Freaking Out, Seeking Advice

When I started this "blog" nearly two years ago, I knew I needed to "be careful". I knew that if I was ever going to write about the "goings on" at work, I would need to be very protective of my patients and their privacy. I knew there were laws I did not want to break. I knew this, I know this, and in my heart, I thought I was doing a good job. I realize that this is a VERY gray area and, at times, I have wondered how close I have come to crossing the line, but still, I thought I was okay.

This morning, "it" hit the fan. I have succeeded at holding back the tears thus far, but really am not sure what I am going to do. I am shaking and I feel ill. I need to re-evaluate the "goal" of this blog. I need to pray for direction. I need some advice...

The issue: a memo from the hospital compliance officer regarding personal use of social networking sites.

The first paragraph addresses two of these such sites by name and states that accessing these sites while on duty is never appropriate. Okay that makes sense to me.

It goes on to say that sharing confidential information including protected health information is prohibited. Okay, that makes sense too.

However, the examples they have used as "prohibited" disclosure really make it very black and white and basically say that what I have done here is illegal. One being that "Any references to a patient or patient care events, even if the name is not included" is a privacy violation. Now, I have not gone back and read any of my posts prior to writing this, but honestly, I know that I have "generally" spoken about events...my question is, is this a violation when NO where here does it state who I am or where I work? Pretty much sounds like it to me...

The next point makes absolutely NO sense to me, and, if I am not "exempt" because my name and location are "secret", then I most DEFINITELY am in violation of this. It states that "Photographs of patients, EVEN if the patient has given a copy to the staff member are protected health information and written authorization is required before disclosing them." Now, that makes absolutely NO sense to me. I understand that me pulling a photo from their personal site for my use or taking a photo without parental consent is not "right". However, if I go out to dinner with a family, I take pictures with them at a hospital event, or the family sends me a picture, how is THAT invading their privacy?!

The third point is that sharing hospital business with people who do not have a need to know is prohibited. Okay, I don't think I have violated that one.

The memo goes on to discuss the policies and what action will be taken if violations are found, including termination.

This was SO hard for me this morning when it was discussed in my morning meeting. Everyone was kind of like "duh", that makes total sense...of course, it makes sense not to post about work and patients on facebook when you are at work (although, the whole picture thing still gets me). However, this page is ME. Yes, I am still an employee at the place where I work, but on here, I am Just Me, and no one I work with even knows about it. Heck, my FAMILY doesn't even know how to get here! There is no way anyone could find me by searching for me, or by searching for patients' names. (And, as one of my "readers" pointed out, she read this entire blog and couldn't figure out where in this country I lived...) So, am I safe, or am I not? Can I continue like this, or can I not? I talked to a couple people at work who couldn't really give me a straight answer. They said I should ask my manager, but I don't want to make a big deal out of it...I don't want her to tell me to shut this whole thing down. I love having this outlet. I love having support on the difficult days. I love sharing pictures of "my kids" (okay, the tears are coming now). I was looking forward to sharing updated photos of "the baby" who has taken his first steps a year after it didn't look like he would ever see sunlight...

It seems like this "memo" is kind of like when the whole class gets punished for one kid's behavior. I'm sure it wasn't directed at me and my "little blog" with less than 7 "hits" a day, but it definitely took the wind out of my sails. I am left wondering what I am supposed to do...where I am to go from here? Too bad I don't have a legal background or I'd know that privacy act backwards and forwards :o) (Personally, I have always thought that law was pretty crazy, or that people took the law WAY out of proportion...) I suppose, there is more to "me" than my work and my patients, but it will be a lot harder to leave that part of my life out of this. Honestly, I'm tempted to think that I am "safe" from getting into big trouble, but is that being naive?!

Well, I definitely need a nap. What a day!