I will try to make this as short as possible, however it is a very complex situation.
First, I am a nursing student in my psych rotation. On my first day of clinicals, my biological father was one of my consumers. I was completely shocked b/c I had not seen him in over 10 years. I was not raised by him and he was somewhat comparable to that great aunt that sends you birthday cards each year. However, upon the death of my mother 4 years ago, my daddy (man that raised me) would not have anything to do with me. I won't get into all that...
So while I had a lot of anxiety about this POSSIBLY being him, I was growing increasingly excited. For any of you who lost a parent, imagine what it must be like to be able to say the word "mom" or "dad" again. Okay, so that's how i was feeling.
My biological father had a name change either right before or right after he was released from prison. He wrote letters to my grandmother and I occasionally throughout my life and on one of them, included his name change. He also let us know about his prison sentence and what agreements he made concerning treatment so he could have a lighter sentence.
OKay, so after my first day of possibly seeing him I called my grandmother to ask what she knew about him - where he was, etc. she was not sure the exact place but we spent the rest of the night talkin about him, what his eyes were like, hair, the way he sat, etc. I was so excited! As a few days went on I was almost sure it was him b/c of the way he treated me. He told me he was proud of me, would pat me on the back each day when I left, etc. I asked my aunt and grandmother (which is comparable to a normal families mother and father) to help me find his name change so I could be sure. So, I found out his name change and it was indeed him!
My aunt felt like I should let my clinical teacher know. So i did. The conversation was fine. She was shocked, of course, but I felt good after having talked to her. She was concerned about safety issues and I told her my aunt and grandmother felt that he would not harm me in any way. So after she and I talked, she apparently talked to the couselor at the facility. I am not sure why but I am thinking it was to ensure my safety. Later that night I get a phone call from my teacher telling me that the counselor was concerned about a breach in confidentiality. I told my teacher he is a past sex offender and his whereabouts are made known to the public, not to mention he has always kept my grandmother somewhat informed.
I thought the issue was at rest until a week later my teacher called to tell me the class coordinator and dean wanted to talk with me. She said she felt like the dean understood how traumatic this all had been and would be sympathetic. So naive me, I walk in there like I am going to be appraised for handling a situation so well, etc. Well, it was the opposite. I was repremanded (sp?) for a breach in confidentiality. They took 30 points away from my TOTAL grade, making it a 70. This means I'd have to be PERFECT and receive a 100 in my clinicals. On my best days I wouldn't be perfect, and these are far from by best days. They also said they were switching my facilities. New group, new teacher, and a long drive into the city (which I can't drive in!). I was in such shock at the meeting I don't remember saying much.
Everything happened so fast, it is slowly sinking in. I am being snatched away from a man i was growing to love, and there is no telling how this is going to make him feel. He doesn't know what's going on but i'm assuming when the clinical group gets there and i'm not, he's going to feel like it's his fault.
And what's the point of going? It's not possible to get a grade of 100, it simply isn't.
I have been through many things in life and overcome all of them, but i don't know how to overcome this situation.
The THOUGHT of Psych gives me severe anxiety. I have cried more the past couple of days then I have ever cried! I am constantly feeling like i can't breath and nauseated. It is affecting ALL areas of my life, including my other classes. I DON'T KNOW WHAT TO DO!
I have class all day on Mon then clinicals on Tues and Wed. I can barely get through a nonproductive day due to being so mentally and physically drained, the very thought of attending clinicals is overwhelming. So what do I do? Quit school? Then what? All of my options are extremely depressing. I need help sorting all of this out.
And I still don't understand how I am in so much trouble for talking to my family about it. His medical info. was NEVER mentioned. I didn't even KNOW his diagnosis until MY TEACHER told me (after I told her about him being my father). And apparently it's okay for the counselor, class coordinator, and dean know about this very personal issue for me, but not my aunt and grandmother?
It was a "need to know' type of violation. Pulling you from the clinical site was appropiate because of the very real risk for boundary violations. That said I don't agree with that type of penalty. An expectation letter would have addressed the issue.
