Nursing Student Blog Lawsuit - page 20

careful with your myspace/facebook/blogs. (article in its entirety)... Read More

  1. by   rockenmomRN
    CardiacRN or anyone for that matter,
    It is my understanding that we don't identify our patients when speaking about them. She never gave the patients name, and for that matter some hospitals still put a patients last name on white board but that isn't considered a Hippa violation. She made generalizations about the patient, even describing the baby was general and true BTW (i worked in l&D for a while, all are weird for the 1st 15min)

    As far as the video camers...why on earth would the Primary RN, MD, school, or instructor allow her to video, it seems like there's some shared responsibility on that one.

    I just looked at it again her "myspace" and nothing specific identifying who this patient was, It could have been me for that matter. If I'm wrong about the Hippa ID thing someone let me know-please in not a condescending manner.
  2. by   BBFRN
    It is not against HIPAA to post a last name + room number- much in the same way that you can call a hospital and ask what room your family member is in. It is however against HIPAA to "advertise" someone's health status, diagnosis, etc.

    Because we don't get to time just when a baby is born, to me, it seems very likely that the student was there without an instructor during the birth. She never mentioned the instructor being there. The primary RN, MD, etc. could have just assumed that she was a family member or friend who was there to video tape the birth for the patient.

    But if you read some of the other posts in this thread (a couple of pages back), you'll note that this isn't the only patient encounter she describes. She also talks about several suicide attempt patients, the events surrounding their attempts, and orders given by the MDs for certain psychological features presented.

    In regard to ethics:
    Her purpose in publicly posting this information is obviously in disparaging these people. Her actions and words show her to be a highly unethical person, who delights in how "two-faced" she can be to her patients' faces, while blogging malicious things about them behind their backs. her blog is miles beyond venting, BTW.

    Is this something we want in our profession? Do we want someone like this taking care of vulnerable patients? Why have a code of ethics then? We make decisions every day that have consequences affecting our patients much more than ourselves. Because of this, these decisions have to come from an ethical axis. We can't be patient advocates without this.

    If you have a copy of the ANA Code of Ethics for Nurses, she breaks just about every provision in there. Here are a few examples:

    -"The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems."

    -"The nurse's primary commitment is to the patient, whether an individual, family, group, or community."

    -"The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient."

    -"Privacy: The nurse safeguards the patient's right to privacy...the nurse advocates for an environment that provides for sufficient physical privacy, including auditory privacy for discussions of a personal nature and policies and practices that protect the confidentiality of information."

    -"Confidentiality:...The rights, well-being, and safety of the individual patient should be the primary factors in arriving at any professional judgment concerning the disposition of confidential information received from or about the patient, whether oral, written, or electronic...only to those directly involved in the patients' care...In general, only that information directly relevant to a task or specific responsibility should be disclosed."

    -"Nursing is responsible and accountable for assuring that only those individuals who have demonstrated the knowledge, skill, practice experiences, commitment, and integrity essential to professional practice are allowed to enter into and continue to practice within the profession. Nurse educators have a responsibility to...promote a commitment to professional practice prior to entry of an individual into practice..."

    American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author.

    Therefore, in addition to the multiple HIPAA violations (previously noted in this thread), she has violated our Code of Ethics. She has acted in an unethical manner inconsistent with the practice of nursing, leaving the school no other choice than to expel her from the program.

    She may disagree that she has acted in such a manner, but if she is allowed to return to the school and graduate, she'll have to argue that point with us working nurses, and the Board of Nursing next.
    Last edit by BBFRN on May 3, '09
  3. by   cardiacRN2006
    Again RockerMom, you obviously didn't read the entire thread, because someone spelled out we could exactly figure out who the woman in labor was. I'm not going to regurgitate that for you.

    If you know Nina, then you know what pregnant lady she was talking about-and Hippa doesn't mean that the majoriry of people can identify you, it means that NOBODY can identify you.
  4. by   rockenmomRN
    thank you for explaining that to me so eloquently and thank you for the added info, I will keep it in mind.

    No i didn't read the entire 200+ messages, and i never asked you to vomit out what others have said. What I did ask was if you or someone could explain what they believed HIPPA meant in an non-condescending manner. Seeing that someone did that, you proprably could have left it at that. I also still believe that anyone who says "I had a patient once...." is breaking HIPPA.

    I really don't want to argue with you or anyone, I come to this site b/c generally we are allowed to give our opinion on matters w/out being scorned for our opinions.
  5. by   BBFRN
    Quote from rockenmomRN
    thank you for explaining that to me so eloquently and thank you for the added info, I will keep it in mind.
    Not a problem at all. I aim to serve.

    Two things I encourage my own students to have on hand are the ANA Code of Ethics & the ANA Scope & Standards of Practice. These are the national, universal guidelines for nurses, and can be very helpful to students as well. You can purchase these at the ANA website, or possibly at your school's book store.
  6. by   cardiacRN2006
    Quote from rockenmomRN
    . I also still believe that anyone who says "I had a patient once...." is breaking HIPPA.

    Again, you clearly don't understand Hippa violations.
  7. by   BBFRN

    Here is the official HIPAA website, for anyone who is interested.

    Here are a couple of pertinent excerpts of the rules:

    "What Information is Protected
    Protected Health Information. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."12
    “Individually identifiable health information” is information, including demographic data, that relates to:

    • the individual’s past, present or future physical or mental health or condition,
    • the provision of health care to the individual, or
    • the past, present, or future payment for the provision of health care to the individual,

    and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.13 Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number)."

    The following identifiers of the individual or of relatives, employers, or household members of the individual must be removed to achieve the “safe harbor” method of de-identification: (A) Names; (B) All geographic subdivisions smaller than a State...All elements of dates (except year) for dates directly related to the individual, including birth date, admission date, discharge date, date of death..."
  8. by   Michele,RN,CDIS
    "My space" is a social network, it is important to realize that information you post can be viewed by a broad audience; it is also possible that someone visiting the patient who saw and/or met the student read the blog on her "my space".
    Discussing a patient with my husband at the dinner table without mentioning the age, sex gender or location is different then when I post his or her information on a site where perhaps a few people may be able to ID her.
    Although I understand that she served our country, but does this mean that honor codes rules and common sense do not apply to her?
    Information provided in confidence should NOT be used or disclosed in any form that might identify a patient without his or her consent and posting it on a social network... Come on!
    Nurses should have purposeful and reflective judgment about what is wrong or right, hence "critical thinkers".
    More nursing programs should follow the University's lead, and yes, she did make the program look bad.
  9. by   dsalgado
    This is about ATS Institute of Technology in Highland Heights, Ohio , I do feel the school is getting a bad rap on being an easy school and they let anyone in. I am an older student reinventing my self with a new career choice and I will tell you it is not a free pass. Since I have been at ATS there have been many improvements, all of the improvements will ensure the students will be ready for nclex and the transition into the nursing field.
    Last edit by dsalgado on Feb 10, '12
  10. by   leenak
    Actually, it is the University of Louisville. It appears that she won her case, went back into the nursing program and graduated nearly 2 years ago. Although the University of Louisville seems to try to appeal, by the time they won their appeal, she had graduated.

    Oh and although she graduated, the school did ultimately win the case. Not that it matters for her but it matters as a term of precedent. Meaning, yes, they can dismiss you for things that you put out there publicly so be careful.