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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My issue is you drew up a significant amount of insulin...way over the dose needed to be given. Your responses here are "well the nurse caught it". Um...thank god she caught it. So if she hadn't...that's when it would have been an issue? So I'll be honest...the amount of insulin you drew up compared to the order is a major issue. Your attitude of "but the nurse caught it so no biggie" is a major issue. That is enough of an issue to create a major concern.

The OP has made several mentions that he/she was affected greatly by the insulin error.

Yes, insulin issues are very serious business, and this is why most hospitals employ the double-check standard. Agreed, though, that 27 units off is a serious cause for concern....

OP, modern nursing is very difficult. It requires perfection. If you fail to meet perfection in nursing school and beyond (we ALL miss the mark of perfection), the best response is that of a contrite learner, not as one being defensive.

Specializes in Med-Surg, LTC, Psych, Addictions..

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.

I think Rubyvee hit the nail on the head with her reply. Even though the nurse caught the insulin error, you made a HUGE and potentially deadly mistake. As nurses we are our patients' protectors, their advocates. We HAVE to be aware of what meds we're giving them, and must provide absolute privacy until we are sure that they have given consent....usually in writing.

I wish you luck in your repeat semester. I hope you stop playing the victim and realize how serious your mistakes were. Be better in spite of them. Perhaps failing the semester is what you needed to show you how serious nursing is. Your patients' lives are in your hands. Be worthy of that responsibility and privilege.

Good luck!

God bless.

Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
The OP has made several mentions that he/she was affected greatly by the insulin error. Yes insulin issues are very serious business, and this is why most hospitals employ the double-check standard. Agreed, though, that 27 units off is a serious cause for concern.... OP, modern nursing is very difficult. It requires perfection. If you fail to meet perfection in nursing school and beyond (we ALL miss the mark of perfection), the best response is that of a contrite learner, not as one being defensive.[/quote']

She has also just written it off because the nurse caught it. I don't think she realizes this alone...enough to be kicked out.

The HIPAA violation is the fact that the other student wasn't involved in the patient's care. Always get permission from the patient or POA to have someone not involved in the patients care to enter the room or discuss care with them.

Something else you said. You've given insulin before did you double check those dosages? There is a huge difference between 3 and 30. I have given that much insulin before but I also double checked the order, looked at the patient's history, looked at the patient's home med record and talked to the patient himself. He actually used more than that at home. Anytime you are giving large amounts of medication double and triple check the order and pharmacy is a great resource for this as well as the patient (if they are a&ox3) and their attending.

I'm a float nurse and am floated to almost every floor in the hospital. I encounter all types of medications I've never heard of. Before I administer them I look them up in our built in med reference program. I look up the reason, dosages, side effects and contraindications. And if the patient never heard of the medication I print out information for them to have too. I'd rather be late passing medications versus making a huge error and harming a patient. Because we all know that wrong medications can be prescribed by physicians and it is up to the nurse to know the 5 rights for medication administration. Because guess who will take the fall if the patient is harmed? The nurse so CYA. Take it as an expensive message learned.

And as far as getting report on patient 2 always get report first and lay eyes on you patient. I can't tell you how many times I've received report insisted on doing bedside report even if the outgoing nurse doesn't want to and found an unresponsive patient.

Sent from my iPhone using allnurses.com

I agree with the others that the school is going to try to and make sure they hold on to their clinical sites at all cost.

All mistakes are meant to be a learning experience. Admit you were wrong, learn from it to become a better nurse and move on.

It has always been a rule that you have to ask a patient beforehand if you want to bring in other observers. I still ask permission today even if it is another nurse that I want to show a procedure to. Even if it was not a violation of privacy, it is polite and respectful of the patient to ask first. One thing I try to do, I imagine if that was me in that bed and how I would feel if..... (fill in the blank). Most times you can't go wrong with that.

First of all, I just want to say that I'm sorry you're going through this. You seem like you're a dedicated and bright student.

