Visitor filming during code

[Lev]

The risk management team at my hospital is faced with their latest case involving a visitor filming staff during a code. A female patient coded and didn't make it. One of the patient's male visitors, who apparently was not POA nor even related to the patient, threatened to sue the hospital and everyone involved. He said "I have you all on video and I'm going to post it online for everyone to see."

This brings a couple questions to mind.

First, what was he even doing in the room? Why didn't they clear him out? And how/why did no one notice? Only thing I can think of is he was standing outside of the room and discreetly filming while pretending to use the phone. Also, what kind of sicko films a code? Finally, and most importantly, it brings up sincere concern about our privacy as nurses.

[CrazierThanYou]

Personally, I think its weird as **** for someone to be present during a friend or family member's code and say "OMG, let me get my phone out and FILM this!"

Crazy.

[akulahawkRN, ADN, RN, EMT-P]

As far as I'm concerned, if the person was allowed in the room by the patient or POA and the patient codes, the person is welcome to stay there and even film the whole thing. Patient Confidentiality isn't broken because clearly the person was allowed in the room before the code. I have no expectation of privacy while at work.

Unfortunately, because resuscitation on TV very often is successful, a lot of people expect those same results in real life. We all know that's not possible, nor even realistic. People might just feel hurt/scared/angry about the whole thing and lash out in the only way they can, in an attempt to gain some sense of control.

Go ahead, film me. I'm going to run the code the way I'm supposed to, following the established procedures/protocols. I've had to do my job in front of 65k people, each of them potentially recording what was going on. Yes, that was on the field at a football game with a stadium full of fans.

[Lev, MSN, RN, NP]

If anything, there is a case against HIM, not the other way around.

Weird.

That was kind of my immediate reaction. If anyone was going to sue anyone it would be us suing him for recording us without knowledge and consent.

[Lev, MSN, RN, NP]

If you are speaking of lay family member, I wouldn't worry too much. As someone who has been in administration dealing with litigation and compliance for many years, I have seen these threats & cases many times. Despite if the code was ran to the algorithm perfection, or if there was a professional clinical judgement to cease the code; these cases never result in anything but a waste of money for the healthcare facility and family. Most family members will not pursue these cases due to the enormous amount of detail, money, and time involved. As long as documentation leading up to the event is accurate, this will go no where.

Thanks. Good to hear. It wasn't a family member filming, so there is probably even less of a case. Just worried about social media.

[lpnpgh123]

Also, this may fall somewhere under HIPAA- the patient was in no way able to consent to being filmed, and the person who did so has no legal right to film, as they were not the POA. I would think it's just an empty threat. I am sure your facility's legal department will nip this in the bud.

[Emergent, RN]

Also, this may fall somewhere under HIPAA- the patient was in no way able to consent to being filmed, and the person who did so has no legal right to film, as they were not the POA. I would think it's just an empty threat. I am sure your facility's legal department will nip this in the bud.

I agree. It's all about the patient. You could say that being coded is the most exposed, humiliating, vulnerable moment in a person's life. We strip them naked practically. They are totally exposed.

To film that without consent is the ultimate violation of their privacy. Then to post it online? Disrespectful beyond belief.

[Asystole RN]

Also, this may fall somewhere under HIPAA- the patient was in no way able to consent to being filmed, and the person who did so has no legal right to film, as they were not the POA. I would think it's just an empty threat. I am sure your facility's legal department will nip this in the bud.

HIPAA only applies to covered entities. A private citizen is not a covered entity. Although the patient cannot consent, as long as the legal authority was present such as the MPOA and did not object to the visitor being present then there would be no fault on part of the facility.

[Ruby Vee, BSN]

The risk management team at my hospital is faced with their latest case involving a visitor filming staff during a code. A female patient coded and didn't make it. One of the patient's male visitors, who apparently was not POA nor even related to the patient, threatened to sue the hospital and everyone involved. He said "I have you all on video and I'm going to post it online for everyone to see."

This brings a couple questions to mind.

First, what was he even doing in the room? Why didn't they clear him out? And how/why did no one notice? Only thing I can think of is he was standing outside of the room and discreetly filming while pretending to use the phone. Also, what kind of sicko films a code? Finally, and most importantly, it brings up sincere concern about our privacy as nurses.

There's a trend these days towards allowing family to remain in the room during codes -- something about improving customer satisfaction. That said, if family is to remain in the room during a code, there ought to be at least one staff member assigned to supervise them. They're going to be anxious, have a million questions and their behavior will be unpredictable. It's not SAFE to have lay persons in the room without someone watching them. (I once watched -- from the patient's chest -- my nurse manager get flung up against the wall by a family member who was sure that if "all those heathen nonbelievers" would just get out of the way, the holy spirit would fly in and save Dad.) So my first question would be where was the family minder while this was going on?

Second, why in the world was a visitor in the room during a code allowed to have a phone out so he could "use it"? Our patient rooms are a "no phone zone" even during normal times. If visitors want to visit, they can visit, but they cannot be on the phone at the same time. That policy was instituted precisely because some visitor with more testosterone than sense took pictures of Granny's peri care while ostensibly "using the phone."

Third, we have no privacy as nurses. none at all. But it does call into question that particular visitor's mental health, ethics, manners, judgement and common sense. I sincerely hope the legal department hands him his a$$ in tatters.

[Ruby Vee, BSN]

Research has found that having family members present during cors and emergent situations lead to better outcomes with regards to family "satisfaction" for lack of a better word. Many facilities are moving towards allowing family to remain present in cors.

What's a "cors"?

Allowing family to remain present is not the best idea I've ever heard of, but allowing them to remain present without a minder boggles the mind.

[Asystole RN]

What's a "cors"?

Allowing family to remain present is not the best idea I've ever heard of, but allowing them to remain present without a minder boggles the mind.

At my facility the SWAT nurse, House Supervisor, social worker, and security all come to codes..not to mention the clinical staff who are actually running the code. There are no official "minders" but usually between everyone there is enough staff to handle family. Usually the social worker is comforting the patient anyways.

It seems counterintuitive but until family witnesses the violence of a code they simply cannot understand what they are doing to their loved one. I have also heard that family that witness the code are much less likely to sue once they see all the extreme measures we take to prolong death.

[NurseDirtyBird]

The thing that bothers me the most about this is if the family does decide to sue based on the video, the facility may offer a settlement just to get them to shut up. Then the family thinks they "won," and health care as a whole has lost credibility. I agree with your sentiment of what kind of sicko films those things. Why would someone want to watch someone die on video? That's awful.

[Lev, MSN, RN, NP]

The thing that bothers me the most about this is if the family does decide to sue based on the video, the facility may offer a settlement just to get them to shut up. Then the family thinks they "won," and health care as a whole has lost credibility. I agree with your sentiment of what kind of sicko films those things. Why would someone want to watch someone die on video? That's awful.

Settlement seems just the type of thing my hospital would do. Throw money at the perpetrator to keep him quiet.