Facebook dilemma

TheCommuter, BSN, RN · Dec 24, 2012

Unfortunately, this all comes down to the almighty dollar.

If the patient is sent to the ER at the local acute care hospital and treated there without being admitted, the LTC facility is on the hook for the nonemergent ambulance transport back to the nursing home. This transport can cost anywhere from $900 to 2500, which is a pretty penny for LTC facilities that are already under financial stress.

Sorry, but when the LTC resident in respiratory distress is satting in the 70s, and nebulizer treatments plus 15 liters of oxygen per NRB mask is doing nothing to help, you bet I'm calling the attending physician to arrange for transport to a higher level of care at an acute care hospital. The bottom line is that nursing homes do not have the same staff and resources as hospitals.

BTW, I have very few Facebook friends. None of them are coworkers!

Daisy_08, BSN, RN · Dec 24, 2012

Well, I guess you have to follow the policy. However in an emergent situation I'd be calling 911 first, its more then a lecture from management it's a life.

nurseprnRN, BSN, RN · Dec 24, 2012

I must be missing something. This isn't a FB "delima" (dilemma?) at all, it's an authority/chain of command issue. So what if the DON/ADON aren't in the building? Call them at home. They should have their 24-hour contact info available if they want to make the decision about transport. Tell them you'll need to post their contact info in the nursing station for that reason. They won't do that? Oh, OK, then, it's your decision, then? Fine, thanks very much, you'll take it from here.

And in a real emergency, you would be liable (IMHO) if you futzed around calling some ADON or MD after-hours service and didn't call 911 for an ambulance first.

Anna Flaxis, BSN, RN · Dec 24, 2012

I'm not sure how this is a Facebook dilemma! It's really bad form to vent about work on Facebook no matter where you work, and whether you are friends with coworkers or not.

It sounds like you have a legitimate issue with your workplace and need to vent, which is totally okay. That sort of thing is best done over a glass of wine or a cup of tea with a friend who understands. And you can vent here too, of course!

CrystalSSA · Dec 25, 2012

My work has very strict rules about facebook. Get caught talking about "work" and you get walked out of the building. Even if you could, I'd be careful. Also, you can make it so that your supervisor is your "friend" but can only view posts that you say she can see.

edimo · Dec 25, 2012

My work has very strict rules about facebook. Get caught talking about "work" and you get walked out of the building. Even if you could, I'd be careful. Also, you can make it so that your supervisor is your "friend" but can only view posts that you say she can see.

I agree about being careful posting anything about work on social media. I've read too many cases of that sort of thing in the magazine our College of Nurses sends to us on a quarterly basis and what disciplinary actions were taken. I would also definitely never add my superviser/manager as a friend; it's all about boundaries!

DoeRN · Dec 25, 2012

The best solution is to delete fb all together and you won't have to worry about coworkers seeing posts about work. Fb got so bad at my old job that they made a policy about it.

Editorial Team / Admin · Dec 25, 2012

I see nothing wrong with Facebook itself. The issue is what people are posting and/or who they are friending. First of all, if it's not something you'd say to someone's face (your boss, for example), don't put it on Facebook. Modify your privacy settings- mine are set to you can only find me if: you know my email, or you're friends with one of my friends. I won't show up in Joe Shmoe's search.

I am friends on Facebook with several coworkers and even my boss, but then again, we also all hang out together outside of work. I also don't post anything at all about work except "Woohoo, extra day off!" if I take a low-census day. My venting either takes place here, where someone would have to dig a little deeper to find my real name (but I do my best to eliminate any identifying information because nothing on the internet can truly be anonymous), or in a private setting with another person lending a sympathetic ear. I also refuse to "like" my employer's page.

Sun0408, ASN, RN · Dec 25, 2012

I agree with Star, this has nothing to do with FB. You have a legit concern.

TiffyRN, BSN, PhD · Dec 25, 2012

I agree with Star, this has nothing to do with FB. You have a legit concern.

What Sun & Star said. This is not a FB issue. 1st, it's just dangerous to have any co-workers as FB friends. 2nd, never never never air your work issues on FB except in the most vaguely nebulous terms (whew, really hoppin' tonight! or something similar, never specifics).

You have legitimate concerns, keep them legitimate and don't fuzz the lines by airing your grievances on FB. How would it look if your management team posted on FB that they felt the 3-11 shift on hall B was endangering patient safety by not checking charts or making hourly rounds? Venting on FB will not effect the kind of change your patients need.

Rhi007 · Dec 25, 2012

Uhmm FB.... Although I have it and am friends with a few of the staff no matter what I would never vent on there about my boss, unprofessional no matter which angle you look at it.

As for concern; your primary concern is the LTC resident not what management say and think. Half of those in management positions that make up such policy have not done the hard work either

A. Never or B. in a really long time

So if you have done a residents obs and your gut says they need more assistance than your facility can provide call for transport just make sure you have followed procedure of trying to get in contact with the RMO