Psych is a demanding area with significant psychological risks for providers. I would encourage you to see someone in the school counselling center as a means to help you develop and maintain healthy boundaries both with patints and other people. I wish you the best!
Specializes in Community Health, Med-Surg, Home Health.
i am so sorry that you had to experience this!
it was a hippa violation, for sure, but considering how unique this was, i think that it would have surficed to have the clinical rotation change, but not the reduction of your grade. this was traumatic, a shock, and really...the reduction of your grade was not very supportive.
Specializes in Community Health, Med-Surg, Home Health.
Also, I think that the contact with your father should be a bit limited until you graduate from that program. Maybe send him letters, or call him if he can receive telephone calls, but visiting him may be considered as an extention of the initial discovery; which lead to these problems. If more problems stem from this, it may affect your standing in the program. Let's say for example, that your family decides to go visit him and this sets him back in his progress (for whatever reasons). The facility will always remember the name of the school and nursing program and will be documenting all of this information. It can really become complicated. If the school finds that you are visiting, they may make an issue of it. Maybe I am thinking totally out of the box, but, I have seen weird things happen.
You should not risk all of the time and energy you placed in nursing school for your dad at this time. I am not saying that your father is not worth it, but thinking about the history; prison, changing his legal name, the crime that lead him to prison, and all else involved. Really, you do not know this man. He was MIA from your life for many years, and he is now in a psych hospital. You are not totally aware of what he is capable of, and your life must come first.
I have true empathy for your situation; I am sure you did not expect this to happen during school. Be well and keep us posted.
Specializes in pedi, pedi psych,dd, school ,home health.
Although you did cross some lines. you should not have had the grade reduction...YOU didnt seek this man out; you didnt know he was there or even if it was really him. I think you should ask for another meeting with the Dean, and accept the change of rotation as a healthy thing; but not accept the grade reduction. If you had kept it a secret and finished the rotation that would have been grounds for punishment. good luck and let us know how things go.
I will try to make this as short as possible, however it is a very complex situation.
First, I am a nursing student in my psych rotation. On my first day of clinicals, my biological father was one of my consumers. I was completely shocked b/c I had not seen him in over 10 years. I was not raised by him and he was somewhat comparable to that great aunt that sends you birthday cards each year. However, upon the death of my mother 4 years ago, my daddy (man that raised me) would not have anything to do with me. I won't get into all that...
So while I had a lot of anxiety about this POSSIBLY being him, I was growing increasingly excited. For any of you who lost a parent, imagine what it must be like to be able to say the word "mom" or "dad" again. Okay, so that's how i was feeling.
My biological father had a name change either right before or right after he was released from prison. He wrote letters to my grandmother and I occasionally throughout my life and on one of them, included his name change. He also let us know about his prison sentence and what agreements he made concerning treatment so he could have a lighter sentence.
OKay, so after my first day of possibly seeing him I called my grandmother to ask what she knew about him - where he was, etc. she was not sure the exact place but we spent the rest of the night talkin about him, what his eyes were like, hair, the way he sat, etc. I was so excited! As a few days went on I was almost sure it was him b/c of the way he treated me. He told me he was proud of me, would pat me on the back each day when I left, etc. I asked my aunt and grandmother (which is comparable to a normal families mother and father) to help me find his name change so I could be sure. So, I found out his name change and it was indeed him!
My aunt felt like I should let my clinical teacher know. So i did. The conversation was fine. She was shocked, of course, but I felt good after having talked to her. She was concerned about safety issues and I told her my aunt and grandmother felt that he would not harm me in any way. So after she and I talked, she apparently talked to the couselor at the facility. I am not sure why but I am thinking it was to ensure my safety. Later that night I get a phone call from my teacher telling me that the counselor was concerned about a breach in confidentiality. I told my teacher he is a past sex offender and his whereabouts are made known to the public, not to mention he has always kept my grandmother somewhat informed.
