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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I am sorry this is happening to you but three HUGE issues are incredibly apparent here.

1. You, not the nurse should be accountable for YOUR actions, always! Unfortunately this is going to be a hard lesson learned. No matter what the RN says, you should have asked the patient or their proxy if it was okay to get others involved in their care ...even if it was just to have another onlooking nursing student look at the vent. That goes against HIPAA as you are divulging sensitive information to people not involved in the care of that patient.

2. Why would you ever give a med/ hang a med without knowing what it is used for and its contraindications? This is just bad nursing practice. If you don't know what may go wrong, how can know what to look for during the administration of that med? Even asking an experienced nurse doesn't guarantee you will receive complete and correct info.

3. The difference between 30 and 3 units of insulin is SEVERE! You could have caused grave injury to the patient. What if the clinical instructor or nurse hadn't caught the mistake?

Unfortunately, you were in your last semester of nursing school. At that time, you should be ready to hit the ground running. Not that you should be able to function as a perfect RN, but you should be able to effectively give Meds, understand what they are for (if you don't, you need to research it before pulling that med from the med cart), and understand privacy as it relates to HIPAA.

Hopefully, you will correct this in the future and become an RN! Wishing you the best!

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Hey zeus&lincoln, thanks for the response. My entire cohort had no clue that allowing another student into the patients room for educational purposes was a HIPAA violation. It was never relayed to us as students that this was an issue, and we were all caught of guard when I got nailed for it, not an excuse, but I think my school or similar agencies should of done a better job at relaying all facets of HIPAA violations to us as students, who are in a learning environment and don't have the experience as other nurses do. Pertaining to the insulin, It was caught at the med station and never made it into the patients room. I always double check with the nurse pertaining to insulin right before I administer it. Relating to the medication we were hanging, after report she immediately went into the patients room to start hanging meds so I didn't have time to prepare and research the medications. So I asked her what a particular medication was that she was hanging (even though I had a good idea what it was used for, I wasn't 100% sure). Had I had at least 30 minutes to prepare before we started hanging meds, I would of had enough time to research what medications my patients were on, but this was accomplished immediately after report and they had a huge issue that I didn't know what the medication was. My school's supervision said that I should of sat out and told her "no", that I needed to sit there and research the meds first, but I was merely trying to learn and be involved, tagging closely to my nurse. I have had zero disciplinary issues at my school and have had a plethora of clinicals under my belt, well into my senior year. I never denied that I made mistakes, but I feel that I was unjustly punished for a 1st time offender.

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The story seems a little convoluted to me. Were you the one hanging the med? If not, why would you be dinged for not being prepared? My school required us to go to the clinical site the evening before to prepare, we also showed up 25-30 min before shift report to see if any orders had changed during the night. On the rare occasion we didn't go the night before to research our patient we would for sure go to the clinical site on the morning of with ample time to research our client. I guess I am wondering why this wasn't done beforehand? In regards to the insulin... Don't you double and triple check yourself before showing the nurse to verify the order? I mean being off by .5 may be difficult to tell, but being off by 27 units seems like you didn't understand how to read the sliding scale... Which would worry a nurse if you were projected to graduate soon. I totally understand your frustration... I guess I am trying to play devil's advocate.

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Actually our school doesn't go beforehand, or the night before to research or patients. We show up the morning of and start gathering information. Had I gone the night before to research meds, I would of been well prepared on what medications were given. My nurse was the one hanging the medication and I asked her what one of the meds were as she was hanging it. As I mentioned before we immediately entered the patients room after report to start hanging meds, so there was not enough time for myself to prepare. My school told me that is not an excuse and that I should of told her that I need to sit here and research meds first before shadowing her. I just wanted to get up and get going, I am there for 12 hours so I have plenty of time to research meds. With the insulin, I pulled out 30 iu's and the nurse noticed immediately that it was too much directly at the med station. It never even came close to the patients room where I do another check. Regardless I admitted to the mistake and have learned from it and will move on. My main problem was with the HIPAA violation, because I felt so caught off-guard by this. My fellow students and I have been doing similar scenarios all throughout our clinical experiences and my entire class didn't know that this was a HIPAA violation, so wouldn't it be the schools responsibility to relay this information to us instead of making me the whipping boy for it? I asked the nurses permission before myself and the other student entered the room if it would be okay for him to see a patient on a ventilator, in which she obliged. What bugs me is that during the entire day, the nurse or her supervision never once talked to me about my behavior or told me I was being unsafe. My nurse continued to let me do patient care all day and literally to the last minute of my day there.

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I'm confused as how that's a violation of HIPAA. We used to go into each others rooms all the time for learning, addressing pumps, helping turn etc. as for the insulin, that's why someone checks behind you. To avoid mistakes. Someone caught you, crisis averted. Seems like BS to me. Sorry this happened to you. But maybe the universe is preventing you from something greater. Best of luck. Chin up!

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I'm confused as how that's a violation of HIPAA. We used to go into each others rooms all the time for learning, addressing pumps, helping turn etc. as for the insulin, that's why someone checks behind you. To avoid mistakes. Someone caught you, crisis averted. Seems like BS to me. Sorry this happened to you. But maybe the universe is preventing you from something greater. Best of luck. Chin up!

