Nursing student Hipaa violation

  1. Hi

    I'm new here and was hoping for some advice. I was recently dismissed from my LPN program for HIPAA violation. I was told it was a HIPAA violation and I was lucky the hospital wasn't going to report it. I was also told that I had no appeal.

    What happened was this, I went to preassign at about 6 p.m. at night. I took my 14 year old son and I was told that I could put him in a type of waiting area while I did my work. I was allowed to do this a couple weeks back as well so I believed there was no issue. I had become friendly with an ex-patient. I had not had this patient for over a month. Feeling badly because this patient was so ill and still in the hospital I stopped quickly just to say hello. I informed him that I was leaving and I was in the process of getting my son who was waiting for me. The patient asked me to please bring my son into his room and let him meet him. Considering I had the patient request this I didn't think it was a problem. I went and got my son who was waiting for me and let him meet the patient. Then we left.

    About a week and a half later I was called to the administrator's office that the hospital had written to them with their concerns. They said when the patient was asked if my son was his visitor he said no. However I'm not sure how the questioning was presented to the patient. Considering my son and I were not unplanned visitors, you can understand the answer.

    I was dismissed from the program and told that the hospital would not be reporting it as I could be in a lot more trouble. This obviously scared me greatly and I haven't even tried to appeal any decision. We touched on HIPAA briefly but an incident like this wasn't really discussed.

    I'm just trying to get some info as I have been scouring any information I can find about HIPAA to see where I went wrong. I'm also afraid to try to appeal to get back into this program even though I spent a lot of money and effort and I had the top grades in the class. As some of you might say from what I've read in past posts, there might be more to the story. One of my clinical instructors didn't seem to like me very much and maybe this could be a deciding factor? Meaning that I read somewhere once that if you are already having issues Maybe they won't be so keen on keeping you and will let you go. I didn't have any issues except for one time I didn't get a patient washed up quick enough for her liking.

    As you can imagine there's a lot and it would take a lot of info to give you more. I'm willing to do that for some insight here and any advice of what I should do. Should I try to fight this or should I leave well enough alone. I don't remember signing anything with HIPAA and I remember getting a very general HIPAA education.
  2. 13 Comments

  3. by   JKL33
    Based only on what you have written here, there is no HIPAA violation - although there may be some poor judgment and violation of professional boundaries.

    I personally would not expect a student to fully understand these things; correction and education would be in order rather than exaggerating the offenses to the level of HIPAA violation.

    In case you aren't sure what I mean regarding judgment and professional boundaries:

    Nurses need to avoid the appearance of impropriety. Being a patient is widely considered to be a "vulnerable" position. Therefore, becoming friendly with a former patient is often called into question. There are many reasons (beyond the scope of this topic) why it is probably best to wish patients well and let the relationship end when you are no longer caring for them - especially when you have neither the wisdom nor experience to judge the situation any further.

    Next, because patients are vulnerable, we take extra cautions with our interactions with them. What if the patient didn't really wish to continue a relationship with you or have you visit but simply felt the need to be "polite?" Or, worse, what if s/he felt it was probably best to treat nurses/students this way, fearing poorer care if s/he didn't allow this kind of relationship? As the ones acting in a professional capacity (which also has an ethical code associated with it) we are responsible to not put patients in those kinds of situations. Generally-speaking, we are there to concern ourselves with patients, not to have them concern themselves with us (aside from not abusing us, etc), or become concerned that they must allow certain things in order to receive good care.

    You may feel that you had an understanding with the patient, you both felt comfortable, and you shouldn't have to worry about these types of things. I don't know what else to say except that, too often, that just isn't the world we live in.

    I'm sorry this has happened to you. I don't know what you can do from here - although I can't see how you have anything to lose by throwing yourself (with or without a lawyer's help) at the mercy of your program. They have acted harshly because they took the hospital's word regarding their investigation of this matter. Sure the patient didn't say your son was his visitor - because he took that question to mean one thing and the hospital used it to mean something different. Anyway, your program wants to show the hospital that they take these concerns very seriously so that the hospital will continue a business relationship with them - which is kind of a big deal because they do need clinical sites.

    Have you thought about all of this?

    What communications have you had with your school? What have you said in your defense?
  4. by   Triddin
    I wouldn't say it's a hipaa violation, but a violation with appropriate patient/ nurse boundaries
  5. by   maxthecat
    I think some of the harshness may stem from you bringing your son along on your preplanning visit, even if he was not directly on the unit. My guess is that some nurse or manager didn't feel that was the type of professional behavior expected of a nursing student and I have to say, I see their point. And given that he did see patients on the unit it could be considered a privacy violation, even if not a HIPAA violation. I know finding a sitter can be a bear, but you really can't bring along your kids for this type of thing.
  6. by   Dhready
    First of all, let me thank you for replying. I so appreciate your input.