I thought the issue was at rest until a week later my teacher called to tell me the class coordinator and dean wanted to talk with me. She said she felt like the dean understood how traumatic this all had been and would be sympathetic. So naive me, I walk in there like I am going to be appraised for handling a situation so well, etc. Well, it was the opposite. I was repremanded (sp?) for a breach in confidentiality. They took 30 points away from my TOTAL grade, making it a 70. This means I'd have to be PERFECT and receive a 100 in my clinicals. On my best days I wouldn't be perfect, and these are far from by best days. They also said they were switching my facilities. New group, new teacher, and a long drive into the city (which I can't drive in!). I was in such shock at the meeting I don't remember saying much.
Everything happened so fast, it is slowly sinking in. I am being snatched away from a man i was growing to love, and there is no telling how this is going to make him feel. He doesn't know what's going on but i'm assuming when the clinical group gets there and i'm not, he's going to feel like it's his fault.
And what's the point of going? It's not possible to get a grade of 100, it simply isn't.
I have been through many things in life and overcome all of them, but i don't know how to overcome this situation.
The THOUGHT of Psych gives me severe anxiety. I have cried more the past couple of days then I have ever cried! I am constantly feeling like i can't breath and nauseated. It is affecting ALL areas of my life, including my other classes. I DON'T KNOW WHAT TO DO!
I have class all day on Mon then clinicals on Tues and Wed. I can barely get through a nonproductive day due to being so mentally and physically drained, the very thought of attending clinicals is overwhelming. So what do I do? Quit school? Then what? All of my options are extremely depressing. I need help sorting all of this out.
And I still don't understand how I am in so much trouble for talking to my family about it. His medical info. was NEVER mentioned. I didn't even KNOW his diagnosis until MY TEACHER told me (after I told her about him being my father). And apparently it's okay for the counselor, class coordinator, and dean know about this very personal issue for me, but not my aunt and grandmother?
Whatever you do, don't tell them you don't understand why it was a violation of the patient's privacy. You violated by telling other people, related or not, his info without his permission. Your school wants to know that you have learned this, no matter what special circumstances did or did not exist - and none did. Please learn this. I know you are a student and hoope I'm not sounding too harsh. It's just that you HAVE to learn this. We absolutely cannot divulge any private information without permission.
That said, I think your instructor and the school should have acted immediately, not waited so long to address this issue.
Also, they are being too harsh, I think. I think you should consult a lawyer, just to see if any of YOUR rights have been violated. Then, after you know that and after you have had time to calm down and start thinking clearly and unemotionally about this, write BUT DO NOT SEND a letter to your Dean detailing this whole business and why you are asking for leniency. Let a little more time go by, meanwhile doing whatever the school is requiring of you. Don't throw in the towel.
After you are totally calmed down, you can revise and send the letter and/or ask for an in-person appointment with the Dean and try for a reduced sentence. Point out how you have learned that you did wrong, how you are so glad that no actual harm occurred, no fines were levied or other punishments against the facility or staff were given out (if they were not, in fact), and how you would be eternally grateful for a reduced sentence so you can actually complete school.
I think you should not have to be flunked out, basically, for making an honest error that is no worse than other errors students make. Welcome to the anal profession of Nursing and I hope you get some mercy. But please do not ever violate HIPAA again. And don't trust anyone, like your instructor.
How much more school do you have? What is the issue with you driving into a different city and why can't you do it? Can you take a leave of absence to get a new perspective and let a little time go by?
It was a "need to know' type of violation. Pulling you from the clinical site was appropiate because of the very real risk for boundary violations. That said I don't agree with that type of penalty. An expectation letter would have addressed the issue.
Psych is a demanding area with significant psychological risks for providers. I would encourage you to see someone in the school counselling center as a means to help you develop and maintain healthy boundaries both with patints and other people. I wish you the best!
