Am I On Camera? No Paparazzi Please!

In a time where technology seems to be the common theme throughout the world, and the majority of people have smartphones with video and camera capabilities at their fingertips, it is most certainly changing healthcare. Have you ever been asked by a family member to be recorded during standard care...or even thought you were being secretly taped by them? Nurses General Nursing Article

There have been lawsuits and stories galore about HIPAA violations related to healthcare practitioners taking pictures of interesting wounds, markings, tattoos, etc. on patients, and when patients found out, they became upset and sued for violations of their privacy. If you are a patient with an interesting medical case, there are two ways it can go: you want to hide under a rock and just get treatment, or you may be interested (especially at a teaching hospital) in having your case discussed at multiple levels and allow pictures of every step of your case so that others can learn from what you experienced.

I understand both sides, which is why most hospitals, if not all, have releases that patients can sign for medical use of photographs (as part of the medical record) so that patients are aware pictures may be taken, but they are being used for medical educational purposes. Patients have the ability to approve or decline the use of pictures, and it gives them that power of decision over their body, in a time when they can feel helpless, which is crucial for them.

Recently there has been a new trend that I have seen at my own hospital, but heard about from various nurses throughout the country, and it is the reverse: patients (or their families) taking videos and pictures of healthcare providers, during routine care and/or family meetings without telling them. During family meetings, especially if a patient is in a critical care unit and family members may be making decisions for a loved one who cannot make decisions for themselves; they may be stressed during the conversation, worried if they are making the right decision and wanting to remember every word of the conversation to relay to other family members to explain their decision making process, but does that give them the right to secretly record our conversation?

I don't think there is anything to hide, but I can also understand how healthcare providers might feel worried that if they are recorded, or videotaped, that this somehow might put them in a position for a possible litigation later on, especially if the outcome of the patient isn't what their family hoped for (and we all know that healthcare providers do the best they can, but we cannot save everyone.)

As for being videoed during routine care of a patient; I don't see what the benefit is for the family, or for the patient. I don't videotape my mechanic when I get an oil change, I trust that they are the expert: they remove the old oil, put new oil in, and my engine is happy and healthy. Granted, I don't have a great relationship with my mechanic, but videotaping their every move would be weird, and I wouldn't blame them if they declined to be videoed.

Maybe that is a bad example, but as a nurse, I form a relationship with my patient and their family members (or at least I do my best to have a trusting relationship) so I think it is even more of an offensive request to videotape me when I am performing care.

Are they wanting to do it to make sure that I am doing things properly? Will they compare and contrast how each nurse cares for them/their loved one? As we all know, there are variations in nursing care, due to personal style, but that doesn't mean that one way is wrong and another is right, the end result can be the same, even though two nurses might go about care in a different way; to an untrained eye, or someone who has no idea about current evidenced based practice or hospital policy, they might think small variations are important, that aren't.

I know some nurses double glove all the time, for no particular reason other than that if they are, for example, removing an IV, they like to take out the IV and pull in into the top glove to throw it out and remove the risk of dirtying a bed. Other people don't do that, but it doesn't mean the nurse is not removing the IV correctly. Those two scenarios look very different to a layperson.

Nurses normally explain what they are doing with a patient either before or during the process, to not only empower them with knowledge, but to make them more a part of their care; doesn't a family member videotaping this make it seem disingenuous, invasive, and distrusting? Where is the trust and the relationship formed with families/a patient when they tape my interactions?

We give patients the power to approve use of pictures of their medical cases as a part of their medical records, but we have had cases of "secret" videos by families, that we found out about afterwards, but were never asked if it was OK. Where is our power to say no when someone is secretly videotaping us? There is no form that has to be signed, as healthcare practitioners to allow families to record us, and if we allow it, do we then have to worry about possible litigation after the fact, even if they were intended just for informational purposes?

Technology is a great mobility for information and keeping people connected electronically, but there are times we need to leave technology at the door, and connect as humans.

Specializes in Critical Care.
Because if anyone else is around you are now violating their privacy rights.

Part of my job is to guarantee the privacy of protected health information. When someone whips out their cell phone and starts recording anyone else who might be filmed has now had their privacy rights violated.

Also you might want to check the laws in your state. Many states require the person being audio recorded and video recorded have knowledge and agree to the recording. Federal facilities are a big no no

The patients have an expectation of privacy, nurses do not (unless they are in a bathroom, locker room, etc). No states require permission for recording or taking pictures where there is no expectation of privacy. There are federal laws that apply to specific federal facilities, typically called secured facilities, but VA hospitals aren't one of these and federal privacy laws most definitely apply to federal buildings which by definition are public property.

Oh, and I'm sure someone videotaping an IV start helps us as nurses do a better job! I'm sure we would just not try unless we were put under survellience. Good grief...

As a brand spankin' new nursing student, this makes me very nervous. I'm uncomfortable in new situations to begin with, I can't even imagine my stress levels knowing that somebody was filming me! :eek: I mean, we're recorded during labs, but that's for my own benefit. This is really, really weird.

Specializes in MICU, SICU, CICU.

There are many facilities with policies that forbid videotaping or audiotaping of their workforce without the employee's written consent. These policies are intended to prevent disruption in the workplace and authorize security to confiscate anything recorded without the employee's written consent.

I had a resident do this when I worked in a rehab unit. This resident was told repeatedly that he could not film the employees without consent. But he wasn't doing it for safety reasons. He was doing it for personal pleasure reasons and gave everyone the creeps. Also this is in wisconsin so I don't know if the laws are different in other states.

Specializes in Critical Care.

"Confiscating" someone's cell phone or other recording device because they violated institutional policy is actually theft and often assault as well. You can trespass someone for violating visitor policy but you can't confiscate private property without exposing yourself to criminal charges.

In my state it is illegal to record audio without the knowledge and consent of those involved.

Video monitoring has certain requirements too but I am only sure of how those apply to a home, not a hospital.

I'm curious (and can't fall asleep) so I'll look into that. It's a good topic.

It seems that it falls on the hospital staff to prevent breech of other patients information but beyond that, it gets fuzzy.

I was correct in that my particular state requires consent of all involved parties for audio recording. There is no restriction on video recording in "public spaces". I don't think that hospital rooms would fall into that category.

Here is a published case study that I found on the topic.

http://www.aqihq.org/files/airscases/CASE_2012_02_Spy_vs_Spy.pdf

Specializes in NICU, Trauma, Oncology.

As far as secret recording it depends on your state laws whether it's permissible or not

No "MOM im on TV!" comments yet? Guess its me :D

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Hospital policy (where I am) strictly prohibits audio or video recording of staff -- with or without permission. If someone whips out the cellphone, we just tell them to stop. If once isn't enough, it gets referred up the chain and either our manager or security gets involved. Thank the heavens for such a policy because I really don't want to star in anyone's home video!

Specializes in Med-Surg.

I am not sure what my facilities policy on this is, but it's something that I intend to look up.

My concern with being taped primarily has to do with my safety. My unit tends to get a lot of psych patients, or inappropriately behaving male patients in general. I have had patients and/or family members that have made me feel really uncomfortable before. If someone like that wanted to video tape me, I don't know what I would do, but I definitely would feel unsafe.

I feel conflicted on a patients right to videotape. Both patients and healthcare workers rights should be considered. Also, it should be considered that a patient filming a nurse may inadvertently film other patients or audio record other patients information. Especially troubling in dual rooms.