Taking picture of patient?

[rkitty198]

Hello all-

A co-worker of mine cared for a minor celebrity and was herself a fan. She wanted a picture with the patient and asked if I wanted to get one too. I declined. She took the picture after the patient was discharged. The patient was dressed and standing outside the room.

After having a very busy day I didnt think much about it. I told another co-worker about myself not "getting a picture" with this patient and then I thought I was glad I didnt choose to, because I didnt think it was right (although it would have been neat to have a picture). The co-worker I told, reported this Nurse to management.

This Nurse had a meeting with management and her job is in jeopardy.

Is this wrong? I personally think it is, but I would never want to get my co-worker into trouble. I feel so bad by saying anything as it is affecting her.

Also this staff member was contacted that evening by this former patient for a bleeding IV site issue at discharge and was instructed to go to the ED (I thought calling 911 would have been better as he was at home). My co-worker met the patient in the ED after she was clocked out and off duty to see how the patient was. Do you think this is inappropriate?

I feel badly for her.

What do you all think?

[YuHiroRN, BSN]

Definitely not something I would have asked of the patient, and I can say this from experience because we have high-profile patients come through our facility all the time and I treat them/their families just like I treat anyone else, and I've NEVER asked about their profession or asked for a photo/autograph. It's not professional, and that's not why I'm there.

With that said, I don't think it's something worth firing someone for if the celebrity gave consent. We all know that FAR, FAR worse could end up online as far as celebrities are concerned...

[Emergency RN]

Frankly, IMHO it isn't ever a matter of HIPAA, or the celebrity, what they feel about it, their consent or whether another nurse had an ax to grind; the bottom line is, somebody pays that nurse's check.

And the nurse had put that somebody (ie her employer) at legal risk. If anything, that is what's going to get her fired; all the other stuff is just fluff and window dressing. Sure, we take about them as rationales, but the final arbiter of whether any of the above matters ultimately rest with her employer. I'm sure that people have also heard of cases where some people have gotten away with murder, whilst another is booted for even the simplest infraction. In the final analysis, it all rests on the whim of the employer.

For that nurse, she better hope that she's been previously viewed as more of a positive than negative, as this would definitely push it over the edge in terms of management decision making.

[babieblue2]

at my place of employment this would be a HIPPA violation resulting in immediate termination

[indigonurse]

Taking pictures of pts. for entertainment purposes without the consent of the hospital admin. and the pt. could possibly be a HIPPA violation to say the least. I imagine that it is against the hospitals rules not to mention workers comp. coverage to have nurses in work areas off the clock. It is also a serious violation of a pts. right to confidentiality to have an off duty nurse visit them without their permission and the hospitals permission as well. It sounds like a professional boundary line has definitely been crossed.

[Dazglue, ADN, BSN, MSN, RN]

Oh, I didn't say she doesn't deserved the consequences of her actions. It's just that I don't wish bad things on people or be happy or "satisfied" of her punishment. It would have been great if the nurse would have thought this thing through. A picture is a HIPPA violation with or without consent. Unless the pt signed a realease from. Well, I'm sure you know! Lol.

[RLeeRN]

What is difficult to understand is why two nurses stood by and allowed a fellow Nurse, a team member, to make a decision they thought was in gross violation of various professional and ethical standards. I wonder how many problems would be stopped if someone has a problem with anothers practice or actions would just give them the professional courtesy of pulling them aside and speaking with them about the issue right then. If one has time to gossip to another nurse why not to the one who the gossip was about? When she asked the OP if she wanted one too, why not inform her of the concerns, and possible fallout. Why tell your concerns to another staff nurse who then takes it upon herself to also not give any professional courtesy to speak to the nurse with suspected violation of policy, etc? I wonder how much money the hospitals could save if they had authority to dock the pay of nurses passing gossip on coworkers. And for the phone call, did anyone ask her about calling 911 instead. Maybe the nurse is not an idiot and felt it was a resonable counsel based on what the pt told her. Lastly, it will be a shame if this nurse loses her job over this when no coworkers even approached her on the issues, maybe even preventing or lessening the damage. This is one of the main reasons many nurses dislike the nursing profession, no unity. When at all possible speak to the other professional adult directly, glad I dont work on that unit.

[raebabelvn, LVN]

I too have an issue with the "tattling" nurse. Are we in grade school again? I can understand a nurse reporting another nurse who puts their patient in harms way, but over a picture? Really? I also agree with the poster about charting... how in the world, or even why for that matter, would you chart on a discharged patient? The patient is no longer under your care. I've called an advice nurse a few times and its not noted on my chart. Even when I'm referred to the ED, I've asked the MD/RN about the advice nurse and they have no notes of it what so ever.

