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Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center
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Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Jan 14, 2016

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Page 1: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines for Nurses Using Social Media

Nancy Spector, PhD, RNDirector, Regulatory Innovations

August 16, 2011University of Chicago Medical Center

Page 2: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.
Page 3: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Mission of NCSBN

The National Council of State Boards of Nursing (NCSBN) provides education,

service and research through collaborative leadership to promote

evidence-based regulatory excellence for patient safety and public protection.

Page 4: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Objectives Discuss the professional, ethical, and

legal implications of using social media inappropriately.

Explain common myths and misunderstandings.

Describe guidelines for the appropriate use of social media.

Page 5: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Background: Changing Times

Blogs Twitter Social networking Cell phone cameras Posts on forums Skype Etc!

Page 6: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.
Page 7: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

The Extent of Social Media

More than 110 billion minutes on social networks and blog sites per month.

More than 22 percent of all online

time. Facebook boasts more than 500

million members. 38 million business people from

more than 200 countries have joined LinkedIn.

Page 8: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Nurses Fired Over Cell Phone Photos of Patient”

ER nurses took photos of an object lodged in her patient’s rectum…

And posted it on her Facebook page!

Page 9: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in NursingHeadlines:

“Disclosure: The New Closure?” (Chicago Tribune article)

“…my sister, fresh from a tenure in Australia, shared with me the distasteful behavior of her nursing colleagues who spend their breaks offering family and cyber cohorts a snapshot of a stressful shift, complete with the evening’s death tolls, diagnoses and patient demographics.”

Page 10: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“State Gives Kitsap Health & Rehab a Deadline After Nude Photos Incident”

LPN and two CNAs were fired for taking nude photos of nursing home residents.

The facility could lose its Medicare/Medicaid reimbursements.

Page 11: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Tweeting – Not Just for the Birds” (Richard Hader, 2009, Nursing Management)

“I recently had a staff member bring me a copy of a social blog in which a nurse had detailed types of patients for whom she had cared during the last shift she worked…”

Page 12: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Nurses Snapped Photos of Dying man and Posted on Their Facebooks”

Page 13: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Nurses' jobs at risk for allegedly posting patient information on Facebook”

Page 14: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Hospital Worker Fired over Facebook Comments about Patient”:

- “I hope he rots in Hell!”

Page 15: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Changing Times in Nursing

Headlines:

“Student Expelled for Posting Photos of Placenta on Her Facebook.”

- Wall Street JournalSubsequent court case

Page 16: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Positive Uses of Social Media

Pew Report on the Future of Online Socializing (n=895 technology stakeholders and critics): 85% agreed that the Internet has been a

positive force on their social world Example comments:

“Geography no longer an issue”

“Costs less to communicate”

Page 17: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Examples in Health Care

As of May, 2011, 965 U.S. hospitals were using social networking.

National Association of Clinical Nurse Specialists – LinkedIn.

Page 18: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Examples in Health Care

Smart phones for downloading information, contacting nurses at work, etc.

Surgeons use of Twitter in double-hand transplant case

Page 19: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

NCSBN’s White Paper on Guidelines

Disciplinary Resources Committee Charge:

Develop guidelines for social and electronic media to protect patient privacy.

Page 20: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Process

Reviewed the literature Surveyed Boards Accessed others’ guidelines Took middle ground approach Approved by Board of Directors in May,

2011 To collaborate with other organizations

Page 21: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Survey Results

33 of 46 Boards reporting had complaints 26 took disciplinary actions Board actions:

Letters of concernCensuring the nurseConditions on the licenseSuspending the license

Page 22: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Other U.S. Organizations

ANA revising their code of ethics

Sigma Theta Tau recently published a book

Page 23: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

An International Experience

Report of study out of Canada (JNR, 2011)

UK: Royal College of Nursing has published legal advice

Page 24: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Privacy Issues

Defined: Right of a person to be free from intrusion into matters of a personal nature.

• Treating patients with dignity and respect.

• Posting about patients.• Can be intentional or unintentional

Page 25: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Confidentiality

Differs from privacy; deals with unauthorized access to data.

• Patient charts• Can be shared with patient consent or

by legal requirements

Page 26: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

HIPAA Violations

HIPAA Standards in 1996 (federal)

Protects privacy and confidentiality

Examples posting photos on Facebook

Page 27: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Other Consequences

Civil penalties – finesDefamation of characterInvasion of privacyHarrassment

Criminal penalities – jail time

Employer - fired

Page 28: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Effect on Team-Based Care

Lateral violence

Cyber bullying

Page 29: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Still being determined:

Labor laws

First Amendment rights to free speech

Page 30: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Common Myths

Communication is accessible only by the intended recipients.

Content that can be deleted is no longer accessible.

Disclosing private or confidential information is harmless if only accessed by the intended recipient.

Page 31: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Common Myths

De-identifying patients is acceptable. Confusion between patient’s right

to disclose and the need for

nurses to refrain from disclosing. Blur of nurse’s personal and

professional life.

Page 32: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines

1. Recognize obligation to maintain privacy and confidentiality.

2. Don’t disseminate information that will degrade or embarrass the patient.

3.Don’t transmit patient related information.

Page 33: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines

4. Do not post information that could reasonably identify the patient.

5. Do not refer to patients in a disparaging manner.

6.Do not take photos or videos of patients, unless authorized.

Page 34: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines

7.Maintain professional boundaries.

8.Consult employer policies.

9.Report breaches of confidentiality or privacy.

Page 35: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines

10. Be aware of employer policies on the use of computers, cameras, etc.

11. Do not post disparaging remarks about coworkers.

Page 36: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case # 1

Photo of vulnerable patient

Showed photo to former employee

Employer found out – was terminated

Board: disciplinary action requiring CE

Page 37: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #2

Strange email at work – patient with exposed backside

Photo went through organization

Prosecutor, Board and national media involved!

Page 38: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #3

Student took photo of pediatric patient

Posted on her Facebook

Student expelled; hospital faces HIPAA investigation; nursing program cannot use the pediatric hospital

Page 39: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #4

Blogging on local newspaper

“Little Handicapper”

Board issued a warning

Page 40: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #5

Student group on Facebook

Clinical error discussed

Students faced expulsion and discipline

Page 41: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #6

Texting orders at party

Read aloud to wife, “Get a drug screen for Edward Smith”

Board issued warning to the nurse and the system

Page 42: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Case #7

Hospital sponsored communication page for hospice

“Hopefully the new happy pill will help, along with the additional morphine”

Self reported to Board – case in progress

Page 43: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Guidelines in October 2011 Issue

Page 44: Guidelines for Nurses Using Social Media Nancy Spector, PhD, RN Director, Regulatory Innovations August 16, 2011 University of Chicago Medical Center.

Questions?

[email protected]

www.ncsbn.org

Thank you!