Nurses fired for taking photos of patient's x-rays (of his rectum, complete with lodged object)

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71 Responses to “Nurses fired for taking photos of patient's x-rays (of his rectum, complete with lodged object)”

  1. zio_donnie says:

    i do not know how the law works in the US but the moral issue is the same everywhere. internal jokes is one thing, going public is another. not everyone lives in NY or in cities that have dozens of hospitals where something like this passes unobserved. where i live news like this travel fast without nurses having to post x-rays and this kind of publicity can ruin lives.

    as anyone that has worked in a hospital i have many anecdotes to share over a dinner but hospital personel that leaks private info for the LULZ is simply unacceptable.

    this is not a case of private medical records of particular interest used for research. in Italy and i guess everywhere in the civilized world medics have the right to use anonymous records for research reasons. this kind of permit does not give blanket licence for fart jokes on facebook.

    people are freaked out as it is going to the doctor. undermining respect and trust in medicine is a huge issue.

  2. Takuan says:

    but feds now have a cross referenced database to match colon-prints with names, that’s why they did all those airport searches, they were secretly taking photos. I told you that camera lens barrel didn’t feel like any rubbergloved digits!

  3. ErikO23 says:

    I’ll be warning my friend who often regales us with pictures of things she has removed from men’s asses.

  4. Anonymous says:

    I can think of one instance where the patient might have been grateful to have public photos of her x-ray.

    It was reported in the news that a woman had to go to the emergency room because of a vaccuum cleaner handle lodged in a private spot. Claimed she fell down the stairs onto it. Snicker snicker. Yeah right.

    But someone I knew said he saw the x-ray. The handle was lodged almost up to her lungs! Terrible injury. Poor woman really had fallen, but lack of details made everyone think something else.

  5. Takuan says:

    they need a good laugh every now and then though. I was in an emergency room once, foot swollen like an angry melon, on crutches. Hospital supplied crutches I might add. I moved to hop along and one splintered. All my weight plus the driving force mashing the bad foot into the ground. Took about twenty minutes for me to get the pain under control enough to try to stand up. The stressed out doctor standing nearby just about wet his pants laughing. I sure it did him some good. Bastard.

  6. grimc says:

    @007ben

    It’s still a violation of patient confidentiality. If not HIPPA, the nurse licensing authority in Wisconsin probably has rules regarding this.

  7. Tom Hale says:

    I worked in a hospital for 4 years, quitting Feb, 2008. Trust me, if you’re a patient, your privacy is being constantly violated during your stay. As soon as a Doctor or Nurse leaves your room, he/she goes out and complains or laughs with staff about something you said or did. Sad but true.

  8. zio_donnie says:

    PS: before someone starts talking trash about civil liberties and research rights i have to point out that hospital personel taking pictures of patients and/or their records and exams with a celphone is neither legal nor useful for scientific purposes. for research we use the actual records and high res fotos not crappy cel snaps.

    by coincidence just yesterday in Italy 2 medics and a journalist got criminally charged for taking fotos of eluana inglaro just before she died (inglaro was a girl that was in coma for 17 years similar to the terri schiavo case)

    http://www.ilgiornale.it/a.pic1?ID=331627

  9. cbuchner1 says:

    Doctors often publish interesting medical cases in research journals, including photos of the patient. And I do not think that every patient will be asked to sign a release form.

    I fail to see a privacy scandal here (assuming that the patient’s name was obscured when posting the x-ray online).

  10. ill lich says:

    On one hand I can see myself taking a photo too (nobody would ever know who’s x-rayed rectum that was, right?), and on the other hand I know that it was probably contrary to hospital rules, perhaps against some kind of moral code for people in that profession, or at least in bad taste.

  11. WeightedCompanionCube says:

    Unfortunately, he forgot zat here in Germany ve use 220-volt electrical current. Our surgeons did all zey could, but it took zem 4 hours just to get ze smile off his face.”

  12. Clemoh says:

    Deleting your Facebook page does not make the content go away. I can see now why Facebook chooses to archive your content indefinitely. I can certainly see them wishing to cooperate with law enforcement.

    Posting something on the internet is a no going back situation, you can’t put the toothpaste back in the tube. I have screengrabbed a ton of stuff I knew would not be there later, just so I can have it to refer to. Guaranteed those x-ray images have been grabbed by some curious person who knew better.

