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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"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" -OP

You say this was your first offense and you dont have a pattern of making mistakes- I think your thinking this way is an unsafe approach to administering medications because as "safe" as you think you are or have been, you still need to do your due diligence and do your 3 checks because everyone makes mistakes and all it takes is 1 to hurt someone. Don't be lulled into a false sense of security just because you haven't made a mistake yet. If you make a mistake that hurts someone, do you think they are going to say "but Nurse X is perfect she has never made a mistake before! All must be forgiven! " - no. If the syringe looked unfamiliar, why didnt you check out the scale on it to make sure you were pulling the correct amount? Either way, 3 units is usually a very minute amount compared to 30...My nursing school had and I am sure yours has a policy about near misses/ med errors and the consequences. 30 units of insulin is a fatal error, I gave 2 units of insulin to a pt once based on an incorrect BG and I felt sick to my stomach afterwards because those 2 units could have also had dire consequences. The mistake was caught but I think there was a lack of attention and critical thinking that lead to the error, and also with your apparent lack of preparation- you should have gotten report on your 2nd pt, not knowing the pt's meds-regardless if you were administering them or not, if that was your assigned pt you should have known them. To the RN you precepted with, you were unsafe. Why she let you continue the 12 hrs, I dont know, but I would have went to my CN or mgr and told them my concerns because it is unsafe and a liability to my license. Having almost given a harmful dose of insulin to a pt, you should feel humbled and accept that you need to repeat the semester and learn from your mistakes, stop dwelling on the HIPAA violation, you could have seriously hurt someone.

Nor does anything you've said convince me that you understand the enormity of your errors or the potential consequences.

My friend Ruby Vee not only has impeccable grammar, she also understands the real definition of the word "enormity" and uses it correctly. Hint: "Enormity" is not related to "really big, enormous." Go look it up.

There was no HIPAA violation here even if the alleged son hadn't been present to allegedly give permission. I'll give you a pass on the vent, although I seriously question how much help you would have been re teaching another student about it. Had it been RT giving a bedside lesson to a few interested students, different deal. But in a teaching institution not a HIPAA violation. OK, OP, feel better? Vindicated? Don't.

As a former instructor I think this case of "she doth protest too much" smacks of a student who has perhaps thought that she has been just terrific all the way through school but the about whom the faculty has been holding its collective breath. Skating by looks different from the other side of the office door, I'll tell ya.

And a big shout out to Esme who points out that none of those insulin syringes says "3" on it, although they all say "30."

Sorry, OP. You would HAVE been better off really practicing safely, as opposed to thinking you were OK, regarding the other patient, the report, the IV med, and the insulin. You didn't. You get to think about it for awhile, and I sincerely hope you do.

My friend Ruby Vee not only has impeccable grammar, she also understands the real definition of the word "enormity" and uses it correctly. Hint: "Enormity" is not related to "really big, enormous." Go look it up.

There was no HIPAA violation here even if the alleged son hadn't been present to allegedly give permission. I'll give you a pass on the vent, although I seriously question how much help you would have been re teaching another student about it. Had it been RT giving a bedside lesson to a few interested students, different deal. But in a teaching institution not a HIPAA violation. OK, OP, feel better? Vindicated? Don't.

As a former instructor I think this case of "she doth protest too much" smacks of a student who has perhaps thought that she has been just terrific all the way through school but the about whom the faculty has been holding its collective breath. Skating by looks different from the other side of the office door, I'll tell ya.

And a big shout out to Esme who points out that none of those insulin syringes says "3" on it, although they all say "30."

Sorry, OP. You would HAVE been better off really practicing safely, as opposed to thinking you were OK, regarding the other patient, the report, the IV med, and the insulin. You didn't. You get to think about it for awhile, and I sincerely hope you do.

I am starting to embrace my time off as this whole situation has been very sobering. You can't get too comfortable or complacent, you have to always be on top of your game. I take full responsibility for the insulin situation and if that is what is enough to make me fail I accept that. My main problem with the situation was that they were trying to throw the kitchen sink at me and pile it on. The HIPAA violation I had an issue with as my entire cohort didn't realize this was a HIPAA violation and they had to pull an emergency teaching situation on what we could and couldn't do according to my fellow classmates. They tried to say that my entire cohort took a long lunch (did they follow us to lunch or what?) which is inaccurate. They also accused me of doing my care plan on their computers, when I was actually in my patients records getting medication information. Another issue I had was why wasn't any of this addressed to me at any point throughout the day? If my nurse felt I was being unsafe, she should of pulled me aside and talked to me about it, or her supervisors. She continued to let me do care until the end of the day. I have had the insulin situation beat into my head and I will learn and become stronger because of it, however I don't appreciate the "piling" on and straight up lying that my professor did in class, trying to make me look even worse and claiming that the nurse never gave me permission to enter the room with another student. Essentially she straight up LIED to the class. Let me reiterate, I am extremely aware and remorseful about the error and it has changed my whole paradigm concerning patient care, I am not trying to come off as rude or uncaring, this whole situation just stinks.

Truths:

You have just begun to realize the gravity of your situation.

You will need to wallow in it first.

You will need to meet with your school nursing admin and totally honestly "own" your situation.

You will be remembered at this particular clinical site.

I BS you not, you will be remembered at this clinical site.

You will most likely have an uphill battle to finish your nursing clinical education.

Best start to construct a way to make up for your losses with your college nursing administration.

Then ask for advisement on apologies to this clinical site...

Why??? because there ain't no nursing shortage.

Specializes in Primary Care, OR.
My friend Ruby Vee not only has impeccable grammar, she also understands the real definition of the word "enormity" and uses it correctly. Hint: "Enormity" is not related to "really big, enormous." Go look it up.