I hope you get counseling where there is far less chance that the school will learn anything about what you say to the counselor. The school is the last place you should seek counseling, IMO.
i wouldn't say flo was that well behaved for her time. she turned down a marriage proposal for a career, which is not what well-bred women of her era did. she went off to war and nursed men, which was often considered an occupation not much better than a prostitute. when she came back from the war she didn't settle down to be a good little spinster. she went on to form a school for more nurses who were considered the same as above. she dared do research in a man's job. no she wasn't so well behaved.
as for the op, i too agree the school was a bit harsh. you're a student put in an unusual situation. yes, they should have changed facilities. having you there with your estranged father is not therapeutic or a good learning situation for you or him. think of it as taking care of a relative in a professional capacity in any hospital. it's considered unethical and a conflict of interest. but to ding you on 30 points is unfair.
just had another thought. if you don't have a car or something for the other clinical site can you find other students to ride with and help them pay for the gas?
I think that this would only be a HIPAA violation if the patient (the biological father of the OP) objected to the student sharing his clinical information. Did he?
Since she wasn't sure it was him until after she talked to her relatives about him, she had no permission. It is a definite HIPAA violation. Even if he found out later and said it wasn't a problem, it's still a violation because she did not have his permission at the time that she discussed him with her family.
wow i feel so bad for you! i hope it all works out.... i really do! what a crazy story. do you think that your school could turn this into a learning experience for you and maybe let you write an essay about what you have learned? what a school!! you are in school to LEARN and make mistakes. schools are supposed to show us the possible mistakes and how to avoid them.
Since she wasn't sure it was him until after she talked to her relatives about him, she had no permission. It is a definite HIPAA violation. Even if he found out later and said it wasn't a problem, it's still a violation because she did not have his permission at the time that she discussed him with her family.
Agreed -- the standard is not "if info gets released, go back after the fact and find out whether the client objects to the info having been released -- if s/he doesn't really mind, it's okay," it's that you cannot release protected info (which is what we're talking about here) without specific, prior permission to do so. Also, folks seem to be discussing this like HIPAA is some sort of general guideline like you should really try not to ... or it would be better if you didn't ... It is Federal law, and violations are punishable by harsh fines and prison time. This is v. serious business! I've been psych faculty in both ADN and BSN programs, and psych courses are usually placed fairly late in nursing curricula -- has this student not been informed about HIPAA requirements and students' responsibilities for confidentiality in earlier clinicals?? Has the subject of caring for family members in clinical settings never been discussed before now??
I understand (and do sympathize) that this is a v. difficult and emotional situation for this student, but I'm really alarmed by the general lack of judgment shown -- not going immediately to her instructor as soon as she suspected the client might possibly be her father. This kind of lack of transparency (pursuing this on her own for, it sounds like, multiple days of clinical without discussing it with the instructor) is how nursing students get themselves (and their schools, and the clinical facilities!) into serious trouble. I truly don't mean to dump on this specific student or add to the misery she's already going through, but I'm afraid I don't really object to the school disciplining/penalizing her in this situation -- if she were my student, I would have v. serious reservations about allowing her to remain in the nursing program, period, and, in my view, the school is being generous (I'm sure they're taking into account the extent to which they may have dropped the ball on this one ...).
I want to ask those of you who are supporting the student and criticizing the school -- what if a (hypothetical) student had done something equally outside the norms/rules/expectations of safe, responsible practice in a med-surg setting, over a period of days, without consulting with her/his instructor?? Would you still be as calm and sympathetic about the situation, or would you feel differently about that? Again, I don't want to sound like I'm frothing at the mouth or wanting to crucify the student, but some situations are just too serious to say "oh well, I'm sure you meant well" and leave it at that.
I feel your school really overreacted in taking 30 points away from you.
I do think it was right to transfer you to another facility- It would be nearly impossible for you to be impartial, not emotionally involved, and clinical in your thinking at this facility with your father around.
They were technically correct, but they could have handled things in a much gentler and non-punitive manner.
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HM2VikingRN, RN
4,700 Posts
It was a "need to know' type of violation. Pulling you from the clinical site was appropiate because of the very real risk for boundary violations. That said I don't agree with that type of penalty. An expectation letter would have addressed the issue.
Psych is a demanding area with significant psychological risks for providers. I would encourage you to see someone in the school counselling center as a means to help you develop and maintain healthy boundaries both with patints and other people. I wish you the best!