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Webcams in Hospital Rooms?
Posted by Raven on March 23rd, 2007
Lights. Camera. Action.
At your nearby hospital room.
A nurse’s discovery of a Webcam hooked up by parents in their child’s Boston hospital room has stunned the patient’s doctor, raised a mound of privacy issues and potentially left medical staff looking over their shoulders.
In nursing homes, families have been using these web cams for a couple years now. It’s not a new technology, and hospitals shouldn’t react like this but, when we consider things like this, I guess I can’t blame them.
Dr. Samuel Blackman, a pediatric oncologist at Dana-Farber Cancer Institute, would not speak for the record when contacted by the Herald about the incident at Children’s Hospital.
But in an entry on his blog titled “Hemorrhage! You’re On Candid Camera,” Blackman strongly questioned the use of the camera in the child’s room, asking, “Should parents have the right to a hospital version of a NannyCam?”
The question is full of arrogance. OF course parents, and anyone else who has a vested interest, SHOULD have the right to know what is going on with their loved one who is in the hospital bed. The concerns for “patient privacy” are silly in this context. These cameras don’t pan the entire room; depending upon where they are set up, they can only “see” a small area- just like the webcams so many of us use at home.
What is an issue, and it’s a legal and legit issue, are the rights of others who might be recorded. Doctors, nurses, everyone- must be informed of the camera’s use and must agree to this. Not as doctors, nurses and others, but as common people. Visitors as well, must have knowledge of the presence of the camera. While patients have rights, so do staff and others. HIPAA covers employees, volunteers, visitors, everyone. Not just patients.
Children’s Hospital families are free to film their own child, but must have permission to record staff or other patients, said spokeswoman Anna Gonski. Blackman consulted a staff attorney about the Webcam incident, she said.
Dr. Deborah Peel of the Patient Privacy Rights Foundation said as long as a patient isn’t recording other patients, she doesn’t see violations of the federal Health Insurance Portability and Accountability Act, or HIPAA, which protects patient privacy.
In the nursing home setting, webcams have been in use for a couple years now. Known as GrannyCams, these devices have been cited as evidence in lawsuits. The use of a cam is not always with good intent and they do present a wedge between family and caregivers. Advocates for nursing home reform have pushed for mandatory cams in every room in these places. These mandates have not been met with enthusiasm by the nursing home industry…as far as I know NO state requires them. YET.
I will say this: When it’s known that a family has set up a webcam in a patients room, very few STAFF want anything to do with caring for this patient. They will do whatever it takes to avoid this patient. Aides will dread being assigned to them; nurses will get defensive and demand two staff be present for all care and ANYTHING else with this patient. Is this what we want? Do families and others want their loved one to be held in such regard? Patients with cams watching them receive the same care as others but nothing else. All the other things, the little conversations and pep talks and hand holding, END abruptly when we know we’re being watched. Every word and action is well thought out and almost scripted. It’s very cold, I think.
MOST medical people are excellent at what they do and they DO it with passion and concern. MOST medical people have more integrity than others in other professions. But we’re human. We make mistakes, usually small mistakes that have no bearing on our patients outcomes. The thought of being sued is ever present in our minds. In fact, we work with policy and guild lines that are defensive in nature. MOST of the paperwork we do is done on the defense…in case of legal problems we have the medical record to back us up. The hours we spend documenting are hours taken away from hands on patient care. These things add to the overall cost of healthcare in America.
March 23rd, 2007 at 4:57 pm
On one hand cameras make doctor/nurse-patient interaction colder for fear of lawsuits. Won’t talk much about that because you covered it pretty well in the post.
On the other, it might cut down on some of the frivolous malpractice suits if there’s documentary evidence that is more palpable to people not in the medical profession (video and explanation is easier to follow than a bunch of documents full of medical terms). It might also prevent or mitigate recurrances of serial poisoners like what happened in the Clinical Centre of Lainz in Vienna and Charles Cullen.
March 23rd, 2007 at 8:39 pm
LOL…well…the sad thing is most people don’t know sound medical and nursing practices SO, before a lawsuit could even happen, someone WITH this knowledge would have to view these videos. THEN even if a mistake is seen, it has to cause actual harm to the patient before the suit could go further. At least those suits that demand HUGE amounts of cash.
We’re not perfect. We make mistakes- medical people. BUT we operate under the tightest controls, the most scrutiny, the highest professional and regulatory standards of ANY industry. A silly little web cam just adds to the stress.
March 23rd, 2007 at 9:25 pm
Behind this desire to add webcams is a breakdown of trust that is increasingly pervading our society. The biggest problem is those situations that are ambiguous in the absence of proper context – or words that can be interpreted differently depending on the level of trust. We all know this in our daily interactions with others, how easily it is even with friends to misinterpret. Far worse in an adversarial environment.
The result, as you note, Raven, will be the loss of spontaneity and those little human touches, replaced by mechanical scripting designed by risk managers to avoid litigation. When that happens, another slice of that which distinguishes us a human beings will be irretrievably lost in the name of a false perfection that obsessively seeks to find blame and resitution when something goes wrong, a false perfection that seeks to wall us off from the vicissitudes and happenstances of life.
March 25th, 2007 at 7:11 pm
Your own process outline supports my point. If there were a recording, medical professional(s) could see if something actually went wrong. If not, no money wasting trial needed, if so, the laymen could understand it more easliy than if they’re just given a lecture and given a quick dictionary definition of the terms used. I wasn’t saying it’s the way to go, just trying to show that there’s a flip side of the coin; possibly the one the webcam people are coming from.
And Yes, I know some of conditions nurses and doctors work under. My aunt is the head ward nurse at the hospital she works at in Missouri. Her crew used to put in longer hours than the law there allows, because if they didn’t then the ward would go unstaffed for hours at a time. Even at peak personnel hours now she has about 25% of what she needs, and she’s gotten more people recently. So she has to juggle that while keeping everyone doing their jobs within standards. It’s a stressful job, made all the more stressful by nobody wanting to do it because it’s stressful.
The loss of spontaneity creating doctor/nurse robots in their patient interactions is already happening, though not neccissarily out of litigation fears. Most of my interactions with medical personnel in the last decade have been them just doing the bare minimum they have to to get the job done ASAP. From what I’ve noticed most of it’s personnel shortages, some of it’s being lazy.