Up front and without a blush or embarrassment I admit to being a complete cretin with technology and a total lack of patience when it comes to problem solving and experimenting with many of the electronic “assets to modern living and learning”. Social media describes the online tools that people use to share opinions, information, experiences, images, and video or audio clips and includes websites and applications used for social networking. I do not really use social media sites to any extent although as an academic I am on Linkedin and of course here I am posting a blog. So not entirely ignorant.
As an educator I have a very healthy if not strong antipathy to social media. Too often in my career I have seen students and graduates crash and burn as a consequence of posting what at the time, they believed was an innocent or justified comment which when examined from a professional standards perspective were deemed professional violations
Considerable effort is devoted to teaching undergraduates the risks of using social media. The published guidelines such as those that came into effect March 2014 from AHPRA underpin legal and ethical concepts. Common sources of social media include social networking sites such as Facebook and LinkedIn, blogs (personal, professional and those published anonymously), WOMO, True Local and microblogs such as Twitter, content-sharing websites such as YouTube and Instagram, and discussion forums and message boards.
In one class exploring the risks of social media and range of potential pitfalls one student pointed out “like that is just everything except an old fashioned letter”! There was considerable class discussion and from where I sat it looked like these students knew only two communication strategies. Face to face or facebook. It is habit and routine to point out risks to privacy and confidentiality should the posting be about a patient and sufficiently explicit to allow their identity to be recognised.
There are many sources highlighting the sheer quantity of social media usage and many published surveys about the extraordinary growth and use of these sites. Like many innovations the young take to them early and with time older folk will get with the plan. What is interesting was one study identified that now the greatest growth area is among the older population.
Most articles point out the positives and in relation to health knowledge and shared learning there has been massive growth. Shared experiences, groups with particular problems and needs can find answers to their questions from others who have faced the same problems. The World Health Organisation has sites and shares information globally about diseases and in one case negated panic generating rumours with their posts. McNab in 2009 reported the experience of WHO, suggesting one fact sheet or an emergency message about an outbreak can be spread through Twitter faster than any influenza virus.
Recognition of the risks of social media misuse is evident with the proliferation of professional guidelines. AHPRA is just one of many organisations around the world that have published nursing regulations linked to their codes of professional practice. While nursing tends to focus on the confidentiality issues there are other risks from a health perspective. Information is not peer reviewed and may be inaccurate or even malicious. People who use health sites have been surveyed and found to be pretty sophisticated in their ability to work out if the site is sponsored by a commercial entity but the lack of peer review could, if relied upon by another nurse reading about a new method, task, and strategy be a road to disaster.
It is not just another scare tactic to control nurses when the risks of social media use are raised. There is evidence that every nurse regulatory authority in UK, US, Canada, NZ and Australia have ever rising numbers of complaints and have taken disciplinary action. It is not just providing information sufficient to identify a client that has led to hearings. Pictures of clients, posting descriptions of identifying events, airing grievances and complaints about colleagues, clients, and employers are also common problems.
In America there was a court case where the nurse claimed unfair dismissal on the basis her employer sacked her after she posted a very hostile, rude and insulting summary of an interaction with her supervisor. It was pretty extreme and the anger of the nurse was patent. Naming the institution and the supervisor so negatively flouted policy not to mention professional standards. Thus she was terminated. The court case claiming unfair dismissal failed.
Online criticism of colleagues and bullying of colleagues and students has been another source of complaints and discipline. The habit of posting thoughts and feelings and the immediacy of the electronic media mean if a person is fizzing with hurt, anger or rage it will hit the ether without any chance to calm down and think things through.
Criticising an institution or colleague about the care or management of a client is another risk. Students are often very judgemental and comprehend a limited amount of what they observe in their clinical placements. Sometimes there are failings and while we are all tasked with protecting the public and bringing to light bad practice an online post can attract legal scrutiny. It may go to the reputation of the employer or individuals and lead to an action in defamation.
So at the risk of sounding unrepentantly old fashioned I would suggest whenever there is an issue like this dust off that old fashioned writing implement and find a piece of paper. You can, with paper and pen write as many characters as you need to be clear and professional in your report.
Regulatory authorities have “lists” of do’s and don’ts. When you read them they are just so obvious yet regularly someone gets it wrong. Promoting good interaction and a caring approach can mislead a student, recognising there is a danger if they accept patients as social network “friends” is one of the pitfalls. It just doesn’t cross their mind that this may damage the nurse-patient relationship.
Be aware that everything you post online is public, even with the strictest privacy settings. The questions you ask or the comments you make open the way for judgements to be made about you. Once something is online, it can be easily copied and redistributed. Presume that everything you post online will be permanent and will be shared.