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.” 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
