I need help regrading an ethics opinion piece!

egglady, LPN · Jan 16, 2011

the topic is if YOU think the measures taken in this case were appropraite. Good luck on YOUR paper!

neuroms · Jan 16, 2011

They probably booted her for being creepy. Who photo ops a placenta?

Burlshoe114 · Jan 16, 2011

I think the measures taken were not appropriate, and that as long as the organ was not identified as "Mrs. X's" placenta, there was no violation of HIPPA or patient privacy. Once the organ is not living, it is now tissue that is on its way to become medical waste.

This is an ethics piece. The point is there is no right or wrong answer, but they want to see your point of view and ability to see things from both sides of the coin.

toughtimes RN · Jan 16, 2011

Nurses are to protect their patient's dignity.

dishes, BSN, RN · Jan 16, 2011

I think the measures taken by the school were not appropriate because they did not follow ethical considerations in their relationships with the nursing students.

The administrator, the school code, and the instructor did not provide the nursing students with the appropriate guidance for the development of nursing competence.

The administrator abused her position of power over the students by not providing them with a fair hearing before dismissal.

See Considerations in Relationships with Nursing Students, Canadian Nursing Code of Ethics

http://www.cna-aiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf

regards

dishes

canesdukegirl, BSN, RN · Jan 16, 2011

Perhaps talk about the sheer creepiness of it? This is akin to holding up a used bed pan and snapping a pic...gross.

eriksoln, BSN, RN · Jan 16, 2011

Nurses are to protect their patient's dignity.

I would give a very concrete and not so helpful "yes and no" when asked if I agreed with the measures taken. I don't strongly disagree with them, but at the same time, would say making the student sit out a semester to consider whether she wanted to continue nursing and to reconsider how she will act if she does......that would have been plenty.

I like the above quote because, in my eyes, thats the line she crossed. Right here, right now, I will tell you the one thing I wish I had been told in nursing school.

If you use your employer's policies and procedures and/or the law (be if federal or state) as your moral guide through nursing, you will be nothing more than a warm body as a nurse. You will never reach the heights of nursing performance our patients need from us. Very often, we must go beyond what is required of us by the policy and law makers in order to deliver the level of care that nursing expects from itself. If I were to list even a few of the examples in which I've had to be better than "the min. requirement", this post would be tens of pages long.

This student's behavior showed a tendency that was not becoming of " a great nurse". Think back to when you had to take the entry exam for your nursing program (if your school has one). That test looks for a capacity to think in the abstract world, to know and understand what has not necessarily been directly taught. This is a term renamed "critical thinking" by us nurses. You take that test to earn your seat in the program because, if you score higher than your peers, you have displayed the ability to do what is necessary to become a nurse (and to pass the NCLEX, which is the school's priority).

Now, during clinicals, this girl took someone else's organ and used it for an opportunity for self promotion. Technically, no laws were violated and no school policies were left without respect. Is that where the moral compass of a nurse ends though? Not to me. The student failed epically in putting the pt. first. Although no direct harm came from this incident, the student displayed a tendency that the school found unbecoming. That tendency was to put her own self promotion ahead of the pt's needs/rights to privacy. If the action had gone unnoticed, I do not doubt other, more borderline incidents would have occurred and the potential for harm to a pt would have multiplied.

One of the few/first teaching videos I've ever watched that were actually informative was a HIPAA video. The video showed how seemingly harmless violations created harm for the pt. involved. They were real life examples, sometimes with the actual patient involved being interviewed afterwards. In one, a co-worker of the pt. called just to "Say hello and see if Mr. Smith is doing alright." Well, the nurse answered that the pt was doing much better. Sure enough it got back to the owner of the pt's company and they decided Mr. Smith was "milking" his injuries for time off. When he was D/C'd, he had no job to go back to. Had to spend much time in court to keep his retirement even.

The student showed a tendency to put privacy at risk, and in the name of self promotion to boot. No, the punishment was not too severe although I believe a simple suspension would have gotten the message across. If the school had not acted, and her career was stained with victims like the one I mentioned above, we all would be on here ranting "Schools don't teach this sort of thing.........she is a victim............the lines are too blurred, how do we know what is allowed and what is not?" Well, now we know. Kudos to the school for being willing to weather the harsh criticism that came after their decision and insisting on the lesson being learned.

BrnEyedGirl, BSN, MSN, RN, APRN · Jan 16, 2011

I'm not seeing this an any kind of HIPAA violation, or even a violation of privacy as much as a very immature and unprofessional thing to do. This is something a teenager would do for kicks. This student doesn't look like good nurse material from where I sit.

April, RN, BSN, RN · Jan 16, 2011

Nurses are to protect their patient's dignity.

I didn't see anywhere that she knew or ever cared for this patient. It was a specimen in a lab.

I think the school went too far. Although her actions could be seen as unprofessional, she didn't violate any HIPAA laws. She asked permission from her instructor who didn't tell her she couldn't take the picture. To me, this was an enthusiastic student who wanted to share her lab experience with family and friends. How many people get to see what those of us in the medical field do everyday?

For those who haven't heard, the nursing student won the case.

http://www.kansascity.com/2011/01/06/2566180/facebook-placenta-photo-case-goes.html

chorkle · Jan 16, 2011

Disclaimer: I am neither a nurse, nor a nursing student. It is conceivable, perhaps, that some day I may get to the second status; the first is a great unknown.

