Fired from first job

[Sj1234]

I graduated about 8 months ago and got a job in general surgery. I got fired after 5 months for taking a picture of something from a patient's chart (no patient identifiers, no facility identifiers). I sent it to a few friends via snapchat, one of the physician's found out and decided to terminate my employment. There isn't any legal action to my knowledge. I know this was a stupid thing to do and I'm extremely embarrassed and remorseful. My question is this: should I include this employment on my resume/applications or leave it off? I live in a city where it is difficult to get a job without experience (though not impossible as I did it already once with this job) and having the experience might help...? I'm also worried it might show up if I try to get credentialed again. Any advice is greatly appreciated

[jmj11]

I graduated about 8 months ago and got a job in general surgery. I got fired after 5 months for taking a picture of something from a patient's chart (no patient identifiers, no facility identifiers). I sent it to a few friends via snapchat, one of the physician's found out and decided to terminate my employment. There isn't any legal action to my knowledge. I know this was a stupid thing to do and I'm extremely embarrassed and remorseful. My question is this: should I include this employment on my resume/applications or leave it off? I live in a city where it is difficult to get a job without experience (though not impossible as I did it already once with this job) and having the experience might help...? I'm also worried it might show up if I try to get credentialed again. Any advice is greatly appreciated

I'm not sure what type of picture you took. Was this like medical information of an interesting case, or something more personal? Did this violate any law?  Most employers (especially large hospitals) to avoid lawsuits will only state (for future potential employers) your time of service and if they would not hire you again. But they don't give any other details. However, smaller practices will ask and be given more details. I had interviewed an MA and had a simple reference (dates of service) from her previous employer. But I called them to get the details. They were quick to tell me everything. She was stealing from the front desk petty cash box. Not only was that a problem, but she had also lied to me saying that her job just ended due to lack of work.

[greenmood]

Hm.

 

I suppose my advice would be to list it. You should absolutely NOT get into why it was a brief employment on your resume though. List the necessary details and your start and end date. The goal of the resume is to get to the interview. When they ask during the interview be prepared with a good, succinct explanation. Your situation is tough because you weren't just "laid off" you were terminated. Don't lie about it. Turn it as positive as possible by describing what you've learned from the experience and how you intend to move forward. And then move on unless you're asked some follow up questions. No dwelling.

 

I could easily see the flip side of this argument since it was such a brief employment. You didn't get very much "experience" from that job, when most of it was probably spent orienting.

 

I'll be curious to see what other people think.

[Sj1234]

I'm not sure what type of picture you took. Was this like medical information of an interesting case, or something more personal? Did this violate any law?  Most employers (especially large hospitals) to avoid lawsuits will only state (for future potential employers) your time of service and if they would not hire you again. But they don't give any other details. However, smaller practices will ask and be given more details. I had interviewed an MA and had a simple reference (dates of service) from her previous employer. But I called them to get the details. They were quick to tell me everything. She was stealing from the front desk petty cash box. Not only was that a problem, but she had also lied to me saying that her job just ended due to lack of work.

It was just a little bit of information about an interesting case. It doesn't even disclose the gender of the patient (or any other personal information about the patient). My employer still felt that it was a hipaa violation as I was not directly involved in the case (though the patient was on the service of our group). I was employed by a private practice. There weren't any performance complaints or any other issues aside from this. I don't know if it would hurt or help to be upfront about it.

[rev ronin]

It was just a little bit of information about an interesting case. It doesn't even disclose the gender of the patient (or any other personal information about the patient). My employer still felt that it was a hipaa violation as I was not directly involved in the case (though the patient was on the service of our group). I was employed by a private practice. There weren't any performance complaints or any other issues aside from this. I don't know if it would hurt or help to be upfront about it.

Get used to people not understanding HIPAA. The list of what is or is not HIPAA Protected is stupid. He may be right... If there was any chart identifier, it likely was a violation.

[GetMeOuttaThisMess]

It sounds like you accessed "protected information" in a patient that you were not directly caring for. If I have a celebrity patient who is seen in a group practice that I work for, but is not my patient or my doc, and I look up their home address just to see where they live, that is a violation. You don't access records of patients who are not your own. See the disaster that UCLA went through about a decade or so ago.

[mmiller3]

I agree with including the employment and being honest about what occurred. Definitely lean on the lesson learned angle if pressed, as it certainly sounds like you did. If you don't disclose the information, get hired, and the company finds out later, it may be a bigger hassle than simply not getting hired.

[sas5814]

Get used to people not understanding HIPAA. The list of what is or is not HIPAA Protected is stupid. He may be right... If there was any chart identifier, it likely was a violation.

actually if he accessed a chart on a patient that wasn't his without a viable medical reason it could be a violation. Even if it isn't many employers consider that to be a very serious offense. Where I am now it is a fireable offense to even look through your own chart without requesting information like any other patient. 

It was a foolish mistake. You are young in the profession. We have all made mistakes. Learn from it. Act humble about it if you have to explain. I think you will find most people understand as long as you are "repentant" about it.

