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?”:

“I had an expectation that it [my placenta] would go from my womb straight into medical waste, with no stops for monkey business along the way. To think of my placenta being played with, photographed, and used as evidence of the oddity of one’s educational experience is jarring at best, humiliating at worst.”

The comments on that Web site were markedly different from those on nursing sites. While they were not calling for expulsion of the students, and there were a few who didn’t see the students’ actions as a “big deal,” it was clear that most of the commenters were uncomfortable with the behavior of health care “professionals”:

“And good for the school for kicking these ‘little girls’ out. They do not have proper respect for others if they can’t even understand why that was wrong.”

“I can’t even pretend to be shocked at this immature excuse for behavior from yet more people who are trying to be in the medical community which is already plagued with problems. None of these girls needs to be let back in college. They aren’t even close to grown up enough to be working in any part of the medical field.”

“This specific instance is just one more situation that reinforces my feelings on health care professionals. They aren’t very professional and their lacking [sic] with the health care because they are to [sic] busy with shenanigans.”

I wonder if our patients will wonder what other playful and “fun” things might be happening in the back room or when no one is watching. Will patients trust that when they are anesthetized they will be treated respectfully? Will hospitals and other clinical agencies be less inclined to host students for fear of litigation over privacy? I imagine that, at the very least, all nursing schools are now quickly developing social media policies. The American Medical Association has one and the American Nurses Association is, I’m told, developing one.

One entry on AJN’s Facebook wall made an interesting point: “The real issue here is how new media is changing everything. Personally, I would never post anything about my patients or their care. It’s just plain unprofessional. Sounds like this girl was made into an example, which might be unfair—but not totally unnecessary.”

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