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 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......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....

One of the reasons many hospitals require two nurses to witness and cosign the med. Then if an error is made, you move on unless it is a chronic problem and you gotta wonder where else is someone screwing up. Computer bar-coding of meds is another safe guard for safety.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
One of the reasons many hospitals require two nurses to witness and cosign the med. Then if an error is made, you move on unless it is a chronic problem and you gotta wonder where else is someone screwing up. Computer bar-coding of meds is another safe guard for safety.
I have had my insulin for 35 years whether it was required or not. I was told in school 35 years ago you double check insulin...and so I check insulin. But the difference between 3 and 30....is a lot either way you look at it. It's significant.

I'm pretty sure this is an insulin problem. At the hospitals I did clinicals in, two RNs had to check insulin dosages and sign off for each other. As in, if the needle came out of the vial without the other nurse seeing, the dose is discarded and you start over. I assumed this was the policy everywhere, but it sounds as though only you and a nurse draw up insulin? Not to beat a dead horse, but 30 vs 3 is a huge error. You do seem casual in that it was caught before it even left the med room---I believe this still counts as a "near miss" and a medication error. Data for near misses are very hard to obtain because people will usually not admit to them, so I do respect you for being able to admit the mistake. But it is still an error. I do think the nurse should have discussed with you her concerns before she called the school and probably should have brought up things as they came up throughout the day and definitely should not have let you continue to perform duties. If she felt whatever you were doing was bad enough to report you for, she should not have allowed that.

As far as HIPAA is concerned, the nurse or his son (unless he had legal charge of the patient) cannot grant you that permission. Even the doctor can't! When doctors wanted us to see something interesting, they made us all line up like ducks in a row outside the room until the patient said we could come in. Unless you are directly involved in their care, it's basically a HIPAA violation. Either the legal authority or the patient themselves have to give consent, so I agree it was a violation pretty cut and dry. I mean, I've had to sign HIPAA release statements before to get paper copies of lab results from the doctor which were about me, to be used only by me. HIPAA violations are so common though, it drives me insane to see how lightly most nurses, doctors, and students take it. But, I also feel this isn't the reason you were told to sit out a semester.

All in all, I think sitting out a semester is appropriate. We've had people kicked out of our program for less, and in our program if we had to sit out a semester, you could start the next semester ONLY if there was space available. Otherwise, you were way out of luck. So if it's really only a semester, consider it a good learning experience that you hopefully won't ever have to repeat. You are owning the experience online, but I hope you are owning it as much in real life as well and taking responsibility for it. If I had ever tried to weasel my way out of that insulin situation by saying another nurse caught it so it's all okay, even if it was in the form of a wrong test question or something, I'm pretty sure there were professors that would have smacked me and rightly so! Lol. While you may feel entitled to some sympathy, as I am sure everyone would in the situation, I think the extra time will help you to be an even better and safer nurse in the end--and ultimately that's what is most important!

Best of luck!

I'm pretty sure this is an insulin problem. At the hospitals I did clinicals in, two RNs had to check insulin dosages and sign off for each other. As in, if the needle came out of the vial without the other nurse seeing, the dose is discarded and you start over. I assumed this was the policy everywhere, but it sounds as though only you and a nurse draw up insulin? Not to beat a dead horse, but 30 vs 3 is a huge error. You do seem casual in that it was caught before it even left the med room---I believe this still counts as a "near miss" and a medication error. Data for near misses are very hard to obtain because people will usually not admit to them, so I do respect you for being able to admit the mistake. But it is still an error. I do think the nurse should have discussed with you her concerns before she called the school and probably should have brought up things as they came up throughout the day and definitely should not have let you continue to perform duties. If she felt whatever you were doing was bad enough to report you for, she should not have allowed that.

As far as HIPAA is concerned, the nurse or his son (unless he had legal charge of the patient) cannot grant you that permission. Even the doctor can't! When doctors wanted us to see something interesting, they made us all line up like ducks in a row outside the room until the patient said we could come in. Unless you are directly involved in their care, it's basically a HIPAA violation. Either the legal authority or the patient themselves have to give consent, so I agree it was a violation pretty cut and dry. I mean, I've had to sign HIPAA release statements before to get paper copies of lab results from the doctor which were about me, to be used only by me. HIPAA violations are so common though, it drives me insane to see how lightly most nurses, doctors, and students take it. But, I also feel this isn't the reason you were told to sit out a semester.