[Sj1234]

I really appreciate all of the feedback. I'm not contesting the legitimacy of the termination so much as I am unsure of how to address it moving forward. I am definitely repentant and am prepared to express that fully as well as the lessons I learned from this in an interview, I just need to get to an interview and I'm not sure if disclosing up front is best or if leaving it off and bringing it up in an interview would be better

[sas5814]

I really appreciate all of the feedback. I'm not contesting the legitimacy of the termination so much as I am unsure of how to address it moving forward. I am definitely repentant and am prepared to express that fully as well as the lessons I learned from this in an interview, I just need to get to an interview and I'm not sure if disclosing up front is best or if leaving it off and bringing it up in an interview would be better

get the interview first. You can overcome the negative aspect of this in person rather than trying to explain it by email or other written means. A huge part of communication is non-verbal. You need to be face to face.

[moestown1016]

No advice really just sorry you experienced that. We all do things we regret from time to time especially the first few years. I'm sure that was pretty traumatizing. I don't think there is a person practicing that hasn't violated hippa in some way since it is so wide. My supervising physician has even asked me to look up MRI results on his wife once so he could tell her. Shouldn't have done it under hippa but I worked for him so....yeah. And he wasn't the only doc that asked me to look up stuff - not maliciously of course but as a favor for a patient or something. Lesson learned! Makes me want to be extra cautious.

 

 

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[jwells78]

This actually brings up a good point.

 

Up until recently, I would occasionally text a photo of a CT finding or wound to the on-call orthopedic or neurosurgeon to give them a heads up on what was coming in to the service.

 

I thought I was ok because it included no pt information, had their consent, and was deleted immediately. We used to do this in Afghanistan with the military for difficult derm cases/ect.

 

Luckily I havent had my hand slapped, but I should have.

 

My pics were for consultation--- (OP's) were not. I think we've established the 'don't do that' part of the convo.

 

But ANYWAY, does anyone have experience with apps available/approved/designed and OK'd for this purpose?

 

 

 

-J

[Sj1234]

get the interview first. You can overcome the negative aspect of this in person rather than trying to explain it by email or other written means. A huge part of communication is non-verbal. You need to be face to face.

I agree with you, I feel that I can explain it better in person. I've read online that an application is a legal document so I will be required to list this job on an application. Some applications ask reason for leaving the job. How would you recommend addressing that? I was thinking to just put "will discuss in person" but I feel like that is just code for "I got fired"

[Sj1234]

No advice really just sorry you experienced that. We all do things we regret from time to time especially the first few years. I'm sure that was pretty traumatizing. I don't think there is a person practicing that hasn't violated hippa in some way since it is so wide. My supervising physician has even asked me to look up MRI results on his wife once so he could tell her. Shouldn't have done it under hippa but I worked for him so....yeah. And he wasn't the only doc that asked me to look up stuff - not maliciously of course but as a favor for a patient or something. Lesson learned! Makes me want to be extra cautious.

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Thank you for the kind words and encouragement. I have been beating myself up over this. I'm worried that I ruined my career before it even really started, and I worked so hard to get here. It was such a rookie mistake. I just hope there is an employer who is willing to give me a second chance

[moestown1016]

Thank you for the kind words and encouragement. I have been beating myself up over this. I'm worried that I ruined my career before it even really started, and I worked so hard to get here. It was such a rookie mistake. I just hope there is an employer who is willing to give me a second chance

You have far from ruined your career. Chin up! My last job I think they basically just made sure I had a pulse. They also called my part time employer as a reference and not my main employer since the part time place was more in line with what I was going for. Once you're in process to be hired again they may just keep ball rolling even if it comes up I doubt it would stop things.

 

 

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[rev ronin]

Where I am now it is a fireable offense to even look through your own chart without requesting information like any other patient.

Nothing in HIPAA requires or encourages this. It's just one more draconian way large bureaucracies respond to mandates with essentially unrelated punishment.

 

I was addressing the copying of PHI, which you can run afoul of HIPAA In ways that literally make no sense, not addressing a potential violation for access without appropriate cause in the first case. Regardless... A mess.

[Reality Check 2]

There is HIPAA and there are policies.

 

Looking into a chart that one has no dealings with is not ethical and may violate policy but then violates HIPAA if the information is shared in a manner unrelated to patient care.

 

Most corporate monsters have policies that you may not look into your own chart - PERIOD, or anyone related to you - spouse, children, mother, mother in law, etc. This policy is really big where I live and I watched an intake clerk get fired on the spot because BIG BROTHER downtown saw that her login opened a window in her daughter's chart. She worked at Urgent Care and her daughter was checked in to be a patient. I am not sure if another clerk was there at that shift. Somehow, the chart was accessed under her login and an alarm went off somewhere and pretty soon a couple of suits showed up and fired her on the spot. I think someone else had checked her daughter in before going to lunch or leaving. No investigation into circumstances - just fired - very humilitating.

