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Introduction
My first impression came from the dirty floor, the scattered elements of medical instruments, and the general untidiness. The picture is quite disturbing; the dirty things and blood on the floor make you think about whether the person was saved or not. The lack of a couch or chair is panic-inducing; the monitors turned off, open drawers, and abandoned gowns and gloves look creepy. The picture is very unpleasant, and the only thought is about the man’s fate.
Second Impression
If a doctor or nurse I know sent me this photo and said something like, “we are saving your relative,” I probably would not believe it at first, and then I would be horrified. I would pay attention to the trash, to the abundance of bright blood on the floor. The incomprehensible instrumentation, the dirty robes would have been fear-mongering, and I would have tried to find signs of life in the photo. Scattered stuff is one of the alarming signs that would scare me a lot. Thrown tools and clothes in a hurry put me in a state of anxiety and made me think of unpleasant things. I would probably immediately rush to the hospital or clinic for more information.
The Incident
The photo was published in 2014: a man was taken to the emergency room after being hit by a train. Fired nurse Katie Duke reposted it from someone else’s Instagram – the doctor who first posted the incident photo. Kathy added a comment, and it probably caused her to be charged with insensitivity to someone else’s tragedy. The doctor who first posted the picture was not reprimanded, fined, or fired. There were no actual signs of a violation of the ethics code: there was no signature on the photo (Palacios-Gonzalez, 2015). Most likely, it was the presence of Kathy’s comment that led to her swift dismissal because it in some way indicates the identity of the victim. I do not entirely agree that her comment falls under ethical misconduct because there is no direct indication. I think the administration could have used a different restraint.
If we imagine a hypothetical situation in which the photo was originally published with the signature, most likely, the doctor would have been fined or fired. The punishment would vary depending on the nature of the signature and any elements indicating a particular person. Nevertheless, it is worth realizing that physicians are the more protected group in a hospital because they provide specialized care to the injured. The priority task of nurses is to provide preventive health and sanitary care related to maintenance and supervision (Chretien & Kind, 2013). In this connection, how the hospital management treats its employees and how willing they are to advocate for their rights also plays a role.
Explanation of HIPAA Violations
HIPAA is a set of criteria related to the patient and their personal data that a healthcare facility and its employees must comply with. If not adhered to, a HIPAA breach occurs, leading to leaks of patient data and severe cases of disclosure of confidential information (Cohen & Mello, 2018). Often violations are due to negligent or negligent employees who mismanage patient privacy risks. Failure to comply with HIPAA regulations is followed by fines depending on the severity of the offense, including criminal liability. In the case analyzed, there was a violation of patient confidentiality that involved two parameters: the geographic identification of the incident and its dating.
At first glance, there does not appear to be any actual violation related to the scene’s geography. Nevertheless, the nurse was reposted to her page, which included details of her work and activities, because Duke was also filming for a medical series. In addition, the doctor from whom she also reposted likely had information about where she worked (Parris, 2015). We can assume that one violation of HIPAA was the indirect reference to the geographic unit – city and street– when the nurse posted.
The second violation is more evident because Duke added additional information when posting the photo: indicating gender and specifying the case. Chances of a person being hit by a train are rare, and it is easy enough to establish the accuracy of the incident. The doctor who posted the photo was the first to keep the information confidential because there were no details about the incident, and it could have happened at any point in time (Alder, 2021). However, the specificity of the case indicates the dates of the incident, that is, the date of admission, which refers to confidential information about the patient.
Two Social Media Standards
Social media standards have to do with how ethical a health care provider is being with a patient. This case falls under several broken rules about posting on social media (Hader & Brown, 2010). Nurses who engage in media posting or blogging about medical topics should be guided by the principles of posting and follow the correct tactics because otherwise, it could lead to more cases.
One of the standards of social media, in this case, can be highlighted in respect of privacy and the absence of photos and videos on personal mobile devices. Any posting involving sharing private information about a patient can lead to a breach (National Council of State Boards of Nursing [NCSBN], 2018; Chretien & Kind, 2013). Having a friendly relationship does not diminish the responsibility for publication, as it will be considered unprofessional in any case (Neporent, 2018). It is worth noting that failure to meet this standard will result in the termination of the employee and that the patient may file a lawsuit and complaint about unprofessional conduct.