    I'm happy to know that it isn't a HIPAA violation, but I'm a little distressed that I was told that it was and I had no appeal. That's the reason that I hesitate to push this because I don't know what repercussions could arise. I've been warned by some other students in the class set the instructor might be a bit vindictive and hinder me in applying to other programs, and there aren't many in the area, maybe two RN programs.

    You gave me a lot of concerns to think about that I hadn't thought about. And believe me in the two weeks since I was dismissed I have been reading and I have learned a lot. Having never worked in Healthcare before I really feel like this was a big eye opener. What you say about the patients, and the patient in this case makes total sense and I should have known better. I will from now on and never make these mistakes again.

    I tried to explain my point to the school at the time. It just seems like it didn't matter what I said. And I was told I had no appeal and I was lucky that the hospital wasn't reporting me.

    Also at this late point I don't know if they even did let me back in if I would be able to catch up, you know with the clinical hours and not being able to miss them.
  7. by   JustBeachyNurse
    First problem bringing a minor child into a facility while you were present as a student at work. Would you bring your child to class with you? While you were at clinical? No? Then your c
    child should not have been brought with you to a hospital to a type of "waiting area". If your teen is t capable of waiting at home alone they shouldn't have been left unattended in a hospital "waiting area". Likely a hire policy violation and a liability for the school and facility.

    Major professional boundary violation in visiting someone you took care of previously in clinical. If you obtained clinical information from staff or the patient you are delving into PHU to which you are not entitled. By visiting the former patient you violated clinical rules. You never should have told him your child was in the hospital waiting for you.
    If staff saw a teen come out of the room of a patient that had no family or rarely had visitors it was red flagged and likely why the patient was questioned. Professional boundaries. Learn them as you crossed them several times in a single evening.

    While likely not a HIPAA violation however if you told your son about the patient and brought your son to visit him even if the patient seemed to want that you crossed a line that should never have been there to cross had you not been visiting someone you shouldn't have, not had your child unattended in a "waiting area" and not brought your child to see the patient.

    Did you have permission from your school and the facility to bring your child? Did you repeat the action because no one noticed (they did I guarantee it) so you thought it was okay (clearly it wasn't)?

    You are likely persona non grata in the hospital as a clinical student. HUGE problem if this is a primary clinical site for your program. Even though not necessarily HIPAA, the fact that you brought your child to the clinical site and left him alone in a "waiting line area" is likely grounds to deny readmissions.
  8. by   Dhready
    Well we were actually done at that clinical site and just moving on to the next one. So I guess I was lucky there. Believe me I am really beating myself up over this. I had so much invested.

    The supervisor did mention readmission for next year might be possible, but maybe she was just saying that.

    My main concern is, will this hinder me from getting into another program? And that's the reason I hesitate to try to appeal.
  9. by   JKL33

    I PM'd you.
  10. by   not.done.yet
    My school had pretty strict rules about bringing kids to clinicals. Here at my hospital we have pretty strict rules about people bringing their children to work. Any time you are doing clinicals, you need to see it as "job training". You would not bring your kids to job orientation. Nobody should be bringing their children to clinical sites, for any reason. We often advise here to have plan A, B and C for sick kids during nursing school. If the child was not sick, then either they need a sitter or they need to stay home. At 14 I am a little surprised you would have felt it necessary to bring them.

    I hope you are able to pick this back up again next year. It is impossible to say whether other schools would accept you. If it is on your transcript as a HIPAA violation, that is regarded as extremely serious.
  11. by   iluvivt
    GREAT response by KKL33!.Can you put your finger on any information that tbe school gave you regarding HIPAA and the professional conduct expected of you in clinical settings.If not how can they except that someone just learning know all this information. You can only be accountable if you have the information and then break the rules.In this case I do not understand the harsh punishment you received.You did ,however, use incredibly poor judgement but the school could have used this to instruct you and others. I would fight it because this is not a HIPAA violation as no PHI was disclosed that the pt did not want known and your son was invited into the room.If they do try and report this as a HIPAA violation it will get tossed out.
    Last edit by iluvivt on Mar 7
  12. by   Dhready

    I tried to respond to your DM but the site won't let me.
  13. by   JustBeachyNurse
    Quote from Dhready

    I tried to respond to your DM but the site won't let me.
    You haven't posted enough. Strongly suggest you review school policy on bringing minor children to clinical sites as that may be.a larger issue
  14. by   psu_213
    Quote from JustBeachyNurse
    You haven't posted enough. Strongly suggest you review school policy on bringing minor children to clinical sites as that may be.a larger issue
    I agree. Even if you get permission from your school and the facility to have your son stay in the waiting area, I would be worried that it could still become an issue later.

    I almost hate to say this: I'm not doubting that your son is a good kid, but even the best behaved 14 years olds do silly things. I would hate to see you get in trouble if your son is accused of something (whether he did it or not).

    You have to make sacrifices to be successful in school, and this is one of those cases.