I honestly think the HIPAA accusation is pretty overkill.

The nurse was probably really spooked about the insulin error, especially coming from a senior nursing student who is close to graduating and practicing on their own. That dose could have seriously harmed or killed that patient and, yes, thank god the nurse caught your error, but she was probably thinking, "What if I hadn't noticed?" Very scary stuff. I know you feel awful about this, but from what I'm gathering I think the insulin was 98% of the problem.

As for the med she hung, maybe next time, say, "I see you're hanging x. I'd like to become more familiar with that medication, would you mind if I go look it up?" Problem solved!

And, lesson learned, never delay report, especially as a student. That's going to make a lot of people cranky.

You'll get through this, just take this time to reflect and move on!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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? Stop pretending to assume how I feel about what happened. And please show me documentation that indeed what I did violated HIPAA.
I am so sorry you are going through this...it is devastating I am sure.

I think you need to realize that this whole situation you find yourself in, as a Senior nursing student, has NOTHING, what so ever, to do with a HIPAA violation.

I has everything to do with a life threatening possible fatal error in drawing up 30! THAT'S.....30! units of insulin 30! UNITS! when the order is three.......3! That's 3! units of insulin.

A SIGNIFICANT DIFFERENCE!

One that would cost a patient their life.

That brief moment of inattention is a BIG deal. To draw up that much insulin....10 times....that's 10 times!! The amount of insulin is more than just again......

playing "would of" harmed the patient etc.
and yes it is possible that a nurse would lose her job over drawing up 10 times the amount of a medication whether or not she was caught by another nurse....this is just a mistake that should never be made....never. Especially by an over cautions, over vigilant student....who has all the supposed safety nets in place.

Taking another student to look at a vent is probably not the big issue here...but is an example of a thoughtless and reckless behavior pattern that is concerning to the faculty/staff.

Hey BostonFNP, thanks for the response. I am still trying to find documentation that what I did essentially violated HIPAA. Wouldn't the nurse who gave me permission to enter the room with another student violate HIPAA as well? I have had a squeaky clean on site and off site history with my school, including many clinical rotations in which I have never had a previous complaint prior to what happened in this situation. I am still trying to figure out if what I did was a HIPAA violation, and I would like to see any documentation that confirms this. If two nurses can go into a patients room for an educational purpose, why can't two students who received permission to from the nurse if students are held under the same HIPAA standards as nurses. The insulin error crushed me, and I have administered dozens and dozens if insulin to patients and have never made a mistake. I will NEVER make that mistake again, trust me.
again your disciplinary action has little to do with HIPAA...but your apparent cavalier demeanor.

I think that you need to take a few steps back and not find fault in others. I think you need a few weeks to carefully consider what has happened here is evident in your post....it begins with Kicked out for a HIPAA violation:mad:

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....please show me documentation that indeed what I did violated HIPAA..
Instead of.....Kicked out for med error:eek:
OMG!!!! I made a horrible med error that was thankfully was caught by the nurse....I feel horrible about this......now I have to repeat this semester
I hope you take this time to reflect on what happened here and learn from this to make you a better nurse.

I wish you the best.((HUGS))

Specializes in ICU.

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.

As far as the other two errors - I don't really understand how that was a HIPPA violation. When I was a student we worked in pairs sometimes. As a nurse, I walk into other nurse's rooms all the time (beeping IV/vent/etc). You should know the meds you're giving, but that's also why you have a preceptor there. And if the school is that strict maybe they should have you go early or look up anything you need to before actually taking over care. That sounds like it's potentially difficult to balance preceptor and school expectations - as far as taking over care, starting at x time, and being completely prepared.

