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You are here: Home / Archives for Employment

Privacy Matters To Patients

December 26, 2019 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

I often hear of nurses who made HIPAA violations, none of whom intended to breach privacy but either curiosity or carelessness got the best of them.

Here are ten such examples:

  1. EMR – If you forget to log out of a computer terminal, someone else can follow you to access anything under you log in. Computers are smart and everything you do on the device can be tracked.  Every keystroke you make, every chart you look at, everything!  Even if you accidentally pull up a wrong patient’s chart, that is a HIPAA violation.  Should this occur, immediately notify your supervisor.
  2. HANDWRITTEN NOTES – When I was practicing, I had a clipboard with all my patients’ names and what I was to do with each one. Many times, I forgot to throw away my sheets and brought them home where I discarded them in the trash.  If these notes are thrown away rather than placed in a secure shred bin, you are violating patient privacy and HIPAA.
  3. PROTECTED INFORMATION – If you have a coworker who has had a procedure and you want to find out how they are, you CANNOT access their records. In that position, you are just like everyone else who is not allowed access to this person’s information.  If you want any information on the coworker, you will have to go through the normal way of finding out, just like any family member or friend.
  4. PATIENT FAMILY AND FRIENDS – Be cautious about any information you give to a patient’s family member or well-meaning friend. Make sure the patient has signed a HIPAA release or authorization giving you permission to share information with that particular person.
  5. SHARING INFORMATION – Be careful not to share information outside protected channels. If you text a doctor from your personal cell phone, you have violated HIPAA.  Any such text or email must be secured through approved software and channels.
  6. SELFIES – As much as you would love to be friends with your patients, anything you share on your Facebook page or other social media, such as a selfie with the patient, is a HIPAA violation. Frankly you should never take a picture with a patient, but a patient may take a picture with you.  I would not even be friends on Facebook with a patient because that too is a HIPAA violation of boundaries.  However, if the patient takes the selfie and they post it on their own social media, no violation has occurred.  The violation occurs it YOU post it.
  7. REPORTING HIPAA VIOLATIONS – You can self-report any HIPAA violation but that does not necessarily mean you will not get in trouble but to NOT self-report can make the situation worse. However, if you note another’s HIPAA violation and fail to report it, you can make the situation worse as you can be considered an accomplice in the violation.
  8. PUNITIVE MEASURES – HIPAA violations can result in a variety of legal responses that go beyond just being terminated from your job. A UCLA surgeon was sentenced to 4 months in jail and fined $2,000 after he illegally accessed medical records over 300 times of his supervisor, coworkers and celebrities.
  9. ELEVATOR CHATS – In one case, a nurse was trying to reach a physician about a patient but he had not called back when she ran into him in an elevator. She promptly began a discussion with the doctor to get an order.  This is a violation of HIPAA because the disclosure of the patient’s situation was not in a secure place
  10. FAXING – If you are extremely busy and need to fax medical information, take the few seconds to confirm it is going to the proper recipient. If you accidentally send medical information to the wrong place, you have violated HIPAA.

A HIPAA violation is an extremely serious offense and can result in huge fines and even imprisonment, as noted in No. 8 above.

In ABC’s reality show, NY MED, they inadvertently filmed two hospital patients without consent.  The hospital paid a settlement of $2,200,000 and was instructed to implement a corrective action plan.

HIPAA violations are extreme and saying “it was an accident” is not an acceptable excuse.  There is zero tolerance for such and 100% compliance of HIPAA regulations is required at all times.

Please careful to protect your patient’s confidentiality.

 

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Filed Under: Employment, Newsletter, Workplace Issues Tagged With: board of nursing, Confidentiality, EMR, family, fax, fines, friends, HIPAA, Medical Records, Notes, nurse, nurses, nursing board, Privacy, protected information, reporting, self reporting, selfies, sharing information, social media, termination

Interview with Yolene Lofton, former nurse and founder of Nurse’s Court

December 5, 2019 by LORIE A BROWN, R.N., M.N., J.D. 4 Comments


Lorie Brown, R.N., M.N., J.D. interviews Yolene Lofton, former nurse and entrepreneur, about her problems when she had to appear before the Board of Nursing and advice to Nurses that may be going through similar problems. Also, the devastation that losing her nursing license caused and how she was able to find her way back and is now thriving with her businesses, Nurse’s Court and Nursing Events Management Production, LLC.

Nurse’s Court provides support and counseling for Nurses who have to appear before the Nursing Board. The website, www.NursesCourt.com, should be operational shortly.

Nursing Events Management Production, LLC which plans events for health care organizations such as job fairs, is currently planning a big event for 2020. 2020 Year of the Nurse and Midwife Worldwide Celebration with take place on April 30, 2020 in Miami, Florida. Tickets will go on sale in January, 2020 through TicketMaster or you can get information by emailing NursingEventsManagementPro@gmail.com.

