Health care providers in any settings often find themselves faced with ethical dilemmas that must be addressed and resolved in ways that assure justice to all stakeholders. Patient confidentiality is an issue of utmost importance that is heavily emphasized even from the very beginning of nursing school. Nursing students are considered to be health care providers and are held to the same standard as licensed nurses who have full access to patient information, therefore are subject to comply with all HIPPA regulations (….).
A case to be analyzed is related to Sue T., a nurse manager who is enrolled in a nursing masters’ degree program, who uses her place of work to gather patient information to complete her school assignments and also to complete her nursing staff performance evaluations. Using the Ethical Model for Ethical Decision Making and the Standards for Privacy of Individually Identifiable Health Information also known as the Privacy Rule developed and implemented by the Department of Health and Human Services (HHS), will help determine whether or not Sue has violated ethical principles by gathering patient data for those mentioned purposes.
Sue T. being a nurse manager, and a student in a master’s degree program is assumed to have been very well imbued with the different HIPPA regulations as well as policies from the school she is attending and the hospital where she works. As a student, assuming that when Sue arrived at the hospital, and that the hospital had offered …. she had her badge identifying her as a student, she did not violate any ethical principles by gathering data from auditing patient’s record. This is similar to asking us in this class to use scenarios from our workplace to share and to complete assignments. Also, going at night and not using the time during her work hours to gather the data are in line with ethical principles. However, making copies of patient’s records is a serious violation of HPPA rules. Students may NOT make photocopies of laboratory values, medication profiles, or any other medical record papers/documentation for use or review (…..)
Considering that the information is necessary to enable Sue to complete her assignment, and as a student, the regulations allow her to take notes as she is auditing the charts. However, the Standards for Privacy of Individually Identifiable Health Information also known as the Privacy Rule developed and implemented by the Department of Health and Human Services (HHS) to regulate privacy and confidentiality of medical records have clear and specific limitations. The rules stipulate that identifiable information such a patient’s name or room number must not be included in the notes (……). Furthermore, the notes must be protected and kept private at all times by being carried in pockets and not being left in areas where they can be read by other individuals. In a hospital setting or any place where patient’s charts must be audited to gather data for any reasons by employees, the data collection is done on site in the hospital because employees, even a nurse-manager, may not remove patients’ charts from any facilities. But being qualified as a covered entity by HIPPA standards, Sue may take notes from patients’ records as the Privacy Rule permits and requires.
Completing the nursing staff evaluation performance is Sue’s task as the nurse manager-employee. Her place of work can not ask Sue to do the employee evaluation when she is off the clock, but if Sue takes it upon herself to use her off work time to complete the nursing staff evaluation, she could do so. The information that she would use would be information that would have been gathered when she had permitted access to the patients’record as an employee on duty. If she was not going to her place of work as a student, she would not have had access to the patient’s records even as an employee if she was not on duty. Unless her place of work has policies and regulations granting her access to charts while not on duty. Sue violated ethical principles by gathering [extra] data for employee performance evaluation while gathering data for her assignments as a student.
The notes for her assignment could be used fro the staff evaluation, however, any further data needed for such purpose should have been collected when she is back at work as an employee of the institution. In conclusion, Sue violated ethical principles by making copies of patient’s records to complete her assignment as a student. She could have taken notes instead while adhering to the Privacy Rules. She also violated ethical principles by collecting further data for employee performance evaluation while being on site as a student. Sue could have used the noted gathered as a student but the extra data needed to fulfill her duty as a nurse-manager should be gathered when she is Sue the nurse-manager employee.