The picture probably wasn't the best idea, but she shouldn't be in fear of losing her job over it. After all, it was with a discharged patient who gave verbal consent. If I were to have an opportunity like that, and I decided to act on it (not saying I would), I'd take the picture outside of the building where it would be more difficult to identify where and why the picture was taken.

[GHGoonette, BSN, RN]

I understand and appreciate both points of view; the nurse's conduct was unprofessional and a reprimand is in order. However, if my opinion was asked regarding the hospital's course of action, I would definitely oppose dismissal, unless it is only one of a long list of unprofessional actions on the part of this nurse. I always bear in mind that nurses are human too. I personally would counsel her, but I would also give her a written and final warning. Allowing your personal fanaticism to overrule your common sense is very immature, and I hope that whatever the outcome, this nurse will learn an important lesson and conduct herself with greater wisdom in future.

Celebrities are human too, and many of them, especially the minor ones, love the limelight that their status brings them, so I think it's highly unlikely that this patient will make an issue of privacy violation.

One thing is bothering me; OP, why did you speak to a co-worker about this? Your duty was to warn the "amateur photographer" that her action is unprofessional and she should speak to the unit manager before taking her photo, or you would approach the UM yourself. I dislike gossips, and your action was definitely gossipy! Please, if you have an issue with a colleague's conduct, take it to the appropriate person-who will then deal with it appropriately.

[tyloo]

The pic was wrong but I would have approached your fellow nurse first about it and not go to another nurse. The other nurse could have not cared for the nurse that took the pic and then took full advantage of the situation. If you were unsure if taking the pic was right or not you could have asked a theoretical question to another nurse. You could have said last month I was taking care of Mrs... and they wanted a pic of me and the patient I didn't do it but could I have?? I wouldn't worry about it too much. Eventually the nurse could have posted pics on facebook or showed pics to fellow staff members which would have bit her in the butt anyways so don't beat yourself up.

I don't understand the whole IV thing though sounds suspicious. Did the patient contact the nurse after he/she left the facility and she was still on shift or is this when she/he was off shift? If this occurred off shift and was a personal number than that is another violation. However if the nurse was contacted while on shift and the patient just got home than I could understand that situation. The nurse meeting the patient at the ER sounds a little like an overkill though. Would the nurse do that for a normal non celebrity patient???

[rkitty198, BSN, RN]

You guys are right. I should have told her about her actions and prevented the entire thing. I feel awful!

She asked me if I wanted to take a picture, I was going to see a patient for a dressing change- it was at the end of the shift- Originally I wanted a picture- didnt have time- then thought it wasnt right- then asked another Nurse their opinion.

She has been an RN for over 25 years and myself 4.5 years. I guess I didnt feel like telling another Nurse with more seniority what to do.

I would have never told management about her decision to take the picture. I was more telling the other RN that I wanted a picture, blah blah, didnt get one, but should you do it, blah blah

I think this RN is great, I have no reason to tattle or hurt her, yet that is what I did.

[Flare, ASN, BSN]

I've cared for a few celebrities over the years. All were very nice and very gracious (and one even sent a gorgeous gift basket of chocolates afterward!!).

overall, I don;t think that any of them would have minded if we had asked for a personal picture. The bottom line is that a picture is seldom taken to be kept as a personal momento. You can imagine that if someone has a picture with Joe Moviestar they will probably show it to a friend of family member. The following questions will undoubtedly be why he was there and what happened to him. You've already said too much by just saying you had him as a patient. And what about the people that aren't just looking for a private, personal picture? There are those that would be willing to sell that picture of a recently recovering Joe Moviestar to tabloids for a pretty penny.

Regarding the call for the IV - it has happened that i've formed a good enough rapport with a patient where they've called after discharge to the unit looking for me. I would probably also stop by the ER on my way out if i had advised a newly d/c'd patient over the phone to return to the ER. That's just human concern.

[jpizzle11]

What kind of IV was this that its bleeding was such a concern? How much bleeding are we talking about?? Why not try putting pressure on it for a few minutes before calling an ambulance? I've never heard of a bleeding IV site being an emergency...unless we're talking about a central line that was d/c'ed from somebody on anticoagulants. I'm confused why they were told to seek emergency care...maybe I don't have the whole picture though.