 

That said - we had an MA apply for a job and her license had a ding on it. She admitted to looking up a local celebrity who had recently died and reading her records. HUGE FACE PALM. That was just stupid. We did not hire her. 

 

Same corporate - I took a phone photo of a blowout crush injury fracture to a toe - the surgeon wanted to see it right away. IT WAS A TOE. No patient identifiers, no faces, just a toe. The surgeon worked for same corp. They do not own our cell phones or pay for them.

 

We both got a lecture about a toe. Corp didn't like it one bit that we sent photos to each other about injuries. We both got over it. I had the patient's permission and you couldn't even tell if it was a girl toe or boy toe - it was a mangled bloody mess of a great toe that almost got amputated. I find this interpretation of policy or HIPAA WRONG and bothersome.

 

I take pictures of stuff with the patient's OWN phone for their benefit. A nice lady had shingles on her back and couldn't see them - I used her cell phone, took a picture and showed it to her. We used it for comparison at next visit. No genitals, no identifiers and it is on HER phone. I call that patient education. 

 

As for the OP - whatever you photoed more likely had the LOOK of inappropriate and no one investigated to find out WHY you did it or to actually see that nothing was identified in the pic. 

 

I agree that in a face to face interview you will have more ability to explain briefly what occurred and move past it. Basically lesson learned - I shouldn't photo anything - even for my own education as it might just LOOK inappropriate. 

 

Move forward, look ahead, look up and do right by the patient.

[sas5814]

I agree with you, I feel that I can explain it better in person. I've read online that an application is a legal document so I will be required to list this job on an application. Some applications ask reason for leaving the job. How would you recommend addressing that? I was thinking to just put "will discuss in person" but I feel like that is just code for "I got fired"

Leave it blank. Not  a perfect solution but might get you to the personal face to face interview. There may be a generic response you can put there but nothing pops into my head. I bet someone else here can offer a good suggestion.

[rev ronin]

I bet someone else here can offer a good suggestion.

Acute cranial-rectal inversion? (note that that doesn't specify whose... Wouldn't want to put a patient identifier on it)

[Sj1234]

Acute cranial-rectal inversion? (note that that doesn't specify whose... Wouldn't want to put a patient identifier on it)

lol that's a great suggestion!

[south]

Just be as vague as you can and you may get through.  For instance, 

 

"took a pic of chart and put it on a well-known social media site, where tens of millions of people (plus hackers) could have access to it, for lulz" 

 

vs

 

"took a picture of a generic non-identifiable piece of information and sent it to someone to get their thoughts for my learning, and was very careful to not violate policy or hippa or the patients privacy, but was terminated for it anyway based on perception .  if I had violated hipaa I would have heard from them"

 

In other words, if you are forced to use the term "snapchat" you probably lost that one.

 

I'd be carefully specific - "it was a picture of a xray that I had carefully removed identifying info"  "it was the narrative on this condition I had never seen before and I wanted to get feedback on it"

 

And put yourself in their shoes as they respond " I expect you may follow up with them, and they will confirm that no actual violation occurred"  

 

"i understand their position that even though no violation occurred, my foolish mistake may have contributed to the perception" 

 

good luck.

[ventana]

use very vague descriptions with nothing that sounds bad

admit that you would never do it again - learning process

give example of how innocent it was "took a photo of an x ray with out any identifying info visible" and an example of the type of infraction - with out saying that is what you did.  And be honest that you do not want to divulge any more about it as you are scared to death for ever for repeating it.

[BruceBanner]

Sj-

 

I was also canned from my first job about 5 months in, but for different reasons. I just wasnt meeting their expectations--also a surgical practice. It was really tough mentally and emotionally to swallow. I did land on my feet, but expect you could have an uphill battle getting a new job. The short duration can raise some concerns.

 

Legally, I'm not sure if they are allowed to disclose the reason of your termination. Assume, however, that they would if asked. There are a lot of ways you could spin this. Better to leave it off any application s and explain in person---say it was a very interesting case and the details were pathological only--no pt identifiers, etc. Say how you realize in retrospect how dumb it was and you are extremely remorseful, that you had no intention of hurting anyone.

 

After you land another job it will be water under the bridge.

[Sj1234]

Sj-

 

I was also canned from my first job about 5 months in, but for different reasons. I just wasnt meeting their expectations--also a surgical practice. It was really tough mentally and emotionally to swallow. I did land on my feet, but expect you could have an uphill battle getting a new job. The short duration can raise some concerns.

 

Legally, I'm not sure if they are allowed to disclose the reason of your termination. Assume, however, that they would if asked. There are a lot of ways you could spin this. Better to leave it off any application s and explain in person---say it was a very interesting case and the details were pathological only--no pt identifiers, etc. Say how you realize in retrospect how dumb it was and you are extremely remorseful, that you had no intention of hurting anyone.

 

After you land another job it will be water under the bridge.

Thank you for the response. So you did include your first job on future applications and resumes?

[BruceBanner]

I did, and I only had to explain myself a few times.

 

Again, I think you'll be fine once you land another job. Just be contrite if asked, but not fake about it.