As ambulatory triage nurses, we faced many challenges when COVID-
19 hit the United States. In the very early months of COVID, these
challenges included any minor symptom or concern for possible
exposure, which was enough to send an employee home until COVID
could be ruled out. While also having more triage calls than we had
ever had before to say the triage nursing team was busy would be an
understatement. The idea of working short-staffed until COVID was
ruled out brought enough anxiety amongst the team we knew we had
to come up with a solution. We knew we did not want to let our team
members down but also did not want to risk the safety of our
colleagues, so with the support of leadership, we were granted access
to work from home and provided with information on how to gain
remote access. Doing so allowed us to bring our work laptops home
and make phone calls from our cell phones. For this reason, scenario
two resonated with me. Challenges in scenario two included having
asked someone to watch their work laptop for them, being unaware
of where the laptop is at present, the laptop containing secure
information, and the laptop having remote access to the clinical
information system. As an ambulatory triage nurse, I have learned the
art of prioritization. Knowing the organization’s data breach policy is
to call tech support immediately to report the breach, this is the first
step that should be taken. I am far from a tech expert, but I gather the
organization has this policy in place for good reason. Bowie (2019)
emphasizes HIPAA security rule standards and reports facilities must
have a security plan for safeguarding the equipment to encompass
situations of stolen equipment. In my mind, I imagine tech support
would be able to disable the clinical information system remotely and
reduce the risk of a security breach occurring. Next, I would request
the flight attendant staff make an announcement regarding the
missing laptop. More eyes looking for the laptop may help it be found.
Lastly, I would evaluate how this could have been avoided. When the
laptop containing personal health information is in my possession, I
am taking responsibility for the contents within. To best secure
patient privacy, the laptop should have been taken with me.
Before I begin to discuss the relationship between ethics and policy,
it’s important to understand what each means separate from one
another. Markose (2016) provided me with a lot of insight into ethics
in general and ethics within the medical field. Ethics is the evaluation
of what is right and what is wrong taking into consideration
circumstances and culture. Ethics sets societal precedence on how to
live by instilling values. Within the healthcare industry, ethics
encompasses what is required of medical professionals in relation to
patients, the public, and other medical professionals. It is important to
note ethics within healthcare is multifaceted and differs among
healthcare team members’ specified roles and across organizations.
The Center for Disease Control and Prevention (2015) states policies
can include regulations, laws, and guidelines enforced by the
administration through organizations or the government. Having
ethics allows individuals to consider what is in the best interest of the
public before setting policies in place. Unfortunately, as all individuals
may withhold their own ethics dependent on their personal life
experiences, one’s ethics may not be in line with an organization’s
policies.
Having a strong understanding of your ethics helps guide you both in
your personal and professional life. I imagine working within an
organization holding policies that do not align with your personal
ethics will ultimately end in the termination of your relationship with
the organization. My understanding of both personal and professional
ethics is built on trust and accountability. Trust and accountability
cannot be formed between the individual and organization if the
policies set forth by the organization do not represent what the
individual feels reflects morally correct and just. If I may, no better
way to bring this point home than a story I once heard regarding
Mahatma Gandhi. The people of India had been planning a march
against the British for months and as the day arrived for this
incredibly important March, there was word of impending violence
and Gandhi decided against the march. And his closest advisors were
very upset and emphatic that the march go on. And they said to him,
“Mahatma, people have taken off work, risked job loss and many
personal freedoms to do this.” And he replied, “My understanding of
truth is that it changes everyday, and I have to be committed to truth,
not to consistency, I’m sorry.” a That is medical professional ethics for
me – it is what you do even when people don’t agree with you – even
when you aren’t popular. You just have that feeling inside of what is
right over anything popular or profitable.
References
Bowie, M.J. (2019). Essentials of health information management
principles & practices (4th edition). Cengage Learning, Inc.
Center for Disease Control and Prevention. (2015). Definition of
policy. https://www.cdc.gov/policy/analysis/process/definition.html
Markose, A., Krishan, R., & Ramesh, M. (2016). Medical ethics. J
Pharm Bioallied Sci, 8(1), S1-S4. https://10.4103/0975-7406.191934
