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 CCU, SICU, CVSICU, Precepting & Teaching.
I think you're confusing public/private property with places of public accommodation, which are two different things. Most places of public accommodation are private property (stores, restaurants, etc), but in terms of an expectation of privacy they are considered public spaces since they are places of public accommodation.

Places of public accommodation are free to have rules about how people must act while in their establishment, but it's very important to recognize the difference between those rules and enforceable laws. If a facility has a policy against wearing hats and someone wears a hat into the hospital, can you have them arrested for wearing a hat?

You can certainly allow them to leave if they won't remove the hat. You can even require that they leave.

Specializes in Critical Care.
You can certainly allow them to leave if they won't remove the hat. You can even require that they leave.

You absolutely can require them to leave, but that's about it, you can't confiscate their phone, erase the recording, etc. The only option is to trespass them.

Specializes in Infusion Nursing, Home Health Infusion.
Since you cannot ban cell phones, at least don't enable the practice of recording. Nurses aren't obligated to help them charge their devices, and they certainly aren't doing their colleagues any favors by making it easy for the abuse to continue.

Who said that I agree with allowing patients and family to use their phones to record. Please do not twist what I said! I follow the policies and do not allow any recording to take place. I will, however help any patient charge up their phone and believe that the nurses are very kind to help their patients. I would want someone to help me if i was in the same position. I do use one piece of equipment that will not work well if a cell phone is nearby and I have never had a patient refuse to let me set it aside and remove it from their bed. Other than that I am not the cell phone police.

Specializes in Clinical Research, Outpt Women's Health.

I don't have a thing to hide, but the idea of people recording me at work and using those images in any way they want makes me uncomfortable. I just don't like having my image "out there" floating around.

I would never go into nursing today if I was young and starting out and this is just another reason.

Why do nurses seem to have no rights? Why must we give them up continually?

I have experienced a patient's family member recording my every move from speaking about non-medical topics with the patient, to simply administering PO medications. I felt as though this was done out of hostility, as to try and find a small flaw in my practice and turn it into a lawsuit down the road if something was to happen to the patient. I am confident I did nothing wrong, but felt violated as a healthcare professional. It would be one thing to record my discharge teaching with the patient, but recording my every move felt quite intrusive. I went to the charge nurse after this happened, and simply asked the family to let me know if and when I was being recorded. Once I requested their notice first, they put their phones away for good.

Specializes in Telemetry.

I understand wanting to record discharge instructions and maybe some things related to a pt's new dx or equipment.

Makes me think that in these cases maybe there could be a dedicated website that the facility endorses that has up to date, easy to understand, and informative videos on things like tube feedings, various wound dressings, cast care etc.

These could be an added resource for pts and caregivers who will be continuing some treatments.

Maybe some additional info on troubleshooting and FAQs.

In general I don't want to be recorded because I agree it feels like they are looking for something to go wrong.

Specializes in Surgery,Critical Care,Transplant,Neuro.

A hospital is not considered a public place in the US; they are private property entities, which is why there can be regulations about use of cell phones, recording devices, etc.

Specializes in SICU, trauma, neuro.

For my second assessment class (first was in my ADN program), our exam consisted of recording ourselves doing the assessments on a volunteer and posting them unlisted on YouTube. We'd then submit the link to the video so the instructor could see it.

I used to spend HOURS making those vids...my poor husband. .. because I was so nervous about the filming I'd flub all over the place. I would stutter or have word finding difficulties, or completely lose my train of thought.

I have nothing to hide, and I'm usually confident at work, but if I was on camera? I don't know.

Specializes in Telemetry.
For my second assessment class (first was in my ADN program), our exam consisted of recording ourselves doing the assessments on a volunteer and posting them unlisted on YouTube. We'd then submit the link to the video so the instructor could see it.

I used to spend HOURS making those vids...my poor husband. .. because I was so nervous about the filming I'd flub all over the place. I would stutter or have word finding difficulties, or completely lose my train of thought.

I have nothing to hide, and I'm usually confident at work, but if I was on camera? I don't know.

I had this sudden flash of someone taking the videos pts/visitors recorded and uploaded and editing and compiling a montage of our flubs. Like an embarrassing nurse blooper reel. :eek:

And that is the problem - if we are recorded, we have no control of what others do with them.

There's definitely a great deal of speculation and layperson interpretation of privacy laws in this thread's comment section. There are really only two sure fire solutions to this problem. First, do research on your individual state's privacy laws and consult a professional (attorney or law enforcement) for specific questions about surveillance at your facility. Second, work with your nurses' union/association and facility management to push for common sense policy that protects employees' privacy in addition to patients' privacy.

Specializes in Critical Care.
A hospital is not considered a public place in the US; they are private property entities, which is why there can be regulations about use of cell phones, recording devices, etc.

They are places of public accommodation, just like restaurants, stores, etc. Private property vs public property is a whole different thing. For the purpose of privacy laws, places of public accommodation are considered public. They can have policies on the use of cell phones, but no, they cannot have regulations about the use of cell phones; you cannot be found guilty of a criminal act for violating a facility policy, which is much different than a law or regulation. Someone violating facility policy can be trespassed from the facility, but that's about it.