Family Involvement

[Djadia]

I work @ a rural hospital that has 1 patient room monitored via camera that we often use for suicide patients but also utilize it for patients that require close monitoring r/t hemodynamic instability and/or restraint patients. We currently have an elderly gentleman occupying that room d/t the need for close observation to maintain central line and drain placement. The family has been very attentative, and involved with his care (assisting in dressing/ bathing)

A few days ago, the nurse who was caring for him had asked the daughter to leave the room so they could perform a wound vac dressing change on an abdominal incision that dehisced. The camera that monitors that room is located in the nurses station a short distance from the patients room. The daughter stood at different areas of the nurses station to be able to view the camera. I could obviously see that she was wanting to see the camera so I asked her if she wanted me to turn the camera so she could view the room. My opinion is this: if the patients family had been actively involved their fathers care, and there weren't any other patients being monitored by that camera, I wasn't violating any privacy issues. The daughter could have chosen to remain in the room instead of leaving. I feel that if the nurse doing the vac change did everything correctly & delivered the optimal level of care that is expected of us each every time we engage in patient care - then there should be no reason why the family couldn't view their fathers room during their abscence. If we refuse to allow them to view their fathers via camera - then we are implying to the family that we are trying to hide something and would cause them to mistrust the staff and question the safety of their father. (I would view it the same way if that were MY father in that bed)

The nurse doing the procedure was Livid that I allowed the daughter to view them while they were in the room. Was I wrong to let the daughter view the camera?

[classicdame, MSN, EdD]

legally wrong or procedurely wrong? Better ask your risk mgmt. officer.

[AnonRNC]

I do think you were wrong. The camera is there for a specific purpose and you violated that purpose. Think about our use of electronic health information and how our purpose for accessing a patient record dictates what we look at in that record. For example, the Diet Tech might look at diet orders, but has no business looking at STD test results, right? It's kind of the same thing. The camera is for medical safety. It's inappropriate to use the camera to watch a patient and their SO make-out and it's inappropriate for a family member to look at the monitor screen at all. The nurse performing the procedure probably felt spied on and violated. If the daughter did not want to leave, she should have spoken up and said so. She also should not have been behind the nurse's station.

Learn your lesson, hold your head up, and move on.