  13. zuzu says:

    Takuan, it’s time for your Freedom Search.

  14. Takuan says:

    ghouls should be punished. We all get calloused by our work, but there are decent limits.

  15. grimc says:

    @clemoh

    Facebook doesn’t care about your content. Your content isn’t necessarily worth money to marketers. Facebook cares about your personal data, which is.

  16. syphax says:

    @19: You do not think patients sign a release for medical journals? Is that a fact or an opinion? I don’t know the answer, but I would think that they do sign a release. I’d be pissed if shots of my colon were visible on every doctor’s desk without my permission (which I’d be glad to give; I just want to have that decision).

    My mother has had a caregiver violate her HIPPA rights on consequential matters; someone got fired; they should have.

    These nurses should have had more self control.

    That said, I’m dying to see these pictures!

  17. zio_donnie says:

    @ takuan and tom hale

    when in a hospital privacy is relative. i mean if someone looks at the internal of your colon you should at least trust him. no “violations” here. if you don’t want to be probed and asked questions go to your local witch doctor.

    it may sound cruel but a swollen foot and a comic fall is nothing in the grand scheme of things. medics have to lose common sensibility if they are to do their job properly. if you panick over a swollen foot what would you do when you see a car crash victim? yeah a slapstick fall is probably a relief after a day of life and death situations (and mind boggling bureaucracy).

    and yes nurses will talk behind your back specially if you are a douchebag or cute (yeah they are not always negative in their comments). but that does not mean that they can update their facebook profiles with your xrays.

  18. Jeff says:

    How humiliating. Butt it happens all the time. People Ending up in the ER with crazy things stuck in crazy places. “I slipped and fell on the shampoo bottle!”

  19. DeeAnAy says:

    If there was identifiable information on the picture of the X-ray, it is a clear cut violation of HIPAA. If there was no identifiable information, I doubt any law was broken. It is, however, a clear cut violation of patient trust which can be more damaging in the long run. I can imagine patients delaying care for embarrassing ailments because they are afraid of how they might be treated. If these staff members took these alleged photos, it sounds as if they are in the wrong profession.

  20. Cpt. Tim says:

    “And I do not think that every patient will be asked to sign a release form.”

    this is whats called argument from ignorance. or argument from personal incredulity at best. I think lots of things are probably certain ways but its a lousy way to ascertain the truth of something.

  21. Tom Hale says:

    Are you familiar with Gallows Humor? That’s not the case in all callousness that I’ve seen in the ER, but I think it counts for a lot of it. From doctors though, it’s usually because they’re being an ass.

    Gallows humor is also seen quite often on emergency scenes – it’s supposed to relieve stress.

  22. Takuan says:

    Antinous, you’re not kidding are you?

  23. aeon says:

    So long as there are no patient identifying data on the photograph (ie. Name, dob, ID No., address) then there is no breach of privacy. One Pelvic X-ray with arse-inserted object looks much the same as any other. The excuses used to explain the presence of said foreign body are generally more entertaining than the radiographs anyway. ;-)

    What there *was* was a breach of good manners, good taste, and nursing ethics in that the photos were taken only for puerile entertainment value. Actions like that cause blanket photography bans which make collecting images for teaching purposes difficult or impossible.

  24. UstinJay says:

    poor guy, stupid girls, I hope they don’t do time nothing extreme happens. Doubts it.

  25. markfrei says:

    @10 Takuan:

    A weapon of ass destruction perhaps?

  26. Clemoh says:

    @ grimc

    That notwithstanding, it is the preservation of content that could verify that a law might have been broken, not their personal info.

  27. Anonymous says:

    Granted, the case discussed here isn’t exactly the same, but it looks like the nurse didn’t include any of these identifiers that would make this a HIPAA violation.

    http://clinicalcases.org/2002/01/case-reports-and-hipaa-rules.html

    Crummy, embarassing, and unprofessional? Yes.
    Grounds for termination? Up to the hospital.
    Illegal? It doesn’t look like it.

  28. guy_jin says:

    @2: remember that next time you’re the butt (lol) of the joke.

  29. Anonymous says:

    ” #40 posted by Anonymous , February 26, 2009 2:46 PM

    No laws were broken. Unless hospital rules were broken, these nurses broke no laws.