And a big shout out to Esme who points out that none of those insulin syringes says "3" on it, although they all say "30." .

:woot: love it

Specializes in NICU, PICU, PACU.

Ok, I work in a very large teaching institution and we have never had to get permission for students of any kind to enter a room for teaching purposes. Now, she probably should have had someone other than herself in there since she is not an instructor, but every single 100 of us plus more would be fired on a daily basis in my unit!

I would be more worried about the insulin, which did not reach the patient.

Near miss on insulin got two different students kicked out of my program. Add on the other things, the HIPAA incident (which sounds like HIPAA was being used shorthand for privacy, and whatever the actual HIPAA laws say, facility policies vary, and violating this facility's policy is all it would take to get in trouble for a "HIPAA violation.") The HIPAA incident was likely just the straw that broke the camel's back. And rather than prattling on about the unfairness of it all, OP should be grateful he's getting to finish at all, because like I said, in many programs, he'd be out for good.

For just one or for generally reckless behavior? If one near-miss got me kicked out of school without any other kind of behavior that supported incompetence... wow :eek:...

In my program, we had to look up all meds, their indications, and dosages (to check if they are in the safe range; and provide reasoning/double-check if they are not), and a few times, I'd forgotten and had to reference the little cheat sheet I always make myself (embarrassing when a clinical instructor makes me do this in front of the patient, but definitely makes me not want to be caught unsure again...) In general, this kind of mistake is not cause to get someone kicked out of my program (though admittedly, it is a very infrequent occurrence). As for med errors/near-misses, perhaps I just haven't heard enough examples of them.

And perhaps, OP, your clinical instructor just wasn't very transparent with you and did not give you enough feedback on what to improve on if they just swept you out of the class, leaving you confused with what exactly the reasoning was for a punishment with such consequences. For something like holding you back a semester, I would've imagined the offending causes to be much graver than isolated instances of med error/lack of knowledge.

I agree with some posters as well that there wasn't really a HIPAA violation (at least, at my institution this would not have been considered one---perhaps yours handles it differently). And if there was truly a HIPAA concern, your nurse should have been equally reprimanded for facilitating it.

Specializes in retired LTC.

With all the commenting that's been going back & forth, I'll not re-hash the 3 issues nor the sequella (real and potential) of this post.

To OP - never say NEVER! Just as an alcoholic can fall off the wagon, or an ex-smoker can start up again, or a dieter can regain lost weight, things do happen despite those folk saying NEVER again. Don't ever be so overly confident to think that something may not ever repeat again. There is no guarantee!

Specializes in LTC, assisted living, med-surg, psych.
I am starting to embrace my time off as this whole situation has been very sobering. You can't get too comfortable or complacent, you have to always be on top of your game. I take full responsibility for the insulin situation and if that is what is enough to make me fail I accept that. My main problem with the situation was that they were trying to throw the kitchen sink at me and pile it on. The HIPAA violation I had an issue with as my entire cohort didn't realize this was a HIPAA violation and they had to pull an emergency teaching situation on what we could and couldn't do according to my fellow classmates. They tried to say that my entire cohort took a long lunch (did they follow us to lunch or what?) which is inaccurate. They also accused me of doing my care plan on their computers, when I was actually in my patients records getting medication information. Another issue I had was why wasn't any of this addressed to me at any point throughout the day? If my nurse felt I was being unsafe, she should of pulled me aside and talked to me about it, or her supervisors. She continued to let me do care until the end of the day. I have had the insulin situation beat into my head and I will learn and become stronger because of it, however I don't appreciate the "piling" on and straight up lying that my professor did in class, trying to make me look even worse and claiming that the nurse never gave me permission to enter the room with another student. Essentially she straight up LIED to the class. Let me reiterate, I am extremely aware and remorseful about the error and it has changed my whole paradigm concerning patient care, I am not trying to come off as rude or uncaring, this whole situation just stinks.

The "piling on", as you put it, is probably happening because you are not putting all of your mistakes together and looking at the big picture. What members are trying to tell you is that they see a pattern of them, and that the implications are rather frightening, as you appear to be more concerned with what's been done to you than what might have happened to someone else.

I was a substitute clinical instructor about fifteen years ago, and as luck would have it, I had to send a student home. He swaddled a newborn baby in a blanket, left her under the warmer in the nursery, then walked away......and when I spoke to him about it, his answer was along the lines of "so what, there was a nurse in the room, nothing happened anyway".

He was summarily dismissed from the nursing program, and we came very close to losing that hospital as a clinical site. He obviously did not fully appreciate the gravity of his error and was flippant about it to boot.

THAT is what will kill a nursing student's chances of making it through his/her program. Everyone makes mistakes, including experienced nurses, but you have to own it---not just in your words but in your attitude. In other words, a little humility goes a long way toward redeeming yourself, and frankly that is just not what we're seeing in your posts. We don't really care if you become stronger......we just want you to understand.

Dang there are some harsh nurses on here for sure. I think the HIPAA is a throw on for good measure but I went to school a day or two ago. As an RN you will need to know what you are giving especially IV meds due to rapid absorption. The insulin thing is a big deal because it would be a huge error. While life isn't fair and nursing isn't either, step back from this situation and realize it will make you better.

Unfortunately you will find very little sympathy or empathy from anyone in the profession. Nursing is considered to be the most depressed occupation and 1 in 5 nurses are considered clinically depressed at any given time. The research doesn't indicate if depressed people are attracted to the profession or the profession causes depression. Nurses are afraid to stand up for themselves and better the profession and as a result they are horrible to each other. They live for emotional crack and it's what gets them through the day. Yes, a lot of generalities and stereotypes, however, there's a lot of truth in both.

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