Hey thanks for the responses, most have been helpful with the exception of Ruby who started off her rebuttal critiquing my grammar which is irrelevant. Before the other student and I entered the patients room to look at her vent, we asked her nurse and since the patient was not able to talk, we asked her son if it would be possible if he could come in the room and check out the ventilator, in which he obliged. The insulin error is tough, and affected me greatly and it has really opened my eyes that you can't get too comfortable giving meds, as I thought I was. A moot point was that the nurse handed me a larger syringe, not the smaller syringes used for giving smaller amounts of insulin, but the larger ones for more potent amounts of insulin. It somewhat threw me off as I saw a "3" and pulled back, withdrew, flicked the syringe for bubbles, and then it was noticed by the nurse that it 30 and not 3. No excuse and I accept full responsibility for issue. I will never make that mistake again and this whole process really opened my eyes. The reason that I mentioned the HIPAA error as the main point is because it seemed like it was the main issue in having me fail and repeat the class, looking over my paper work. I received permission from the nurse and the patients son to have another student come in the room to look over the ventilator, I had no idea what I was doing violated HIPAA in any way.

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.

As far as the other two errors - I don't really understand how that was a HIPPA violation. When I was a student we worked in pairs sometimes. As a nurse, I walk into other nurse's rooms all the time (beeping IV/vent/etc). You should know the meds you're giving, but that's also why you have a preceptor there. And if the school is that strict maybe they should have you go early or look up anything you need to before actually taking over care. That sounds like it's potentially difficult to balance preceptor and school expectations - as far as taking over care, starting at x time, and being completely prepared.

This was the first med error I have ever made, having quite a few clinicals under my belt. I also have zero disciplinary or nurse related issues nearly 3 years through my program.

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. This is indeed not the case, I feel horrible about my mistakes. The main issue I have with my school is I felt like I didn't have an advocate through the entire process. It was my school supervision and the clinical site vs the nursing student.

The HIPAA violation is the fact that the other student wasn't involved in the patient's care. Always get permission from the patient or POA to have someone not involved in the patients care to enter the room or discuss care with them.

Does not the conditions of admission inform the patient at which their signature gives consent for students to be present in a teaching facility? Have never heard of a consent being obtained for a student to be present. I think there must be more to the situation than a student just looking at a ventilator.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Hey thanks for the responses, most have been helpful with the exception of Ruby who started off her rebuttal critiquing my grammar which is irrelevant. Before the other student and I entered the patients room to look at her vent, we asked her nurse and since the patient was not able to talk, we asked her son if it would be possible if he could come in the room and check out the ventilator, in which he obliged. The insulin error is tough, and affected me greatly and it has really opened my eyes that you can't get too comfortable giving meds, as I thought I was. A moot point was that the nurse handed me a larger syringe, not the smaller syringes used for giving smaller amounts of insulin, but the larger ones for more potent amounts of insulin. It somewhat threw me off as I saw a "3" and pulled back, withdrew, flicked the syringe for bubbles, and then it was noticed by the nurse that it 30 and not 3. No excuse and I accept full responsibility for issue. I will never make that mistake again and this whole process really opened my eyes. The reason that I mentioned the HIPAA error as the main point is because it seemed like it was the main issue in having me fail and repeat the class, looking over my paper work. I received permission from the nurse and the patients son to have another student come in the room to look over the ventilator, I had no idea what I was doing violated HIPAA in any way.

I know you are upset over this and you are trying to wrap your brain around what happened. Again I think it was the appearance of a reckless demeanor. You still are looking for an explanation to rationalize what happened and that is normal.

Whether or not another nurse handed you another/wrong syringe has NO BEARING on what happened....your first critical thinking response should be...

.that is not the right syringe.
Not..........
I saw a "3" and pulled back, withdrew, flicked the syringe for bubbles
never needing the other
then it was noticed by the nurse that it 30 and not 3.
I do not think that looking at the vent is a HIPAA violation as you were looking at the vent and not the medical record. But that is for your school to decide. HIPAA is blamed for a TON of things in medicine these days and about 40% of them are not really HIPAA. But it is not HIPAA that was the focus...it's really the med error and then other behaviors "consistent with" reckless demeanor that what caused them to discipline you.

It is really about the med and not the vent.

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