Question

Using course content, discuss how you would handle the following scenario:

You are the manager on a medical/surgical floor and received a report of two of your night shift RNs that were venting their feelings about their “horrible” night at work. They were still in scrubs and wearing hospital badges while conversing over breakfast at a local restaurant. One RN has been with the hospital for three years, while one has recently been hired upon graduating. An elderly couple overheard the detailed conversation and reported the 2 RNs to the hospital administrator, who in turn notified you.

Review current HIPAA guidelines and your state’s Nurse Practice Act as they relate to patient privacy. Using this as a teachable moment, how could you as the manager turn this scenario into a professional development opportunity?

Answer 1

Here is how I would handle this scenario as a nursing manager while adhering to HIPAA and state nursing guidelines:

First, I would privately meet with the two RNs to discuss the report I received about their public discussion of patient details from their shift. I would remind them about the importance of protecting patient privacy and confidentiality at all times, even outside of work, as outlined in HIPAA and our state's Nurse Practice Act. Violations can result in disciplinary action including termination.

While venting about a stressful shift is understandable, specific patient details, medical conditions, names, or other identifying information should never be discussed in public spaces. This breaches patient privacy and public trust in healthcare professionals.

For the new RN, I would frame this as a learning opportunity about the legal and ethical standards we are held to as nurses. I would review hospital privacy policies and have them complete additional HIPAA training to prevent future violations.

For the experienced RN, I would express greater disappointment, as they should be well-versed in confidentiality policies and lead by example for newer nurses. I would issue a formal write-up, re-training, and consider a brief unpaid suspension given it's a repeat offense.

Moving forward, I would schedule an in-service day focused on HIPAA and ethics training as a refresher for the whole team. Role-playing exercises allowing staff to constructively vent their frustrations would also be beneficial. My goal would be turning this incident into a professional development opportunity for all nurses to understand their duties as healthcare professionals to maintain patient privacy at all times.