    One does not require authorization from the patient to post on the internet if none of these 18 Identifiers are present

    The Happy Hospitalist”

    #2 If you are posting the picture to your facebook, your friends know where you live and/or work thus revealing the geographical location.

    #3 If she was discussing when this occurred or was a mobile update, there’s two!

  30. jimh says:

    @Eric #16: I really wonder if taking a photo of the thing, once removed, is a violation of patient rights? It can’t be as clearly cut as the case of actual x-rays, which are an image of the patient.

    I mean, a photo of a Windex bottle is just a photo of a Windex bottle when taken out of… ahem, context. Theoretically the object might still be considered the patient’s personal property, but I’d imagine most patients don’t want these objects returned.

  31. zio_donnie says:

    as a medic i can assure you that this kind of behaviour is standard in every hospital. a dildo stuck up someone’s ass is always hilarious and provides a diversion from (often cruel and not at all funny) routine. i have lots of similar anecdotes specially from the fertility lab.

    these nurses got what they deserved tho’. an inside joke is one thing. a patient’s record on facebook is another.

  32. TroofSeeker says:

    People entrust nurses on the very worst days of their lives. It was unprofessional of them to publish the photo. Maybe the doctors should have, and publish some sort of warning about things entering an exit.
    Then again, the only people who ever stuck anything in my behind were doctors. Hmmm.

  33. grimc says:

    @clemoh

    I agree that preservation of content can be helpful in the pursuit of justice. I’m just saying that Facebook isn’t necessarily concerned with the preservation of user content, and likely doesn’t spend a whole lot of effort or money to provide backup storage of stuff like user photos. There’s no profit in it.

  34. Anonymous says:

    I agree the nurses are in the wrong profession,
    because this kind of stuff is so common in
    ERs, the humorous aspect fades quickly. To put this then on facebook is stupidity itself. ERs require mature, intelligent professionals who see beyond the sometimes sophomoric aspects of their
    occupations.

  35. zio_donnie says:

    from the wikipedia definition i understand that victims of violence make gallows humor. medics are not personally in a life threatening situation so they are just making black humor i guess.

    anyway i can understand why medics pass as assholes. every patient rates his situation as important and rightly so. but for a medic it is a matter of priorities. your carpal tunnel is not as important as a brain tumor. in the pussified western world you get panicked moms that bring their children in the emergencies for a bruise or a cold. unfortunately most doctors are not politically correct and they will laugh at stupid things.

    want a real story? when i was in the military i was in the army general hospital in athens greece (known as 401). it’s 3 AM when i hear a speeding car, that passes with a red light and is coming full steam towards the hospital gate. an incoming car from the other direction crashes into it 50mt before my eyes. thank god the guards did not shoot (as they should have) so we pull out the two drivers and a woman that was in the speeding car. luckily noone was hurt tho’ both cars where trashed. to cut a long story short it turned out that the speeding driver was an army general that wanted to bring his wife in the hospital because she had a sprained ankle.a fking sprained ankle in 3 in the morning. i let you immagine the comments.

    medicine is not an exact science and it takes 10-15 years to become a medic so you get your fair share of human misery. black humor is just a way to cope with the futility of it. hate the doctors if you will. the important thing is that you keep trusting them.

  36. Phil_A_Minion says:

    @Eric #16 — We also need to warn our physician friends who have collections of such objects in their curio cabinets.

  37. Anonymous says:

    No laws were broken. Unless hospital rules were broken, these nurses broke no laws.

    One does not require authorization from the patient to post on the internet if none of these 18 Identifiers are present

    The Happy Hospitalist

    • Antinous / Moderator says:

      Happy Hospitalist,

      Thanks for the info. We don’t allow blog links in comments, but if you register as a user, you can put it in your profile.

  38. Takuan says:

    oh don’t get me wrong, I was mad at the time because it hurt like hell, but I honestly don’t hold it against him. I’ve spent many hours in emergency over the years, I’ve seen plenty of what they deal with. Some shouldn’t be in medicine, but most do well, considering.

