Social media and online networking profiles have blurred the line between what is considered professional and personal. Though many individuals worry about employers are searching profiles and basing decisions on what you allow the world to see, nurses also need to consider what they can see of their patients and what their patients can see of them. This requires a careful balance of privacy, posting professionally, and acting ethically.
This week's class posed many challenging ethical question that have become a nurse's reality because of the use of social media.
Can I document my nursing assessments on a smart phone or tablet?
Is it legal to Google a client's name?
Can I vent about my job if I don't reveal names?After class, I analyzed various forms of social media and searched links involving nursing, nursing students, and health-care. Among the different streams I began to notice similar themes of the content related to nursing. These major themes focused on nursing "problems and humour", praise of nurses, and education-based.
To begin, let's analyze the first topic of "nursing problems". Across every form of online media many nurses have found a place to vent about their jobs and complain about the daily toils they face. Twitter, Facebook, Pinterest, Tumblr and blogs each have pages dedicated to this topic, where nurses can post, tag, or hashtag photos and cartoons that belittle the profession. Unfortunately, a majority of these posts provide negative lenses of the nursing profession and role.
Take for example this tweet by a group called 'Male Nurse Problems':
The tweet was public and retweeted (shared) by 146 others, and most likely viewed by many more on the popular site of #NursingProbs. This post almost comes across as a threat to prospective patients: either you behave or be prepared to receive the worst treatment imaginable.
As well, it is highly insensitive to those who require a brief or incontinence product to be seen as just another problem. Yes, these jobs are very hard and have an impact on nurses physically and emotionally but it is inappropriate to make light of these situations. While hygienic care may be unpleasant, it is still a very important aspect that when not completed properly significantly affects a person's health.
Another form of patient belittling can be found in the common nursing cartoon and photos:
While this picture (right) may seem harmless and humorous, to others it may seem insensitive and uncaring. This picture enforces the idea that the patient is ignorant, and the nurse doesn't want to hear their perspective. If the patient thinks nurses feel this way, they may withhold information for fear of being judged by the nurse.
Additionally, it sends the message that nurses assume a false pretense of that they care and that all patients can be handled the same way. Instead of spending individual time with each client, this message portrays that this is a waste of time and patience.
Other websites have forums where health care professionals can share stories of the most strange and outrageous cases they have seen. Despite not revealing names, these stories do include many identifiers such as age, gender, location and some health history that can be considered violated confidentiality (CNO, 2009).
While these funny cartoons and stories seem like a fun way to vent about the job to release stress, this affects the public's view of nursing. This may not break confidentiality but it seems morally wrong as it mocks the role of the nurse and reduces the importance of messy tasks. Seeing nurses discuss and make fun of their patients (even when confidentiality is maintained) makes nurses seem uncaring and untrustworthy which hinders the therapeutic relationship (CNO, 2009). Patients will wait in fear that either they are being a nuisance to their nurse or that their experience will be unknowingly shared. Not only will patients view nurse as untrustworthy but also they will lose their respect for the importance of the nursing role. When this bond is broken it is very difficult to re-establish, and unfortunately this means that the patient loses a vital resource in the health sphere.
As these stories and complaints continue, patients may group all nurses to be uncaring and ungenuine. Just as there are sites of nurses complaining, there are sites for patients to analyze their nursing care and share their "horror stories" of nursing care. Take for example the following forum posted by a mother after giving birth:
This experience should have been one of great joy, it was clouded by the impression left by poor nursing. When these sites become common place the public generalize and make unfair biases towards other health care professionals.
Despite the large presence of negative sites, within the online community exists a nursing faculty dedicated to advocating for the role of the nurse and providing online resources (Betton, V. & Tomlinson, V. 2013).
These sources use social networking sites in their favour to not only educate the public on the importance of nursing care, but also to continue learning for nurses. This benefits young graduates who are still in need of support to continue good practice and to help seasoned nurses become familiar with social media.
