Professional Use of Social Media

Nursing & Midwifery Subject LibrarianJessica Eustace-Cook

Email: eustacj@tcd.ie

How did this course come about?Started in new role officially in May 14

Started providing training to department Oct 13Reports by staff of students using social media

inappropriatelyNeed to clarify with students the “ethics” of patient

confidentiality in social mediaClarification of “what is a breach” of confidentialityCurrently social media is not covered in any systematic

way by the department

Course has been run twiceFirst year Midwives age range 18-26HDip in Midwifery age range 22-40

Very different responses

Aim of course Highlight the need for awareness of students behaviour

onlineProfessional implications of posting comments and imagesFallibility of “private conversations”Patient safety and privacyPersonal safetyBacked up with real life examples

Guidelines for professional online behaviourPrivacy - Keep your personal and professionallife separate. Check your privacy settings and respect privacy of others. Have two accountsPerson-free; patient-free; patient confidentialityProtect yourself Images - Protect your professionalism, yourreputation and yourself.

The patient and youNever accept a request to “friend” a patientHaving a so-called dual relationship with a patient — that is, a

financial, social or professional relationship in addition to the therapeutic relationship — can lead to serious ethical issues and potentially impair professional judgment.

You need professional boundaries to do your job well.

Patient ConfidentialityAlthough individual pieces of information may not breach

confidentiality on their own, the sum of published information online could be enough to identify a patient or someone close to them.

Privacy & medical data• Online privacy means the ability to control patient/client data

with dignity and autonomy of the user.• Patient privacy breaches online due to the reach of social

media and the permanency of digital information to cause greater harm

• Never discuss patients in any social media • Keep under review your privacy settings for each of your social

media profiles.• But be aware that this cannot guarantee confidentiality whatever

privacy settings are in place.

ImagesIf you post images of yourself and others on Flickr, Facebook,

Instagram - they are “on the record” and are part of your digital imprint

Consider what lasting image you want to have professionallyseparate personal and professional accounts it is easier to

manage this imageNever post images from your work place without express prior

permissionNever post image of patients

Examples of a breach in confidentialityAs a licensed practical nurse for more than 20 years, Bob knew the importance of safeguarding a patient’s privacy and confidentiality.

One day, he used his personal cell phone to take photos of Claire, a resident in the group home where he worked. Bob received permission from Claire’s brother to take the photo since she was unable to give consent due to her mental and physical condition.

That evening, Bob ran into William, a former employee of the group home. While catching up, he showed William the photo of Claire and discussed her condition with him. The administrator of the group home later learned of Bob’s actions and terminated his employment for breach of confidentiality.

Emily, a 20-year-old junior nursing student, wasn’t aware of the potential repercussions that could occur when she took a photo of Tommy, a 3-year-old leukemia patient in a pediatric unit, on her personal cell phone.

When Tommy’s mom went to the cafeteria, Emily asked him if she could take his picture, which Tommy immediately consented to. Emily took his picture as she wheeled him into his room. She posted Tommy’s photo on her Facebook page with this caption: “This is my 3-year-old leukemia patient who is bravely receiving chemotherapy! He is the reason I am so proud to be a nurse!”

In the photo, Room 324 of the pediatric unit was visible. Days later, the dean of the nursing program called Emily into her office.

A nurse from the hospital found the photo Emily posted of Tommy on Facebook and reported it to hospital officials who also contacted Emily’s nursing program.

Never post in haste

CyberbullyingLewis identifies the following bullying acts in UK nursing:

undermining of work continual criticism

disadvantaging the target demeaning

verbal abuse destroying confidence

isolating individuals fabricating complaints

Setting up to fail

Cyberbullying is the use of Information Technology to harm or harass other people in a deliberate, repeated, and hostile manner. All of the above traditional forms of bullying can occur in a virtual environment

CyberbullyingCyberbullying can be as simple as continuing to send e-mails

or text messages harassing someone who has said they want no further contact with the sender.

It may also include public actions such as repeated threatssexual remarkspejorative labels (i.e., hate speech) defamation (false accusations)

GeotaggingGeotagging is adding geo-location metadata to an image

or social media post e.g. Instagram and foursquare Your photos can tell everyone who’s watching them

where you livewhere you spend your timewhen there is no-one homewhere you park your carand other information

you are making yourself vulnerable

The digital you and the futureRecruiters are increasingly screening potential employees

online. Employer surveys have found that between one-fifth and two-

thirds of employers conduct internet searches, including of social networking sites, and that some have turned down applicants as a result of their searches

Real life examplesan employer who turned down an applicant after discovering

that he had used Facebook to criticise previous employers and disclosed company information

a doctor who missed out on a job because the doctor’s online activities revealed an interest in witchcraft

and a female psychiatrist who failed to gain employment after a recruiting agency found explicit pictures on MySpace of her intoxicated

Follow upSessions are then followed up with a 10 minute forum

where students are encouraged to share their own experiences of social media

If time allows they are given a specific situation where they can discuss how they would / should react

Different experiencesUndergrads HDipsAll of this group used facebook and

or twitterLack of awareness about how

images can be taken out of contextMany have no privacy settings in

place for their postsBelief that if a patient name wasn’t

used it was ok to discuss the situation

Geotagging – many didn’t realise the safety issues associated with posting their location

Approx 25% of class did not use social media tools like facebook or instagram or twitter

Lack of belief by some students that recruiters would bother to look on social media

Facebook and Instagram were used for family and had not considered its use as a professional tool

Questions askedCan I delete myself from facebook and twitter and start

again?How can I protect my children with facebookHow can I change my privacy settingsWith geotagging – how can I still post to my friends

without this informationWhere is a safe place to talk about patient situations for

study purposes?How can I use linked in to search for jobs?

SuccessesThe class was offered for the first time this year in February it

has now been adopted into 4 other modules for the 2015 intake Two courses in the School of Nursing and two in Midwifery.The presentation is now embedded into first year introductory

modulesThis new class has allowed me to meet members of staff

offering something “new” in my new roleThe informal section of the class encouraged group sharingStaff in the department have contacted me asking for advice

on profile creation in LinkedIn