  39. sassifrassilassi says:

    i am a primary care provider, and though this behavior is tacky and immature, it is not a hipaa (health insurance portability and accountability act) or other legal violation if there are no patient identifiers associated with the photograph.

    that’s why we are able to talk about patients at grand rounds and case conferences without their consent – we don’t give any identifiers.

    however, the nursing licensing board of their state may act to condemn the behavior as a violation of the tenet of benevolence. as for the removal of their licenses…. not likely.

  40. andygates says:

    @33 – X-rays commonly have patient-identifiable data (PID in the trade) on the: name, patient number, that sort of thing. That’s clearly a breach. Even without it, it’s a crass failure of patient confidentiality (the patient could be identified indirectly from the date and local gossip, for example).

    I work in IT for the NHS. When this sort of thing comes up at work, like Zio says, we have a laugh but it stays internal (heh) and stays professional. Gallows humour is par for the course. But posting to Facebook is definitely worth a disciplinary slap.

    Mind you, with insty-posting (viva Twitpic) to the immortal cloud, the genie is well and truly out of the bottle. There’s no technical solution to this. It’s a cultural thing – and always has been.

  41. Takuan says:

    in a world where Photoshop etc. exists, all it takes to deny something embarrassing is steadfast denial. The fact is, an image isn’t worth much any more as report of facts. So the liability of exposure is deflated as well.

  42. seanboing says:

    You know, if it didn’t have any patient identifying information, who gives a crap?

  43. Brother Provisional says:

    The only problem I have with this is that the nurse posted the photos under her own public identity, which directly reflects on the institution that employed her. Personal freedoms are all well and good, but her actions pretty clearly put her employers in legal jeopardy.
    If doctors and nurses need to laugh at rectums to get through there days, that’s fine, but they would be wise to not do so in the public eye.

    • Antinous / Moderator says:

      If the nurses identified their location more narrowly than the state of Wisconsin or gave any indication of the date of the incident, they violated HIPAA. In this case, bizarrely, the whistleblower violated HIPAA by identifying the hospital to the media.

  44. Roy Trumbull says:

    A doctor at Kaiser Hospital who’d worked in ER telescoped 5 years of crazy events into a one act play that was performed at little theaters in the area. It was pretty funny.
    I can’t recall if it was in an interview he gave or maybe it came from another source but the all time winner of the prize for strange objects in rectums was a light bulb.

  45. PFlint says:

    At minimum, this is an ethical violation. Where is the compassion for the patient, no matter what the injury and how it occurred? Termination from their jobs would be easily justified. A hospital would have an interest as well: who would go to a hospital if there was a chance that s/he could be unduly humiliated.

    We tend to use the law as our minimum criteria for right/wrong. How about compassion?

    True, medical professionals may gab about “interesting” cases among themselves or even with family and friends. This isn’t the best behavior, to be avoided if possible, but as another commenter wrote, we all have need of humor. However, taking a pic and posting it online is asking for trouble. (And I don’t think that the nurse was posting the pic on Facebook for the purpose of medical education.)

    Even with identifiers on the x-ray removed and with no HIPAA violation to speak of, the humiliation of the patient may yet be real. Did anyone ask? Does anyone care?

  46. BrotherPower says:

    The weirdest one I’ve heard about (from a close friend who’s a career ER doc) was a guy who presented with terrible abdominal cramping. X-rays revealed a series of about a dozen Ken Doll heads impacted throughout his colon. Poor guy.

    I’m generally of the opinion that the more shit one has to put up with on the job, the more leeway they should get for work-related hijinks. (That’s how come the Fat Boys could get away with so much in that one movie they did.) What those nurses did was stupid, and it was mean, but if there was no identifying info posted about the patient, it’s hard to say in this day and age that they should be fired for it. Reprimanded severely, sure.

    That said, one of the memories that nags at me many years later is a vague, hazy recollection of coming off of anesthesia for a minor surgery while the surgeon and several others had a grand old time fucking with me in my barely-coherent state. It felt like a violation, still does.

  47. Tom Hale says:

    Takuan, You’ve said more about yourself in post 51 than I’ve ever heard – you almost seem human. You’re gonna have to post some really cryptic weird shit to make up for this.

  48. Takuan says:

    I can extrude feet as required.

  49. IamInnocent says:

    Anti has a real point: the simple humiliation is one thing. Most of us do live with one or more singing memory. The possible consequences of such humiliation though is no laughing matter and I can’t believe that someone who should be empathetic by profession if not nature could forget that.

