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What Can Nursing Students Blog About?

When University of Louisville nursing student Nina Yoder blogged about her experience watching a patient give birth in a post entitled “How I Witnessed the Miracle of Life,” she may have thought she was just blowing off some steam. Well her school saw things very differently.

When school officials read Yoder’s post, which included a description of the baby as a “creep” and “a wrinkly, bluish creature, all Picasso-like and weird, ugly as hell, covered in god knows what, screeching and waving its tentacles in the air,” they moved to expel her from school by calling her into an office, searching her for weapons (apparently because Yoder had separately blogged about her support for the Second Amendment), and informing her she was no longer enrolled at the school.

That’s right. No hearing, no notice. Expelled from nursing school for blogging.

Not surprisingly, Yoder sued the nursing school in federal court for reinstatement–and won. U.S. District Court Judge Charles R. Simpson III ordered that Louisville reinstate Yoder because her blog didn’t violate the school’s honor code, confidentiality provisions, or principles of professionalism; the judge concluded that although the post was “crass and uncouth” and that Yoder’s attempts at humor were an “abject failure,” it wasn’t written in a professional capacity or from the view of a representative of the nursing school.

The school had argued that Yoder broke confidentiality principles and the school’s honor code by disclosing “the following identifying information about the birth mother: the number of her children; the date that she was in labor; her behaviors; the treatment that she underwent (an epidural); her reaction to labor (vomiting); and the reactions of her family.”

The court rejected that argument, though, finding that such information was non-identifying; types that would be considered identifying, according to the judge, include “the birth mother’s name, address, social security number, or the like….age, race, or ethnicity….‘financial’ or ‘employment related information’ [and] where she was in labor.”

Yoder maintains that her blog post (and others, such as those in which she mocks a suicide patient and calls alcohol abuse “a choice”) “is a mixture of fiction and satire, aimed to be an emotional relief from daily stress.”

Well Yoder won this round in court, but what do you think? What should students in RN programs be allowed to blog about? Did Yoder cross the line?

Guest post by Michelle Fabio, About.com Guide to Law School and frequent contributor at LegalZoom.com.

My particular take on this is that she crossed the line.  I’m not sure that she crossed it enough to be expelled without due process, though.  She was technically within the lines of HIPAA and thus did not break any laws.  But there are more appropriate ways of letting off steam.  Others will probably disagree with me, which is fine.  I personally found her comments very unprofessional.  -ed.

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Comments

This is an interesting topic. On one hand, I can see how the nursing school would want only the highest representation of their program (and the students enrolled in the program).

On the other hand, the student still has freedom of speech, assuming she’s not violating HIPPA laws. Nursing schools are not able to limit what their students do in their free time. For instance, if a nursing student wants to go out to a bar, have a few too many drinks, and tell everyone that she’s in the nursing program at UofL, they have no way of stopping him/her, right? I think it’s the same principle.

This nursing student needs to take into account that the things she’s saying, especially if she’s saying not-so-positive things about nursing, can and will be found later by potential employers. I’m glad that she has a passion for blogging, but caution needs to be taken if saying anything directly relating to her experiences in nursing school.

I am not completely sure how I feel about this, to be quite honest. Without reading the student’s post, it is hard to know just what the context of those statements were. I agree with the previous poster, in that it is wise to be careful what you put out in your blog for the world to see. You never know just who is reading your words.

At the same time, however, part of what I love about living in America, is the right to freedom of speech. This girl has every right to her opinion, crude as it might be. I think it would have classier on the part of the school, if they had just let the girl hang herself by her own actions. Instead they chose to go after her in a way, and I think that sort of makes them look bad. As if they need to control people, because of their concern about their reputation. Student grades and state nursing test pass rates should be the sounding bell in my opinion, for the quality of their school. Not what one girl had to say on her blog.

Do you want her to be your nurse?
Do you want her on your floor or in your hospital?

FYI, for those who would like to see the full blog posts in question:

PDF file of Yoder’s blog posts

Thanks again to Code Blog for letting me post here :)

[...] 29, 2009 I recently read an interesting post over at Code Blog about a nursing student who was expelled– and later reinstated– over her blog. She had [...]

From the comments she has made so far in her blog why does she want to be a nurse ?!

Letting off steam is usually being annoyed at colleagues or situations, not patients for being suicidal or alcohol dependant.

I don’t have a problem with it. She didn’t name the patient and it was her personal blog. Nurses are just regular people with jobs, everyone else can blog about their job.

