Social Media Posting: Implications for Health Professionals
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By the end of this session you will:
- have increased knowledge on the range of platforms considered “social media”
- appreciate the positive uses for social media in both your professional and personal life
- learn from example the types of social media usage that carries with it professional and personal risk.
- understand what constitutes safer use of social media.
Social Media: Implications for Health Professionals
The use of social media has been part of main stream life for two decades or more and its uses and applications in healthcare are diverse and in some cases extraordinarily creative and ingenious. But for most of us social media is nothing more than a set of platforms that allow us to express our thoughts, seek information and enhance our connection to the wider world. Social media can be an invaluable tool when used carefully and in accordance with well-considered guidelines. It can also be a world of risk where circumstances challenge our boundaries between the personal and the professional and in extreme situations threaten our careers.
This short page is designed to explore the uses and misuses of social media from a health professional’s perspective for the purpose of developing safer use.
Social Media is much more than Instagram and SnapChat
When most people think of social media they automatically think of the three or four most commonly known platforms. The term is much broader than that however and includes at least nine major types.
Social networking sites enable connections between individuals or groups. They allow us to express our thoughts, share the thoughts of others and to advertise. Postings include text, images and clips. Examples include Facebook and LinkedIn. Facebook has numerous special interest groups that may interest a health professional, whilst LinkedIn’s forte is linking and connecting like-minded individuals. Facebook’s design allows for re-posting and sharing of others’ posts which effectively means there is no such thing as a private post. Many health professionals have suffered consequences for posting something private that was later shared by others, or, have posted something in breach of professional codes of conduct. Be cautious.
These allow individuals to save and organise links to multiple online sources. They are very useful as search tools and information management. Examples include: Pinterest and Flipboard.
A social news site that allows its users to post news links and other items. Items posted are voted on by users which determines an item’s level of prominence. An example of such a site is Reddit.
Media sharing sites are capable of displaying a range of media types but are most often associated with images or video. The social participation element to these sites is the capacity for users to post, create profiles and make comments which frequently result in conversation and debate. The largest of this type would be YouTube. Health professionals use youtube for a multitude of purposes including one famous example of a rural emergency doctor you-tubing a procedure to save a patient’s eye.
These sites allow an account holder to post short text based inclusions that could be on any and every topic. Users tend to follow others and in turn are followed. They allow posts to go to a select few or are open to public viewing. Facebook and Twitter are two well known examples and serve to demonstrate that these category types have substantial overlap.
Some sites are highly topic specific, i.e. journal clubs critiquing articles on Intensive Care Nursing.
These sites allow users to post reviews of experiences with just about anything from vacuum cleaners to holiday venues. Reviews assist potential users’ decision making. Examples include Trip Advisor and Zomato. Users need to be aware that they may be legally liable for damages to business consequent to their review and also aware that fake reviews abound. Health care experiences occasionally show up on these sites and this can be of concern for a range of reasons. The Health Practitioners Act makes some very specific requirements regarding including and editing testimonials.
Effective Use Of Social Media In Health
Anatomy classes have traditionally been laboratory based and very “hands on” in medical education. More recently medical students have been accessing online classes via YouTube. They report very high rates of satisfaction with YouTube based anatomy Education (Barry 2015) and a number of specialised commercial channels exist for this purpose e.g. Sqaddia.com
ACT (Acceptance and Commitment Therapy) therapists from across the globe contribute to each others’ peer supervision. A therapist presents a client issue making sure the client cannot be identified and their peers assist in formulation and make suggestions for therapeutic intervention. It is a closed group and participants have to become members. This DOES NOT protect posts from becoming public however and members must exercise the height of care and discretion with details contained in the posts.
Large city-based recruitment agencies search for appropriately credentialed health professionals who may be interested in filling rural and remote based skill shortfalls.
The Do’s and Dont’s of Social Media: A Few Simple Rules
- Any posting on social media must maintain the levels of client/patient privacy and confidentiality as applies to real life.
- A posting that can be seen as giving advice or sharing heath information must be best practice, unbiased and evidence based. The responsibility for this lies with the posting health professional and not the original source. Health Professionals are held to a higher level of accountability than the general public because of their perceived expertise.
- The relevant Professional Code of Conduct applies equally to the online environment as it does to the real world. All online behaviour must comply to the code. Unsure of your own profession’s code? Here’s a link to the Nursing Code of Conduct as a sample: Nursing Professional Standards
- Use or allow use of testimonials as part of marketing. Patients often review health services and name individuals (for positive and negative reasons). Often a health professional can do little about this. The Health Practitioners Act prohibits use of these as part of marketing especially if the patient’s comments are altered or are edited to present them in a better light. If you work in private practice it’s best to steer clear of this.
