rse3

You're right. I'm letting myself get very defensive. It's hard not to be defensive when I've been accused of everything from stalking to being the subject of nepotism to doing more than just observing a delivery to having my picture taken with a school name tag on (??), all when seeking what I was hoping to be a simple answer (HIPAA violation vs not a HIPAA violation) to an honest question. And you're right that I probably need to check out from this discussion for the night (if not permanently).

That's kind of how I interpreted it. She definitely wasn't saying that to get permission to put it on Facebook. She was just telling me it was on there. If she had not have told me it was on there, I never would have looked for her.

You're correct. I did ask strangers on the Internet about something totally different. I never asked anyone if they thought it was okay that I was working with my dad. My feelings aren't hurt. That's why I said "luckily." If the school or the clinical sight had a problem with it, I would be screwed.

Neither the school (I just looked in the handbook), nor the hospital (I know because I work in the hospital, and know plenty of people working with relatives) have policies that one cannot work with a relative. Even my peers said that they thought that it was really neat that I got to have that experience. Luckily, it seems that the only people having a problem with it are some strangers on the Internet.

My motive for searching her was that she took the pictures and told me she was posting them to Facebook. I later thought that I would like to have a copy of the picture, and thought that if her profile was public (I didn't know that at the time; it was a big "if"), I could possibly get a copy of it. I was not trying to check up on her or pry into her personal life or anything. It was honestly an innocent motive.

Not calling you anything. I was asking. You clarified.

You still haven't explained what's inappropriate. Just the nepotistic angle? Or are you immaturely (or creepily) implying that it's inappropriate in another way?

The patient and her husband both took the pictures.

Wow. This may only be a discussion between professionals, but it may be a bit too dramatic for me. It's not good for my psyche. :) I know that it is not MY moment. In no way am I trying to take it from this new mother. I didn't really think anything about it in the moment, but the patient is the one who wanted to take the picture. She and her husband even asked me to cut the umbilical cord. For the record, I did not cut it (not that I would admit it here for fear of being accused of practicing outside of my scope or having a better clinical experience than my peers, even though this is something that is customarily done by people with absolutely no medical experience.) As far as having a better clinical experience than my peers, you're right. I do get more out of clinicals than my peers because I am more assertive and prepare more for each clinical experience. I have a better clinical experience because I ask for a better clinical experience. On postpartum, I asked to spend several hours with the lactation consultant as she made rounds. At the nursing home, I asked to go around with the wound care nurse. On med-surg, I asked for the patients with the more complex issues and interventions. My better clinical experience has pretty much nothing to so with whom I know, and almost everything to do with seeking that better clinical experience for myself. And conflict of interest? That's interesting. Is it also a conflict of interest to work where a family member works? Work with a close friend? I don't see how being a student is any different as far as that goes. We have no rules about taking pictures (even pictures for social media) or where we can wear our uniforms. I don't really understand the problem with taking pictures of uniforms. However, I wasn't even in my uniform (and no name tag) because I changed into surgical scrubs for a possible emergency c-section per my instructor's orders (I explain because I would hate to get flamed on here for possibly being out of uniform, too.) I honestly did not think I was doing anything wrong by searching (and only searching. No stalking. No downloading pictures. Searching only.) on Facebook. I did not write her name down and take it home to look her up. I simply remembered it. Do I regret looking her up? I'm not sure, but y'all have certainly given me a lot to think about.

How is it not "appropriate"?

As a student, am I only supposed to be observing and minimally involved? I was told the opposite by my clinical instructor, the director of the program, etc. Perhaps I've been given erroneous information by my school?

1. Again, I have no intentions of posting to social media. 2. My #1 (and honestly only) idea about trying to legitimately contact this person: have my dad ask her about it at her 6 wk follow up. He said he would do that for me. 3. Why do I want this picture? Well, it's my first (of hopefully many) "deliveries." I don't see it as any creepier than wanting to have a picture of my child with his teacher on the first day of preschool. 4. I was a nursing student, there with school. This was the patient assigned to me by school. My father, my preceptor, and I were in there. I'm not sure what is being implied as far as my "helping" goes. I'm sorry to have caused such a heated discussion. The world of Facebook and publishing private pictures is relatively new in the medical world. I was obviously unsure of this situation, and thought I would ask for some insight. I guess I learned my lesson.

Thanks, MunoRN. That's what I thought, but I wanted to double check. I have no intent to repost these pictures on social media, regardless of how I get them. I simply want a picture to print off and put in a personal photo album. I will make ever legitimate (and non stalker) attempt to contact this girl. I'm 99.9% positive that she would want me to have them. I just need to find out how to contact her now.

Let me just clear something up: there was no "Facebook stalking" about it. As a user of Facebook, one knows that if one has a public profile, the general public has access to it. Perhaps I'm misunderstanding, but I don't appreciate the insinuation that I'm doing something morally wrong or sneaky by accessing these pictures. Legally wrong to posses them? Perhaps, but that's why I'm asking. Morally wrong to access public pictures on the Internet of myself? I think not.

So do you think that a picture of my dad and me (no baby, no pt info, literally 2 people in scrubs standing against a blank wall) that she posted to her public Facebook page is protected by HIPAA? Oh, how I wish I had addressed this issue the other day, but it didn't even occur to me at the time.

I am a nursing student, and my dad is an ON/GYN. I recently helped him deliver a baby, and his pt took pictures of us and posted them on Facebook. I would like to have these pictures, as I hope to become a CNM, and would love to have a picture of my dad and me at my first delivery. (There are pics of us with and without the baby.) Is it a HIPAA violation if I click on the "..." and save these pictures to my phone since she made them public on Facebook (we are not FB friends. I searched for her.) I really want these pictures, but want to have them legitimately. Thanks!

