I'm seeing a lot of unprofessional posting here related to venting about patients

multi10 · Jan 19, 2013

Of course they are already people I know. The point I was attempting to get across was that we are not as anonymous as we might like to think imagine if you are posting a vent about a supervisor and they also post here. That could become problematic.[/quote']
We are exactly as anonymous as we like to think. And even better. We live in America. I wouldn't give one whit about a supervisor who posts here for the reason of looking up your post.

KelRN215, BSN, RN · Jan 19, 2013

I 100% agree with the OP. Sometimes, I read some of the grossly detailed patient information
here and I cringe. This is such a violation of HIPAA and is extremely unprofessional.
Patient information should be protected at all cost no ands, ifs, or buts about it.

Please cite an example. I have been on this site for several years and have never read a post which violates HIPAA.

HIPAA violation: "I was taking care of Mrs. Bernice Johnson, DOB 5/9/1934 who lives at 123 Smith St. New York, NY while working at NYU Medical Center today. She had an appendectomy but the surgeon accidentally removed her left kidney." (ETA: This is a made up person.)

Not a HIPAA violation: "I had a patient today who has end-stage cancer; she is 90 years old and a full code. Her family won't let go. It's really challenging caring for her day after day."

Beautiful Mind RN · Jan 19, 2013

It's wrong to say that people here are merciless wolves. We aren't. There's an abundance of people here who are more than willing to extend themselves to new members, offer guidance to new nurses who are struggling, etc.
The OP started a thread that showed little understanding for how members here use this site for support; sometimes there isn't time to talk to co-workers, so it's nice to vent with your other nursing community.

It's not wrong to say, nor was it meant to offend, just an observation. It's a saying. Not a literal characteristic of the members of this forum. Most of the members that have posted on this thread towards the OP were pretty ruffled by what the OP said since it hit a sore spot. That's what I meant, please do not take it literally. That is why I went on to say before that, a piece of advice. And many others have given it in the same manner.

I have no doubt those in here will reach out to the new member of the forum. I only hope the OP will heed their advice.

metal_m0nk, BSN, RN · Jan 19, 2013

I don't know what you and jnjo are referring to with "detailed information" about any individual, and never by name. Not sure why you're implying that nurses have never had their personal information posted in a public place. If you can provide a rough description of these, we can take the appropriate action. If you don't remember the specifics you can send them a Private Message if you like.
While staff keeps a good eye on this forum, the number of posts ensures that not every one of them will be seen. I'm sure you wouldn't want someone's detailed information to remain on the board.

I'm not admonishing anyone's right to vent their frustrations here. All I'm saying is that doing so is not necessarily harmless. It concerns me that some who vent here grow so comfortable with the HIPAA cloak that they sometimes take broad and distasteful liberties with the information that they are technically allowed to share. I've read some absolutely hateful diatribes about patients' families, economic status, lack of education, appearance, vocabulary, life choices.... all under the auspices of a vent-friendly online community.

I think people tend to forget that this little community is a part of a larger world wide web community that hundreds of millions of people have access to. AN comes up readily in a Google search indicating just about anything nursing or healthcare related. Some of the things I've read on this site over the years might make me very angry and distrustful if I were a general healthcare services consumer with no intimate knowledge of the daily plight of nurses.

The majority of people I know who don't have any real ties to the healthcare field don't really know all that much about HIPAA or don't fully understand the restrictions and allowances. A layperson might read these vents and come away thinking, "If I can't trust a nurse to keep the details of my family dynamics and lifestyle choices private, how can I trust one with more sensitive information?" I think most of the nurses here know how difficult and frustrating it can be to provide nursing care to a patient who is leery of providing information that could be very influential in their treatment course. One of a nurse's most powerful tools is the establishment of a nurse-patient relationship based on trust and trust once lost is very, very difficult to earn back.

allnurses Guide · Jan 19, 2013

I'm not admonishing anyone's right to vent their frustrations here. All I'm saying is that doing so is not necessarily harmless. It concerns me that some who vent here grow so comfortable with the HIPAA cloak that they sometimes take broad and distasteful liberties with the information that they are technically allowed to share. I've read some absolutely hateful diatribes about patients' families, economic status, lack of education, appearance, vocabulary, life choices.... all under the auspices of a vent-friendly online community.

First, I really appreciate your taking the time to write a thoughtful reply. There are times when I've read things members say about groups of people, such as the obese, addicted, or smokers that make me cringe. I understand why members of the public who read that might be offended by it. Some members are offended by other members characterizations of groups of people. See some of the many threads on the topic of smoking, overeating and other lifestyle-related diseases and conditions.