- Post content that reflects poorly on the profession. Examples include explicit images, drug use, or criticisms of health services and colleagues. Many health professionals have fallen foul of this one even when their post seemed quite benign. BE WARNED! (case studies of this are below)
- Transgressing professional boundaries, most obviously done by friending patients and commencing an online relationship which then runs the risk of bringing the health professional’s personal life into the professional relationship between themselves and their patient. While there is no clear prohibition of this care needs to be taken.
SOCIAL MEDIA POSTINGS CAN BE LIKE SKATING ON THIN ICE
Its usually obvious what type of post is okay and what is not. Where most health professionals have jeopardised their careers is with posts that are in the “grey Zone” The following case studies illustrate this.
Case Study 1: Nurse fired for posting photo of trashed trauma bay following resuscitation.
A nurse, at the end of her shift posted a photo to Instagram with a caption “man vs train”. It showed the trauma bay following emergency intervention with a man struck by a train. The hospital became aware of the posting and fired her based on their conclusion that it was grossly insensitive bringing both the nursing profession and the organisation’s reputations into question. No images of the patient nor his name were revealed. There was no criticism of colleagues or organisation contained within the post.
Case Study 2: Nurse fired for shooting video inside her workplace.
In the video a nurse of 10 years experience narrates that she and her colleagues are over run with critically ill patients with Corona virus. She reported of “bodies lined up in the corridor”. Her view was that the video displayed the lack of safety in her workplace whilst her employer viewed it as a flagrant breach of their “Use of Social Media” policy. The case is in the courts at present with litigation proceeding in relation to unfair dismissal.
Source: Nurse fired Detroit hospital
Case Study 3: Anaesthetist apologises for post.
A visiting anaesthetist made an apology in response to community anger and action from his employing health service following a tweet which he claims was sent in jest but on reflection was inappropriate.
In the post he wrote; ” Dear pregnant women. Please respect your friendly duty anaesthetist and consider getting your epidural inserted prior to 11.30pm when he may have already been in bed for an hour getting beauty sleep. Also, please be patient because unlike you, we were snuggled in our warm comfy beds and can’t feel a thing so don’t want to rush when called at this hour. I’ve said it before, if in doubt cut it out. That could have saved us all some pain and been done at a reasonable hour. Sincerely, me.
Case Study 4: Something slightly different
This case study has been included because it shows how a slight indiscretion can be magnified when taken into context with others. A a school teacher from USA accepted the friendship of a student. Some time later she posted a photo of herself on a night out holding two glasses of, what presumably is, alcohol. Despite wisely having her security settings set to high, the post was shared and found its way to the parents of the befriended student. The photo, along with some language some considered profane became the substance of a complaint to the Principal of her school. The Principal dismissed her from her teaching position based on the finding that her public show of alcohol use was inappropriate as was the language. This dismissal was taken to court for appeal by the teacher but was subsequently dismissed.
Source: High School teacher
What we know about these case studies is that the consequences of posting them was not anticipated at the time of posting. None of them are breaching the law, none of them are obviously likely to be offensive to most people and none of them are immediately obvious as being completely out of line. Yet that is how they’ve been judged. Do we need to delete our social media accounts? Certainly not. But we do need to be cautious and thoughtful about the potential audience that our posting may reach.
Here are some ways that we can be a safer participant of social media:
- Set your security so that public access is restricted. Check your privacy settings.
- Accept the fact that there is no such thing as a private post. If it can be seen by one, it can be shared.
- Our professional image extends to our private life. If we wouldn’t do it or say it in the real world we shouldn’t in the virtual world either. “it was a not meant for public viewing” is not an excuse under the law.
- If you are not at your thoughtful best (tired, emotional, angry, alcohol affected) resist posting.
- Never ever criticise your employer or your colleagues online
- Think about the necessity to post about your work or your placement (if you’re a student). It makes your employer very nervous. It has the same effect on your university.
- Be careful who you friend.
- Read your university’s, AHPRA and professional organisation’s social media policy and adhere to it.
- Never take photos of patients or colleagues without their consent (its better to just not do it at all).
- Be very careful about over disclosure. It can identify things about you that you’ve never thought possible.
- Pictures of cats can be posted safely. Everything else is in a scale of escalating risk. Consider the risk prior to posting.
AHPRA’s Guide to Social Media Usage: https://www.ahpra.gov.au/News/2019-11-11-Social-media-guide.aspx
Amnesty’s Guide to Safe Use of Social Media: https://www.amnesty.org.au/how-to-stay-safe-on-social-media/
Barry, Denis & Marzouk, Fadi & Chulak‐Oglu, Kyrylo & Bennett, Deirdre & Tierney, Paul & O’Keeffe, Gerard. (2015). Anatomy education for the YouTube generation: Online Video Use in Anatomy Education. Anatomical Sciences Education. 9. 10.1002/ase.1550.