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Filed Under: Employment, License Protection, Workplace Issues Tagged With: board of nursing, charting, counseling, late entries, Lorie Brown, Nurse Attorney, Nurse Entrepreneur, Nurse's Court, nurses, Nursescourt.com, nursing license, revocation, Revoked, support, thriving business, Yolene Lofton

Keeping Your Nurse Practitioner License Safe

November 27, 2019 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

Recently I attended the Nursing Service Organization Annual Summit where they discussed the results of their annual statistical analysis of claims against nurse practitioners.  They look at things such as area of practice, resultant injuries, alleged breaches in the standard of care and on their license protection claims.

Here are some of the risk management strategies that they recommended.

  1. Professionalism is the key. Nurse practitioners have an amazing way of developing a great rapport with their patients.  Establishing the rapport and complying with your employer’s standards, policies and procedures is a great step in reducing your risk as a nurse practitioner.
  2. You will “live and die” by your documentation. Therefore, document, document, document!  It is important to note in your chart your reasons for your clinical decision making process and rationale.  If your reasoning is supported in the chart, that goes a long way to protect you.  There has never an attorney who has said, “I wish they didn’t document so much.”  It has always been: “I wish they would have documented more!”
  3. Additionally, it is important to document all discussions, consultations, clinical information along with the risk benefits and alternatives to treatment options. If you hand out any educational materials, that also should be noted.
  4. If the patient it is not compliant, it is important to note that fact in the medical record. You should also document any efforts you have made to encourage compliance.  Simply stating that the patient was noncompliant is not enough.  As a health care professional, you have a duty to warn the patient of the risks of their noncompliance and the benefits of their being compliant.
  5. You do not have to provide care to patients who are not compliant. If you have concerns about continuing to provide care to a noncompliant patient, bring that concern to your employer’s attention and consider terminating the care for that patient.  Unlike nursing, as a nurse practitioner, we can somewhat choose our patients.  If you have a concern that a patient may sue you or is not compliant, you can discontinue services by giving them 30 days notice and send the letter by certified mail.  You are required to provide emergency care for the 30 days, and it is helpful to refer them for other care.

Do you have any suggestions for other risk management strategies?  I’d like to read them in the comments below.

 

 

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: APRN, documentation, license protection, Lorie Brown, medical record, noncompliant, NP, NSO, Nurse Practitioners, nurses, patients, policy and procedures, Risk Management, standards

You’re Always A Nurse

November 7, 2019 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

Year after year, nursing is voted as the most trusted profession.

And there’s good reason for that because we help people at their most vulnerable times.  We are entrusted with their health, their healing and their mental, physical and psychosocial well-being.

Historically, nurses were nuns which adds to our trustworthiness and credibility.

Anything that you do that could be unbecoming as a nurse, the Board can take action.  If you have a criminal matter against you, you must notify the Board.  Each state varies so I strongly recommended that if you are arrested, know your Nurse Practice Act and reporting requirements so you can report an arrest or conviction in a timely manner.

Remember, anyone can report you to the Board.  I’ve had ex-spouses report nurses to the Board.  Given this, it is important that you remember that you are a nurse 24/7 so no one will report you.

One of my biggest complaints about TV shows with nurses is when they are portrayed going to a bar in their scrubs and drink alcohol.  This is conduct unbecoming of nurse and is unprofessional.  I have no problem with anyone drinking responsibly but I would recommend changing out of your scrubs first!

Remember, it is your license and your livelihood and so protect it.

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: arrest, board of nursing, conviction, criminal matter, license, license protection, Lorie Brown, Most Trusted, nurse, Nurse Practice Act, nursing board, nursing license, scrubs

Fatal Medication Error Update

October 24, 2019 by LORIE A BROWN, R.N., M.N., J.D. 1 Comment

The nurse from Tennessee who made a horrific medication error, RaDonda Vaught, was originally told there would be no charges against her nursing license.  Regardless, the Tennessee Board of Nursing since has proceeded to file charges.

I reported RaDonda’s story to you here wherein she accidently gave a patient vecuronium instead Versed which resulted in death.  Criminal charges against her are pending.  And on September 27, 2019, the Board filed charges against RaDonda Vaught’s nursing license.  The Board matter will likely be continued because when a nurse has a criminal charge pending, most attorneys advise the nurse to take the Fifth Amendment to protect her Constitutional right against self-incrimination.

I find the excessive delay in the Board filing actions against her license to be very concerning.  The Board can file charges when a violation of the Nurse Practice Act has allegedly been committed.  Clearly, RaDonda Vaught did violate the Nurse Practice Act by her fatal medication error.

As I stated previously, I don’t think a nurse should have criminal charges filed against her license for negligence, an unintentional act.  Clearly, RaDonda breached the standard of care resulting in death.

However, this matter is properly before the Board of Nursing and if the patient’s family chose to file a medical malpractice action.  It is sad when a nurse is doing her job, albeit incompetently, can end up with a criminal charge.

If you would like to review the charges against RaDonda’s license, click here.

What are your thoughts about the Tennessee Board of Nursing filing charges against RaDonda Vaught’s license?  Should the Board be able to file charges after telling her that no charges would be filed?  I would love to hear your comments below.

 

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: board of nursing, criminal charges, fatal, medication error, negligence, Nurse Practice Act, nursing board, nursing license, RaDonda Vaught, standard of care, Tennessee

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