While it is unfortunate that Ms. Yoder shows such a clear lack of regard and respect for her patients, she didn’t break the law. As long as she didn’t break HIPPA, she was entitled to express her views freely. Still, I think it should be the job of other nurses to challenge Ms. Yoder’s views (which shows why social media and blogs are really powerful!), and the school could have helped facilitate debate, instead of just being reactionary. Not only did the school go too far by trying to expel her, they also missed an opportunity to use Ms. Yoder’s writings as a teaching on nursing ethics. Just because its legal to post rude, nasty, and demeaning comments about patients doesn’t mean its ethical, and any conscientious nurse should know this. Since blogs are public domain, and because Ms. Yoder chose to publicly express her views, I think the school could have done a better job and perhaps surprised Ms. Yoder by showing her blog to an entire class, and seeing how her peers reacted.

I am a nurse and I often scream out my work-related stresses in the blogosphere too just like what, I believe, Ms. Yoder did; I find it cathartic somehow and I’ve been doing it ever since I was a student nurse. Good enough I didn’t have to suffer the same consequence as Ms. Yoder. I always make it a point that my blogs would be a bit misleading by changing some facts as long as I know for myself what I’m talking about. Still of course, if one would enact such rudeness in the ward, then that will be an entirely different topic. We nurses are expected to be sympathetic and lenient and our profession dictates us to carry it out even if it means playing “plastic” in the workplace.

I had faculty gunning for me in nursing school because of my blog, but it was because I was complaining about the program and instructors—not patients (and even with that, I was careful to use no names). My school asked me to stop but recognized I had freedom of speech. I stopped.

Nursing students should, I think, be given more leeway unless they are clearly violating HIPAA. It is an opportunity for education regarding professionalism and can be a good way to open a dialogue on the subject. That applies to RNs and MDs as well, actually, although I do hold myself to a much higher standard now that I’m employed officially as an RN. Right or wrong. I should have all along, but it’s been a process, and one that I’ve learned from.

Blowing off steam in public is a bad idea because anonymity does not exist anymore. Have I done it? Yes. Have I regretted it? Yes. But I feel strongly that the online medical community needs to retain the ability to appropriately discuss patient issues, maintaining HIPAA safety, because we can all learn from many of each other’s experiences. This lawsuit was important because it gives us that freedom. We need to use it responsibly.

Still, I hope Yoder doesn’t go in to OB!

If I were an instructor or a dean, I wouldn’t want someone like that graduating from my program. She’ll make a terrible nurse if she truly things like she types…

Instant karma typo! **thinks like she types**

I don’t know how nursing students even have TIME to blog. Oh wait, I do it.

I really anonymousized myself after realizing that even if I think something is okay (and I don’t use my blog to vent or complain or tell voyeuristic stories), if my instructors ran across even the slightest inkling of something amiss could get me thrown out of school.

Employers can be like this too. I’ve thought about asking my hospital’s Risk Management people what they think of blogging about healthcare without violating HIPAA or linking my opinion to their company. I mean, just to get an expert opinion by someone versed in the law. But I’m sure the answer would be “don’t”. It’s a knee-jerk safety issue, because they can get sued. I’m sure anyone would say no rather than try to fine-tune the right way to do it and ensure that your student or employee is going to follow the rules at all times.

With that said, I do think that nursing instructors have a right to discipline and even expel if they don’t think someone is fit to be a nurse, and this can be for fairly nebulous reasons. You don’t have to actually kill someone for them to think you’re unsafe to practice. I don’t think whining online makes you unsafe to practice, but I would probably judge that she’s unready to graduate, and maybe hold her back a semester. It takes a fair amount of maturity and objectivity to be a nurse, right?

I am way late on this thread. It is about the law…period. It does not matter if we do not like what she thinks, or writes, it is her opinion, and she has a right to express it. If she is not violating HIPAA or naming the school or persons in the school, she has a right to express herself just like any other citizen. Does she sound like a crass, ignorant nurse…yes. But legally that does not matter. To try and shut down and shut up medical professionals for writing or blogging anonymously who are not violating any laws, is un-American and un-Constitutional.

Well, she’s certainly free to express her thoughts and she apparently did not violate HIPPA. As a student nurse myself, I have been warned by my University to not do anything like this. Her University should have had something specific written out if they were going to try and expel her. That being said, I hope she’s not going into L&D. ;-)

[...] you haven’t heard the story, check out What Can Nursing Students Blog About? at Code Blog, with an update at Kevin, [...]