  50. ecobore says:

    but what of the sex toys? Were they still usable? No, of course not, getting them out rectum! :-)

  51. sanity says:

    Good. What any person does with his or her body is his or her own business and, with very, very few exceptions, no other person should be allowed to breach that privacy.

    Let the truth come out about this situation and let the care providers to violated to law for essentially giggles suffer the consequences.

  52. Purly says:

    That’s funny.

    Remember folks, there is no place for jokes in the workplace.

  53. eclectro says:

    Shame on you boing boing readers. Where is the talk about the lawsuit against the sex toy manufacturer?

  54. zuzu says:

    I’m guessing this violates the privacy provisions of HIPAA.

  55. TJ S says:

    I came here to say what Zuzu just said.
    Also, those nurses should have known better than
    1) to take those pictures in the first place
    2) to post and talk about them online

    (FWIW, my wife, mother, and mother-in-law are all nurses)

  56. dculberson says:

    “The nurse removed her Facebook page from the Internet last week.” Ahh, the naivete reflected in that sentence..

  57. zuzu says:

    One of the nurses is accused of then posting the photo she snapped to her Facebook page.

    Which is how she got caught and fired.

    See how not protecting your privacy comes back to haunt you?

    (If this was anonymously posted on Something Awful it would just be a funny picture.)

  58. peterbruells says:

    Purly, when they took the photo, the “joke” effectively left the workplace. In a possible non-anonymous way.

    Fire them because of allegations? No. But I’d make it crystal clear that it’s a severe breach of trust and the next time, it’s off to the unemployment office.

  59. Takuan says:

    yeah Zuzu, but the Patriot Act trumps any privacy legislation so all she had to do was say she thought it was a terrorist rectum and she’d be off scot-free

  60. TroofSeeker says:

    I once challenged a friend to a proctography contest, to see who can get the best pictures of their butt in different places. I’ve got Catalina, the Luxor in Vegas and others, but I think she chickened out. My license plate frame said “Proctographer On Board- All Pants Half Off!” d8^)

  61. zuzu says:

    Takuan, “If you see something, say something.” ;)

  62. fiatrn says:

    I’m an ER Nurse, have been for 9 of my 11 years as a nurse. Humor keeps us sane. When five people have died next to you in two shifts, humor may be your only hope. When sober patients can scream and curse and throw things at you in triage, what do you do? When the hospital expects more work in less time, how do you react? When someone shoots them-self in the head at the ER desk, how do people cope? When 100% accuracy is expected, plus empathy to ALL patients in ALL situations, how should people continue at this job?

    Humor gets people through all kinds of situations. IF you don’t think we’re victims of violence, you’ve never been to a real ER. If you don’t think we’re stressed, you’ve never known a nurse. If you don’t think we’re human, you’re out of touch.

    So we make jokes. We laugh at each other, at the situations, at patients. We’re amazed at stories and xrays and CT scans and blood alcohol levels, at the raw number of visits on patient can rack up, at the horror and the beauty of our jobs.

    Those two nurses should never have published that photo, and I sure hope there was NO identifying information on it. With no ID info, it was stupid and a poor choice – with ID info it was every type of wrong our profession can undertake.

    Those two nurses have no hope of retaining their jobs – hospitals don’t care, and see firing nurses as a way to help defray lawsuits. Unless unionized, nurses are easy to fire and it happens every day. Unless they posted the file with identifying information in place, there’s nothing in most nurse practice acts to cause them to lose their licenses.

    Thank god no one in any other profession ever makes a mistake.

    Jonathan
    The FiatRN

  63. Takuan says:

    doctors prescribe, nurses provide…I’d rather have a good nurse than a poor doctor any day.

    I’ve always thought triage should be real triage; a real dick and burden on humanity through sheer malevolence and self-injured to boot?(deft stroke across carotid) NEXT! But whenever I suggest it, they hit me.

  64. sum.zero says:

    agreed, with takuan. clearly they were attempting to hide some sort of ied in there.

  65. pukool says:

    Apparently nobody remembers this classic website:

    http://www.well.com/~cynsa/newbutt.html

  66. 007ben says:

    unless there was information to reveal who the customer was in the photos I dont think this would be a hippa violation.

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