What bothered me is that I felt I did not have an advocate throughout the entire situation. My school's leadership was only concerned with the image of the school and not what my side of the story was. I am out nearly $3k in tuition for the semester and my graduation date is pushed back by 2 more months. If that is indeed a HIPAA violation, my school did not properly educate it's students that it indeed was as my entire class was absolutely stunned by this and were so worried they asked my teacher in class "what exactly are we allowed and not allowed to do" during lecture. Mind you these are senior nursing students still confused on what we can and can't do. I asked the nurse beforehand hand if it was fine if he looked at the patients ventilator in which she gave permission. Next thing you know I am being kicked out of class for "unsafe reckless behavior and HIPAA violation."

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Okay there has to be more to the story...

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Seems like the nurse made a stink to your college admin and the school doesn't want to lose the clinical site. Sites are extremely difficult to obtain (as you probably know) and losing them is not really an option especially if you're in an area in the country with many nursing schools competing for the same sites. Unfortunately, the school seems like they would rather have a student held back than to lose the clinical placement... It is harsh.

They should have discussed your behavior with you to the point where you understood what you did wrong (seems like you still don't know exactly why this happened) and then offered some kind of remediation. Is there anyone you can discuss this with? Clinical instructor? Professor?

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Actually our school doesn't go beforehand, or the night before to research or patients. We show up the morning of and start gathering information. Had I gone the night before to research meds, I would of been well prepared on what medications were given. My nurse was the one hanging the medication and I asked her what one of the meds were as she was hanging it. As I mentioned before we immediately entered the patients room after report to start hanging meds, so there was not enough time for myself to prepare. My school told me that is not an excuse and that I should of told her that I need to sit here and research meds first before shadowing her. I just wanted to get up and get going, I am there for 12 hours so I have plenty of time to research meds. With the insulin, I pulled out 30 iu's and the nurse noticed immediately that it was too much directly at the med station. It never even came close to the patients room where I do another check. Regardless I admitted to the mistake and have learned from it and will move on. My main problem was with the HIPAA violation, because I felt so caught off-guard by this. My fellow students and I have been doing similar scenarios all throughout our clinical experiences and my entire class didn't know that this was a HIPAA violation, so wouldn't it be the schools responsibility to relay this information to us instead of making me the whipping boy for it? I asked the nurses permission before myself and the other student entered the room if it would be okay for him to see a patient on a ventilator, in which she obliged. What bugs me is that during the entire day, the nurse or her supervision never once talked to me about my behavior or told me I was being unsafe. My nurse continued to let me do patient care all day and literally to the last minute of my day there.

First, it's would HAVE, not would OF. Same with should HAVE.

Second, you may have 12 hours to research meds, but you'd better know what your patient is getting and why, what are the side effects and contraindications BEFORE the meds are given. Whether you do it the night before or show up early the day of your clinical, it's your responsibility to know. There is no excuse for that.

You pulled out ten times the ordered dose of insulin. One THOUSAND percent of what was ordered. Even if the nurse stopped you before you got near the patient's room, that is an egregious error! And you don't sound very concerned about it, saying that you admitted to the error and will now move on. It shows a lack of awareness of the effect -- damage -- your actions could have on your vulnerable patients.

The HIPAA violation was probably the last straw. You were in your last semester and with all of these errors at the same time, they needed to make sure you didn't graduate. The HIPAA violation was probably just the last straw that they hung it on.

I'm very glad you're not graduating soon -- it sounds as if you have a lot to learn, and concern for others is probably the very first of those many things you need to learn.

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Okay there has to be more to the story...

I have been honest throughout this whole ordeal. The main accusations against me was the insulin mistake, asking her what the medications were when we were hanging them early in the shift, and the supposed "HIPAA" violation. I also didn't take report immediately on my 2nd patient in which she threw a fit about. I took report on my first patient because I was going to make create a care plan for them, but the 2nd patient I didn't immediately take report on and gathered the rest of the data earlier in the day. That is 100% why I got failed for the clinical and made to sit out of the class for nearly 4 months. I cannot retake the class until January...

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
What bothered me is that I felt I did not have an advocate throughout the entire situation. My school's leadership was only concerned with the image of the school and not what my side of the story was. I am out nearly $3k in tuition for the semester and my graduation date is pushed back by 2 more months. If that is indeed a HIPAA violation, my school did not properly educate it's students that it indeed was as my entire class was absolutely stunned by this and were so worried they asked my teacher in class "what exactly are we allowed and not allowed to do" during lecture. Mind you these are senior nursing students still confused on what we can and can't do. I asked the nurse beforehand hand if it was fine if he looked at the patients ventilator in which she gave permission. Next thing you know I am being kicked out of class for "unsafe reckless behavior and HIPAA violation."

I'd wager a guess that it's the "unsafe reckless behavior" that got you kicked out. You seem to be focused on the HIPAA violation and how unfair things are to YOU. What about the patient you could have killed with 10 times the ordered amount of insulin? I don't think you're ready to be a nurse. You don't seem to be concerned about your patients.

Whether or not you and the rest of the class knew that inviting another student into the room to see the ventilator would be a HIPAA violation, it's up to you to LEARN these things. That's why you're in school. But as I said, I don't think that's the reason you got kicked out of school -- there are so many other -- better reasons.

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