I blogged as a student. I never told anyone I went to school with, because I was using that blog as a journal to learn from.
I anonymized as much as possible.

For a while, I linked to my current blog. I finally decided that if someone were clever enough, they could figure out who was who and end my blogging career.

After that, I went more with topics that describe my life as a rehab RN rather than much about details.

The topics of this business get so little press and really are fascinating. They make me want to learn, and I just use my blog as a vehicle to share what I find.

It is much more rewarding that way than a he-said-she-said journal of the floor. What goes on where I’m at happens all over the place with a different set of characters.

I’d rather be unique in my perspective.

To students: use your journal wisely and keep it to yourself. Share it with the folks on the internet, but have the ability to make it go away later if you’d like.

[...] you haven’t heard the story, check out What Can Nursing Students Blog About? at Code Blog, with an update at Kevin, [...]

Though nursing student Nina Yoder’s blog entry was crude and uncalled for, it did not violate any codes that would cause her expulsion from Louisville’s nursing program. She was within the limits of HIPPA, she did not break the school’s honor code, confidentiality provisions or principles of the profession; what she did was outside the program’s walls and an exercise of her freedom of speech. What she did was not a reason to get expelled from the program and I am glad she fought this decision and won in court. However, I believe Mrs. Yoder may need to rethink her choice of profession. Nurses must be compassionate and considerate and though she did not give any identifying information about the woman she blogged about giving birth, it would be mortifying and upsetting if this patient found the blog entry describing her labor and newborn child in such crude language. Mrs. Yoder’s blog entries may just be satirical in nature, used to blow off steam after long days, but if she can even discuss patients in this way, then she needs to seriously ask herself if nursing is the right career for her. I find it appalling that she would describe something as special as a newborn child as “…ugly as hell, covered in god knows what, screeching and waving its tentacles in the air” or that she would even joke about alcohol addiction being a choice. As a nursing student, she should have at the very least the scientific evidence to know better.
So, even though I am glad Mrs. Yoder fought her expulsion from nursing school and won in court, I do not believe Mrs. Yoder would make a good nurse. Nurses need to be compassionate, understanding and patient with the people they care for. These values must translate both inside the hospital and outside its walls. Blogging about patient’s personal experiences and struggles may be considered lawful under HIPPA, but I cannot help but ask: “What if she was MY nurse? What if she was blogging about ME?” That is enough for me to argue that though her blogging does not constitute a need to be expelled, it does bring about a need for Mrs. Yoder to consider if nursing is right for her. Because as another responder says, “Do you want her as your nurse? Do you want her on your floor or in your hospital?” My answer would be no to all of those questions.

When i first read the above post and read the quotes this girl said, i thought wow, she really must hate nursing school.or something. but after reading her ORIGINAL post i understood what taken out of context really means this girl was just having a rough day and blowing off some steam, in a sarcastic manner, but she wasn’t being hurtful or mean, it actually was funny some of the things she wrote about. she said when the baby came out it looked like a bluish creature, wrinkly,..covered in God knows what. then she said 15mins later turned into a cute baby girl. what kid wasn’t born bluish and ugly at first? she was being sarcastic her auidence understands that, she wasn’t being hurtful. her school punished her for her using her 1st amendment right to the freedom of speech.

SO BUMMED OUT!

My wife and I have wanted to be nurses for as long as we can remember. We attended Sinclair Community College of Nursing and we left due to the fact that the professors gave us such a hard time about being a husband and wife in the program together. We were straight A students and got along with all of our peers. We left Sinclair’s “ADN” program to attend a four year University and to obtain our “BSN.’

Just as luck might have it, today in the Dayton Daily Newspaper there was an article about Sinclair and how the Director of Sinclair Community College Nursing Program Marcia Miller is facing felony charges and Gloria Goldman (Sinclair College Assistant Provost of Nursing) has also been put on administrative leave for knowingly hiring a friend to teach Nursing students without having a nursing license. you can read more about here http://tinyurl.com/36qr2nq

I feel so lucky that my wife and I did not let a corrupt school or negative professors detour us from a career in nursing. I do feel sorry for our fellow peers that are still attending Sinclair’s nursing program. If Sinclair loses their Accreditation will our friends be able to go elsewhere and have those classes transfer? Have you ever heard of a school doing something like this before?

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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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