There is a clear distinction to be made when we talk about a person and their diagnosis. That particular person is who the law is designed to protect. A person browsing through this forum should never be able to say "they are talking about me" (or someone they know)specifically. A member of the public might read something here and say "they are disparaging chronic pain sufferers by calling them drug-seekers!". I'm sure that is upsetting, but it is not a HIPAA violation. Sometimes people read something like that, and become a member just so they can read us the riot act, and those posts stay unless they violate the Allnurses Terms of Service.

So, it comes down to whether we want to have a balanced set of terms, which most people adhere to, which may contain something a non-nurse will be offended by or we have a closed "member's only" group. After reading so many posts from people who have lurked for years and joined, as well as my own experience, that express the positive aspects of the forum, I think having an open forum is better. Not perfect, but better.

metal_m0nk, BSN, RN · Jan 19, 2013

First, I really appreciate your taking the time to write a thoughtful reply. There are times when I've read things members say about groups of people, such as the obese, addicted, or smokers that make me cringe. I understand why members of the public who read that might be offended by it. Some members are offended by other members characterizations of groups of people. See some of the many threads on the topic of smoking, overeating and other lifestyle-related diseases and conditions.
There is a clear distinction to be made when we talk about a person and their diagnosis. That particular person is who the law is designed to protect. A person browsing through this forum should never be able to say "they are talking about me" (or someone they know)specifically. A member of the public might read something here and say "they are disparaging chronic pain sufferers by calling them drug-seekers!". I'm sure that is upsetting, but it is not a HIPAA violation. Sometimes people read something like that, and become a member just so they can read us the riot act, and those posts stay unless they violate the Allnurses Terms of Service.
So, it comes down to whether we want to have a balanced set of terms, which most people adhere to, which may contain something a non-nurse will be offended by or we have a closed "member's only" group. After reading so many posts from people who have lurked for years and joined, as well as my own experience, that express the positive aspects of the forum, I think having an open forum is better. Not perfect, but better.

I said nothing of HIPAA violations. Perhaps you are thinking of another poster. I did say that it concerns me that some would take broad and distasteful liberties with the information that they are technically allowed to share.

I don't claim to be personally offended. I'm not. I do think that some of these vents are not entirely harmless and I still believe that to be true. But also, what I was hoping to get across is that the ways in which some nurses present themselves and other nurses by association to the world at large through their very, very public vents is not entirely sensible - because it isn't just the patient's (whether real or fictional) reputation at stake. The nurse also puts his/her prejudices on display for the world to see. And while an onlooker might not come away from reading one of those vents able to say, "they are talking about me specifically," one might very well come way thinking, "they could be talking about me," not as in, "OMG is it ME they're talking about?" but as in, "I'm a smoker/diabetic/overweight/poor/Black/Hispanic/under-educated/sweaty ...did my nurse talk about me this way when I was out of ear-shot?"

Question...

Is this offensive to nurses? Keep in mind that there isn't one specific nurse identified in this excerpt. This is directed at nurses in a general sense:

"Thank you, dear nurse, for bothering me when I was sleeping, talking to me like I'm an idiot and referring to me by my room number instead of my name. Thank you further for choosing a profession that requires you to deal intimately with people and then complaining loudly when I needed assistance to empty my bowels into a toilet instead of into my underwear. There are plenty of other jobs you could have chosen: a stock clerk, a janitor, a night shift convenience store cashier where you wouldn't have to deal with people since you so obviously would rather not. But then, what would you have had to complain about? Thank you also for your excessive lack of personal hygiene when you decided to come into my room smelling like sweat and dirty socks. Bathing probably takes too much time away from texting, tweeting and shopping online at the nurse's station. I just adore the smell of tuna left out in the August sun! Thank you for also bringing your unprofessional drama while you discussed your at home coworker with your buddy outside my room - about how you think she's too flirty with the doctors. I haven't gotten to see Jerry Springer all week because I'm too ill to focus on the television, but this certainly filled in the gaps. My, the way you can badmouth a member of your own team is certainly poetic. You have certainly broadened my horizons when it comes to trash-talking."

I recently read this on the boards directed at patients and it received quite a few likes:

Thank you, dear patient, for coming to us when you were in labor. Thank you further for choosing the local medical school to provide your obstetrical care rather than the group of private physicians that were also available, and then screaming the entire labor about "all those mofos in my business and in my dookie!" You could have chosen ONE doctor instead of a herd of doctors, but then what would you have had to complain about? By the way, what exactly is a dookie? Is that the same thing as a monkey or a pocketbook or a cat? Thank you, also, for your excessive lack of personal hygiene prior to your scheduledinduction. Bathing probably takes too much time away from texting, tweeting, and threatening the putative father with child support. I just adore the smell of tuna left out in the August sun! Thank you for bringing your 8 visitors with you despite the sign and my polite reminders about only 3 visitors in the room at any one time. So sorry I couldn't provide a pallet on the floor as requested by that one particularly charming fellow. The verbal abuse I caught when I refused to part with 3 blankets so he could stretch out on the floor certainly broadened my horizons when it comes to profanity! My, but he is a poetic fellow. Thank you also for bringing your drama. I haven't gotten to see Jerry Springer all week because I'm employed, but this certainly filled in the gaps! To hear that you didn't discover you'd procreated with your second cousin until after it was "too late to do sumpin about it" really made my day. I'm an old fashioned girl, and always liked to know the last name of the person I was intimate with, thus sparing me those pesky incestuous situations, but I certainly see the excitement of doing it your way. And I was truly inspired with your mothering when you handed the baby back to me and told me you'd hold him after we cleaned him up, because he was "nasty." Yes, he probably was considering the entrance you provided him to the world. Thanks for refusing that tubal ligation, too, because we certainly hope to see you back here next year!"

The above was directed at patients in a general sense. Maybe it's just me, but I don't think it would be terribly surprising or melodramatic for some patient to be offended after reading something like that.

Garethaus · Jan 19, 2013

Ok, I havent abandoned the thread. I've just been reflective of what I said and to the extent of what I said, hence I have not posted while considering the extent; how I feel about it. I'm surprised this thread has been commented on so much. Firstly a lot of people have been saying "Wait until you get on the floor, it'll be different then". Well, Ive been working as an AIN in Oz here for over a year now and I've certainly had my share of 'difficult' patients. Personally I don't think it is appropriate to post here what are sometimes quite detailed vents against patients. Even with the name of the patient changed and hospital unidentified I contend some patient *could* recognize their story here. Definitely IMO.

I do think it unprofessional the more details that are shared about a patient online, especially when it is effectively a rant as some people describe it. I also do not think it is in the spirit of nursing itself, the promotion of health to come online and complain about some patient.

I think it is professional to mention what happened in the day with a patient in a general sense, to share the experience with other experienced nurses to gain feedback. What follows is all theoretical btw.

What I mean is in the veins of: "Today a patient threw fecal matter at me and made physical contact with me. This made me feel.....etc.

Rather than: "Ok....I gotta vent about this. You guys listening here? This patient, who I'll call Adam threw his disgusting feces at me today. I'm not normally on this ward but they were short here today. I hadnt nursed Adam before but he sure made himself memorable in a short time. Sure Adam's suffering from dementia but that's no excuse - he's not THAT demented not to know what he did today. All I was trying to do was put toilet paper on the roll for him to use. I was wondering what he was doing at first just after I put the roll in but it unfortunately became very apparent. He threw his feces at me - landed on the abdomen area of my just new WHITE uniform - YUCK!!!!. Immediately his son entered the toilet hearing my disgusted sound. Advice to myself: Wear an apron - always....I should have known better I'll admit. The son was no help - after walking in through the door, he looked at me and said - get this - "What did you do!?" EXCUSE ME!!!! WHAT DID I DO?!!! Nothing except try to help your demented father by giving him toilet roll! And get covered in feces on my previously CLEAN uniform! To top it all off and put the cherry on the cake, the father then grabbed my arm. And yes, using the hand he threw the doo-doo with. The son did NOTHING and just stood there with his gaping mouth watching it all. I cried "HELP! Let go!" trying to get my arm back. You'd think other staff would respond quickly to this right? Nope, true to our hospitals staffing policy no one was in hearing distance. I couldnt reach the button - not that anybody would have come quickly anyway. I extricated myself from this demented patient with some difficulty, went to clean myself up and alert others to the incident. I left the son to attend to his fathers needs - it turns out no-one else in his family will bother with the father due to his behavioural problems. No wonder if he does things like that. He hadnt really hurt my arm - luckily - but he'd left disgusting streaks on my arm"

And well, so on for another three paragraphs to detail staff support, the aftermath of the incident and complain some more about the patient / son in descriptive detail. In conclusion a further complaint is made about the unsupportive NUM of that ward and how nobody likes the NUM of that ward.

I wouldnt choose to tell a real-life story like that. I think how I've crafted that story is how some nurses tell their story here. Names changed but enough details for a participant like the son in that story to recognize themselves.

The thing I wonder about for myself, is how much details could I reveal of a patient before it becomes unprofessional IMO? Because I havent really posted on a nurses site while thinking about myself as a nurse before.

For example theoretical: "A patient came up to me on night shift and said the nurse down the other end is listening to music on his headphones. I said "Are you sure? He's not meant to do that" The patient said, "see for yourself dude - he's not answering my call button so I had to get up". I went down the corridor to investigate. Sure enough, the other nurse was plugged in - I could clearly hear the Black Eyed Peas resonating in a small tinny audio from his Iphone headphones. I got his attention. "What the hell are you doing!" I said in a quiet voice. The other nurse really wasnt bothered with my stern expression "Theyre all asleep" etc etc....

