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Discussion

Appropriate interception or invasion of privacy?

I'm interested in your opinions about an incident at my workplace a while ago. Although I felt outraged, my response was apparently in the significant minority.

The patient was a 17 year-old street kid who had come in with cellulitis of the foot for IV anti's. I looked after him overnight and, as it was quiet and I had the time, we talked a bit. I found him to be polite, co-operative and surprisingly well-adjusted given his social and family situation (abusive/neglectful parents, foster care issues etc); no criminal history, no IVDU history, working part time with an eye to going back to school.

I came on duty the following night to a furore. About ten minutes before I arrived, a courier had delivered an envelope to the ward. It was addressed to the patient, and sealed.

One of the nurses (who, I think, wasn't actually looking after the patient) had assumed that the envelope contained dope and - after drawing the rest of the shift's attention to it - opened it. It did indeed contain a bag of fragrant, grass-like substance - about enough for two (not particularly generous) joints.

The nurse locked the bag up in the DD cupboard, and when I arrived was holding forth about the inappropriateness of the delivery.

I have two issues here - the first is that (as far as I know) opening another person's mail is an offence. I don't believe that she had any right to take that action, at least in this case. Had the courier arrived fifteen minutes later, I believe I would have taken the envelope into the patient and said "If this is what I think it is, be discreet." It's not like marijuana is going to interfere with his antibiotic therapy. In fact (and I think this may lead to some strong disagreement), I advised the patient to contact the hospital's patient advocate to make a complaint, which he decided not to do.

My second issue with this incident is what really interests me, though. I may have felt less indignant if the nurse involved had a moral objection to drug use, or some concern about an interaction with his meds/impact on his medical treatment.

However Jane (as I'll call the nurse) was not opposed to recreational drug use. Although I knew this because we were friends, she was quite open about her own recreational drug use. In fact, she had only the previous week had a planned "Ecky weekend" - taking ecstasy one night and coming down over the next two days.

I was therefore very taken aback by this hypocrisy on her part. So my questions are these:

What would you have done if the courier gave you the package?

Was Jane being a hypocrite, or am I too judgemental?

Am I being a hypocrite by having different standards of appropriate response for drug-partaking and non-drug-partaking nurses? I, incidentally, am one of the latter :)

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I'm with you...if the courier had given me the package, I'd have taken it in to the patient...what patients do, as long as they keep me out of it and I don't get in trouble, is their own business. It's not my place to judge.

Kacy

P.S.. Working in nursing for close to 5 years, I have discovered that a large majority of nurses drink and/or use drugs...very interesting..

I have to say I agree with you. I'm not here to judge my patients' actions, I'm here to be their nurse. I'm not going to cure anyone's drug problem in the short time I care for them. Now if he had lit up, I'd have had to say something, obviously; otherwise, I'm minding my own business.

I'm with you. It is inappropriate, not even considering the legalities, to open another person's mail. I would be tempted to report the incident myself.

Not sure what legal age is where you are, but a 17 year old street kid is on his own anyway. If it had been a kid with family, I may have chosen a time when a parent or guardian were present to deliver the envelope, just to cover my own butt.

  • Expert

It was wrong to open the envelope.

Were this a court case, that's all that would matter. Doesn't matter what the crime is - if the evidence is obtained illegally, tough.

On a psych unit, the envelope would have been opened by a staff member in the patient's presence. On a regular unit, I don't know why it was not simply taken to the patient to whom it was addressed.

It's a federal offense to open another's mail.

I don't think you can compare marijuana to ecstasy except for in terms of the law reagarding the possession/use of "illicit" drugs.

If Jane is taking ecstasy, Jane needs help. That's a very dangerous drug.

So we know that co-workers who are responsible for the care of other people are taking drugs... and we don't do anything about that? Y'all don't have random drug screens? I normally try very hard to stay away from nursing issues that are not related to students, because after all I'm not working as an RN yet and don't have your perspective on what's going on, but holy moly. Flame me up if you want, but I hope I don't ever become so apathetic as to know that drug use is going on and yet... say nothing.

It's a federal offense to open another's mail.

The original poster stated that the envelope was delivered by courier, which makes me think it was a private service. "Mail" refers to items sent by the postal service, which is a federal entity. (However I do realize this happened in Australia so forgive me if I'm completely off the mark!)

I do agree that an equally big (or bigger) problem is Jane's drug use!

It's a federal offense to open another's mail.

The original poster stated that the envelope was delivered by courier, which makes me think it was a private service. "Mail" refers to items sent by the postal service, which is a federal entity. (However I do realize this happened in Australia so forgive me if I'm completely off the mark!)

I do agree that an equally big (or bigger) problem is Jane's drug use!

I agree that most of us who have replied have no idea what the laws there are regarding mail delivery. That does not affect the ethical aspect of the issue, though.

That's the only reason I did not comment on the fellow nurse's open use of Ecstacy, also. I don't know how it is regarded in Australia. If one of my coworkers here in CA were that casual about the use of such a dangerous drug, I would consider that person a candidate for a diversion program. (Is that the right term? At the moment, it doesn't sound right...)

In answer to the questions posed:

1) Wouldn't have opened the package. Would have followed the facility's policy.

2) Can't be determined. We don't know what Jane's rationale was.

3) Don't think the term "hypocrite" applies here.

... Doesn't matter what the crime is - if the evidence is obtained illegally, tough... [/i]

Not clear on what's intended with the above.

Can you clarify? Thanks.

I don't think any law was broken by opening the package (Americal law), I would think that since a hospital is a private facility that any object brought in has the right to be searched I do believe security would have been better to open it. I say this because at any time in a public school any student's locker may be opened by the facility (this was the rule when I was in school it may have changed).

Patients have the right to send and receive mail, and to personal privacy. The nurse could havewatched the patient open it to make sure there were no dangerous articles in it, and then could remove and lock up anything- if she thought the items were dangerous. She can't search the patient's belongings without their permission, and she can't open mail that has not been delivered to the intended recipient. The fact that the letter was given to her to give to the patient is a very weak defense, especially since she is in a position of trust.

What if there were no illegal drugs in the envelope, but there was private letter? (with a very home-grown smell :)) That would be an obvious breach of privacy. Just because the nurse happened to be right about the contents doesn't make her action legal or ethical.

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