Violation of Nursing Laws: Illegal Action or Ethical Dilemma

“To err is human, to forgive is divine” (Pope, 1709). In the medical field, there is no ground for errors and definitely no forgiveness, only consequences. There are laws that dictate every aspect of nursing. These laws are written by the governing bodies and strictly enforced. The most common is the Health Insurance portability and accountability Act (HIPAA). This rule protects the privacy of patient health information, and the confidentiality provisions of the Patient Safety Rule. It protects the information that is used to research patient safety events (U. S. Department of Health & Human Service).

There are many stringent regulations under the HIPAA laws, which have to be followed by health care individuals (HIPAA, 2003). The term “whistle blowing” is described as an action taken by a nurse who goes outside the organization for the public’s best interest. The individual omits the organization’s proper chain of command and directly reports the events to governing authorities. The nurse takes photos of a bad patient situation and presents the events for investigation. This is seen as an illegal action by a nurse and is a violation of the HIPAA standards.

The nurse has the best interest of the patient, but is in violation of the privacy act. A visiting wound care nurse is given a camera to photograph the patient’s wounds on a weekly basis. This helps identify healing progression and determines if changes need to be done to the wound care. During a visit to an assisted living facility (ALF), a wound care nurse used her camera to take pictures of the unhygienic facility. She stated “look at this filth; it’s no wonder the patient’s wounds won’t heal. ” She related that she had sent some of the pictures to the state so the facility could be inspected.

With great concern, she was reminded that the camera was only to be used for photographing patient wounds. She was asked if she had reported the unhygienic events to the administrator of the facility. She stated she did not have to report it as the facility should know the standards of hygiene. The photograph was of an elderly patient in a bed that had food stains on the rails and on the walls. Authorization is signed by a patient to photograph their wounds for charting and progression, not for release of information identifying the face of the patient. The nurse was in violation of the Privacy Act.

This was a HIPAA violation. Administration separated the nurse for misuse of the company camera but could not comment on the reports to the state. A formal complaint was filed identifying disclosure of patient’s private information outside of consents authorized (Office of the Civil Rights, DHHS). The nurse had good intentions for her patient’s well being; however, she did not consider the consequences involved with her actions. The Company, she worked for, could not protect her once she was in violation of the HIPPA law. The recent Margaret Haywood controversy comes into play here.

She was banned from nursing because she took a risk and exposed the neglect of an elderly patient at a facility. She did not follow the chain of command for fear of retaliation. She lost her career trying to protect her patient’s best interest. This was aired on the BBC news in 2005 across the country. She was charged with breaching patient confidentiality and was banned by the Nursing and Midwifery Council (NMC) (Nursing Standard, 2009). Another Nurse Practitioner fell to the same fate, when she went above her chain of command to report policy violations at a facility.

She was fired when she attempted to inform the facility of its violations. The whistleblowers are not protected (Legal Eagle Eye, 2009). A similar incident about compromised photography caught scrutiny. Anne Penney had her personal camera confiscated when she photographed poor sanitary conditions of a facility to support the cleanliness concerns (Penney, 2009). It is not unusual that care givers who blow the whistle, catch retaliation from employers. The “at will” employment has its hand at this. This means that an employee or employer can terminate employment at any time without cause and if the reason isn’t illegal.

There are conditions under which a nurse or other health care professional may be protected from having retaliation for reporting patient safety violations or health care fraud. There are guidelines that govern whistle blowing, and health care individuals are encouraged to consider them (Drew & Garrahan, (2005). Whistle blowing guidance from the Nursing and Midwifery Council (NMC) will tell nurses how to raise concerns about patient care without breaching professional rules (Nursing Standard, 2009).

In conclusion, breach of patient confidentiality and the privacy act violation is an illegal act. Healthcare workers must consider the consequences when blowing the whistle. Cautionary methods to avoid retaliation need to be in place to protect the whistleblowers. According to The Constitution, all humans must be protected. How about equal protection? Should all human life be given equal protection under the law, or can certain human lives be discriminated against, and, if so, on what basis? Why are patient’s rights protected and not the nurses? Where is equality shown here?

The charter of the United States, the Declaration of Independence, is guiding here: “All men are created equal and endowed by their creator with certain unalienable rights, among these are the right to life, liberty and pursuit of happiness. ” The first right is “life,” for without it there are no rights. Furthermore, the notion that “It is the role of the government to protect life” serves as a double-edged sword for nurses and patients. The government cannot remove a segment of the human population from its protection without adequate justification. Rights have limits. I have a right to swing my fist, but that right stops at your nose.

We have the right to freedom of speech, but not to shout “fire” in a theater. We have a right to freedom of religion, but not if that religion involves human sacrifice. Where then does equality stop? Are patients and nurses not human lives? Are we not equal? Nurses care and nurture their patients like mothers and protect them. In a verse of the Holy Quran, 6-12, we can note a passage stating, “That mothers shall not kill their children. ”

We are protecting our children when we report safety violations. We hold their lives at greater levels when we think about their best interests, as oppose to ours. In Psalm 139, vv. 3-16, David gives praise to the lord in the following verses: “For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made. ” Patients look to nurses to protect them. They entrust us with their lives. Nurses are responsible to speak on behalf, and advocate their patients. Nursing is an ambiguous word. We are healers, counselors, caregivers, and teachers. According to the American journal of nursing, the Hippocratic Oath for nurses is very similar to that of the doctors “to do no harm” (1909). Hence our duty must meet our romises.

We are vowed to take care and never to falter in rendering care of our patients. We must always strive to perform our duties in the most altruistic manner. According to the Webster dictionary (2005) the word ethical means “threatening of morals” and retaliation for whistle blowing is a perfect example of this. The word “dilemma”, means a disaster. We as nurses have faced an ethical dilemma in trying to protect our patients. We have lived the standards of nursing. We have been altruistic. We have been selfless and we have given all that we have of ourselves. We are nurses and we care.

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