Inappropriate Facebook postings by family and friends of the patient

[morman]

A young parent of young children recently coded in our emergency room. Unhappily, resuscitation was unsuccessful. Once the body was cleaned up, family and friends were allowed in to say their goodbyes. Someone posted pictures of the deceased on Facebook which were widely circulated and commented upon, not always favourably.

This patient was well known by us as a very private and dignified individual. In your facility, how do you help to protect a person's dignity when they can no longer give consent? When do you consider your duty to care to be ended in a case like this?

[dream'n, BSN, RN]

If I understand correctly, the parent allowed friends/family to see the deceased and one of them photographed the child and posted it to Facebook? If that is the case, and it wasn't a staff member that did it, then I don't see where it becomes the medical/nursing providers dereliction of duty. It's horrible that a friend/family did that, but the parent was in control of who viewed the body, correct? Now if a staff member took it upon themselves to let people see the deceased without the express approval of the parent, then that staff member is in very hot water.

[morman]

No, it was an adult who has young children. And no, I doubt anyone sought the family's permission to post the picture.

I guess my question is that, if we wouldn't allow media to take such pictures for reasons of patient confidentiality, why would we not extend that ban to members of the general public as well? It would be completely unenforceable though...

[MunoRN, RN]

I know it sounds weird, but post-mortem portraits are actually pretty common and have been around for as long as cameras, and many consider it an important part of recognizing someone's passage into death, as well as the grieving process. It used to be that people put these photographs on the mantel or other areas of designated shared viewing, which today we call facebook. Really, the only way to keep this from happening is to not allow any family or friends near the deceased, which seems impractical.

[Pat_Pat RN]

Looks to me like you couldn't do much about it.

[jadelpn, LPN, EMT-B]

Please be sure to report this, however, to risk management. There's lots of what-ifs. The most glaring one is did the parents consent to this, did the parents do this, etc. etc.

This is a tough one and also could use a run through your ethics committee.

With all that being said, how did you know that the pictures were posted on social media? Be mindful of keeping work separate from your social media, and don't ever, ever comment on social media regarding ethically questionable posts from your work.

[NickiLaughs, ADN, BSN, RN]

Anytime we catch family with cameras or taking pics or video in ER, they are immediately told to stop delete or they will be asked to leave the hospital. If it's a patient, they can either delete and stop or they are discharged and no longer welcome other than emergency circumstances. We view it as a potential hippaa violation of any patient. Our guards are pretty good at enforcing it too.

[Hoosier_RN, MSN]

I would notify risk management. As this was family of deceased that did this (tacky), I'm not sure much that staff can do. Let management figure out if there is anything that needs to be done

[NOADLS]

You will be in more trouble for looking at this person's social media than the person posting it.

I would use the "not my problem" card here.

[BittyBabyGrower, MSN, RN]

Honestly, if it was family that did this, you are best to stay out of it. I doubt there is anything that can be done and it is up to the family to what should be done.

[OrganizedChaos, LVN]

Not my monkey, not my circus.

[Julius Seizure]

You will be in more trouble for looking at this person's social media than the person posting it.

I would use the "not my problem" card here.

I agree. Also, technically your "duty" of care ended when the patient was discharged from the hospital. You have no responsibility here, and I think the best move would be to stay out of it. I can't see any good result that could come from you getting involved.