybe something in the system is causing this type of mistake to happen), but these reports would never be punitive (after all, that would dissuade people from reporting) unless it were a repetitive occurrence. Being asked to leave clinicals for a week (as mentioned by another above) to do remediation is very reasonable, but failing you for the class and pushing you back for a semester seems really harsh.

If we are going to talk about hypothetically administering 30 iu's to the patient, than we must hypothetically consider that I would of caught it bed side before administration.

No RN with a license intact, shares your brand of "common sense".

I am confused... Prior to the dismissal, how long ago had the insulin error occurred? If it wasn't handled at the time of actual occurrence, it would make sense that the OP is somewhat confused about the real reason for being dismissed from clinical. Agreed the insulin error could have resulted in serious harm, but does it not behoove the nursing program to impart the seriousness of the error then and there rather than wait for a scapegoat reason?

No RN with a license intact, shares your brand of "common sense".

The fact of the matter is I always double check my insulin with my nurse prior to administration. The fact that she caught it at the med station before I was able to is what I am getting in trouble for. In reality, we are still talking about a hypothetical situation any way you slice it.

I am confused... Prior to the dismissal, how long ago had the insulin error occurred? If it wasn't handled at the time of actual occurrence, it would make sense that the OP is somewhat confused about the real reason for being dismissed from clinical. Agreed the insulin error could have resulted in serious harm, but does it not behoove the nursing program to impart the seriousness of the error then and there rather than wait for a scapegoat reason?

The insulin error occurred after lunch, roughly 1pm. She never mentioned anything relating to the error other than noticing that it was not the right dose. She continued to let me provide care for the patient the rest of the day till around 6pm, not expressing any concerns she had with the effectiveness of my care which is rather perplexing. This was on a Monday, I was notified that following Friday via email not to show up to clinicals on Monday and to meet with my supervision.

Specializes in Pediatrics, Emergency, Trauma.

I can completely understand if there was a pattern of inappropriate and irresponsible care that shows a correlation that I do not care about my patients.

You can care about your patients and still make costly mistakes.

You did show a pattern of inappropriate and irresponsible care; you didn't get report on your 2nd patient, you missed a chance to find out what your patient was receiving with a med, not double checking the insulin syringe before drawing up the extra 27 units is a near-miss, equivalent to a med error, then to add more to it, showing another student your patient, where you may have needed to be doing something else; whether you realized it or not.

I have made a procedural error where prophylaxis abx needed to be given; however the patient was allergic to another prophylaxis abx in the course of treatment! I gave excellent care to the patient; however, I made a grave mistake; this was during orientation. I decided to quit; although my unit wanted to give me one more chance. I could've stayed; I'm not a quitter, however, I knew I needed to be in a better situation for my patients to hone my skills in order to regain that confidence again and a stronger base for my fundamentals; as well as my nerves; there were other extraneous issues I had; yet, it doesn't matter; I'm accountable for my actions at the time and the support I needed to acquire what I needed to have a better process in place for my practice.

I am more vigilant today about missed care, errors, etc, especially in the current position I am at now.

I am sure that you will take this as a lesson learned; you had three (known) issues that occurred that constituted an unacceptable pattern of behavior, you know now, as well as very helpful hints to do better in January. :yes:

Specializes in Critical Care.

This is not a HIPAA violation, HIPAA specifically allows for access to patient information for learning purposes and leaves it up to facilities to decide how they protect patient information in educational situations.

You can care about your patients and still make costly mistakes.

You did show a pattern of inappropriate and irresponsible care; you didn't get report on your 2nd patient, you missed a chance to find out what your patient was receiving with a med, not double checking the insulin syringe before drawing up the extra 27 units is a near-miss, equivalent to a med error, then to add more to it, showing another student your patient, where you may have needed to be doing something else; whether you realized it or not.

I have made a procedural error where prophylaxis abx needed to be given; however the patient was allergic to another prophylaxis abx in the course of treatment! I gave excellent care to the patient; however, I made a grave mistake; this was during orientation. I decided to quit; although my unit wanted to give me one more chance. I could've stayed; I'm not a quitter, however, I knew I needed to be in a better situation for my patients to hone my skills in order to regain that confidence again and a stronger base for my fundamentals; as well as my nerves; there were other extraneous issues I had; yet, it doesn't matter; I'm accountable for my actions at the time and the support I needed to acquire what I needed to have a better process in place for my practice.

I am more vigilant today about missed care, errors, etc, especially in the current position I am at now.

I am sure that you will take this as a lesson learned; you had three (known) issues that occurred that constituted an unacceptable pattern of behavior, you know now, as well as very helpful hints to do better in January. :yes:

Thank you for sharing your story.

Specializes in FNP, ONP.
I didn't get kicked out of school, I was kicked out of the class and made to repeat. And again you are playing "would of" harmed the patient etc. The medication was never administered, should a nurse lose her job if she drew up the wrong medication and another nurse caught the mistake?

I don't have an opinion on the HIPPA issue, other than to say I suspect there are other details we are not hearing on this point.

The answer to the question above, however, is a resounding YES. Yes, absolutely, I would fire a nurse for this "near miss." Thankfully, the standard for competence is a little higher than waiting until a nurse actually kills someone before there are consequences.

Carry on.

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