Posts Tagged ‘HIPAA’

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Magnet Hospitals: It’s About the Process, Not the Designation

January 23, 2012

By Shawn Kennedy, AJN editor-in-chief

When I had a recent medical emergency, I went to the local community hospital near my home in northern New Jersey. I had been there before for outpatient testing or to the ER with a child and found the care attentive and efficient and the staff friendly and professional. Besides, it was a Magnet-designated hospital, so I was confident that I’d receive good care.

The ancillary staff was wonderful, but I found myself disappointed with the nurses on the acute med/surg unit where I was located. There was no rounding that I was aware of, and they seemed to only show up when it was time to administer meds. Only a few nurses introduced themselves, and only two nurses over three days really engaged me in any conversation. Nurses seemed to respond to call lights only for those patients to whom they were assigned. The unit clerk who promptly answered the call light intercom would say, “I’ll let your nurse know and she’ll be in soon”—when I asked for pain medication, she told me “your nurse is giving report; I’ll let her know when she’s finished.” I waited uncomfortably for more than half an hour.

There were whiteboards, but often the information—especially regarding the date and the name of the nurse—was unchanged from day to day and no longer accurate. (This was annoying, in that they kept asking me what date it was and I kept getting it wrong!)

The worst, though, was the noise level at night. I’ve worked nights, and I know it’s easy to forget to keep conversations hushed. But this unit was a good example of those that are as “noisy as chainsaws” (see our recent post on this). I was two doors down from the nurses’ station and I could hear every conversation, people singing holiday carols, detailed discussions of patients (forget HIPAA!). Requests that they reduce the noise made no difference. One night, I learned every detail about one nurse’s vacation plans while she and a colleague spoke in normal, conversational tones, occasionally laughing, while providing care to the elderly woman in the bed next to me at 2:30 am.

When I asked if they could speak a bit more quietly, one of the nurses angrily pulled back the curtain and told me that I had to understand that they needed to take care of the woman and would be done shortly. She then resumed talking about her vacation. I barely slept at all the three days I was there. It was exhausting, and I was happy to get home.

A few days later, I was admitted to a large teaching medical center in Manhattan, where I stayed for 10 days. The contrast was startling. The ICU nurses were incredibly attentive and supportive; they made me and my family feel that I was safe and in excellent hands. On the med/surg unit, the nurse manager introduced herself when I arrived. My assigned nurse for each shift would introduce herself and ask me if I needed anything; she came by frequently, even if only to poke her head in the room and say, “Everything OK?” Nursing assistants likewise introduced themselves and would inquire if I needed anything. Read the rest of this entry ?

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Patient Privacy and Company Policy: What Nurses Should Know About Social Media

August 26, 2011

Should you be able to have an online discussion about hospital policies that aren’t working or are unfair? What if the point of your discussion is to improve working conditions or to troubleshoot and not to cast an uncomplimentary light on your employer? Right now, the answer is “good question.”

If you’re a nurse or health care worker of any sort, if you sometimes use one or more of the many available social media options (Facebook, blogging, Twitter, etc.), if you’re worried about what it’s OK for you to do or say online, if you have a job or are thinking of looking for one, we strongly suggest you take a look at this month’s iNurse column in AJN (quoted above).

In it, Megen Duffy, RN, aka blogger Not Nurse Ratched, considers such issues as the following:

  • hospital social media policies (always read them; some are surprisingly restrictive)
  • HIPAA and potential issues raised by blogging about aspects of work
  • the ways your social media history may be mined by HR departments at prospective employers
  • the reasons why she strongly believes that social media isn’t going away and has many potential benefits, despite various well-publicized pitfalls—and why nurses need to let their input be known so that social media policies will be sane and balanced

And, since this is social media, we hope you’ll let us know your thoughts, in the form of comments. Maybe Megen will even weigh in, if you really get her attention.—Jacob Molyneux, senior editor

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Nurses, Hospitals, and Social Media: It Depends What Business You’re In

January 19, 2011

By Julianna Paradisi, RN

Zuckerberg/via Flickr, World Economic Forum

Before the placenta picture posted on Facebook by a nursing student made national news, I read Time Magazine’s “Person of the Year 2010,” by Lev Grossman. Born in 1984, Mark Zuckerberg, the inventor of Facebook, is decades younger than the average working nurse. According to the article, so many people now belong to Facebook that if the Web site were a country “it would be the third largest, behind only China and India.” To refuse to recognize the social impact of Facebook is to miss the boat.

Throughout the nurse blogosphere, nurses are demanding that hospitals create policies about the use of social media. Some hospitals have. Not surprisingly, these documents state that no unauthorized photographs of staff, patients, or patient care areas should be taken, let alone posted on the Internet.

Hospitals with social media policies are not necessarily squelching their employees’ right to freedom of speech. They don’t want to spend time and money in court defending their public image. They already spend lots of money on marketing. They are in the business of patient care, not entertainment. So hospitals with social media polices take the position that you can post or tweet to your heart’s content, but should keep in mind the following:

  • Nothing you post is private.
  • If your online behavior disrupts patient care or creates hospital liability, the hospital reserves the right to fire you.

Consider your personal commitment to your own rights. Do you really want to catch every ball that’s thrown to you? Hospitals don’t want to spend their time and money on social media lawsuits. Do you?

Social media is not going away. One of Mark Zuckerberg’s profitable insights is that people like reading about and seeing their friends and friends of friends online. A few years ago, many of us were upset when the Patriot Act made it possible to force libraries and bookstores to report which books their patrons read. Now we want everyone to know what books we “like,” and no one seems to mind that Amazon tracks what we read, then focuses ads according to our purchases.

My own concept of privacy is changing. Read the rest of this entry ?

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Placenta Facebook Photos: Nurse and Mommy Tribes See Student Expulsion Differently

January 12, 2011

By Shawn Kennedy, AJN editor in chief

Many of you may be familiar with the recent “nursing-in-the-news” topic involving nursing students and a placenta. (For those who’ve been out of touch, here it is in a nutshell: three students were involved in photographing themselves with a placenta from a recently delivered mother and posting it on, where else, Facebook. The students were expelled. One student sued; the judge ordered all the students reinstated. See this article by the Kansas City Star that sums it up.)

The incident has provoked debate on various Web sites, including our own Facebook page, where the discussion mainly concerns whether the students were treated fairly or too harshly:

“It’s a placenta. I agree that it can seem a bit juvenile to photograph yourself with it, but an offense worthy of expulsion?”

“Juvenile? Perhaps. Punishable by expulsion? Absolutely not, imo. What exactly was wrong with taking a picture of a placenta? It’s not like you can identify who the placenta came from.”

“I think she should be punished but not expelled. in all reality a placenta is medical waste after delivery but it showed no respect for her patient, which needs to be addressed.”

And a really interesting question:

“Would she have been handed the same punishment had it been a picture of a full bed pan?”

Other sites also argue the “no harm, no foul” rationale—since there was no way to link the organ to a patient and so no breach of privacy, what was the harm? Comments on one of several posts about this issue at Those Emergency Blues came out in favor of the students. Nurse and blogger Phil Baumann’s post, “The Placenta Incident and The Shawshank Redemption,” did as well.

The school did seem to react harshly, especially when there seems to be some question as to whether the clinical faculty member might have been aware of the students’ activities.

However, there was a decidedly different tone on a blog called The Stir at CafeMom, a Web site focusing on pregnancy and motherhood, that should give us pause. Author Jean Sager writes the following in a post called “New Pregnancy Fear: Who’s Got Your Placenta Now?”: Read the rest of this entry ?

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