But I have found that my natural reserve--to be quietly efficient and industrious, in the background--has served me well. As if my first principle were, Attract no attention, except by demonstrated excellence.

Otoh (for the instant concern), hardly anyone in my generation would be likely to "understand" the appeal of Facebook, Twitter, and all that.

Professional program schools, or employers, looking for any, ah, indiscretions, posted on various on-line "social networking" sites? If the appeal, if any, for such things doesn't exist, it seems likely nothing will be found--because, nothing notable exists.

Long Term Care Columnist / Guide · Jan 17, 2011

I would give a very concrete and not so helpful "yes and no" when asked if I agreed with the measures taken. I don't strongly disagree with them, but at the same time, would say making the student sit out a semester to consider whether she wanted to continue nursing and to reconsider how she will act if she does......that would have been plenty.
I like the above quote because, in my eyes, thats the line she crossed. Right here, right now, I will tell you the one thing I wish I had been told in nursing school.
If you use your employer's policies and procedures and/or the law (be if federal or state) as your moral guide through nursing, you will be nothing more than a warm body as a nurse. You will never reach the heights of nursing performance our patients need from us. Very often, we must go beyond what is required of us by the policy and law makers in order to deliver the level of care that nursing expects from itself. If I were to list even a few of the examples in which I've had to be better than "the min. requirement", this post would be tens of pages long.
This student's behavior showed a tendency that was not becoming of " a great nurse". Think back to when you had to take the entry exam for your nursing program (if your school has one). That test looks for a capacity to think in the abstract world, to know and understand what has not necessarily been directly taught. This is a term renamed "critical thinking" by us nurses. You take that test to earn your seat in the program because, if you score higher than your peers, you have displayed the ability to do what is necessary to become a nurse (and to pass the NCLEX, which is the school's priority).
Now, during clinicals, this girl took someone else's organ and used it for an opportunity for self promotion. Technically, no laws were violated and no school policies were left without respect. Is that where the moral compass of a nurse ends though? Not to me. The student failed epically in putting the pt. first. Although no direct harm came from this incident, the student displayed a tendency that the school found unbecoming. That tendency was to put her own self promotion ahead of the pt's needs/rights to privacy. If the action had gone unnoticed, I do not doubt other, more borderline incidents would have occurred and the potential for harm to a pt would have multiplied.
One of the few/first teaching videos I've ever watched that were actually informative was a HIPAA video. The video showed how seemingly harmless violations created harm for the pt. involved. They were real life examples, sometimes with the actual patient involved being interviewed afterwards. In one, a co-worker of the pt. called just to "Say hello and see if Mr. Smith is doing alright." Well, the nurse answered that the pt was doing much better. Sure enough it got back to the owner of the pt's company and they decided Mr. Smith was "milking" his injuries for time off. When he was D/C'd, he had no job to go back to. Had to spend much time in court to keep his retirement even.
The student showed a tendency to put privacy at risk, and in the name of self promotion to boot. No, the punishment was not too severe although I believe a simple suspension would have gotten the message across. If the school had not acted, and her career was stained with victims like the one I mentioned above, we all would be on here ranting "Schools don't teach this sort of thing.........she is a victim............the lines are too blurred, how do we know what is allowed and what is not?" Well, now we know. Kudos to the school for being willing to weather the harsh criticism that came after their decision and insisting on the lesson being learned.

I love this post, because it shows exactly what is missing in so much of what passes for "ethics" these days: the ability to assess a given situation, think at least one step beyond it, and refrain from acting on one's impulses even if there's no law that expressly forbids it.........just because it's the wrong thing to do. I know moral absolutes are hopelessly out of fashion in this supposedly 'progressive' era, but honestly---what was so terrible about having clear guidelines as to what's OK and what isn't? And what happened to the instinctive human decency that took over when the guidelines weren't so clear?

In this case, that would have meant the student thought about being photographed with an anonymous placenta and posting it on Facebook, then decided against it......not just because she might get into trouble at school, but because she had considered how such an act might affect someone other than herself. Like the owner of the placenta and the infant who was nourished by it for nine months. After all, there really is no such thing as anonymity in cyberspace anymore; all it would have taken to learn the mother's identity were a few mouse clicks by a computer-savvy (and curious) user.

The school, for its part, acted properly IMHO. If I were running a nursing program, I wouldn't want students who think that this sort of action is fine as long as no one knows whose placenta it is. If they don't see anything wrong with that, what will they do if they're ever in a position of authority and have to handle a missing-narcotics case? Will they simply blow it off when no one admits to having seen the drug since it 'supposedly' came up from pharmacy? What if they witness a demented patient being force-fed by his daughter---will they fail to notify APS because her intentions are good?

Personally, I wish we could get back in touch with the idea that "wrong" does not always equal "illegal". Sometimes it's wrong to do a thing merely because it violates principles of human dignity, which can never really be legislated because they vary so much among cultures and even among the genders. (And I wish our government would STOP trying to legislate them, because it's as useful as nailing Jell-O to a wall......but that's a subject for another thread. :coollook: ) I think that's where this particular incident falls on the morality barometer---not necessarily a HIPAA violation, but definitely an offense against nursing ideals. Not to mention the "yuck" factor. 'nuff said.