All in all, I think sitting out a semester is appropriate. We've had people kicked out of our program for less, and in our program if we had to sit out a semester, you could start the next semester ONLY if there was space available. Otherwise, you were way out of luck. So if it's really only a semester, consider it a good learning experience that you hopefully won't ever have to repeat. You are owning the experience online, but I hope you are owning it as much in real life as well and taking responsibility for it. If I had ever tried to weasel my way out of that insulin situation by saying another nurse caught it so it's all okay, even if it was in the form of a wrong test question or something, I'm pretty sure there were professors that would have smacked me and rightly so! Lol. While you may feel entitled to some sympathy, as I am sure everyone would in the situation, I think the extra time will help you to be an even better and safer nurse in the end--and ultimately that's what is most important!

Best of luck!

Hey thanks! It's one of those errors you make as a student or a nurse that really opens your eyes, the kind that you never make again. And I was perplexed why my nurse never brought up anything to me at the site, and waited to nail me when I left. I would of really appreciated if she would of pulled me to the side and explained how she felt and that I needed to slow down and focus. She continued to let me perform care for the entire day, even after the insulin error for whatever reason.

Specializes in PCCN.

what's done is done. learn from it, take the punishment ( the med error), and move on. I know I feel awful if I ever come close to making an error;as a result, if anything , I over do it triple checking, getting a second eye-ball, etc.

I guess in this day and age , be glad you weren't kicked out completely. I know where I am, people have been kicked out of school for lesser violations. Just saying.

As a learning curve- did you read the order wrong? was it the wrong syringe? I know with the syringes my facility uses, 3 and 30 are very obvious.Did the mar have a smear? was it handwritten? Sometimes it's good to look at the "why did this go wrong" aspect so that something is learned from this.

I'm sure you will be very vigilant as a result of this.

Hang in there, be ready to kick butt when you return the next semester. :)

what's done is done. learn from it, take the punishment ( the med error), and move on. I know I feel awful if I ever come close to making an error;as a result, if anything , I over do it triple checking, getting a second eye-ball, etc.

I guess in this day and age , be glad you weren't kicked out completely. I know where I am, people have been kicked out of school for lesser violations. Just saying.

As a learning curve- did you read the order wrong? was it the wrong syringe? I know with the syringes my facility uses, 3 and 30 are very obvious.Did the mar have a smear? was it handwritten? Sometimes it's good to look at the "why did this go wrong" aspect so that something is learned from this.

I'm sure you will be very vigilant as a result of this.

Hang in there, be ready to kick butt when you return the next semester. :)

Thank you very much, your response was very motivational. She handed me the 1/2 mL/cc syringe which is typically for insulin dosages between 31-50 units. So I saw a 3 and pulled back (being 30 units) because I had been familiar with the smaller syringe (3/10 mL/cc) for much smaller dosages. Not saying it was her fault that she handed me the larger one, it just threw me off. I take full responsibility.

Specializes in PCCN.

^ ahh, so ,lesson learned. Now you know to look at the syringe. Also lesson number 2- always check,check ,and check anything anyone else hands to you. That's one lesson I learned early on :)

Also, don't take it personally, but some nurses get "volunteered" as preceptors. They don't always want to do it. I remember the nurse I was paired up with in my last semester made that obvious- and not only that, then I never saw her for the rest of the shift!! I was thinking "gee, these pt's are actually assigned to her, and under her license" , but apparently she didn't care . Told my instructor- she just told me to check back with her if I had any concerns.

I have precepted many times before- I don't mind it at all. I like teaching. I'd rather someone ask the " dumb " question than not bring it up at all.

Just count the next semester as a do- over. And hope you get a better precepter. Not saying she was wrong in bringing it up to the instructors, but it could have been done in a more constructive way- ie: when the adverse event is happening- bring it up then and there?

Best wishes:)

Your repeating the class because of the insulin med error. A girl in my Med-Surg class almost made an insulin error. She was not allowed to return to clinicals for one week and during that time they gave her remediation. Sorry, I have no idea what the remediation consisted of.

