August 9, 2010
Social media — Web-based technologies that allow users to generate their own content and participate in dialogue — has quickly become embedded in our everyday lives. Nurses are finding their way in this electronic new world, using the technology to build communities and enhance their careers while trying to avoid the special dangers that it presents for those working in the healthcare field.
The online environment is not new to RNs. A reader profile study conducted by Harvey Research Inc. for Nursing Spectrum last year found 63.4% of nurses had searched for clinical information online, 41.1% took a continuing education course, 31.7% searched for jobs, 26.6% searched for certification review information and 25.2% searched for seminars or career fairs.
About a quarter of online U.S. RNs and APRNs used the social media tools Facebook, LinkedIn, Twitter and YouTube for professional purposes in the past 12 months, Manhattan Research, a healthcare market research firm, said in a June 30 study. Data published in February by the Kansas City-based marketing communications company Nicholson Kovac showed 65% of nurses surveyed planned to use social media in the future for professional development. Neither study, however, looked deeply into the reasons nurses tap into online social networks.
“Social media are just tools,” says Phil Baumann, RN, host of the popular #RNchat on Twitter, a service that allows users to send and read short messages called “tweets.” Baumann hosts scheduled chats when nurse users can get together and communicate real-time on Twitter.
“Traditional media open you up to new ideas and opportunities. It’s no different with the new media,” Baumann says. “To some nurses it might be scary or a way to waste time, but just like you can waste time reading a poorly written book, you can gain time by reading a book by an expert.”
In Baumann’s view, social media is another form of intelligence. “By intelligence, I mean information, access to relevant data, evidence-based research, your social network, your business network and your education network.”
Baumann also sees social media as a way of learning what patients are saying outside the clinical setting. By monitoring discussion boards, which provide forums for groups to communicate online, “You can get a sense of what patients are thinking but might not be asking questions about.”
And nurses can teach the public more about their role. “You can advocate for the profession, provide better patient care and help the public understand what nurses do,” says Robert Fraser, RN, BScN, research analyst for University Health Network and a graduate student at Massey College, Toronto.
Proceed With Caution
However, there are significant pitfalls for nurses using these public venues. Kathleen McCormac, RN, JD, who has been a nurse attorney in San Francisco since 1992, cautions against giving healthcare advice on social media sites. “You aren’t covered by insurance when you do this,” she says. You may want to help, but the person you are communicating with might not live in the state where you are licensed. “You should have them call their health provider and avoid the slippery slope,” McCormac says.
Facebook, a privately owned social networking website launched in 2004, allows users to post profiles, then add people as “friends.” Organizations such as schools, associations and employers also can become users and create Facebook pages where people can interact. But limits must be set.
In June, an Oceanside, Calif., hospital fired five nurses for allegedly discussing patient cases (reportedly no names were disclosed) on Facebook. In 2009, two nurses in Wisconsin were fired after they took photos of a patient’s X-ray and allegedly posted them on Facebook. That case was referred to federal authorities. While some believe the employers overreacted, these examples illustrate the professional dangers of social networking.
“Nurses should not share patient experiences online,” McCormac says. “Even if you don’t identify the patient, the HIPAA [Health Insurance Portability and Accountability Act] violation still exists. You don’t have the patient’s permission.”
What’s more, “There isn’t sufficient security on these sites,” McCormac says. “Everything is ‘discoverable,’ ” meaning it could be used as evidence in all legal matters, including claims with the board of registered nurses.
McCormac says using blogs and listservs sanctioned by a professional association to network and share ideas can be valuable. The problem arises when access is open to anyone. “If it’s not controlled and hasn’t been sanctioned, you are probably outside the safety net,” she says. And, of course, there should be a disclaimer that the discussion is not intended to provide medical advice.
According to a March survey by nCircle, a security solutions provider, 39% of companies ban use of social media on the job. But most experts agree that banning access to social networking sites is a lost cause.
“Social media is fast approaching being the primary form of [electronic] communication,” says Regina Caffey, CEO/principal, Wave Integrated Marketing Solutions. Many people are accessing their networks through their mobile phones so they aren’t even using the work computer.
Caffey says it’s best to have a social media policy (sample policies at ebennett.org/hsnl/hsmp) and educate employees. “Just like you educate your staff on sexual harassment and a safe work environment, you have to educate on social media,” she says.
Ethical considerations include whether to become a patient’s “friend” on a social media site. “There is no right or wrong answer,” Baumann says. “The answer depends on the consensual discussion between the patient and the provider. It’s an issue of boundaries. It’s a lot easier to violate boundaries online than in real life.”
Nurses need to be front and center as social media develops. “Get involved and figure out how to make social media work for you personally and professionally,” says Caffey. “Don’t ignore it.”
Baumann takes it a step further. “I would make the case that it is the responsibility of the nurse to become informed about, and competent with, social media,” says Baumann. “We need to be contributors to the conversation as to what role the Net will have in our lives.”
Getting started with social networking doesn’t have to be intimidating. “Consider what you want to accomplish with social media and choose [the outlet] accordingly,” says Fraser, whose first effort was the website Nursing Ideas (nursingideas.ca). He records videos and posts them to share the “incredible things nurses are doing.”
For a simpler start to video posting, YouTube is a free website where users can upload, view and share video clips.
Many nurses want to be online because that is where professional networking is moving. “LinkedIn is the perfect way to start your professional networking,” Fraser suggests. LinkedIn, a business-oriented social networking site launched in 2003, allows registered users to maintain contact information about people they know in business.
Another option is to start a blog, a type of website where a person posts regular entries. Word Press and Blogger are two sites that allow users to start a blog for free.
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