See, now is even that too much? Even that small bit about the patient I feel is revealing too much. Although not complaining about the patient theres enough dialogue there (unless I change it of course) for somebody to recognize themselves. And even, as I acknowledged, if I did change the dialogue what is left might still resonate with some patient and they'd say that was their story.

In general I think for myself it might be (is it?) alright to talk about staff interactions to gain valuable feedback, but not to mention the patient at all.

SaoirseRN · Jan 19, 2013

I get very weary of being told how I must behave. What I must and mustn't say, simply because I am a nurse.

You know what? Perhaps a patient may happen across this forum and read something they didn't like. Perhaps they may even feel offended. They didn't need to read it, and neither do you.

My "reputation" as a nurse depends on how I am when I'm with my patients, not some website. If a patient mistrusts me simply because they read something online then likely they would have found some other reason regardless.

You have offended me, and others, by deeming us unprofessional for venting. You've decided it's okay to talk about some aspects of nursing, but we must not be allowed to express our frustrations, because we can't be seen to be upset when patients behave inappropriately?

Is it also okay for you to deliberately offend us, but not for us to potentially offend some wayward patient?

Do some people overdo it? Likely, but they are using AN as an outlet to express their thoughts and ask for feedback. Often times these threads are written in the OP's "speaking" voice, writing down what they would say aloud had they a pair of understanding ears nearby. Some of us don't have that, and so yes, emotions end up in the posts and all that means is we are human.

Don't like the venting? Don't do it. But don't come here and tell me I shouldn't either.

MandieeRN · Jan 19, 2013

Today I left work in tears all because of one patient. Sometimes nurses need to vent to other nurses who will understand and advise.Its a healthy outlet:) I'm sure you will leave work mad or in tears at some point. I just hope a fellow nurse is there for you.

tewdles, RN · Jan 19, 2013

Of course they are already people I know. The point I was attempting to get across was that we are not as anonymous as we might like to think imagine if you are posting a vent about a supervisor and they also post here. That could become problematic.[/quote']
I have always been mindful that there are people posting and reading here who know me and do or have worked with me. It has always been that way for me. No secret that I enjoy this site, I recommend it.
For that reason, I do not make it a practice to vent about my co-workers on this public nursing forum. I probably have slipped from time to time but everyone's got a tipping point!

metal_m0nk, BSN, RN · Jan 19, 2013

I get very weary of being told how I must behave. What I must and mustn't say, simply because I am a nurse.
You know what? Perhaps a patient may happen across this forum and read something they didn't like. Perhaps they may even feel offended. They didn't need to read it, and neither do you.
My "reputation" as a nurse depends on how I am when I'm with my patients, not some website. If a patient mistrusts me simply because they read something online then likely they would have found some other reason regardless.
You have offended me, and others, by deeming us unprofessional for venting. You've decided it's okay to talk about some aspects of nursing, but we must not be allowed to express our frustrations, because we can't be seen to be upset when patients behave inappropriately?
Is it also okay for you to deliberately offend us, but not for us to potentially offend some wayward patient?
Do some people overdo it? Likely, but they are using AN as an outlet to express their thoughts and ask for feedback. Often times these threads are written in the OP's "speaking" voice, writing down what they would say aloud had they a pair of understanding ears nearby. Some of us don't have that, and so yes, emotions end up in the posts and all that means is we are human.
Don't like the venting? Don't do it. But don't come here and tell me I shouldn't either.

I don't think anybody here is telling you how to behave. I know for sure that I at least didn't. I did however, share an example of how a nurse's online behavior might be perceived and what the consequences of that perception might conceivably be.

I for one will ardently defend your (and anyone else's) right to behave however you like.

Just don't be surprised when, if you behave in a way that others deem unprofessional, you might be thought of as.....unprofessional.

SaoirseRN · Jan 19, 2013

I don't think anybody here is telling you how to behave. I know for sure that I at least didn't. I did however, share an example of how a nurse's online behavior might be perceived and what the consequences of that perception might conceivably be.
I for one will ardently defend your (and anyone else's) right to behave however you like.
Just don't be surprised when, if you behave in a way that others deem unprofessional, you might be thought of as.....unprofessional.

Yes, I am always terribly surprised when I slap doctors, mistreat my patients, and show up at work drunk that people find my behaviour unprofessional.

Honestly, you can think what you want and you can skip your lecture. Knowing a vent I may write is considered unprofessional by someone with "0" years of experience is not going to haunt me for the rest of my life.