I'm a new grad, but some of the more experienced and expert nurses on here may agree that in practice you don't always get that Insulin Double-Check by another RN. Many times the second nurse verifies the syringe, but, they don't verify my patient's MAR........ they use MY word. After graduation, I worked at a facility where they don't even use the double-check. Nonetheless, I decided to use it anyway. On two occasions when I approached 2 different RNs for verification, they looked at me like I was cray-cray.

Plus, you said yourself, that you noticed the syringe was a different size.... even more reason to stop and look again at the measurements on the side,.... fill, double-check MAR, then approach instructor or second RN........ if, and when one is available.

Best wishes next semester !

Specializes in PCCN.

Mar's! thats why I like the EMR's where we have to scan pt and meds. Now with the insulin, yes ,we still have to visually confirm whats in the syringe, but it's easier to account for it.

The best thing you can do is accept you made a mistake and move on. It makes no sense to try to fight it. It's you against the school. I understand it might be upsetting to repeat the semester, but look at it from a good perspective; at least you didn't get terminated from school altogether.

What I don't understand is your attitude. Again, it's understandable you're upset, but please care more about the mistake you made with the insulin. You seem to care exclusively about your situation, and you don't show any concern about how sorry you should be about the insulin med error.

We all make mistakes, but it's imperative to make sure we take responsibility, learn and become better because of the mistake; something you're obviously not doing.

Good luck :)

Sent from my iPhone using allnurses.com

Specializes in Med Surg, PCU, Travel.

Irregardless, isn't part of learning making mistakes? With pulling meds isn't it a rule to have another nurse verify the med dosage? This is all part of the Rights of medication. The mistake was recognized, it patient never got the dosage and the original poster corrected the action. I fail to see how this was the Op's fault.The Rights of medication was followed and the error was identified. Now had the step of not verifying with the RN not been followed and the dosage given, I say that would warrant being kicked out. A nursing student is not licensed it's the RN's responsibility whom he was working under to catch the error and assist in the learning experience. About the Hippa thing, that is just plain confusing how that could possibly be a violation of HIPPA.

Yes the student needs to be vigilant and understand everything as well but frequently, nerves get the better of us and we frequently make mistakes. Who here as a nursing student never made a mistake??? Who here has never received help from another nursing student??? If such was the case I can tell you now, my entire cohort would be kicked out. Either that or something else is missing in this story.

Irregardless, isn't part of learning making mistakes? With pulling meds isn't it a rule to have another nurse verify the med dosage? This is all part of the Rights of medication. The mistake was recognized, it patient never got the dosage and the original poster corrected the action. I fail to see how this was the Op's fault.The Rights of medication was followed and the error was identified. Now had the step of not verifying with the RN not been followed and the dosage given, I say that would warrant being kicked out. A nursing student is not licensed it's the RN's responsibility whom he was working under to catch the error and assist in the learning experience. About the Hippa thing, that is just plain confusing how that could possibly be a violation of HIPPA.

Yes the student needs to be vigilant and understand everything as well but frequently, nerves get the better of us and we frequently make mistakes. Who here as a nursing student never made a mistake??? Who here has never received help from another nursing student??? If such was the case I can tell you now, my entire cohort would be kicked out. Either that or something else is missing in this story.

Nope, that is the entire story. They were really after me that day, they tried to say my cohort took a long lunch, and also tried to say that doing my care plan on their computers when I was actually looking up patient information to compile my care plan. It just seems like they were trying to ding me for everything. Just because I question the ambiguity of the situation does not mean that I don't have remorse or seem unsympathetic as some posters are claiming that I may "seem" like. This is certainly not the case. Certain aspects of this situation are puzzling, and resulted in my of my cohort being very worried on what they were and weren't allowed to do at the clinical facility. To make things worse, my classmates told me that our instructor told them that I never asked the nurse permission to enter the room, which is a bold faced lie. Again, the whole situation sucked, and I have certainly moved on from it and have fault awful over the last month, it has been an eye opener. But this situation raises a lot of question about the structure and foundation of nursing students at the clinical setting.

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