Another necessary standard is related to the previous one and relates to professionalism: in this particular case, the rules of interaction with the patient were violated. Although the published photo does not contain names or images of the patient, it carries a direct reference to a specific person (Lord & Roseen, 2019). If he sees this post, he is likely to regard the nurse as a non-professional who has allowed himself to publish an image related to his injuries. Observing professional boundaries should be not only in the workplace but also in the media, which is not always evident for some reason.
Two Concepts of Nursing Professionalism
Professionalism in nursing is associated with skilled care and adherence to commonly held values. The manifestation of professionalism is expressed in independent ethical decision-making and effective interaction with the patient (Poorchangizi et al., 2019). For the case being analyzed, the concept of building ethical socialization and commitment to one’s work is first and foremost worth recalling. Duke may have achieved high quality of care but did not maintain patient confidentiality. Second, Duke should have applied the concept of building a trusting relationship with the patient (NCSBN, 2018). She did not express sympathy or compassion for the patient’s distress. Neglecting this concept leads to a situation in which patients may cease to regard nursing assistance as sincere and become less cooperative in their treatment.
Two Concepts of a Code of Ethics
The Code of Ethics is based on cumulative evidence arising from years of interaction between healers and people. The care provided should not only do not harm but also create a psychologically comfortable environment for recovery. As previously mentioned, the ethical side of a nurse’s work is one of the criteria for professional status (Palacios-Gonzalez, 2015). In this regard, an essential provision of the code would be provision 5, which imposes on the nurse the responsibility for the integrity of character safety to herself and others (American Nurses Association [ANA], 2015). This provision regulates the nurse’s activities, directing them towards personal growth and maintaining competence in front of patients. Another clause worthy of mention, in this case, would be the first clause, which commits the nurse to treat each person with compassion and understanding. Duke’s posted photo does not appear to be compassionate and respectful of the injured person’s problem so that one could claim a violation (ANA, 2015). In addition, provision 3 is also essential for a situation like this: protecting patients’ rights is necessary not only in an institution but in every aspect of life.
Impact of the Case
The incident illustrates several essential aspects of work in medicine: the ethical, the professional, and the personal. The ethical one is expressed in the subordination and competence to the patient; the professional one consists of conducting one’s duties to preserve the patient’s dignity and protect his data; the personal one refers to the qualities of the nurse such as compassion and empathy. All three aspects are closely related, and following them will make for a good nurse. For me, this case showed that social media is not just a private space. I want to respect the privacy of my colleagues and patients, so in my practice, I will avoid unethical behavior in the media to show my professionalism as a nurse.
References
Alder, S. (202). HIPAA social media rules.HIPAA Journal. Web.
American Nurses Association. (2015). Code of ethic with interpretative statements. Silver Spring.
Chretien, K. C., & Kind, T. (2013). Social media and clinical care. Ethical, professional, and social implications.Circulations, 127, 1413-1421. Web.
Cohen, G. I., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st century.JAMA, 320(3), 231-232. Web.
Hader, A. L., & Brown, E. D. (2010). Patient privacy and social media. AANA Journal, 78(4), 270-274.
Lord, R., & Roseen, D. (2019). Chapter 5: Workforce. In Do no harm 2.0 (pp. 60–74). New America.
National Council of State Boards of Nursing. (2018). A nurse’s guide to use of social media [PDF document]. Web.
Neporent, L. (2018). Nurse firing highlights hazards of social media in hospitals. ABC News. Web.
Palacios-Gonzalez, C. (2015). The ethics of clinical photography and social media.Medical Heath Care and Philosophy, 18, 63-70. Web.
Parris, T. H. (2015). HIPAA violations on social media. Applied Research Projects, 23. Web.
Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students’ perspective.BMC Nursing, 18(26). Web.
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