From the moment we learn to walk and talk, human beings quickly learn that life is structured with rules. But as we master walking and talking and move on to, say, whispering and tiptoeing, we quickly realize that rules without consequences are rarely motivating.

As the Mother of a dear and devious four-year-old, I’m keenly in touch with this educational concept.  For my little darling, a rule without a consequence is like a 20-inch, rainbow-striped candy cane: she can’t resist breaking it.  Rules are just words; consequences impact actions.

For many of us, understanding the relationship between rules and consequences is a lifelong learning process.  Enter five nurses in San Diego accused of violating their employer’s social media policy.  Local news reports indicate the nurses “posted personal discussions concerning hospital patients” on Facebook.  The CEO of the hospital has said “no patient names, photographs or similar identifying information appear to have been used,” but has indicated his intention to fire the five nurses and discipline a sixth.  The California Department of Health has launched its own investigation. A union representative with the California Nurses Association has defended the nurses, who are entitled to a hearing under California law.

Presumably, the hospital has a clear social media policy it has communicated well to employees. Presumably, that policy articulates the expectations of employees while on the Internet – for either personal or professional use.  And presumably, the potential consequences of violating that policy were well-defined and commonly understood by the hospital’s workforce. While I’m sure it was a difficult decision for the CEO to take this personnel action, it shouldn’t be unexpected consequence.

The case is anticipated to drag on for months, and the spotlight will likely not fade.  The industry and its many ancillary players will be watching this with (self) interest.  The impact and potential consequence to hospitals and healthcare providers for violating the federal laws of the Health Insurance Portability and Accountability Act (HIPAA), and its sister legislation, the Health Information Technology for Economic and Clinical Health Act (HITECH), are real … and the$e con$equence$ have bite.

Under these laws covered entities and their employees must act responsibly and play by the rules – and with the passage of HITECH, so must their business associates.

Rules are rules, and consequences are consequences.