Does anyone know about Vandy's "out of state" travel requirements? It mentions it several times on their website, and I'm wondering if these periods or travel are days? Weeks? Months? I love Nashville, and my family and I are willing to relocate there, but having a young family could make the travel requirements nearly impossible depending on length of time. Also, do you know if you have any say where you go? Thanks so much!

I helped my dad deliver a baby for the first time yesterday, and it was absolutely amazing. I wasn't actually of much help (everything went VERY smoothly... it really was pretty much a one person job), but I was there and way more involved than I've been able to be as a student. It was not my ideal first birth to "assist" with (she wanted an epidural, had NO interest in breastfeeding), but I realize that most CNMs have to deal with pregnancy and birth on both ends of the spectrum. My reason for being a volunteer doula is because of my very restricted schedule. I know that babies are unpredictable, and that as a CNM, I will not be scheduling deliveries around my life. However, at this point in my life, my husband and I both work full time and we're full time students, which would sometimes (or often) require me to find after hours child care at the last minute. I'm really not sure that my dad's practice would be interested in hiring doulas (especially not more than one). I know that people think that being a physician and owning a practice is big money, but it's not (at least not in our area where the vast majority of patients are on Medicaid), and I don't think that a "luxury" like hiring doulas is a feasible option, and I understand that. Does anyone know anything about some online doula courses? Are they even worth the time and money?

Now I've got a doula question (I hope it's okay to post here, but I assume y'all would know the answer). Does it matter who the doula certification is through? I mean, which "governing body" I guess?

Thank you for the input. I talked to a lady at Vandy yesterday, and they don't require experience either. I was feeling very hopeful after that phone call. She kept emphasizing that they look for "we'll rounded" students, and she HIGHLY encouraged me to become a volunteer doula while I'm in school. I talked to my dad about it, and he said that after I do the doula training, I can volunteer for his practice. I know that ideally I would volunteer for one mother, follow her through pregnancy and all the way through postpartum, but as a full time employee, a full time student, and a mother, I just don't see that as a reasonable responsibility to add right now. Basically, I'll volunteer every other Thursday (or however often I can), and be a doula for a lady partsl delivery that day (or deliveries). I'm really looking forward to the possibility of this being my future.

A little background on me: I have a BS in research psychology, I've been a NT in a level 2 trauma center for over 2 years, and I'm currently a student in a ASN program. I went into the whole nursing school thing with the sole intention of immediately applying to emergency nurse practitioner programs, and hopefully immediately starting an MSN program upon graduation (yes, those programs that don't require experience exist). While I love the ED, it has become increasingly emotionally challenging for me, and I'm just loving my OB rotation and the time I'm spending in L&D. I've always been borderline obsessed with breastfeeding, and I've always been pretty interested in pregnancy and labor, so I'm not sure why CNM has never crossed my mind, but I'm becoming increasingly interested in it. My questions are, are there talks of CNM requiring a doctoral degree like NP and CRNA are headed toward? And does anyone know of any programs that don't require nursing experience to apply? I will add that my father is an OB/GYN. I only add that to state that I understand that women's health is not all butterflies and unicorns, and I know how challenging the hours can be. Thanks for any input.

In my defense, I did not just decide to break protocol (we're assuming it's protocol at this point) on my own accord. I was following a direct verbal order from the ERP (yes, ERP=ER physician). Order was read back and verified. I will definitely follow up on official protocol, and also let my coworkers know what I find out, as they didn't really have a sound argument about the official protocol either as far as paging the code overhead or following the physician's order on the matter.

I'm not sure if it's policy to page codes overhead or not. It's what we usually do, but there have been a few times that I know of when the code hasn't been paged. However, this is the first time that anyone has made a big deal about it. The ER codes are called overheard to get lab, radiology, resp, and registration there. Labs had recently been drawn, so there was no need for lab to be there. Pt was on a vent, and that was working fine. No need for X-ray. Pt already had a chart. My argument was that there was just no need for the code to be paged overhead since all of these needs had been met, AND the ERP said not to. It seems that I was the only one of my coworkers agreeing with the ERP. I know I'm making a big deal out of this, but I don't like being accused of being negligent by my coworkers, as I was actually the one beside the a phone at the time, and the one talking to the ERP about his decision. In our hospital, codes are usually paged everywhere but surgery and NICU. Even our units usually call codes overhead, but I assume that this would have gone differently in a unit. His nurse was actually on the phone with MICU giving report when this happened, and he's now a DNR, so this won't come up with this pt again, but I guess I really need to find out the specifics of hospital policy as soon as I get to work next weekend.

Today, we had a pt who was an unwitnessed arrest at home this morning, EMS/fire got him back, there was no activity on his EEG this afternoon, and he quickly bradied down and coded less than an hour ago. By the time of the second code, the patient had already been admitted to and seen by the hospitalist. When the pt went asystole, ERP went in the room, and said not to call switchboard about the code, but to get the hospitalist in there stat. ACLS protocol was initiated, and the unit secretary decided to call switchboard about the code because pt was not a DNR. Some of my coworkers were angry that the code was not called overhead immediately because of "legalities," "negligence," and "best practice." The neurologist and hospitalist were angry that it was called overhead at all. Does anyone have any insight?

I will also add that I know that sometimes people legitimately cannot fill out the paper. That's not the point of this thread. And ideally, we could have gotten the pt's info off of his med bottles and confirmed it with him, but Dr. X's wife refused to hand them over, stating "I'm Dr. X's wife. Just take him to a room."