Scenario #1: HIPPA Violation You are about halfway through your first shift as a charge nurse. Unfortunately, it is the night shift, and you are short-staffed so you had to take an assignment, but yo

Scenario #1: HIPPA Violation

You are about halfway through your first shift as a charge nurse.  Unfortunately, it is the night shift, and you are short-staffed so you had to take an assignment, but you slept well and are up for the challenge.  After working for two years as a PCT and now one year as a nurse on this trauma floor you are feeling pretty confident.  Just as you are giving the last of your nighttime medications you get a call from patient placement – another patient is coming.  This patient is a VIP and will be taking your last private room.  After getting report from the ER you learn that it is the new up-and-coming pop artist Kanaya Minja!  She hasn’t been on the scene long, but you have a few of her CD’s.  She apparently fell off the stage at her concert tonight and broke her leg.  The diagnosis is not too concerning but she is also 14 weeks pregnant and is being admitted for observation until she can have surgery to fix her fracture.  When you look at the assignment sheet you suddenly realize that you are the charge nurse and can give her to any nurse.  It only makes sense that the VIP patient would be cared for by the charge nurse, right??  This is one admission you are happy to take!

Kanaya arrives on the floor just before 0200.  You get her settled in and comfortable.  You talk about how excited she is to have a baby and she mentions that she has been craving chocolate milk but has been too busy touring to have a steady supply. You look in the pantry but don’t find any.  As you sit down to start charting you realize that the cafeteria is about to close.  You hop up and head downstairs for some lunch and to see if they have any chocolate milk for your new friend.  When you return to the floor you drop off the sweet dairy goodness to Kanaya and then head to the nurse’s station to finish charting.  When you sit down you realize that you are still logged into the computer.  You roll your eyes as you forgot to log out.  Again.  Oh well, it just gets you to your assessment faster.  The rest of your shift is uneventful.  You say goodbye to Kanaya before you leave and think to yourself that you might pick up an extra shift tonight if you can have your assignment back and spend more time with Kanaya.  Maybe she would even sign your CD’s!

When you wake up that afternoon you call your manager and ask if you can work extra tonight.  She says no and asks if you can come in the next morning.  You let her know that you can not work a day shift so soon after working a night shift.  She starts to get a little evasive and then says that she wants you to come in for a meeting with her, your director, and an HR representative.  You are not sure what is going on, but you figure you better say yes.  Later that evening you call your bestie who is at work and ask if she knows what is going on.  She informs you that there was a HIPPA violation on the floor and they are talking to everyone that worked last night and accessed Kanaya’s chart.  Kanaya was upset and requested to be transferred to another hospital.  Your heart drops as you realize that you left your computer unattended for thirty minutes and it hadn’t automatically logged you out like it is supposed to after 5 minutes of inactivity.  Surely, someone wasn’t accessing Kanaya’s chart while you were in the cafeteria; or were they?

The next morning, after a fitful sleep, you get dressed and head in to work.  You are beyond stressed so you decide to listen to your favorite radio station for some distracting music.  However, instead of music, you hear the “breaking news” that Kanaya Manji fell off the stage during her concert last night and that her toxicology report showed several illegal substances as well as alcohol in her bloodstream.  Additionally, they mention that her pregnancy test was positive and that she has a history of two short-term psychiatric admissions at your hospital about a decade ago.  Now your stomach drops as well as your heart.

When you arrive to work you take a peek at your phone to check what is trending.  There are screenshots of Kanaya’s test results, address, and medical history.  Whoever took the pictures was kind enough to block out your name, but you can see the date and time in the lower right-hand corner of the computer and you recognize the bits of nurse’s station you see as the place where you charted last night.  By the time you get to human resources, you are ready to vomit. 

A HIPPA violation has occurred and a patient’s data was exposed to the media.  Your fear is correct – someone accessed Kanaya’s chart with your login and committed a major violation. You have no idea who would have done this, and the evidence points to you!  The meeting was surreal.  The HR representative informed you that Kanaya’s lawyers are aware of the breach of her personal information and that you may be facing a civil suit.  They also mention that she had not informed her significant other or family that she was pregnant.  One of the hospital lawyers was present and talked about the multiple consequences you could be facing at the hospital and with your nursing license in general.  How did you get here?  Yesterday evening you were a charge nurse and today you may be losing your nursing license!