On YouTube, there are many nursing vloggers who offer tips and their own experience. These modern day narratives are a great way to reach a large audience to share stories and discuss current events pertaining to nursing.
While insightful, it is important to maintain confidentiality as these videos can be globally shared with others. One vlogger who maintains these boundaries while still keeping the audience engaged is NurseMendoza (video right). His positive perspective is refreshing as he offers tips to nursing students and advocates for male nurses. In his videos, he explains his experience in different nursing fields, how to prepare for clinical practice and caring for a spectrum of diseases.
Other educational forms of social media include a series of nursing pin boards on Pinterest: http://www.pinterest.com/clarityh/nursing/
These quick posters offer nurses easy references for an array of conditions and important care and considerations to remember. This health information is useful and enhances communication between nurses and patients at home. These and other guides improve health literacy and allow nurses to share their knowledge in safe and fun way.
As well, positive social media plays a large role in how nurse stay connected and up-to-date with standards of care. Many nursing organizations and associations now have online presences that are more easily accessed.The Canadian Nurses Association (CNA) have profiles on Facebook (see right), Twitter, and YouTube that updates followers about Canadian news such as Aboriginal health, and articles on mental health awareness. The CNA profiles encourage nurses to contact them and ask questions, but ask to do so respectively. The profile states that profanity, nudity, discrimination and defamation, and name calling will not be tolerated on their site. Any comment or member who does so will be removed.
By encouraging discussion of current events and promoting a safe online environment, these site set the example of how nurses need to consider behaving before posting, tweeting or venting. These positive sources help the public to regain their trust in the health care system to create open communication and awareness.
By targeting the online audience these networks are able to establish fast and convenient bridges of information between nurses and patients. This appeals to modern society as it is readily available as opposed to visiting a health clinic or hospital, and receive a number of different opinions (Betton, V. & Tomlinson, V. 2013).
To maintain confidentiality and professional standard, nurses need to follow their practice standards, the Personal Health Information Privacy Act, and abide by employers regulations. This means understanding that personal health information is more than a patient's name, but includes pictures of them, body parts or their surroundings, documentation of previous care, and ANYTHING that can identify or recognize a person (CNO, 2009).
Personally, I do an internal test to see if I think a post, comment or picture is morally accepted. I think to myself : would I want a potential patient to see this? Does this make me look like a "bad" nurse? If you're posting or uploading information that you would be embarrassed to show a client, chances are it probably is embarrassing. Although these posts likely don't reflect who you are as a nurse, be aware that they can inadvertently define your practice.
References
Betton, V. &
Tomlinson, V. (2013, June 19) Benefits of social media for nurses and service users. Nursing
Times.net. edited by Jenni Middleton. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/educators/benefits-of-social- media-for-nurses-and-service-users/5060041.article
College of Nurses
of Ontario. ( revised 2009). Therapeutic
nurse-client relationship. Retrieved from
http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
College of Nurses
of Ontario. (2009) Confidentiality and privacy—Personal health information. Retrieved from http://www.cno.org/Global/docs/prac/41069_privacy.pdf
Jones, J. M. (210, December 3). Nurses top honesty and ethics
for 11th year. Gullup Economy.
Retrieved from http://www.gallup.com/poll/145043/nurses-top-honesty-ethics-list-11-year.aspx
Lehavot, K., Ben-Zeev, D., & Neville, R. E. (2012).
Ethical considerations and social media: A case of suicidal postings on
Facebook. Journal of Dual Diagnosis, 84 (4), 341 – 346. doi: 10.1080/15504263.2012.718928
NurseMendoza. (2012, March 4). Diabetes mellitus
type 1 & 2. Retrieved from http://www.youtube.com/watch?v=98uMco2YiCM
Highly Appreciated ! The quality of that post shows the amount of efforts you put into this!
ReplyDeleteRetailEscaper.com