HowardsSummaryandPolicySuggestionsforSocialNetworkingandtheNurse1

Overview of social networking Social networking is an ethical dilemma faced by nurses nationally. The use of technology among healthcare professionals will only continue to increase. Facebook reports 200 million people worldwide use their social networking site (McBride, 2009). With such a large number of people participating in social networking, there needs to be an increase in awareness about transparency by those users while balancing their right to free speech (Farnan, Paro, Higa, Reddy, Humphrey, & Arora, 2009). Social networking is widely used by nurses and health professionals. Hospitals are just beginning to use social media as a tool for education, public relations, community outreach, recruitment, service recovery, and crisis communications (Bennett, 2009b). Technological literacy demands upon users increase as the popularity of these sites continues (Livingstone & Brake, 2010). This use triggers an increase in public consumption of typically private information. Ethics According to Farnan, et al. (2009), medical students are sharing inappropriate information and possibly inappropriately friending patients. An increase in awareness and education about proper usage of social networking media and the ramifications of posting inappropriate information need to occur as early as medical school or nursing school (Farnan, et al., 2009). Outlined are the ethical responsibilities of the nurse as they relate to the ANAs Code of Ethics (2001) and social networking in general. Nursing Code of Ethics to considers: 2.4 Conflict of interest for nurses: A conflict of personal boundaries and professional boundaries could be considered a conflict of interest. The ANA suggests that nurses have to resolve conflicts to preserve the integrity of the nurse (ANA, 2001).

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4.2 Accountability for nursing judgment and action: The ANA does not address personal activities but the ANA does state that nurses should be accountable for their own actions (ANA, 2001).

5.2 Professional growth and maintenance of competence: Though it has consequences for others, maintenance of competence and ongoing professional growth involves the control of ones own conduct in a way that is primarily self-regarding (ANA, 2001, p.18).

5.4 Preservation of integrity: This is the most informative ethical guide that is related to social networking. According to the ANA, nurses have a duty to remain consistent with both their personal and professional values and to accept compromise only to the degree that it remains an integrity-preserving compromise (ANA, 2001, p. 19).

Should nurses participate in social networking? YES!!! Nurses need to be participating in blogs to learn about up and coming therapies, connect with other nurses, and follow current healthcare trends. Nurses do need to be careful and have an increased awareness about what they are posting. By using social networking sites, personal and professional boundaries are blurred and personal social habits may affect how a nurse is treated by colleagues or patients (McBride, 2009). Patients that are able to access nurses personal information may lose trust in them (McBride, 2009). Legal concerns, such as HIPAA laws, also have to be considered. The nurses responsibility should be to report any breeches in patient confidentiality. Many NC nurses, through personal conversations, have shared that they have received tweets or read posts on social networking sites that gave too much detailed personal health information. While many

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nurses are aware of risks such as termination, others seem to have a false sense of comfort when posting personal content or digital media for the world to access. Organizations also need to consider their credibility for any information that is posted about them. Although many organizations have a policy about professionalism inside and outside the organization, the nursing profession as a whole does not have one that specifically addresses social networking (McBride, 2009). Many NC organizations are prohibiting the participation in social networking during work hours by blocking access to social networking sites. However, many nurses are bringing their own laptops or hand held devices and participating anyway without sanctions. Healthcare organizations deal with social networking in many ways. Some designate specific computers away from clinical areas, such as a medical library, for employees to participate in their social networking sites. Some organizations refuse to allow participation at all while others allow participation in a secure intranet based social networking site. While over 400 hospitals have an official social networking site nationally, healthcare organizations still fear decreased productivity, HIPAA violations, security risks, reputation management and unprofessional conduct of its employees (Bennett, 2009a; Bennett, 2009c; Roop, 2009). Policy incorporated into the Code of Conduct Many organizations including the Mayo Clinic, The American Red Cross, and The University of Maryland address social networking as part a of or as a separate code of conduct. The Joint Commission has mandated that organizations address disruptive behavior by establishing a code of conduct. With the code of conduct now present in most organizations where it may not have been before, social networking can now be addressed (Bennett, 2009c).

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Organizations that do have specific social networking policies detail what not to post, and how to interact in social networking media (Bennett, 2009c). Reminders are given that the organization will monitor and address any post containing their name. These organizations have set out clear guidelines as to how employees should be loyal to their employer. Similar to disruptive behavior, employees are given reminders that their personal social networking activities are being monitored for any defamatory remarks which could be considered bullying, defamation of character, or harassment (Bennett, 2009c; Russell Herder & Ethos Business Law, 2009). Although many persons take for granted that their personal social networking site is private, the remarks are public for the world to see and may be interpreted very differently than the original author intended. Suggestions on what to include in social networking policy According to research done by Russell Herder and Ethos Business Law (2009), eight out of ten business leaders nationally stated they had concerns about social networking while only one in three had implemented social media guidelines with 10% participating in employee training. While this study does not list detailed data collection methods, 438 management, marketing and human resource executives nationally were randomly sampled. The companies study reflects the growing organizational concern about social networking. Russell Herder and Ethos Business Law (2009) suggest 10 best practices in a social media policy: 1. Overall organizational philosophy 2. Honesty and respect from employees 3. Confidential and proprietary information should be reinforced 4. Online identity should be differentiated between personal and professional

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5. Focus on job performance so that it is clear when social networking should take place to address worker productivity 6. Avoid conflicts of interest 7. Include a disclaimer 8. Monitoring should be done by the organization and employees should be aware that disciplinary action can be taken 9. Universal application to all employees 10. Policies, such as the code of conduct, apply to social networking Russell Herder and Ethos Business Law (2009) shared that it is a best practice to include effective training attributes such as engagement, inclusiveness, training on various topics, and training should be ongoing. Sample policies The following highlights suggested best practice social networking policies from two top healthcare organizations: The American Red Cross (2009) advises: Acknowledge your professional relationship with your employer or volunteer organization. If you acknowledge on your own personal website that you are a Red Cross volunteer or worker, many people will assume you are speaking on behalf of the Red Cross. Communications should be transparent, ethical, and accurate. Similarly, if nurses acknowledge they are nurses, consumers will assume any shared health information is valid. If employer affiliation is given, readers assume the nurse is speaking on behalf of their employer.

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The Red Cross monitors any report of the organizations name. Employees and volunteers should abide by the code of conduct. There is a specific list of Dos and Donts. Some of the Dos include: use disclaimers, be transparent, be accurate, be considerate, respect copyright laws, and respect work commitments. Under Donts is: dont reveal confidential information.

The Mayo Clinic (2010) advises: Follow all Mayo Clinic policies including the code of conduct. Use the first person when participating in blogs or any social networking site so that it is known that the employee is speaking for themselves, not the Mayo Clinic. The Mayo Clinic asks to add a disclaimer to the employees personal sites. Use good judgment and accuracy in posts. Use personal email as the primary identification not your work email. Be respectful to colleagues, patients and competitors. Follow the Code of Ethics. Ask the Department of Public Affairs if you dont know the answer to a question. References

Anderson, C. (2009). How does social networking enhance the nursing narrative? Nursing Management, 40(9), 16-20.

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: ANA.

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American Red Cross. (2009). American red cross online communications guidelines. Retrieved Feburary 25, 2010 from http://docs.google.com/View?docid=df4n5v7k_98chfqrnch&hgd=1#_PERSONAL_COMM UNICATIONS.

Bennett, Ed. (2009a). Found in cache. Social media resources for health care professionals from Ed Bennett. Retrieved December 2, 2009 from http://ebennett.org/hsnl/hsmp/.

Bennett, Ed. (2009b). How are hospitals using social media? Retrieved December 2, 2009 from http://ebennett.org/fall-09-presentation/.

Bennett, Ed. (2009c). Social media governance. Empowered with accountability. Retrieved December 2, 2009 from http://socialmediagovernance.com/policies.php.

Farnan, J.M., J.A.M. Paro, S.T. Higa, S.T. Reddy, and V.M. Arora. "Commentary: The relationship status of digital media and professionalism: it's complicated." Academic Medicine. 84.11 (2009): 1479-1481.

Livingstone, S., & Brake, D. R. (2010). On the rapid rise of social networking sites: New findings and policy implications. Children & Society, 24(1), 75-83.

Mayo Clinic (2010). For mayo clinic employees. Retrieved March 16, 2010 from http://sharing.mayoclinic.org/guidelines/for-mayo-clinic-employees/.

McBride, D., & Ccohen, E. (2009). Misuse of Social Networking May Have Ethical Implications for Nurses. ONS Connect, 24(7), 17. Retrieved from Nursing & Allied Health Collection: Comprehensive database.

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Roop, E. (2009). Healthcare atwitter over social networking. Radiology Today 10(10), 12 Retrieved December 2, 2009 from http://www.radiologytoday.net/archive/rt051809p12.shtml. Russell Herder and Ethos Business Law. (2009). Social media: embracing the opportunities, averting the risks. Retrieved December 5, 2009 from http://www.russellherder.com/SocialMediaResearch/TCHRA_Resources/RHP_089_Whit ePaper.pdf.